Adult: 0.5-1.5 mg once daily at bedtime. Dosage is individualised and may be increased depending on patient response and tolerability. Max treatment duration: 4 weeks (including dose tapering). Elderly: 0.5 mg once daily at bedtime.
Dose reduction may be necessary.
Mild to moderate: Dose reduction may be necessary. Severe: Contraindicated.
May be taken with or without food.
Severe respiratory insufficiency, sleep apnoea, myasthenia gravis. As single agent for the treatment of insomnia associated with depression. Severe hepatic impairment. Pregnancy and lactation.
Patient with depression, mild to moderate chronic respiratory insufficiency, CV or cerebrovascular disease, personality disorders, narrow angle glaucoma, history of alcohol or drug abuse. Not indicated for the primary treatment of depressive disorders or psychotic illness. Avoid abrupt withdrawal. Mild to moderate hepatic impairment and renal impairment. Elderly, debilitated, and patients at risk of falls. Concomitant use with opioids.
Significant: Blood dyscrasias, respiratory depression, CNS depression, anterograde amnesia, sleep related activities (e.g. sleep-driving), paradoxical reactions (e.g. restlessness, agitation, irritability, aggressive behaviour, rage, delusion, hallucinations, nightmares, psychoses), encephalopathy, elevated liver enzymes, suicidal ideation, physical and psychological dependence. Rarely, hypotension. General disorders and administration site conditions: Asthenia, fatigue. Musculoskeletal and connective tissue disorders: Muscle weakness. Nervous system disorders: Daytime drowsiness, sedation, dizziness, ataxia.
Patient Counseling Information
This drug may cause sedation, amnesia, dizziness, and impaired cognitive or muscular function, if affected, do not drive or operate machinery.
Monitor CBC, LFT, renal function, and respiratory status.
Symptoms: Mild cases: Drowsiness, mental confusion, lethargy; serious cases especially when other CNS depressant drugs or alcohol is ingested: ataxia, hypotension, hypotonia, respiratory depression, coma. Very rarely, death. Management: Supportive and symptomatic treatment. Induce vomiting or perform gastric lavage if ingestion is recent. Activated charcoal may be given if gastric emptying is not advantageous. Control hypotension with noradrenaline. Administer flumazenil as antidote.
Increased risk of profound sedation, respiratory depression, coma, and death with opioids. Enhanced CNS depressant effect with barbiturates, antipsychotics, antidepressants, antihistamines, anticonvulsants, anaesthetics, other sedative/hypnotics, and anxiolytics. Increased activity with CYP450 inhibitors. Decreased sedative activity with theophylline or aminophylline. Increased hypotensive effect with antihypertensive agents.
May potentiate the CNS depressant effect of alcohol.
Description: Lormetazepam is a short acting benzodiazepine with anxiolytic, muscle relaxant, sedative and hypnotic effects. It has minimal effects on REM sleep and next-day psychomotor performance. Pharmacokinetics: Absorption: Rapidly and completely absorbed from the gastrointestinal tract. Bioavailability: Approx 80%. Time to peak plasma concentration: Approx 2 hours. Distribution: Enters breastmilk (small amounts). Plasma protein binding: 88%. Metabolism: Metabolised in the liver to an inactive glucuronide. Excretion: Via urine (86% ±14.9%) and faeces (<3%) as conjugate. Elimination half-life: 11 hours.