# Burning Mouth or Tongue (Glossodynia) - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - Sources: Clonazepam tablets US prescribing information, DESCRIPTION and DOSAGE AND ADMINISTRATION (DailyMed SetID 30d674f9-f1b3-4c2d-a8e9-3bc8e476f1ec, Advagen Pharma): "available as scored tablet with debossing containing 0.5 mg of clonazepam". The label's own starting dose is for seizure disorders - "The initial dose for adults with seizure disorders should not exceed 1.5 mg/day divided into three doses" - so 0.5 mg daily is a third of that, and the label carries no burning-mouth indication. · Burning Mouth Syndrome - StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK519529/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class DS20.01 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care - Verified date: 2026-08 ## Verified against - Clonazepam tablets US prescribing information, DESCRIPTION and DOSAGE AND ADMINISTRATION (DailyMed SetID 30d674f9-f1b3-4c2d-a8e9-3bc8e476f1ec, Advagen Pharma): "available as scored tablet with debossing containing 0.5 mg of clonazepam". The label's own starting dose is for seizure disorders - "The initial dose for adults with seizure disorders should not exceed 1.5 mg/day divided into three doses" - so 0.5 mg daily is a third of that, and the label carries no burning-mouth indication. - No dose - referral pathway, no medicine given in primary care - Burning Mouth or Tongue (Glossodynia) - disease-level clinical article (burning-mouth-tongue-clinical.txt) ## Treatment metadata - No drug therapy in primary care (Referral & Advice) - Clonazepam — oral.solid ## Complete treatment card ```text BURNING MOUTH OR TONGUE (GLOSSODYNIA) Sources: Clonazepam tablets US prescribing information, DESCRIPTION and DOSAGE AND ADMINISTRATION (DailyMed SetID 30d674f9-f1b3-4c2d-a8e9-3bc8e476f1ec, Advagen Pharma): "available as scored tablet with debossing containing 0.5 mg of clonazepam". The label's own starting dose is for seizure disorders - "The initial dose for adults with seizure disorders should not exceed 1.5 mg/day divided into three doses" - so 0.5 mg daily is a third of that, and the label carries no burning-mouth indication. · Burning Mouth Syndrome - StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK519529/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class DS20.01 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care Review status: REVIEWED against Clonazepam tablets US prescribing information, DESCRIPTION and DOSAGE AND ADMINISTRATION (DailyMed SetID 30d674f9-f1b3-4c2d-a8e9-3bc8e476f1ec, Advagen Pharma): "available as scored tablet with debossing containing 0.5 mg of clonazepam". The label's own starting dose is for seizure disorders - "The initial dose for adults with seizure disorders should not exceed 1.5 mg/day divided into three doses" - so 0.5 mg daily is a third of that, and the label carries no burning-mouth indication., No dose - referral pathway, no medicine given in primary care, Burning Mouth or Tongue (Glossodynia) - disease-level clinical article (burning-mouth- tongue-clinical.txt) (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (6) - Deep, bilateral burning pain is reported daily [burning pain] - The burning pain lasts at least 4 to 6 months [burning pain] - Pain is constant or worsens through the day, but eases rather than worsens with eating or drinking [burning pain] - Sleep is not disturbed by the pain - Most patients also notice a taste disturbance, such as a metallic or bitter taste [taste disturbance] - Additional features can include dry mouth, altered sensory or chemical perception, or a mood disorder [dry mouth] SIGNS - what you find (2) - No visible oral lesions are present, and their absence is required for the diagnosis - A biopsy is not needed when the tongue looks normal on exam; it is only done when a lesion is seen TESTS (6) - Salivary flow rate and taste function are measured with objective tests - Neurological exam and imaging are done to rule out degenerative or other neurologic disease - Oral cultures are taken to exclude bacterial, fungal, or viral infection - Allergy patch testing is done in patients with a suspected allergy - Gastric reflux disease is investigated as a possible cause - Hormonal, autoimmune, and nutritional causes are ruled out IF NOT THIS - what else fits (5) - Stomatitis and atypical facial pain can present similarly - Atypical odontalgia and idiopathic facial arthromyalgia are considered - Pemphigoid, pemphigus, and oral neoplastic lesions are on the differential - Acoustic neuroma and a poorly fitting denture or restoration should be considered - Herpes simplex, herpes zoster, and post-surgical injury to the lingual or mandibular nerve are also differentials Source StatPearls "Burning Mouth Syndrome" - disease-level clinical article Status traced to the source above 1. NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE) [1st line] Adult A burning sensation of the tongue or mouth; a GP screens for treatable causes such as vitamin deficiency, oral thrush or diabetes and treats those directly, referring persistent cases with no identified cause. - Refer, with advice Peds Children follow the same pathway: recognise and refer. No primary-care medicine is implied. Source No dose - referral pathway, no medicine given in primary care Why A burning sensation of the tongue or mouth; a GP screens for treatable causes such as vitamin deficiency, oral thrush or diabetes and treats those directly, referring persistent cases with no identified cause. Caution RED FLAG - Unintentional weight loss or persistent mucosal bleeding: assess urgently and refer. RED FLAG - Progressive dysphagia or odynophagia: assess urgently and refer. RED FLAG - Unexplained oral mucosal ulceration or erythroplakia/leukoplakia: assess urgently and refer. No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to. Look for visible white patches, which suggest oral candidiasis, and for signs of anaemia or nutritional deficiency. Refer for specialist evaluation when symptoms persist despite treating the reversible causes. 2. CLONAZEPAM [2nd line] Adult 0.5 mg per day Peds No paediatric dose is stated in the sources held for this drug. Source Clonazepam tablets US prescribing information, DESCRIPTION and DOSAGE AND ADMINISTRATION (DailyMed SetID 30d674f9-f1b3-4c2d-a8e9-3bc8e476f1ec, Advagen Pharma): "available as scored tablet with debossing containing 0.5 mg of clonazepam". The label's own starting dose is for seizure disorders - "The initial dose for adults with seizure disorders should not exceed 1.5 mg/day divided into three doses" - so 0.5 mg daily is a third of that, and the label carries no burning-mouth indication. Why Low-dose systemic clonazepam for treating burning mouth syndrome pain after excluding secondary organic causes. Caution Clonazepam is a benzodiazepine: sedation, cognitive impairment, and physical dependence are risks. Avoid alcohol and driving. The formulary doses clonazepam systemically for seizures and panic. Sucking a tablet for local effect in burning mouth syndrome is an off-label use of the tablet and is not a dose the formulary gives. Egypt RONATRIL 0.5MG 10 TAB. HI-PHARM 1.75 EGP (0.17/unit) SIGOTRYL 0.5MG 10 TAB. SIGMA 1.75 EGP (0.17/unit) RONATRIL 2MG 30 TAB. HI-PHARM 9.50 EGP (0.32/unit) AMOTRIL 0.5 MG 30 TAB. AMOUN 16.50 EGP (0.55/unit) APETRYL 0.5 MG 50 TAB. MULTI-APEX 45.00 EGP (0.90/unit) CLOPAM 2MG 30 TAB. EIPICO 30.00 EGP (1.00/unit) APETRYL 2 MG 30 TAB. MULTI-APEX 45.00 EGP (1.50/unit) KLOZEPAM 2 MG 20 TABS. SIGMA 32.00 EGP (1.60/unit) KLOZEPAM 2.5MG/ML 15ML ORAL DROPS SIGMA 40.00 EGP -> ? strength differs, ? different route - not oral solid RIVOTRIL 2.5MG/ML ORAL DROPS 10ML F.HOFFMAN LA ROCHE > EGYPTIAN PHARMACE... 87.00 EGP -> ? strength differs, ? different route - not oral solid Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)