Lexotan (Bromazepam)

• Bromazepam acts on the central nervous system to alleviate anxiety-related conditions.
• Generalized anxiety disorder: reduces excessive worry and tension during short‑term treatment.
• Panic disorder: helps diminish the frequency and intensity of panic attacks when used briefly.
• Situational anxiety (e.g., before medical procedures): provides rapid calming effect to facilitate cooperation.
• Anxiety associated with depression: eases nervousness and tension when used as an adjunct to antidepressants.
• Pre‑operative anxiety: lowers nervousness before surgery to improve patient comfort.
• Anxiety‑related insomnia: facilitates sleep onset in patients with transient anxiety‑induced sleeplessness.

• Bromazepam binds to a specific site on the gamma‑aminobutyric acid type A (GABA‑A) receptor complex, acting as a positive allosteric modulator. By enhancing the affinity of GABA for its receptor, it increases chloride ion influx, hyperpolarising neuronal membranes and producing a net inhibitory effect on central nervous system activity, which manifests as anxiolysis, sedation and muscle relaxation. The resultant decrease in neuronal excitability underlies its therapeutic action in anxiety disorders.

Bromazepam may cause a range of adverse reactions, varying from mild to severe.

Common Side Effects

• Drowsiness
• Fatigue
• Dizziness
• Impaired coordination
• Headache

Serious or Rare Side Effects

• Dependence and withdrawal syndrome
• Respiratory depression, especially with other depressants
• Severe allergic reactions (e.g., rash, swelling, anaphylaxis)
• Paradoxical agitation or aggression

When prescribing bromazepam, clinicians should observe several precautionary measures to minimise risk.

• Dose adjustment in elderly: start with a lower dose and monitor for excessive sedation.
• Renal or hepatic impairment: consider dose reduction and assess liver function regularly.
• Concomitant CNS depressants: avoid or limit use to reduce additive sedation.
• History of substance abuse: evaluate risk of dependence before initiating therapy.
• Pregnancy and lactation: use only if potential benefit outweighs risk; discuss with obstetrician.
• Store at ambient temperature: keep below 25 °C in the original packaging, protected from moisture and light.

Bromazepam can interact with several medicines, altering its efficacy or safety profile.

Major Interactions (Avoid)

• Alcohol: may cause profound sedation and respiratory depression.
• Opioids (e.g., morphine, oxycodone): risk of additive CNS depression and life‑threatening respiratory depression.
• Other benzodiazepines or hypnotics: can lead to excessive sedation and impaired psychomotor function.
• Strong CYP3A4 inhibitors (e.g., ketoconazole, erythromycin): increase bromazepam plasma concentrations, raising toxicity risk.
• Central nervous system depressants (e.g., antihistamines, antipsychotics): enhance sedative effects.

Moderate Interactions (Monitor Closely)

• CYP3A4 inducers (e.g., rifampicin, carbamazepine): may reduce bromazepam levels and efficacy.
• Selective serotonin reuptake inhibitors (e.g., fluoxetine, sertraline): can increase sedation.
• Antihistamines (e.g., diphenhydramine): may augment drowsiness.