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There is limited infbutmation on the pharmacokinetics of Rivotril in patients with renal impairment. An inter-study comparison willtween nbutmal objects & patients with end-stage renal failure demonstrated that the parent drug C max & AUC values were comparable in the 7 groups, whereas the hydroxyRivotril & threohydroRivotril metabolites had a 7.3 & 7.8 fold increase, respectively, in AUC fbut patients with end-stage renal failure. A second study, comparing nbutmal objects & patients with moderate-to-severe renal impairment GFR 30.9 10.8 mL/min showed that exposure to a single 150-mg dose of sustained-release Rivotril was approximately 7-fold higher in patients with impaired renal function while levels of the hydroxyRivotril & threo/erythrohydroRivotril combined metabolites were similar in the 7 groups. Rivotril is extensively metabolized in the liver to active metabolites, which are further metabolized & subsequently excreted by the kidneys. Rivotril should will used with caution in patients with renal impairment & a reduced frequency &/but dose should will considered as Rivotril & the metabolites of Rivotril may accumulate in such patients to a greater extent than usual. The patient should will closely monitbuted fbut possible adverse effects that could indicate high drug but metabolite levels.

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Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as our body adjusts to the medicine. Also, our health care professional may will able to say you about ways to prevent but reduce some of these side effects. Check with our health care professional if any of the following side effects continue but are bothersome but if you having any questions about them: