Lormetazepam: Effect and Application

How does lormetazepam work?

Lormetazepam calms, relieves anxiety, and makes it easier to fall asleep and stay asleep through the night. It can also stop seizures (anticonvulsant) and relax muscles (muscle relaxant).

To this end, lormetazepam binds to the docking sites of the endogenous messenger GABA (gamma-aminobutyric acid receptors) and enhances its inhibitory effect on nerve cells. The depressant effect triggers numerous effects depending on which nerve cells of the brain are inhibited.

The active ingredient is one of the so-called medium-duration benzodiazepines. After about ten hours, half of the active ingredient has left the body again. Lormetazepam is therefore suitable for treating both sleep onset and sleep maintenance disorders.

How to use lormetazepam correctly?

If possible, it is best to sleep seven to eight hours so that you are not noticeably tired and unfocused afterwards (hang-over effect). Also, do not take the tablet on a full stomach immediately after eating, as this will delay the onset of the effect.

Before or during surgery or other procedures, doctors can also administer lormetazepam directly through the vein. For this purpose, the active ingredient is available as an injection solution in ampoules.

Lormetazepam dosage

as a solution for injection via the vein containing 0.4 to one milligram of active ingredient (0.1 to 0.8 milligram for children aged two to ten years, older children as adults)

If needed, doctors also give this dose on the day of the procedure up to an hour before. If doctors want to induce anesthesia sleep with lormetazepam, they give up to two milligrams through the vein.

Lormetazepam is approved in children for use before surgery or exams alone.

Duration of use

It is important to gradually reduce the dose after taking the drug several times if you want to stop taking it (“tapering”). If the therapy is stopped abruptly, so-called rebound phenomena can occur: The symptoms experienced before taking lormetazepam intensify and manifest as sleep disturbances, restlessness, or anxiety.

What are the side effects of lormetazepam ?

In individual cases, lormetazepam causes so-called ataxia, which manifests itself in coordination and balance disorders. Due to the muscle-relaxing and depressant effect, older patients in particular are at risk of falling more easily. With regular use, the symptoms usually subside.

Slurred or slow speech or eye tremors (nystagmus) are also possible. After you stop taking lormetazepam, these side effects usually resolve completely.

Common gastrointestinal side effects include vomiting and nausea, abdominal pain, or dry mouth.

Sometimes a pre-existing depression becomes particularly apparent under lormetazepam. Previously, anxiety has overridden the illness. The anxiety-relieving lormetazepam can then also become dangerous: The risk of suicidal thoughts increases. In depressive disorders, doctors therefore administer lormetazepam only in combination with antidepressant therapy.

You can read about other side effects in the package leaflet of your lormetazepam medication. If you suspect you are suffering from any unwanted symptoms, contact your doctor or pharmacist.

When is lormetazepam used?

Doctors use lormetazepam to.

Treat insomnia and sleep disturbances for short periods of time.
calm down especially anxious and nervous patients before surgical procedures or examinations (so-called premedication).
after operations (postoperative).

Accordingly, lormetazepam belongs to the sleeping pills (hypnotics) and to the sedatives (tranquilizers).

When should lormetazepam not be used?

Medicines containing lormetazepam should not be taken in:

hypersensitivity to the active substance, other benzodiazepines, or other ingredients of the drug
severe lung weakness (respiratory insufficiency), such as in severe COPD.
sleep apnea syndrome (pauses in breathing during sleep)
acute intoxication with alcohol, other sleeping pills, painkillers or psychotropic drugs (neuroleptics, antidepressants, lithium)
current or past alcohol, medication or drug addiction
sleep disorders in children and adolescents under 18 years of age

What drug interactions may occur with lormetazepam?

Typically, affected individuals become increasingly sleepy, possibly confused, and have slower breathing. Heart rate and blood pressure drop.

Let your doctor explain to you how you and your caregivers can recognize the first signs and act correctly if necessary!

Antipsychotics such as haloperidol
tranquilizers (sedatives)
some medicines for depression (antidepressants)
medicines for treating epilepsy (antiepileptics)
medicines for allergies, called antihistamines, such as cetirizine or loratadine

Alcohol also has a depressant effect and enhances the effect of lormetazepam. Therefore, patients ideally do not drink alcohol during treatment.

Other interactions with lormetazepam are possible if patients are also taking cardiovascular medications such as cardiac glycosides or beta-blockers. Also estrogen-containing drugs (such as the “birth control pill”) may interact with lormetazepam.

Tell your doctor or pharmacist about all medicines and dietary supplements you are taking or have taken in the past few weeks. This includes herbal preparations and those you can buy over the counter.

Lormetazepam is not approved for the treatment of sleep disorders in patients under 18 years of age. Doctors usually only use the active ingredient to calm children and adolescents before operations or examinations.

Lormetazepam during pregnancy and lactation

Only a few studies are available on lormetazepam in pregnancy. Other agents from the benzodiazepine group have been better studied.

If you are taking lormetazepam and are planning to become pregnant or may be pregnant, contact your doctor immediately. He or she will discuss further lormetazepam treatment with you.

For lormetazepam during breastfeeding, there is too little experience to rule out possible side effects for the child. According to experts, taking it once does not require a break from breastfeeding. Nevertheless, your doctor will most likely prescribe better-studied medications.

Lormetazepam tablets are available in Germany and Switzerland from pharmacies with a doctor’s prescription. In Austria, the tablets are (currently) not available.

In Austria, however, lormetazepam is available in “liquid form” as an injection solution – just as in Germany, but not in Switzerland. Pharmacies dispense the preparations directly to the practice or clinic, for which a doctor’s prescription is also required.

In Germany, an exception applies to patients who are addicted to alcohol or narcotics. In these cases, the lormetazepam drug must always be prescribed on a narcotic prescription.

Other important information about lormetazepam

If patients take lormetazepam regularly over several weeks, the body gets used to it and the sedative effect may decrease. It develops a tolerance. Patients then require higher doses to achieve the full effect.

Lormetazepam is physically and psychologically addictive after prolonged use. Therefore, take the drug for as short a time as possible, in low doses, and only in consultation with your doctor.

Withdrawal symptoms may occur when switching from long-acting benzodiazepines (such as nitrazepam) to lormetazepam.

Overdose

A mild overdose typically makes people dizzy and tired. Affected individuals have coordination and balance problems, slowed and slurred speech, or poor vision, among other symptoms.

In a more severe overdose, patients are hard to wake up and blood pressure drops. In severe cases, sufferers become unconscious and no longer breathe adequately.

The active ingredient flumazenil can also neutralize the effect of lormetazepam. Flumazenil binds where lormetazepam would also dock, thus displacing it from its target. However, the treatment also carries risks such as seizures and is therefore only used in severe overdoses.