Bromazepam
Indications
Bromazepam is used for:
Anxiety, Panic attacks
Adult Dose
Adult: PO Initial: 6-18 mg/day in divided doses. Higher doses occasionally given to hospitalized patients.
Dose should be reduced at least half in elderly patients and patient with hepatic impairment.
Child Dose
Renal Dose
No dosage adjustment needed for Renal impairment.
Administration
May be taken with or without food.
Contra Indications
- Preexisting CNS depression or coma, Respiratory depression, acute pulmonary insufficiency or sleep apnea;
- Severe hepatic impairment;
- Not indicated for chronic psychosis, phobic or obsessional states;
- May precipitate suicide or aggressive behavior, not used alone to treat depression or anxiety associated with depression;
- Glaucoma.
Precautions
Chronic pulmonary insufficiency;
elderly or debilitated patients;
muscle weakness, impaired liver or kidney function;
drowsiness may affect skilled tasks;
monitor cardio-respiratory function when used for deep sedation;
patients with personality disorders or organic brain changes;
pregnancy and lactation;
history of alcohol or drug addiction due to risk of dependence. Respiratory depression and hypotension with parenteral administration, therefore this route should only be used when facilities for reversing resp depression are available.
Pregnancy-Lactation
Interactions
May enhance the activity w/ CYP450 inhibitor (e.g. azole antifungals, macrolides, HIV protease inhibitors, Ca channel blockers).
Elevated plasma levels w/ disulfiram or cimetidine.
Additive CNS depressant effects w/ barbiturates, sedatives, anaeasth, anxiolytics, hypnotics, phenothiazines, other antipsychotics, skeletal muscle relaxants.
May potentiate anticholinergic effects of atropine, antihistamines and antidepressants.
Increased psychic drug dependence w/ narcotic analgesics.
Adverse Effects
Side effects of Bromazepam :
Drowsiness, sedation, muscle weakness and ataxia;
less frequently vertigo, headache, depression, confusion, slurred speech, changes in libido, visual disturbances, tremor, urinary retention, GI disturbances, changes in salivation and amnesia;
rarely,
jaundice, blood disorders and hypersensitivity reactions;
pain and thrombophlebitis;
raised liver enzyme values;
paradoxical excitation.
Mechanism of Action
Bromazepam is a benzodiazepine with general properties similar to diazepam. It is used in the treatment of anxiety occuring alone or associated with insomnia.