How long does bromazepam take to work?

Bromazepam, also known as Lectopam, is a benzodiazepine, typically used in the treatment of anxiety disorders. It is important to use this medication exactly as prescribed and to consult with your doctor prior to taking any other medications (prescribed or over the counter) while taking bromazepam, as adverse effects can occur.

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Bromazepam brand names

Bromazepam is not produced under a brand name in the US but is known as Lectopam in Canada and Lexotan in Australia [1].

What is bromazepam prescribed for?

Bromazepam is a benzodiazepine medication which is typically used as an anxiolytic. Bromazepam is not approved by the US Food and Drug Administration (FDA) for any specific uses but can be prescribed off-label by a medical professional when it is deemed necessary [3].

Bromazepam is not FDA-approved as there is a lack of research and evidence into its safety and effectiveness, whereas many other benzodiazepines have been thoroughly researched and approved for use [3][4]. However, it is approved for medicinal use in other countries, such as Canada, where it is prescribed for severe anxiety [1].

As with other benzodiazepines, bromazepam can be used in the treatment of anxiety disorders, due to its sedative effects [4]. However, benzodiazepines are usually only used as a short-term treatment, due to their potential for physical dependence and addiction [5].

How does bromazepam work?

Bromazepam works by affecting a neurotransmitter in the brain called gamma-aminobutyric acid (GABA), enhancing its effects. This slows or reduces certain brain activity, thereby resulting in a calming effect, helping to reduce the symptoms of anxiety [6][7].

How is bromazepam usually taken?

Bromazepam is available as a tablet, in 3mg and 6mg strengths, which must be swallowed whole, without crushing.

For the treatment of anxiety, your doctor will likely prescribe between 6-18mg per day, which will be split into 2-4 doses to be taken at set times throughout the day [1]. This dose can be increased, if necessary, up to a maximum daily dose of 60mg [2], although typically this is not required as lower doses have been found to be effective, while the risk of dependency increases the more you take [8][9].

Your prescription will depend on the severity of your mental health condition, your age and weight, your response to the medication, and any physical health conditions you have, as these can all impact the effectiveness of the medication and the risk of side effects [1].

It is important that you take your medication exactly as prescribed by your doctor, as taking too much, intentionally missing doses, or suddenly starting or stopping this medication can cause adverse effects.

If you forget to take your medication, you can take it as soon as you remember, or if it is close to the next dosage time, skip that dose and just take the next. Never take double your prescribed dose of bromazepam.

Bromazepam can cause withdrawal symptoms when stopped, as physical and emotional dependence can occur [1]. The risk of this is increased with longer-term use, so it is advised that bromazepam is used short-term, for a few weeks or months [5]. Your doctor will then slowly reduce your prescription, to prevent withdrawal symptoms.

How long does bromazepam stay in your system?

You will feel the effects of bromazepam within a few hours of your first dose and these effects can continue for up to 12 hours [2].

Bromazepam will be entirely out of your system within 2-3 days.

Withdrawal symptoms can last several months after stopping the medication if a physical dependency has occurred. You may be more likely to experience withdrawal symptoms if you have taken large doses for prolonged periods, or if the medication is misused or abused [5][10].

Bromazepam side effects

When you start taking a new medication, you may experience some common side effects. These will likely reduce within a couple of weeks, but if they continue or become problematic, consult with your doctor, as you may need a reduced dose or a change of medication.

Common side effects of bromazepam include [1][2]:

• Feeling drowsy and sleepy
• Feeling dizzy or unsteady
• Stomach upset, including nausea, vomiting, diarrhea, or constipation
• Headache
• Muscle weakness
• Dry mouth
• Difficulty concentrating

Serious side effects of bromazepam are less common but may still occur. You should contact your doctor immediately if you experience any of the following:

• Tremors or shaking
• Memory loss
• Seizures
• Yellowing of the skin or eyes
• Allergic reactions, such as rash, hives, swelling in or around the mouth, or breathing difficulties
• Unexplained bleeding or bruising
• Insomnia
• Changes in mental state, including agitation, aggression, depression, hallucinations, or delusions

Bromazepam precautions

It is important that your doctor is aware of any past or present mental health conditions you have experienced, to enable safe monitoring of your condition while on this medication, or to decide if it is safe for you. Your doctor should recommend that you meet with a therapist while taking this medication due to fact that the conditions it’s prescribed for are best treated mental health counseling.

It is important to tell your doctor if you have ever had a substance or alcohol addiction, as this medication can be addictive, so may not be suitable for you [1].

Discuss with your doctor all your past and present physical health conditions, as they may impact your ability to take this medication safely.

Because of the potential side effects of bromazepam, you should tell your doctor if you have ever experienced lung disease or breathing problems such as asthma or sleep apnea, liver or kidney problems, epilepsy, or glaucoma, as it may not be safe for you to take this medication [1][2].

Ensure you tell your doctor if you are pregnant or planning to become pregnant, as bromazepam can cause serious risks to your fetus and may cause withdrawal symptoms in newborns. As such, it is advised not to take bromazepam while pregnant, unless it is absolutely necessary for treatment and the benefits outweigh the potential risks.

Bromazepam can be excreted in breast milk, so it is advised not to take this medication if you are breastfeeding, as it can cause serious risks to your baby [1].

This medication causes drowsiness and sedation, so it is important to avoid driving until you are aware of how bromazepam affects you and it is safe to do so.

Tell your doctor about all medications you are currently taking, or plan to take (including vitamins and dietary supplements), as they may cause adverse reactions.

Bromazepam interactions

Certain medications and substances may interact with bromazepam and increase the risk of side effects, including some antifungals, antibiotics, and heart medications [2].

Bromazepam causes a sedative effect, so it should not be used with any opioid medications, as there is an increased risk of severe breathing problems that may lead to coma or death [1].

Similarly, the use of bromazepam alongside other medications such as sedatives, tranquilizers, antihistamines, and anticonvulsants should be carefully monitored, as they may also increase the risk of breathing problems or oversedation [2].

Alcohol and illicit substances can increase the sedating effects of bromazepam, and may also increase the risk of heart, liver, or kidney problems, so it is strongly recommended to avoid these substances while taking this medication [1][7].

Always discuss your medications with your doctor before starting a new treatment.

Bromazepam storage

Always keep all medications out of reach of children.

Store bromazepam in its original packaging, in airtight containers, and at room temperature (68-77°F).

If you need to dispose of medication that is out of date or no longer needed, contact a medical professional to ensure it is disposed of appropriately. Never flush medications down the toilet or put them in the trash, as this can create unnecessary risks.

What to do if you overdose on bromazepam

If you overdose on bromazepam, call a medical professional or Poison Control on 1-800-222-1222, or in case of an emergency, call 911. Symptoms of a bromazepam overdose may include fatigue, muscle weakness, confusion, slowed heart rate, breathing difficulties, coma, or even death.

Frequently asked questions about bromazepam

Is bromazepam addictive?

Bromazepam is considered an addictive substance. Depending on the dosage and length of treatment, bromazepam can cause physical and emotional dependency, which can then lead to withdrawal symptoms when the medication is reduced or stopped [3][10].

Withdrawal symptoms may include changes in mood, trouble sleeping, headaches, muscle pain and stiffness, restlessness and agitation, confusion, delusions, and numbness in the hands and feet [1][5].

Sometimes people misuse bromazepam, continuing to take the medication after their prescription has been stopped, in order to prevent withdrawal symptoms. This can lead to ongoing and worsening dependence and addiction to the medication.

Similarly, if the medication has been used for some time, tolerance to bromazepam may increase, potentially resulting in the individual taking higher doses than are prescribed, in order to feel an effect. Again, this can increase the risk of dependence and addiction, as well as worsening withdrawal symptoms when the medication is stopped [5].

Because of this, bromazepam is usually only prescribed as a short-term treatment, which will be gradually reduced rather than stopped suddenly, to prevent withdrawal symptoms and the potential for addiction. As such, it is important to take it exactly as prescribed by your doctor [3][10].

Resources

1. Hoffmann-La Roche Limited. (Revised 2018). Lectopam Bromazepam Consumer Information. Roche Canada. Retrieved from https://www.rochecanada.com/PMs/Lectopam/Lectopam_PM_CIE.pdf
2. Roche Products PTY Limited. (Revised 2012). Lexotan (Bromazepam) Product Information. e-lactancia. Retrieved from https://e-lactancia.org/media/papers/Bromazepam-DS-2012.pdf
3. US Food & Drug Administration. (2020). FDA Requiring Boxed Warning Updated to Improve Safe Use of Benzodiazepine Drug Class. FDA. Retrieved from https://www.fda.gov/drugs/drug-safety-and-availability/fda-requiring-boxed-warning-updated-improve-safe-use-benzodiazepine-drug-class
4. Bounds. C.G. & Nelson, V.L. (2022). Benzodiazepines. In StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK470159/
5. Brett, J., & Murnion, B. (2015). Management of Benzodiazepine Misuse and Dependence. Australian Prescriber, 38(5), 152–155. Retrieved from https://doi.org/10.18773/austprescr.2015.055
6. National Center for Biotechnology Information (2023). PubChem Compound Summary for CID 2441, Bromazepam. Retrieved from https://pubchem.ncbi.nlm.nih.gov/compound/Bromazepam
7. Griffin, C.E., 3rd, Kaye, A.M., Bueno, F.R., & Kaye, A.D. (2013). Benzodiazepine Pharmacology and Central Nervous System-Mediated Effects. The Ochsner Journal, 13(2), 214–223. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3684331/
8. Kragh-Sørensen, P., Holm, P., Fynboe, C., Schaumburg, E., Andersen, B., Bech, P., & Pichard, J. (1990). Bromazepam in Generalized Anxiety. Randomized, Multi-Practice Comparisons with Both Chlorprothixene and Placebo. Psychopharmacology, 100(3), 383–386. Retrieved from https://doi.org/10.1007/BF02244611
9. Bornstein, S., Benoudich, H., Kaufman, E., Konqui, M., & Pigeon, P. (1982). Treatment of Anxiety with Bromazepam in Clinical Practice. La Nouvelle Presse Medicale, 11(22), 1731–1734. Retrieved from https://pubmed.ncbi.nlm.nih.gov/6124945/
10. Murphy, S.M., & Tyrer, P. (1991). A Double-Blind Comparison of the Effects of Gradual Withdrawal of Lorazepam, Diazepam and Bromazepam in Benzodiazepine Dependence. The British Journal of Psychiatry: The Journal of Mental Science, 158, 511–516. Retrieved from https://doi.org/10.1192/bjp.158.4.511

Medical Content

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Author

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Naomi Carr is a writer with a background in English Literature from Oxford Brookes University.

Published: Feb 20th 2023, Last edited: Sep 22nd 2023

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Content reviewed by a medical professional. Last reviewed: Feb 20th 2023

How does this medication work? What will it do for me?

Bromazepam belongs to the class of mediations known as benzodiazepines. It is used for the short-term relief of symptoms of excessive anxiety. It works to reduce anxiety by affecting certain substances in the brain called neurotransmitters.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

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What form(s) does this medication come in?

Bromazepam by ProDoc Limitee is no longer being manufactured for sale in Canada. For brands that may still be available, search under "bromazepam". This article is being kept available for reference purposes only. If you are using this medication, speak with your doctor or pharmacist for information about your treatment options.

How should I use this medication?

The recommended starting dose of bromazepam for adults ranges from 6 mg to 18 mg daily, in divided doses. Your doctor may have you gradually increase the dose, based on how well it works and the side effects you experience. For seniors, the maximum dose is a total of 3 mg daily, given in divided doses. To avoid excessive drowsiness or motor impairment, it is important to adjust the dose to a person's specific needs. In general, seniors are more sensitive to benzodiazepines and usually require lower doses.

The length of treatment should not exceed one week unless, after that period of time, your doctor recommends otherwise. Bromazepam is normally used for a short period of time. It may be habit-forming when taken for long periods of time. If you have been taking this medication regularly for a long time (i.e., longer than a month), do not stop taking bromazepam without first speaking to your doctor. When stopping this medication, the dose should be reduced gradually to avoid withdrawal effects.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important that this medication be taken exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store at room temperature in a dry place and keep it out of reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take bromazepam if you:

• are allergic to bromazepam or any ingredients of the medication
• are allergic to any other benzodiazepines
• have myasthenia gravis
• have narrow angle glaucoma
• have severe breathing difficulties
• have severe liver disease
• have sleep apnea

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• blurred vision
• clumsiness or unsteadiness
• constipation
• delayed reactions
• dizziness or lightheadedness
• drowsiness
• headache
• nausea
• rash
• slurred speech
• tremor

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• anxiety
• behaviour changes (e.g., aggressiveness, agitation, unusual excitement, nervousness, or irritability)
• confusion
• dizziness or lightheadedness when rising from a sitting or lying position
• falls
• fractures
• hallucinations (hearing or seeing things that aren't there)
• memory loss of recent events
• nightmares or trouble sleeping
• signs of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
• symptoms of withdrawal after stopping the medication (e.g., headache, seizures, extreme anxiety, sleep problems, restlessness, confusion, irritability)
• urinary problems (leakage, increased urgency to urinate)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• seizures
• signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
• thoughts of self harm or suicide

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are any nutrients depleted by this medication?

Some medications can affect vitamin and nutrient levels in the body. Below is a list of nutrient depletions associated with this medication. Talk to your doctor or pharmacist about whether taking a supplement is recommended or if you have any questions or concerns.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Alcohol and other medications that cause drowsiness: People taking this medication should not consume alcohol since doing so can reduce the effectiveness of this medication and increase the risk of side effects. Do not combine this medication with other medications that cause drowsiness (e.g., antidepressants, sleeping pills, anxiety medications) since additional drowsiness and potentially life-threatening decreases in breathing may occur.

People who have an addiction to alcohol or other drugs should not take bromazepam except in rare situations under medical supervision.

Breathing: Bromazepam can suppress breathing. This effect on breathing may be more pronounced for people with breathing problems, brain damage, or who are taking other medications that suppress breathing (e.g., codeine, morphine). If you have severe breathing problems, discuss the risks and benefits of taking this medication with your doctor.

Dependence and withdrawal: Physical dependence (a need to take regular doses to prevent physical symptoms) has been associated with benzodiazepines such as bromazepam. Severe withdrawal symptoms may be experienced (e.g., seizures) if the dose is significantly reduced or bromazepam is suddenly stopped. Withdrawal symptoms include irritability, nervousness, sleep problems, agitation, tremors, diarrhea, abdominal cramps, vomiting, memory impairment, headache, muscle pain, extreme anxiety, tension, restlessness, and confusion. Reducing the dose gradually under medical supervision can help prevent or decrease these withdrawal symptoms.

Depression: Bromazepam, like other benzodiazepines, has been known to cause mood swings and symptoms of depression. If you have depression or a history of depression, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. If you experience symptoms of depression such as poor concentration, changes in weight, changes in sleep, decreased interest in activities, or notice them in a family member who is taking this medication, contact your doctor as soon as possible.

Bromazepam is not recommended for use by people with depression or psychosis or who have attempted suicide.

Drowsiness/reduced alertness: Bromazepam causes drowsiness and sedation. Avoid activities requiring mental alertness, judgment, or physical coordination (such as driving or operating machinery) while taking it. This is particularly true when first taking the medication and until you have established how bromazepam affects you. Alcohol may increase the drowsiness effects and should be avoided.

Falls and fractures: Bromazepam can cause dizziness, lightheadedness, and decreased coordination. People taking bromazepam may be at increased risk of falls resulting in bone fractures. This is more likely to happen to seniors or people who are also taking other medications that cause drowsiness, including alcohol.

Lactose intolerance: Lactose is one of the ingredients in this medication. If you have a hereditary condition that makes you intolerant to lactose, discuss other alternatives with your doctor.

Liver function: Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication may pass into breast milk. If you are breast-feeding and are taking bromazepam, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: Bromazepam is not recommended for use by children or adolescents under 18 years of age.

Seniors: Seniors may be at increased risk of experiencing the drowsiness and impaired coordination effects of bromazepam. They should be particularly careful, for example, to avoid falling when getting up during the night.

What other drugs could interact with this medication?

There may be an interaction between bromazepam and any of the following:

• alcohol
• antihistamines (e.g., azelastine, cetirizine, doxylamine, diphenhydramine, hydroxyzine, loratadine)
• antipsychotics (e.g., aripiprazole, chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
• "azole" antifungals (e.g., itraconazole, ketoconazole, voriconazole)
• barbiturates (e.g., butalbital, phenobarbital)
• benzodiazepines (e.g., alprazolam, diazepam, lorazepam)
• brimonidine
• buprenorphine
• buspirone
• cannabis
• chloral hydrate
• cimetidine
• clonidine
• deferasirox
• diphenoxylate
• efavirenz
• entacapone
• esketamine
• flibanserin
• general anesthetics (medications used to put people to sleep before surgery)
• kava kava
• ketamine
• lemborexant
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• melatonin
• methadone
• metoclopramide
• mexiletine
• mirtazapine
• muscle relaxants (e.g., baclofen, cyclobenzaprine, methocarbamol, orphenadrine)
• nabilone
• narcotic pain relievers (e.g., codeine, fentanyl, morphine, oxycodone)

• pomalidomide
• ropinirole
• quinolone antibiotics (e.g., ciprofloxacin, norfloxacin, ofloxacin)
• scopolamine
• seizure medications (e.g., carbamazepine, clobazam, levetiracetam, phenobarbital, phenytoin, primidone, topiramate, valproic acid, zonisamide)
• selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, fluoxetine, paroxetine, sertraline)
• St. John's wort
• suvorexant
• thalidomide
• theophylline (e.g., aminophylline, oxtriphylline, theophylline)
• trazodone
• tricyclic antidepressants (e.g., amitriptyline, clomipramine, desipramine, trimipramine)
• valerian
• vemurafenib
• zolpidem
• zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

All material copyright MediResource Inc. 1996 – 2024. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Bromazepam

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