Zepam

Indications

Bromazepam is used for the short-term relief of severe anxiety, tension and nervousness that is disabling or causing great distress. It is meant for short courses only.

How It Works

It belongs to the benzodiazepine group. It boosts the effect of GABA, a natural calming chemical in the brain, which reduces anxiety and relaxes muscles.

Dosage and Administration

• Adults: usually 1.5 to 3 mg two or three times a day. In severe anxiety, especially in hospital, the doctor may give more.
• Older people and those with liver, kidney or breathing problems: a lower dose, as prescribed.
• Children: not recommended.

Use the lowest dose that works for the shortest time, usually no more than 2 to 4 weeks including the time needed to reduce the dose. Do not stop suddenly after regular use; the doctor will lower the dose slowly.

Interactions

Alcohol, opioid painkillers and cough medicines (such as Tramadol and Codeine), sleeping tablets, sedating antihistamines, antidepressants, antipsychotics and epilepsy medicines can greatly increase drowsiness and slow breathing. Taking it with opioids can be life-threatening. Cimetidine, Fluvoxamine and some antifungal medicines can raise its level.

Contraindications

• Allergy to bromazepam, other benzodiazepines or any ingredient of the product.
• Severe breathing problems or sleep apnoea (breathing stops during sleep).
• Severe liver disease.
• Myasthenia gravis (a disease causing muscle weakness).

Side Effects

Common: drowsiness, tiredness, dizziness, muscle weakness, unsteadiness, slowed reactions and poor memory. Older people may become confused and are more likely to fall.

Get urgent medical help if you have: slow or shallow breathing or extreme sleepiness; unusual excitement, aggression, anger or hallucinations; worsening depression or thoughts of harming yourself; or swelling of the face, lips or throat or difficulty breathing.

Pregnancy and Lactation

Avoid in pregnancy unless the doctor decides it is essential. Use late in pregnancy or during labour can make the newborn floppy, cold and slow to breathe or feed, and can cause withdrawal symptoms in the baby. It passes into breast milk and can make the baby sleepy, so it should not be used while breastfeeding.

Precautions and Warnings

It can cause dependence, even after a few weeks at normal doses. Stopping suddenly can cause withdrawal symptoms such as anxiety, sleeplessness, shaking and, rarely, fits. Do not drive or use machines while drowsy, and avoid alcohol. Tell the doctor about any history of depression, alcohol or drug misuse, or lung, liver or kidney disease. Keep it safely and never share it.

Overdose

Overdose causes deep sleepiness, confusion, slurred speech, poor coordination and slow breathing, and can be life-threatening, especially with alcohol or opioids. Call for emergency help or go to hospital at once.

Therapeutic Class

Anxiolytic (anti-anxiety medicine), benzodiazepine.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.