lormetazepam: clinical use

Prescribing considerations

• Confirm that insomnia is severe and assess for an underlying physical, psychiatric or sleep disorder.
• Discuss dependence, addiction, tolerance and withdrawal before treatment and agree an individual stopping strategy.
• Review concurrent prescribed, over-the-counter and online medicines, alcohol and substance use.
• Use particular caution in older or debilitated people because sedation, hypotension, ataxia and muscle weakness increase fall risk.
• Do not use as sole treatment for depression-associated insomnia; assess depression and suicide risk.
• Avoid abrupt discontinuation after regular use.

Contraindications and cautions

• Severe respiratory insufficiency
• Sleep apnoea syndrome
• Myasthenia gravis
• Severe hepatic failure
• Hypersensitivity to lormetazepam, other benzodiazepines or product components

Monitoring

• Sedation, cognition, coordination, falls and ability to drive or operate machinery
• Respiratory status, especially with opioids, other central nervous system depressants or chronic respiratory disease
• Emerging tolerance, misuse, addiction, dependence or withdrawal symptoms
• Paradoxical reactions, mood deterioration and suicidal thinking
• Clinical response and ongoing need; monitor more closely in renal or hepatic impairment

Clinical pharmacology

Lormetazepam is a benzodiazepine positive allosteric modulator at GABA-A receptors with hypnotic, sedative, anxiolytic and muscle-relaxant properties. It is rapidly absorbed and conjugated to a pharmacologically inactive glucuronide, with no major active metabolites and a terminal half-life of about 11 hours.

Formulation and product differences

• The selected product is a round, white tablet marked “GP036” on one side.
• It contains lactose, maize starch, polyvinylpyrrolidone and magnesium stearate.

Tablet

Route: Oral

Strengths: 0.5 mg, 1 mg