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.

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 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

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.

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.

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

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.