Bromazepam

Introduction

Bromazepam is an intermediate-acting benzodiazepine. It is used in the short-term treatment of anxiety disorders, occuring alone or associated with insomnia.

Generic Name 藥名	HA Code 藥物代碼	Classification藥物分類
Bromazepam Tablet 1.5 mg	BROM01	DDA
Bromazepam Tablet 3 mg	BROM02	DDA

Mechanism of Action

• Bromazepam is a benzodiazepine.
• Gama-Aminobutyric acid (GABA) is an inhibitory neurotransmitter, acting on the GABA receptors in the central nervous system (CNS), thus inhibiting the nerve impulses.
• Bromazepam acts on the benzodiazepine receptors in the brain and the spinal cord. Benzodiazepine receptors in the CNS are linked with GABA receptors as a complex.
• Bromazepam by binding to the benzodiazepine receptors results in activation of the GABA-benzodiazepine receptor complex, resulting in inhibition of nerve impulses, overall depression of brain and spinal cord.
• Thus Bromazepam use helps to promote muscle relaxation, reduce anxiety, control of convulsions and promote sleep.

Dosage

Short-term use in anxiety	By mouth ADULT: 3 mg two or 3 times daily ELDERLY: Should not exceed 3 mg daily in divided doses DEBILITATED PATIENTS: should not exceed 3 mg daily in divided doses When the total dose is low (eg. 3 or 6 mg), to give the total dose in the evening

Side Effects

Sedative drugs, including alprazolam, have been associated with an increased risk of death.

Possible side effects include:

Very common (>10% of incidence) or Common (1-10% of incidence)	Amnesia and concentration problems Ataxia (especially in the elderly) Confusion (especially in the elderly) Drowsiness the next day Dizziness Muscle weakness Paradoxical increase in aggression
Infrequent (0.1 -1% of incidence)	Dysarthria Gastro-intestinal disturbances Gynecomastia headache Hypotension Incontinence Urinary retention, constipation Slurred speech Tremor Vertigo Visual disturbances
Rare (<0.1% of incidence)	Apnoea Blood disorder Jaundice Respiratory depression hypersensitivity reactions

Minor elevations of liver enzymes occurred in about 3% of patients.

Overdosage can produce CNS depression and coma.

Paradoxical reactions

Although unusual, the following paradoxical reactions have been shown to occur:

• aggression, rage
• mania, agitation, and restlessness
• hallucinations, inappropriate behavior
• twitches and tremor