Healthy pregnancy hub

Clonazepam (Rivotril®)

Last Update: 08 Apr 2025

Welcome to our fact sheet on Clonazepam (Rivotril®) during pregnancy and breastfeeding/ chestfeeding. The information given is based on recent research and may change as science progresses. Please remember that this content does not replace personalized advice from your healthcare team.

The HEALTHY PREGNANCY HUB team is collaborating with MotherToBaby to share information on this topic. The original version is available here (updated on November 2023).

Serene, our chatbot, can also answer your questions about medications during pregnancy.

Please note that this fact sheet is based on United States information and has been adapted for Canada, with a review by our Canadian experts. Minor differences may exist between the two countries. Always consult your healthcare professional for information tailored to your situation.

1. What is clonazepam?

Clonazepam is a medication that has been used to treat seizures, anxiety, panic attacks, and insomnia (trouble sleeping). It belongs to a class of medications called benzodiazepines. Clonazepam is sold under the brand name Klonopin®. A common brand name in Canada is Rivotril® 

Sometimes when people find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy. For more information on anxiety, see our fact sheet here: https://mothertobaby.org/fact-sheets/anxiety-fact/. 

2. What are the risks according to research?

I take clonazepam. Can it make it harder for me to get pregnant?

It is not known if clonazepam can make it harder to get pregnant. 

Does taking clonazepam increase the chance of miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. It is not known if clonazepam can increase the chance of miscarriage. One study found that people who were taking more than 4 mg/day of clonazepam had a slightly higher chance of miscarriage. As there can be many causes of miscarriage, it is hard to know if a medication, the medical condition, or other factors are the cause of a miscarriage. 

Does taking clonazepam increase the chance of birth defects?

Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. Data on the use of clonazepam only in pregnancy is limited. Information from a small number of studies of individuals taking clonazepam only during pregnancy has not found an increased chance of birth defects. There might be different risks for individuals who take clonazepam in combination with other medications. 

Does taking clonazepam in pregnancy increase the chance of other pregnancy-related problems?

It is not known if clonazepam can increase the chance of other pregnancy-related problems, such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). Two prescription record studies suggested that babies exposed to clonazepam during pregnancy might be more likely to be born preterm or with low birth weight. Studies based on filled prescriptions/prescription records cannot tell if a person took the medication. This makes it hard to know if the study outcomes are related to the medication or other factors. 

I need to take clonazepam throughout my entire pregnancy. Will it cause withdrawal symptoms in my baby after birth?

The use of clonazepam during pregnancy can cause temporary symptoms in newborns soon after birth. These symptoms are sometimes referred to as withdrawal. Some babies exposed to clonazepam at the end of pregnancy might have trouble breathing, poor circulation, and low muscle tone (floppy baby syndrome). Some babies might need to spend some time in the neonatal intensive care unit (NICU). Not all babies exposed to clonazepam will have these symptoms. It is important that your healthcare providers know you are taking clonazepam so that if symptoms occur your baby can get the care that is best for them. 

Does taking clonazepam in pregnancy affect future behavior or learning for the child?

It is not known if clonazepam can increase the chance of behavior or learning issues for the child. A study of 314 children exposed to clonazepam during pregnancy found an increased chance of intellectual disability and delayed developmental milestones. One study of 269 children exposed to clonazepam during pregnancy did not find an increased chance of autism. 

A prescription record study found no increased chance for autism or intellectual disability when clonazepam was used in the first trimester of pregnancy to treat seizures. This report did find an increased chance for intellectual disability in those exposed to clonazepam for something other than seizures. Studies based on filled prescriptions/prescription records cannot tell if a person took the medication. This makes it hard to know if the study outcomes are related to the medication or other factors. 

3. Breastfeeding/ chestfeeding while taking clonazepam

Clonazepam gets into breastmilk in small amounts. It can cause sedation (sleepiness) and levels might build up in the infant’s body. Other medications might be preferred while breastfeeding/ chestfeeding a newborn or an exclusively breastfed/ chestfed infant. If you suspect the baby has any symptoms (sleepiness, not gaining weight, delayed milestones) contact the child’s healthcare provider. If excessive sleepiness occurs, contact a healthcare provider immediately. 

The product label for clonazepam recommends breastfeeding/ chestfeeding individuals to not use this medication. However, the benefit of using clonazepam along with the benefits of breastfeeding/ chestfeeding your baby might outweigh the possible risks. Your healthcare provider can talk with you about using clonazepam and what treatment is best for you. Be sure to talk to your healthcare provider about all your breastfeeding/ chestfeeding questions. 

4. Fathers and sperm donors

If a male takes clonazepam, could it affect his fertility or increase the chance of birth defects?

Studies have not been done to see if clonazepam could affect male’s fertility (ability to get a partner pregnant) or increase the chance of birth defects. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet on Paternal Exposures here

Key points

  • Clonazepam (Rivotril®) is a benzodiazepine medication used to treat seizures, anxiety, panic attacks, and insomnia.
  • Studies on clonazepam are limited. It is not known whether it increases the risk of miscarriage, birth defects, or other pregnancy-related complications.
  • The baby may experience temporary symptoms shortly after birth. However, not all babies exposed to clonazepam will have these symptoms.
  • Clonazepam passes into breastmilk/ chestmilk in small amounts and may cause drowsiness in the baby. Talk with your healthcare team to find the best option for your situation.
  • Always consult your healthcare provider before stopping or changing your treatment during pregnancy.

References

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Disclaimer

HEALTHY PREGNANCY HUB provides a source of information validated by health professionals; however, this information is provided for informational purposes only and should not replace professional advice. Medical standards and practices evolve as new data becomes available, so it is imperative to consult your doctor or a qualified health professional for any questions or concerns regarding your health without delay or omission. It is the responsibility of your treating physician or any other health professional, based on their independent experience and knowledge of the patient, to determine the best way to evaluate and treat you.

HEALTHY PREGNANCY HUB does not specifically recommend or endorse any test, practitioner, treatment, product, or opinion mentioned on our platform. HEALTHY PREGNANCY HUB also does not replace the individual patient assessment based on the examination by the healthcare provider of each patient and the consideration of laboratory data and other patient-specific factors.

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While consulting symptoms or other medical information on our platform may guide your discussions with your healthcare professional, this information should not be used to make a medical diagnosis or determine treatment. Before making changes to your supplement or medication regimen, please discuss with your medical team or contact 811 (Canada) to ensure the relevance of these changes to your individual situation.

Credits
MotherToBaby
Organization of Teratology Information Specialists (OTIS)
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Émy Roberge
Centre hospitalier universitaire Sainte-Justine
Brigitte Martin
Centre Hospitalier Universitaire Sainte-Justine

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