Included in the formulation
АТХ:N.05.B.A.08 Bromazepam
Pharmacodynamics:Benzodiazepine derivative of medium duration of action; causes depression of the central nervous system from mild sedation to coma, depending on the dose. Stimulates the gamma-aminobutyric acid receptors of the ascending activating reticular formation. Increases braking effect gamma-aminobutyric acid at central nervous system, enhances the effects of endogenous gamma-aminobutyric acid, reduces the excitability of the cortex and limbic system of the brain, inhibits polysynaptic spinal reflexes. Has anxiolytic, sedative-hypnotic (shortens the period of falling asleep, prolongs the duration of sleep, reduces the number of nocturnal awakenings) and central-miorelaxing effects.
Pharmacokinetics:Absorption after ingestion is rapid and complete. The connection with plasma proteins is 70%. It can pass through the placenta, the blood-brain barrier, into breast milk. The time of the maximum concentration of the substance in the blood plasma after oral administration - 1-4 hours. The equilibrium concentration in plasma is usually achieved within 2-3 days. Biotransformation in the liver by microsomal oxidation. Half-life - 20 hours, can increase in patients of senile age. It is excreted by the kidneys mainly in the form of compounds with glucuronic acid.Accumulation with a reappointment is minimal, excretion after cessation of treatment is rapid. After the abolition, the concentration in the plasma is reduced to subclinical within 24 hours. It is not removed during hemodialysis.
Indications:Neuroses and psychopathies; fupholstery; insomnia; dermatoses; anxiety and fear of operations; functional psychosomatic disorders of the cardiovascular system - pseudostenocardia, arterial hypertension of emotional genesis; psychosomatic from the respiratory system: shortness of breath, difficulty breathing; psychogenic disorders of the gastrointestinal tract - irritable bowel syndrome and urogenital system - frequent urination, menstrual cycle disorders.
V.F40-F48.F41 Other anxiety disorders
V.F40-F48.F48 Other neurotic disorders
V.F60-F69.F60 Specific personality disorders
VI.G40-G47.G43 Migraine
VI.G40-G47.G47.0 Disturbances of falling asleep and maintaining sleep [insomnia]
IX.I10-I15.I10 Essential [primary] hypertension
IX.I10-I15.I15 Secondary Hypertension
XII.L80-L99.L98.9 Lesion of skin and subcutaneous tissue, unspecified
XIV.N80-N98.N94.6 Dysmenorrhea, unspecified
XVIII.R40-R46.R45.7 Condition of emotional shock and stress, unspecified
XXI.Z100.Z100 * CLASS XXII Surgical Practice
Contraindications:Myasthenia gravis; alcoholism; drug dependence; individual intolerance; pregnancy and breastfeeding.
Carefully:Older patients who are weakened by the patient, as well as patients with impaired liver function, should be given smaller doses.
Pregnancy and lactation:Contraindicated in pregnancy and during breastfeeding.
Dosing and Administration:Dosage of the drug is selected individually in each case. Average doses for adults - 1,5-3 mg 2-3 times a day, in hospital conditions, the dose can be increased if necessary up to 6-12 mg 2-3 times a day.
Children older than 1 year of age are individually determined depending on body weight. The duration of treatment is no more than 8-12 weeks, including a period of gradual dose reduction.
Side effects:Nervous system: headache and dizziness, increased fatigue, drowsiness, impaired concentration, muscle weakness, slowing of mental and motor reactions, memory loss, gait disturbance, muscle weakness. Possible aggressiveness, fear, suicidal tendencies and hallucinations.
Digestive system: increased appetite, dry mouth, diarrhea, nausea.
Others: decreased libido, impaired liver and kidney function, arterial hypotension, a change in the pattern of peripheral blood.
Overdose:When an overdose is observed, oppression central nervous system varying degrees of severity (drowsiness, confusion, coma), gait disturbance, lowering of arterial pressure, disappearance of reflexes, oppression of cardiac and respiratory) activity.
For treatment, gastric lavage is necessary, the appointment of enterosorbents with constant monitoring of pressure, pulse and respiration, maintenance of cardiovascular activity and airway patency, symptomatic appointment of additional medications.
Interaction:Neuroleptics, hypnotics, other anxiolytics, tricyclic antidepressants, sedatives and anticonvulsants, muscle relaxants, antihypertensive drugs, narcotic analgesics, anesthetics, antihistamines with sedatives and alcohol enhance the effect of bromazepam.
Inhibitors of microsomal enzymes, carbamazepine, H2-gistaminoblokatory increase the half-life of the drug.
Bromazepam reduces the therapeutic effect of levodopa and increases the toxicity of zidovudine when used together.
Special instructions:Do not prescribe a drug for depression alone (increases the probability suicide). Side effects are more common in older people and children.
It is recommended to reduce the dose gradually, since the risk of withdrawal syndrome is higher when the drug is abruptly withdrawn.
When taking bromazepam, there may be physical and mental dependence.
Benzodiazepines can cause anterograde amnesia, and the risk increases with the dose.
Long-term therapy requires the control of hepatic enzymes.
Do not use the tool when driving transport and other activities that require increased concentration of attention.
During the period of treatment, the use of alcoholic beverages is prohibited.