Onfi (clobazam) is a brand-name drug that’s prescribed along with other medications to treat seizures related to Lennox-Gastaut syndrome. Onfi comes as an oral tablet and oral suspension that’s typically taken twice daily.
Onfi belongs to a drug class called benzodiazepines. Onfi is available in a generic version.
Keep reading for specific information about the dosage of Onfi, including its strengths and how to take the medication. For a comprehensive look at Onfi, see this article.
Note: This article describes typical dosages for Onfi provided by the drug’s manufacturer. When taking Onfi, always follow the dosage prescribed by your doctor.
Keep reading below for more information on Onfi dosing.
Onfi forms
Onfi comes as an oral tablet and an oral liquid suspension. The oral suspension comes in a bottle that can be used for multiple doses. The bottle comes with an oral syringe that you’ll use to take the medication by mouth.
Onfi strengths
Onfi oral tablets come in two strengths: 10 milligrams (mg) and 20 mg.
Onfi oral suspension comes in one strength: 2.5 mg per 1 milliliter (mL).
Typical dosages
Typically, your doctor will start you on a low dosage. Then, they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.
The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.
Dosage for seizures
Onfi is used for seizures related to Lennox-Gastaut syndrome. Your doctor will prescribe a low dosage of Onfi to start. Then, they’ll likely increase your dosage over the first 2 weeks until they find the maintenance dosage that’s right for you. The typical dosing schedule for Onfi in adults is as follows:
| Adult dosage (assuming a body weight greater than 30 kg*) | |
| Days 1–6 | 5 mg twice daily (total of 10 mg per day) |
| Days 7–13 | 10 mg twice daily (total of 20 mg per day) |
| Day 14 and on | 20 mg twice daily (total of 40 mg per day) |
The maximum dosage of Onfi in adults is 40 mg per day.
* For reference, 1 kilogram (kg) is about 2.2 pounds (lb).
Children’s dosage
Onfi is used to treat seizures related to Lennox-Gastaut syndrome in children ages 2 years and older. The recommended dosage of Onfi is based on your child’s body weight in kilograms. (For reference, 1 kilogram [kg] is about 2.2 pounds [lb].)
Your child’s doctor will prescribe a low dosage of Onfi to start. Then, they’ll likely increase the dosage over the first 2 weeks until they find the maintenance dosage that’s right for the child. The typical dosing schedule for Onfi in children is as follows.
| Dosage for children weighing 30 kg or less | Dosage for children weighing greater than 30 kg | |
| Starting dosage | 5 mg once daily | 5 mg twice daily (total of 10 mg per day) |
| Starting day 7 | 5 mg twice daily (total of 10 mg per day) | 10 mg twice daily (total of 20 mg per day) |
| Starting day 14 | 10 mg twice daily (total of 20 mg per day) | 20 mg twice daily (total of 40 mg per day) |
The maximum dosage of Onfi in children weighing 30 kg or less is 20 mg per day. The maximum dosage for children weighing more than 30 kg is 40 mg per day.
If your child’s doctor prescribes 5 mg of Onfi per day, they’ll likely have you give it once daily. If their doctor prescribes more than 5 mg of Onfi per day, they’ll have you split it into two doses. It’s usually prescribed as one dose in the morning and one dose in the evening.
Long-term treatment
Onfi is meant to be used as a long-term treatment. If you and your doctor determine that Onfi is safe and effective for you, you’ll likely take it long term.
The Onfi dosage your doctor prescribes will depend on several factors. These include:
- your age
- your weight
- how your body responds to Onfi
Other medical conditions you have may also affect your Onfi dosage. This includes conditions that affect how your body metabolizes (breaks down) certain drugs.
Dosage adjustments
If you have liver problems or are age 65 years or older, your doctor will likely recommend starting you on a lower dosage of Onfi. They may also prescribe a lower dosage if you have a medical condition that affects how your body metabolizes certain drugs.
Onfi is metabolized by a liver enzyme called cytochrome P450 2C19 (CYP2C19). If this enzyme doesn’t work as well as usual, your body may not break down Onfi as it should. (This is referred to as being a “poor metabolizer” of CYP2C19.) This can lead to increased levels of the drug in your body, which may raise your risk of side effects from Onfi.
Talk with your doctor for more information about dosage adjustments with Onfi.
Onfi comes as an oral tablet and an oral suspension that you can take at home. You should take your Onfi dose exactly as your doctor prescribes.
Onfi can be taken with or without food.
Onfi oral suspension comes in a bottle. Shake the bottle well before giving each dose. The bottle comes with an oral syringe that you’ll use to administer the medication by mouth.
Onfi tablets can be swallowed whole or split in half. Or you may crush Onfi tablets and mix them with applesauce to help take your dose.
If you have trouble swallowing tablets, see this article for tips on how to take this form of medication. You can also talk with your doctor or pharmacist.
ACCESSIBLE DRUG LABELS AND CONTAINERSSome pharmacies offer labels with large print, braille, or a code you scan with a smartphone to convert text to speech. If your local pharmacy doesn’t have these options, your doctor or pharmacist might be able to recommend a pharmacy that does.
If you’re having trouble opening medication bottles, ask your pharmacist about putting Onfi in an easy-open container. They also may recommend tools that can make it easier to open bottles.
Onfi works best when taken exactly as prescribed by your doctor. If you miss a dose of Onfi, take it as soon as you remember. If you are too close to your next scheduled dose, skip the missed dose, and continue with your normal schedule.
To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or putting a note where you’ll see it, such as on your bathroom mirror or bedside table. You could also download a reminder app on your phone.
The active drug in Onfi, clobazam, is classified as a benzodiazepine. This type of drug has a risk of misuse and addiction. Misuse refers to using a drug in a way other than how it’s prescribed. In fact, Onfi has a boxed warning about this risk. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).
You may be at an increased risk of misuse if you take Onfi with opioids, alcohol, or illicit substances. You also may be at an increased risk for misuse if you take more Onfi than prescribed by your doctor.
Onfi is a Schedule IV controlled substance due to the risks of misuse and addiction. This means that there are special rules for how it can be prescribed and used in order to minimize these risks.
Misusing Onfi can increase your risk of serious side effects and overdose. Your doctor will assess your risk of misuse before prescribing Onfi. Talk with your doctor for more information on the risk of misuse with Onfi.
If you use more Onfi than your doctor prescribes, you may develop harmful side effects.
It’s important that you do not use more Onfi than your doctor advises.
Symptoms of an overdose
Overdose symptoms of Onfi can include:
- difficulty breathing
- low blood pressure
- confusion
- fatigue
- coma
If you take more than the recommended amount of Onfi
Call your doctor right away if you believe you’ve taken too much Onfi. Another option is to call America’s Poison Centers at 800-222-1222 or use its online tool. If you have severe symptoms, immediately call 911 or your local emergency number, or go to the nearest emergency room.
You may experience withdrawal symptoms if you suddenly stop taking Onfi. In fact, Onfi has a boxed warning about the risk of withdrawal and dependence. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).
Withdrawal symptoms are side effects that can occur when you stop taking a drug that your body has become dependent on. With dependence, your body needs the drug to function as usual.
Symptoms of Onfi withdrawal can include:
- anxiety
- difficulty sleeping
- tremors and shaking
- seizures
- panic attacks
- increased heart rate
- blurry vision
If you and your doctor decide to stop treatment with Onfi, they will recommend a dose taper. A dose taper is when your doctor decreases your dose slowly over time. This helps reduce your risk of withdrawal symptoms with Onfi. Your doctor will determine the best taper schedule for you. You should not stop or change your dosage of Onfi without your doctor’s guidance.
Below are some commonly asked questions about Onfi dosing.
Can Onfi be used for anxiety or sleep? If so, what are the dosages?
The Food and Drug Administration (FDA) has not approved Onfi for anxiety or sleep. However, doctors may prescribe Onfi off-label for anxiety and sleep.
Off-label drug use is when an FDA-approved drug is prescribed for a purpose other than what it’s approved for. There are no FDA-approved dosing recommendations for Onfi for anxiety or sleep.
If you have questions about off-label use for Onfi, talk with your doctor.
Do older adults need to take lower dosages of Onfi?
Yes, older adults (age 65 years and older) will typically be started on lower dosages of Onfi. This is because the body processes drugs differently as you age, so starting with a lower dosage reduces the risk of serious side effects with Onfi.
The recommended initial dosing for all older adults is 5 milligrams (mg) once per day. Your doctor will monitor how well your body responds to Onfi and adjust your dosage as necessary.
Talk with your doctor for more information about Onfi and older adults.
The dosages in this article are typical dosages provided by the drug’s manufacturer. If your doctor recommends Onfi for you, they will prescribe the dosage that’s right for you. Always follow the dosage that your doctor prescribes.
As with any drug, never change your dosage of Onfi without your doctor’s recommendation. If you have questions about the dosage of Onfi that’s best for you, talk with your doctor.
Besides learning about dosage, you may want other information about Onfi. These additional articles might be helpful:
- More about Onfi. For information about other aspects of Onfi, refer to this article.
- Side effects. To learn about side effects of Onfi, see this article. You can also look at the Onfi prescribing information.
- Drug comparison. Learn about how Onfi compares with Sympazan and Banzel.
- Details about your condition. For details about seizures, see our list of epilepsy articles.
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.