Anxirel
Generic Name
Bromazepam
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
Loading images...
Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| anxirel 3 mg tablet | ৳ 4.01 | N/A |
Description
Overview of the medicine
Anxirel 3 mg tablet contains Bromazepam, a benzodiazepine derivative with anxiolytic, sedative, hypnotic, and muscle relaxant properties. It is used for the short-term treatment of severe anxiety and tension, panic disorders, and insomnia associated with anxiety.
Uses & Indications
Dosage
Adults
Usual initial dose is 1.5 mg three times daily, which can be increased to 3-6 mg three times daily in severe cases. Maximum 18-30 mg/day.
Elderly
Lower doses recommended, e.g., 1.5 mg once or twice daily, gradually adjusted as needed.
Renal_impairment
Use with caution; dose reduction may be necessary depending on the degree of impairment.
How to Take
Oral administration. Tablets can be taken with or without food. Swallow whole with water. Do not crush or chew.
Mechanism of Action
Bromazepam acts by enhancing the activity of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter in the brain. This leads to hyperpolarization of neuronal membranes, decreasing neuronal excitability and producing anxiolytic, sedative, and muscle relaxant effects.
Pharmacokinetics
Onset
30-60 minutes (anxiolytic effect)
Excretion
Excreted mainly by the kidneys as conjugated and unconjugated metabolites.
Half life
10-20 hours
Absorption
Rapidly absorbed after oral administration. Peak plasma concentrations reached within 1-4 hours.
Metabolism
Primarily metabolized in the liver via cytochrome P450 enzymes (CYP3A4) to inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to Bromazepam or other benzodiazepines
- Acute narrow-angle glaucoma
- Myasthenia gravis
- Severe respiratory insufficiency
- Severe hepatic insufficiency
- Sleep apnea syndrome
Drug Interactions
Alcohol
Enhanced sedative effects, increased risk of central nervous system depression.
Opioids
Increased risk of profound sedation, respiratory depression, coma, and death.
CYP3A4 inducers (e.g., rifampicin, carbamazepine)
May decrease bromazepam plasma concentrations and effects.
CYP3A4 inhibitors (e.g., ketoconazole, erythromycin, cimetidine)
May increase bromazepam plasma concentrations and effects.
Other CNS depressants (e.g., antidepressants, antipsychotics, antihistamines)
Additive central nervous system depressant effects.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach and sight of children.
Overdose
Symptoms of overdose include somnolence, confusion, diminished reflexes, ataxia, dysarthria, and in severe cases, coma, hypotension, and respiratory depression. Management is primarily supportive: induce vomiting or perform gastric lavage if recent ingestion, administer activated charcoal. Flumazenil may be used as an antidote, but with caution due to seizure risk, especially in long-term benzodiazepine users.
Pregnancy & Lactation
Pregnancy Category D. Bromazepam should not be used during pregnancy, especially during the first and third trimesters, due to potential risks to the fetus (e.g., congenital malformations, neonatal withdrawal symptoms). It is excreted in breast milk and should not be used during lactation.
Side Effects
Contraindications
- Hypersensitivity to Bromazepam or other benzodiazepines
- Acute narrow-angle glaucoma
- Myasthenia gravis
- Severe respiratory insufficiency
- Severe hepatic insufficiency
- Sleep apnea syndrome
Drug Interactions
Alcohol
Enhanced sedative effects, increased risk of central nervous system depression.
Opioids
Increased risk of profound sedation, respiratory depression, coma, and death.
CYP3A4 inducers (e.g., rifampicin, carbamazepine)
May decrease bromazepam plasma concentrations and effects.
CYP3A4 inhibitors (e.g., ketoconazole, erythromycin, cimetidine)
May increase bromazepam plasma concentrations and effects.
Other CNS depressants (e.g., antidepressants, antipsychotics, antihistamines)
Additive central nervous system depressant effects.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach and sight of children.
Overdose
Symptoms of overdose include somnolence, confusion, diminished reflexes, ataxia, dysarthria, and in severe cases, coma, hypotension, and respiratory depression. Management is primarily supportive: induce vomiting or perform gastric lavage if recent ingestion, administer activated charcoal. Flumazenil may be used as an antidote, but with caution due to seizure risk, especially in long-term benzodiazepine users.
Pregnancy & Lactation
Pregnancy Category D. Bromazepam should not be used during pregnancy, especially during the first and third trimesters, due to potential risks to the fetus (e.g., congenital malformations, neonatal withdrawal symptoms). It is excreted in breast milk and should not be used during lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date.
Availability
Pharmacies
Approval Status
Approved
Patent Status
Expired
Clinical Trials
Bromazepam has been extensively studied for its anxiolytic and sedative properties. Clinical trials have established its efficacy for the short-term management of anxiety disorders and related conditions.
Lab Monitoring
- Liver function tests (especially with prolonged use or in patients with hepatic impairment)
- Renal function tests (in patients with renal impairment)
Doctor Notes
- Prescribe for the shortest effective duration to minimize the risk of dependence and withdrawal.
- Counsel patients on the risks of concomitant use with opioids and alcohol.
- Emphasize the importance of gradual dose reduction when discontinuing treatment.
Patient Guidelines
- Do not stop taking this medicine abruptly to avoid withdrawal symptoms. Your doctor will gradually reduce the dose.
- Avoid alcohol and other CNS depressants during treatment.
- Inform your doctor about all other medications you are taking, including over-the-counter drugs and herbal supplements.
- Use for the shortest possible duration as recommended by your doctor to minimize the risk of dependence.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to compensate for a missed one.
Driving Precautions
Anxirel may cause drowsiness, dizziness, or impaired concentration, which can affect your ability to drive or operate machinery. Avoid such activities until you know how this medicine affects you.
Lifestyle Advice
- Practice relaxation techniques such as deep breathing or meditation.
- Maintain a regular sleep schedule to improve sleep quality.
- Avoid excessive caffeine and nicotine, as they can worsen anxiety.
Alternative Medicines in Bangladesh
Similar medicines available in the market
Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.