Lendormin (Brotizolam)

Brotizolam is a benzodiazepine that acts on the central nervous system to facilitate sleep.

• Sleep onset insomnia: reduces the time required to fall asleep.
• Sleep maintenance insomnia: decreases the number of nocturnal awakenings.
• Transient insomnia: provides short‑term relief of occasional sleep difficulty.

• Brotizolam binds to the benzodiazepine site on the GABA‑A receptor complex, acting as a positive allosteric modulator. This enhances the inhibitory effect of gamma‑aminobutyric acid (GABA) on neuronal firing, leading to increased neuronal hyperpolarisation and a calming, sedative effect that facilitates sleep.

Brotizolam may cause a range of adverse reactions.

Common Side Effects

• Drowsiness: feeling unusually sleepy during the day.
• Dizziness: sensation of light‑headedness or unsteadiness.
• Fatigue: persistent lack of energy.
• Headache: mild to moderate cranial pain.
• Dry mouth: reduced salivation causing throat discomfort.
• Amnesia: difficulty recalling events after taking the medication.

Serious or Rare Side Effects

• Respiratory depression: slowed or shallow breathing, especially with other depressants.
• Dependence or withdrawal syndrome: difficulty stopping the drug after prolonged use.
• Paradoxical reactions: agitation, aggression, or increased anxiety.
• Severe skin reactions: rash, Stevens‑Johnson syndrome.
• Suicidal thoughts: emergence of depressive or self‑harm ideation.

Brotizolam requires careful use to minimise risks.

• Avoid use in severe respiratory insufficiency: risk of further breathing compromise.
• Caution in elderly patients: increased fall and fracture risk due to sedation.
• Do not combine with alcohol or other CNS depressants: additive sedation may occur.
• Limit duration of therapy: recommended for short‑term use to reduce dependence.
• Pregnancy and lactation: consult a healthcare professional before use.
• Store at ambient temperature: keep in the original pack, protect from moisture.

Brotizolam can interact with several drug classes, altering its safety profile.

Major Interactions (Avoid)

• Other CNS depressants (e.g., opioids, barbiturates): may cause profound sedation or respiratory depression.
• Alcohol: additive central nervous system depression.
• Potent CYP3A4 inhibitors (e.g., ketoconazole): can increase brotizolam plasma concentrations.

Moderate Interactions (Monitor Closely)

• Moderate CYP3A4 inhibitors (e.g., erythromycin): may modestly raise drug levels.
• CYP3A4 inducers (e.g., rifampicin): may reduce therapeutic effect.
• Certain antidepressants (e.g., SSRIs): can enhance sedative effects.