Bromazepam
Indications
Bromazepam is indicated in-
- Emotional disturbances, i.e. acute tension and anxiety states. Difficulties in interpersonal contact. Agitation, insomnia, anxious and agitated depressive reactions.
- Functional disturbances in the cardiovascular and respiratory systems, i.e. pseudoangina pectoris, pericardial anxiety, tachycardia, emotiogenic hypertension, dyspnea and hyperventilation.
- Disturbances in the gastrointestinal tract, i.e. irritable bowel syndrome, epigastric pain, spasm, bloating diarrhea etc.
- Disturbances in the urinary tract, i.e. frequency, irritable bladder and dysmenorrhea.
- Psychosomatic disorder, i.e. psychogenic headache, asthma, gastric and duodenal ulcer.
- It is also indicated in emotional reactions to chronic organic disease.
Pharmacology
Bromazepam is a powerful psychotropic
agent. In lower dosage, it selectively reduces tension and anxiety. In
higher dosage, it shows sedative and muscle-relaxant properties.
Bromazepam binds to the GABA-A receptor producing a conformational
change and potentiating its inhibitory effects. Other neurotransmitters
are not influenced.
Dosage
Standard dosage: Average
dosage for outpatient therapy is 1.5-3 mg up to three times daily.
Treatment of outpatients should begin with low doses, gradually
increasing to the optimum level.
In severe cases, especially in hospital: 6-12 mg 2 or 3 times daily. The overall treatment generally should not be more than 8-12 weeks. In certain cases extension beyond the maximum treatment period may be necessary; if so, it should be taken with re-evaluation of the patient's status with special expertise.
Elderly and debilitated patients: Elderly patients and those with impaired hepatic functions require lower doses.
Children: Bromazepam is usually not indicated in children, but if the physician feels bromazepam treatment is appropriate, then the dose should be adjusted to their low bodyweight (about 0.1-0.3 mg/kg bodyweight)
In severe cases, especially in hospital: 6-12 mg 2 or 3 times daily. The overall treatment generally should not be more than 8-12 weeks. In certain cases extension beyond the maximum treatment period may be necessary; if so, it should be taken with re-evaluation of the patient's status with special expertise.
Elderly and debilitated patients: Elderly patients and those with impaired hepatic functions require lower doses.
Children: Bromazepam is usually not indicated in children, but if the physician feels bromazepam treatment is appropriate, then the dose should be adjusted to their low bodyweight (about 0.1-0.3 mg/kg bodyweight)
Administration
Bromazepam tablets are for oral administration
Interaction
If bromazepam is combined with other
centrally active drugs, its sedative effects may be enhanced. These
drugs are antidepressants, hypnotics, narcotics, antipsychotics,
sedatives, antiepileptic drugs, sedative antihistamines and anesthetics.
Co-administration of cimetidine may prolong the eliminiation half-life
of bromazepam. Concomitant intake of bromazepam with alcohol should be
avoided, because the sedative effect of bromazepam may be intensified by
alcohol.
Contraindications
Bromazepam is contraindicated in patients
with known hypersensitivity to bromazepam, severe respiratory
insufficiency, severe hepatic insufficiency or sleep apnea syndrome.
Side Effects
Common side-effects include fatigue,
drowsiness, muscle weakness, numbed muscle, reduced alertness,
confusion, headache, ataxia etc. These phenomena occur predominantly at
the start of therapy and usually disappear with prolonged
administration. Anterograde amnesia may occur using therapeutic doses.
Pregnancy & Lactation
The safety of bromazepam during pregnancy
has not been established. As bromazepam is excreted in breast milk, use
should be avoided during lactation.
Precautions & Warnings
The use of benzodiazepines and
benzodiazepine like agents may lead to the development of physical and
psychological dependence upon these products. This dependence depends on
the dose and duration of treatment; it is also greater in predisposed
patients with a history of alcohol. Once physical dependence has
developed, termination of the treatment will be accompanied by
withdrawal symptoms. These may consist of headache, muscle pain, extreme
anxiety, tension, confusion and irritability. Since the risk of
withdrawal phenomena and rebound phenomena is greater after abrupt
discontinuation of the treatment, it is recommended that the dosage be
decreased gradually. Bromazepam is not recommended for the primary
treatment of sleeplessness caused by psychotic illness. Caution should
be exercised while driving cars or using machineries.
Therapeutic Class
Benzodiazepine sedatives
Storage Conditions
Keep in a dry place away from light and heat. Keep out of the reach of children.
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