Meds and you

Updated 11 February 2013

Brotizolam

Brotizolam is a short-acting hypnotic drug and part of the benzodiazepine group of drugs. It is prescribed to treat short term insomnia.

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Brotizolam is the active ingredient of Lendormin.

General information

Brotizolam is a short-acting hypnotic drug and part of the benzodiazepine group of drugs. It is prescribed to treat short term insomnia, as well as moderate to severe anxiety and panic disorders. It is effective as an anticonvulsant and possesses muscle-relaxing properties. Unlike the benzodiazepine alprazolam it does not possess any antidepressant qualities.

This benzodiazepine should in most case not be used for longer than 2 - 4 weeks, as tolerance and physical and psychological dependence can occur. Brotizolam shares with other benzodiazepines the risk of abuse, misuse, psychological and/or physical dependence. It is reckoned that brotizolam has a greater abuse potential than many other benzodiazepines because of its rapid onset of action. As a result of its short duration, withdrawal symptoms may be more severe and more frequently encountered than with long-acting benzodiazepines such as diazepam. Anxiety and tension related to everyday life should not be treated with brotizolam. If prescribed for longer than 4 weeks your doctor should periodically reassess your need for brotizolam.

How does brotizolam work?

Brotizolam has an effect on gamma-aminobutyric acid (GABA). GABA is the brain's quieting or tranquilising neurotransmitter, possessing an inhibitive effect on the transmission of nerve signals. Brotizolam and other benzodiazepines enhance the effect of GABA, thus slowing down the transmission of nerve signals.

Fast facts

Drug schedule: Schedule 5

Available as: Brotizolam is available as tablets

What does it do? Brotizolam has an anti-anxiety and sedative action.

Overdose risk: Medium

Dependence risk: High

Is brotizolam available as a generic? Yes

Is brotizolam available on prescription only? Yes

User information

Onset of effect: Short - Within 30 minutes

Duration of action: Up to 8 hours

Dietary advice: Brotizolam may be taken with or without food.

Stopping this medicine: Brotizolam should not be stopped abruptly. Sudden discontinuation may lead to withdrawal symptoms. The dosage should be gradually reduced in accordance with the advice of your doctor.

Prolonged use: Short-term therapy is advised and treatment should generally be no longer than 4 weeks, including a tapering off process. Do not take brotizolam for longer periods unless expressly instructed by your doctor.

Special precautions

Never exceed the prescribed dose of brotizolam.

Consult your doctor before using this drug if:

  • You have a known hypersensitivity to benzodiazepines
  • You have acute closed-angle glaucoma
  • You have liver or kidney disease.
  • You have a history of alcohol or substance abuse
  • You have a chronic lung disease
  • You suffer from porphyria
  • You suffer from mental illness or depression
  • You suffer from sleep apnoea.

Pregnancy: Avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.

Breastfeeding: Avoid. This medication is passed through breast milk and may affect your baby adversely. Consult your doctor before use.

Porphyria: Avoid. This medication may cause serious adverse effects. Consult your doctor before use.

Infants and children: This medication is not intended for use in children.

Elderly: Use with caution as side effects may be emphasised. Dosage may need adjustment.

Driving and hazardous work: This medication should be avoided as it may cause extreme sedation.

Alcohol: Brotizolam's effect may intensify the effect of alcohol and vice versa. Do not consume alcohol while taking this medication, as side effects may be drastically pronounced.

Possible side effects:

Side effect

Frequency

Consult your doctor

Common

Rare

Only if severe

In all cases

Drowsiness

x

x

Loss of coordination/dizziness

x

x

Slurred speech

x

x

Headache

x

x

Forgetfulness

x

x

Extreme fatigue

x

x

Nausea/vomiting

x

x

Rash/itching

x

x

Anger/behaviour changes

x

x

Yellow tinge: eyes/skin

x

x

Bruising/bleeding

x

x

Interactions:

Drug interactions:

Alcohol, antihistamines, antidepressants, other benzodiazepines, narcotics

Increased depression of central nervous system (CNS)

Digoxin

Increased possibility of digoxin toxicity

Disulfiram

Increased possibility of brotizolam toxicity

Ketokonazole and other related antifungals

Increased possibility of brotizolam toxicity

Cimetidine

Increased possibility of brotizolam toxicity

Isoniazid

Increased possibility of brotizolam toxicity

Oral contraceptive

Increased possibility of brotizolam toxicity

Propranolol

Increased possibility of brotizolam toxicity

Valproic acid

Increased possibility of brotizolam toxicity

Isoniazid

Increased possibility of a brotizolam toxicity

Levodopa

Decreases levodopa's anti-Parkinson effect.

Probenecid

Increased possibility of brotizolam toxicity

Rifampicin

May decrease the effect of brotizolam.

Theophylline

May counteract the sedative effects of brotizolam.

Disease interactions

Consult your doctor before using this drug if you have acute closed-angle glaucoma, myasthenia gravis, liver or kidney disease, a chronic lung disease, epilepsy, mental illness or depression, or if you suffer from sleep apnoea.

Overdose action

An overdose of brotizolam can be serious. Seek immediate emergency medical attention. Symptoms may include poor coordination, slow breathing, tremors, drowsiness, slurred speech, confusion, slow reflexes and loss of consciousness.

Recommended dosage

0.25 mg at bedtime strictly as prescribed by your doctor

 

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