Tranxene (Clorazepate) at a glance: schedule, half-life, and class
- Generic name
- Clorazepate dipotassium
- Brand names
- Tranxene T-Tab
- Drug class
- Long-acting benzodiazepine (prodrug)
- US legal status
- Schedule IV, prescription only
- Approved uses
- Anxiety disorders; add-on therapy for partial seizures; acute alcohol withdrawal
- Forms
- Tablets (3.75, 7.5, 15 mg)
- Onset
- Within 1 hour
- Active metabolite
- Desmethyldiazepam (nordiazepam), half-life 40 to 50 hours or more
Tranxene uses: what clorazepate is prescribed for
Clorazepate treats anxiety, adds to other antiseizure medicines for partial seizures, and eases acute alcohol withdrawal.[1]
It is a prodrug: stomach acid converts it into desmethyldiazepam, the same long-lasting metabolite produced by diazepam.[1]
Tranxene dosage: how clorazepate is usually prescribed
The figures below come from the FDA-approved label and describe how prescribers typically use clorazepate. They are not personal dosing advice. A prescriber sets the dose for each person and adjusts it over time.[1]
| Product | Typical adult dose | Notes from the label |
|---|---|---|
| Anxiety | 30 mg a day in divided doses | Usual range 15 to 60 mg a day |
| Partial seizures (adults) | 7.5 mg three times a day | Increase by no more than 7.5 mg a week; maximum 90 mg a day |
| Older adults | 7.5 to 15 mg a day | Higher risk of falls and confusion |
Tranxene (clorazepate) side effects and risks
FDA boxed warnings
- Use with opioids can cause profound sedation, slowed breathing, coma, and death.[2]
- Abuse, misuse, and addiction, which can lead to overdose and death, especially with alcohol, opioids, or other drugs.[3]
- Physical dependence: stopping suddenly or reducing the dose quickly can cause life-threatening withdrawal reactions, including seizures.
Common side effects include drowsiness, dizziness, and stomach upset.[1]
Seizures on stopping: in people with epilepsy, stopping suddenly can trigger frequent seizures or status epilepticus.[1]
Tranxene interactions: what not to mix with clorazepate
Choose what it would be combined with:
| Combined with | What happens | Label guidance |
|---|---|---|
| Opioids (oxycodone, hydrocodone, fentanyl, heroin) | Profound sedation, slowed breathing, coma, death | Boxed warning; avoid unless no alternative |
| Alcohol | Deeper sedation, blackouts, slowed breathing | Avoid |
| Other sedatives (sleep medicines, gabapentinoids, muscle relaxants, antihistamines) | Additive drowsiness and impaired coordination | Use caution |
| Other antiseizure medicines | Additive sedation | Monitor |
This is not a full list. A pharmacist can check a complete medication list, including supplements and over-the-counter products.[1]
Tranxene overdose: signs of clorazepate overdose and what to do
Clorazepate overdose causes deep drowsiness, confusion, poor coordination, slowed reflexes, and coma. With opioids or alcohol, breathing can stop.[1]
If someone may have overdosed
- Call 911 if the person is unresponsive, hard to wake, or breathing slowly.
- For advice when the person is awake and stable, call Poison Help at 1-800-222-1222 (US, free, 24 hours).
- If opioids could be involved, including pills not from a pharmacy, give naloxone if you have it. Naloxone does not reverse clorazepate, but it will not harm the person.
- Stay with the person and place them on their side if they are drowsy or vomiting.
Tranxene withdrawal timeline: how long clorazepate withdrawal lasts
People who take clorazepate regularly, even as prescribed, can become physically dependent within weeks. Its long-lasting metabolite means withdrawal often begins several days after the last dose.[3]
- Days 2 to 7Symptoms beginRebound anxiety, insomnia, restlessness, sweating, and tremor.
- Weeks 1 to 4Acute withdrawalPanic, irritability, muscle pain, nausea, sensitivity to light and sound, and in severe cases seizures or delirium.
- MonthsProtracted symptoms in some peopleA minority have lingering anxiety, poor sleep, low mood, or tingling that can last weeks to more than 12 months.
Warning: Stopping clorazepate abruptly after regular use can cause seizures. The dose should be reduced gradually under the care of a prescriber.
A 2025 joint guideline led by the American Society of Addiction Medicine advises tapering gradually, usually by 5% to 10% every 2 to 4 weeks and rarely faster than 25% every 2 weeks, adjusted to how the person feels.[4]
How to get prescribed Tranxene (clorazepate) legally in the US
In the United States, clorazepate is a Schedule IV controlled substance. The only legal way to get it is with a prescription from a clinician registered with the Drug Enforcement Administration (DEA), filled by a licensed pharmacy. Depending on state law, that can be a physician, nurse practitioner, or physician assistant.[5]
- Refills: a Schedule IV prescription can be refilled up to five times within six months of the date it was written. After that, a new prescription is needed.[6]
- Telehealth: federal flexibilities let DEA-registered clinicians prescribe Schedule II to V medicines after a telemedicine visit, without a prior in-person exam, through December 31, 2026. A permanent DEA rule was under final review in late 2026. State rules can be stricter.[7]
- Monitoring: prescribers and pharmacists in most states check a prescription drug monitoring program, a database of controlled-substance prescriptions, before prescribing or dispensing.
- Pharmacies: a legitimate pharmacy always requires a valid prescription, has a licensed pharmacist available, and is licensed in the state it ships to. The FDA's BeSafeRx tool and the NABP's safe pharmacy list help confirm a pharmacy is real.[8][9]
- Cost: generic clorazepate costs more than diazepam but is widely covered.
Traveling: keep the medicine in its original pharmacy container and carry a copy of the prescription. Check the rules of the destination country before travel, because many countries restrict controlled medicines or require a permit.
Can you order Tranxene (clorazepate) online legally?
Yes, but only with a valid prescription and only from a pharmacy licensed in your state. Many licensed pharmacies, including mail-order pharmacies run by insurers, fill clorazepate prescriptions online and ship them. Buying clorazepate from a website that does not require a prescription is illegal, and the product is often fake.[8][10]
- See a licensed clinicianA clinician evaluates you in person or by telemedicine and decides whether clorazepate is appropriate.
- The prescription goes to a pharmacyPrescriptions are usually sent electronically, straight from the prescriber to the pharmacy you choose.
- The pharmacy checks and fills itA pharmacist verifies the prescription and your identity, then dispenses the medicine in person or by mail.
Signs that an online seller is illegal:
- It sells clorazepate with no prescription, or after only a short online questionnaire.
- It takes orders through social media, messaging apps, or email.
- It asks for payment in cryptocurrency, gift cards, or money transfers.
- It has no US street address, no state pharmacy license, and no pharmacist to speak to.
- Its prices are far below those of ordinary pharmacies, or it ships from another country.
The FDA's BeSafeRx tool links to each state's license lookup, and the National Association of Boards of Pharmacy lists verified online pharmacies.[8][9]
Tranxene price: how much does Tranxene (clorazepate) cost without insurance?
Generic clorazepate costs more than diazepam but is widely covered.
What you pay depends on the strength, the number of doses, your insurance plan, and the pharmacy. Cash prices for the same prescription can differ several times over between pharmacies in the same town, so check current prices before you fill it.
Ways to pay less, legally:
- Ask the prescriber whether a generic clorazepate is available. FDA-approved generics work the same way as the brand and usually cost much less.
- Compare cash prices between pharmacies before you fill the prescription.
- Use a free prescription discount card, such as GoodRx or SingleCare, when you pay cash. These cards cannot be combined with insurance on the same fill.
- For brand-name medicines, check the manufacturer's savings program or patient assistance program.
- Ask about a 90-day supply or your insurer's mail-order pharmacy, which often lowers the cost per dose when your prescriber agrees it is appropriate.
Warning: A price far below what licensed pharmacies charge, especially with no prescription required, is a strong sign of an illegal seller and counterfeit medicine.[8]
Is Tranxene legal? Clorazepate legal status in other countries
| Country | Status |
|---|---|
| United Kingdom | Class C; prescription only |
| Canada | Schedule IV of the Controlled Drugs and Substances Act |
| Australia | Schedule 4 prescription medicine |
| International | Schedule IV of the 1971 Convention on Psychotropic Substances |
Laws change and differ in detail. Check current rules before carrying any controlled medicine across a border.[11]
Common questions about Tranxene (clorazepate)
Is Tranxene (clorazepate) the same as diazepam?
No, but both are converted to the same long-lasting metabolite, desmethyldiazepam.
Is Tranxene (clorazepate) used for seizures?
Yes, as an add-on treatment for partial seizures.
How long does Tranxene (clorazepate) stay in your system?
Its metabolite can be detected for a week or more after regular use.
Is Tranxene (clorazepate) addictive?
It can cause dependence and addiction like other benzodiazepines.
Can Tranxene (clorazepate) be stopped suddenly?
No. It should be tapered, especially in people with epilepsy.
Can you buy Tranxene (clorazepate) without a prescription?
No. Tranxene (clorazepate) is a Schedule IV controlled substance in the US, so it is illegal to buy or possess it without a valid prescription. Websites and social media sellers that offer it without one are not legal pharmacies, and the DEA warns that pills sold this way are often counterfeit and can contain fentanyl. The legal route is a visit with a licensed clinician, in person or by telehealth, and a prescription filled at a state-licensed pharmacy. The FDA's BeSafeRx tool and the NABP's safe pharmacy list help confirm an online pharmacy is real.
Sources
- Tranxene (clorazepate) prescription information. DailyMed, US National Library of Medicine.
- FDA warns about serious risks and death when combining opioid pain or cough medicines with benzodiazepines. US Food and Drug Administration, 2016.
- FDA requiring Boxed Warning updated to improve safe use of benzodiazepine drug class. US Food and Drug Administration, 2020.
- Joint Clinical Practice Guideline on Benzodiazepine Tapering. American Society of Addiction Medicine, 2025.
- Controlled Substance Schedules. DEA Diversion Control Division.
- 21 CFR 1306.22, Refilling of prescriptions (Schedules III and IV). Electronic Code of Federal Regulations.
- Prescribing controlled substances via telehealth. US Department of Health and Human Services.
- BeSafeRx: Your Source for Online Pharmacy Information. US Food and Drug Administration.
- Safe Pharmacy. National Association of Boards of Pharmacy.
- One Pill Can Kill. US Drug Enforcement Administration.
- International drug control conventions. United Nations Office on Drugs and Crime.
