Comprehensive medication guide to Tranxene including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$30 copay for generic clorazepate dipotassium on most commercial insurance plans (Tier 1–2); quantity limits and prior authorization may apply due to controlled substance status. Medicare Part D and Medicaid generally cover generic clorazepate.
Estimated Cash Pricing
$29–$155 retail for a 30-day supply of generic clorazepate 7.5 mg; as low as $28–$34 with GoodRx or SingleCare coupons. Prices vary significantly by pharmacy — warehouse clubs like Costco often have the lowest cash prices.
Medfinder Findability Score
45/100
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Tranxene is the brand name for clorazepate dipotassium, a long-acting benzodiazepine medication. It has been FDA-approved for use in the United States since 1967 and belongs to the same drug class as diazepam (Valium), lorazepam (Ativan), and alprazolam (Xanax). Tranxene is available as oral tablets in three strengths: 3.75 mg, 7.5 mg, and 15 mg.
Tranxene is FDA-approved for three indications: anxiety disorders, adjunctive therapy for partial seizures (in patients age 9 and older), and symptomatic relief of acute alcohol withdrawal. It is a DEA Schedule IV controlled substance, requiring a prescription from a licensed provider with DEA prescribing authority.
Generic clorazepate dipotassium is available from multiple manufacturers. As of 2026, ANI Pharmaceuticals received FDA approval for a new generic version, which should gradually help improve availability and pricing. Brand-name Tranxene is produced by Recordati Rare Diseases Inc.
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Tranxene is a prodrug — it is pharmacologically inactive until converted by the acidic environment of the stomach to its active form, nordiazepam (desmethyldiazepam). This conversion happens rapidly, so that by the time clorazepate reaches the bloodstream, essentially all of it exists as nordiazepam.
Nordiazepam works by binding to GABA-A receptors in the central nervous system and amplifying the effect of GABA (gamma-aminobutyric acid) — the brain's primary inhibitory neurotransmitter. This enhanced GABAergic activity reduces neuronal excitability throughout the CNS, producing anxiolytic, anticonvulsant, sedative, and muscle-relaxant effects.
Nordiazepam has a half-life of approximately 40 to 50 hours, making Tranxene one of the longest-acting benzodiazepines available. This long duration allows for stable, sustained therapeutic effects with less frequent dosing, and makes it particularly useful for alcohol withdrawal management where a slowly tapering drug level is clinically advantageous.
3.75 mg — tablet
Starting or low-dose option; often used in elderly or debilitated patients
7.5 mg — tablet
Most commonly prescribed strength for anxiety management
15 mg — tablet
Higher-dose tablet for patients requiring larger daily doses
Tranxene (clorazepate) is notoriously difficult to find at many pharmacies in 2026. While it is not formally listed on the FDA Drug Shortage Database, patients frequently encounter what is often called a 'soft shortage' — the drug exists and is not discontinued, but limited manufacturer participation and low pharmacy stocking rates make it genuinely hard to fill at large chain pharmacies.
The main drivers of Tranxene's limited availability include: a thin manufacturer base (historically just a few companies), low prescribing volume relative to other benzodiazepines, DEA Schedule IV quota and inventory regulations, and ongoing supply chain pressures. Large chain pharmacies often don't stock it because demand is low compared to alprazolam, lorazepam, or clonazepam. The good news: ANI Pharmaceuticals received FDA approval for a new generic clorazepate in early 2026, which should gradually improve market supply.
Independent pharmacies are more likely to carry or special-order clorazepate than large chains. If you're struggling to locate it, use medfinder to find pharmacies near you that currently have it in stock — saving you the time of calling pharmacy after pharmacy on your own.
As a DEA Schedule IV controlled substance, Tranxene can be prescribed by any licensed provider who holds a valid DEA registration. An in-person evaluation is typically required to initiate a new prescription — telehealth prescribing of Schedule IV benzodiazepines is generally not permitted under DEA regulations.
The most common prescribers of Tranxene include:
Psychiatrists — for anxiety disorders and anxiety-related conditions
Neurologists — for adjunctive management of partial seizures
Primary care physicians (PCPs) — for anxiety and ongoing management of prescriptions initiated by specialists
Nurse practitioners (NPs) and physician assistants (PAs) — with a valid DEA registration; prescribing independence varies by state
Addiction medicine specialists — for alcohol withdrawal management
Telehealth availability is very limited for clorazepate. Due to DEA regulations on controlled substance prescribing, an in-person visit is generally required. Patients needing a new prescription should plan for an in-person appointment with a licensed provider who holds DEA prescribing authority.
Yes. Tranxene (clorazepate dipotassium) is classified as a DEA Schedule IV controlled substance. Schedule IV substances have an accepted medical use in the United States but carry a recognized risk of abuse and physical dependence. All benzodiazepines, including clorazepate, fall into Schedule IV.
As a Schedule IV drug, Tranxene carries FDA boxed warnings covering: (1) abuse, misuse, and addiction — which can lead to overdose or death; (2) physical dependence and withdrawal — abrupt discontinuation can cause life-threatening seizures; and (3) dangerous interaction with opioids — concurrent use can cause profound sedation, respiratory depression, coma, and death.
Prescriptions for clorazepate require a licensed provider with a valid DEA registration. Because of the controlled substance status, telehealth prescribing is generally not available — an in-person evaluation is typically required. Refill restrictions, quantity limits, and mandatory PDMP checks apply in most states. Insurance plans may also impose prior authorization requirements for benzodiazepines.
The most frequently reported side effect of clorazepate is drowsiness. Other common side effects include:
Dizziness and lightheadedness
Gastrointestinal complaints (nausea, upset stomach)
Blurred vision and dry mouth
Headache and mental confusion
Ataxia (unsteady gait), fatigue, tremor
Nervousness or irritability
Serious side effects requiring immediate medical attention: respiratory depression (especially with opioids or alcohol), severe allergic reactions, seizures from abrupt discontinuation, suicidal thoughts, paradoxical reactions (agitation, hostility), and hallucinations.
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Diazepam (Valium)
Most pharmacologically similar alternative; shares same active metabolite (nordiazepam). Long-acting, FDA-approved for anxiety, seizures, alcohol withdrawal, and muscle spasms. Widely available.
Clonazepam (Klonopin)
High-potency, long-acting benzodiazepine. FDA-approved for seizures and panic disorder. Widely available and very commonly prescribed. Careful dose conversion required.
Lorazepam (Ativan)
Intermediate-acting benzodiazepine for anxiety and acute seizures. Widely available, safe in liver disease, multiple formulations. Shorter duration requires more frequent dosing.
Chlordiazepoxide (Librium)
Long-acting benzodiazepine, the oldest in the class. Standard treatment for alcohol withdrawal. Less commonly used for anxiety in modern practice.
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Opioids (oxycodone, fentanyl, hydrocodone, buprenorphine)
majorFDA boxed warning: concurrent use can cause profound sedation, respiratory depression, coma, and death. Avoid when possible; if necessary, use lowest doses with close monitoring.
Alcohol
majorAdditive CNS and respiratory depression. Even small amounts of alcohol can significantly increase sedation and respiratory risk. Avoid completely.
Other CNS depressants (barbiturates, antipsychotics, sleep medications, antihistamines)
moderateAdditive CNS depression and increased respiratory risk. Use with caution; dose adjustments and close monitoring required.
Rifampin, phenytoin, carbamazepine, apalutamide, enzalutamide
moderateCYP3A4 inducers that accelerate clorazepate metabolism, potentially reducing effectiveness. May require dose adjustment or alternative medication.
Ketoconazole, erythromycin, cimetidine, fluoxetine, disulfiram, isoniazid
moderateCYP3A4 inhibitors or other drugs that slow clorazepate metabolism. Can increase nordiazepam blood levels and intensify side effects including sedation.
Valproic acid (Depakote)
moderateMay affect clorazepate metabolism. Monitor for increased sedation when used concurrently, especially since both are commonly used in seizure management.
Tranxene (clorazepate dipotassium) is a well-established, long-acting benzodiazepine that plays an important role for patients with anxiety disorders, partial seizures, and acute alcohol withdrawal. Its prodrug mechanism and long-acting metabolite (nordiazepam) provide stable, sustained CNS effects that make it distinct from shorter-acting benzodiazepines. For epilepsy patients in particular, long-term evidence supports its effectiveness as an adjunctive anticonvulsant.
The main challenge with Tranxene in 2026 is availability — not efficacy. The medication is not discontinued, and the addition of ANI Pharmaceuticals as a new generic manufacturer is a positive step for supply. Generic clorazepate is also affordable for most patients, often under $35 per month with discount coupons. As a DEA Schedule IV controlled substance, Tranxene requires careful management, gradual tapering when discontinuing, and awareness of its significant drug interaction profile — particularly with opioids and alcohol.
If you're having trouble finding Tranxene at your pharmacy, medfinder can help. medfinder contacts pharmacies in your area to find which ones can fill your prescription — saving you the time and frustration of calling pharmacy after pharmacy on your own. Never stop clorazepate abruptly; always work with your prescriber to manage your medication safely.
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