Clobazam (Onfi)


Indications for Prior Authorization:

  • Indiated for adjunctive treatment of seizures associated with Lennox-Gastaut syndrome (LGS) in patients 2 years of age or older

Patients must meet the following criteria for the indication(s) above:

  • Prescribed by or in collaboration with a neurologist, AND
  • 2 years of age or older, AND
  • Diagnosis of Lennox-Gastaut syndrome, AND
  • Currently receiving treatment with at least one other antiepileptic medication


  • Dose patients according to body weight.  Individualize dosing within each body weight group, based on clinical efficacy and tolerability.
  Less than or equal to 30 kg Body Weight Greater than 30 kg Body weight
Starting Dose 5 mg 10 mg
Starting Day 7 10 mg 20 mg
Starting Day 14 20 mg 40 mg






  • Administer tablets whole, broken in half along the score, or crushed and mixed in applesauce.
  • To discontinue, taper by decreasing the total daily dose by 5-10 mg/day on a weekly basis until discontinued.


  • 1 year

Last review date: June 12, 2017

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