Lexotan

Leaflet accompanying the packaging: patient information

Lexotan, 3 mg, tablets

Lexotan, 6 mg, tablets

Bromazepam

It is necessary to carefully read the contents of the leaflet before using the medicine, as it contains important information for the patient.

• This leaflet should be kept, so that it can be re-read if necessary.
• In case of any doubts, the doctor or pharmacist should be consulted.
• This medicine has been prescribed to a specific person. It should not be given to others. The medicine may harm another person, even if the symptoms of their illness are the same.
• If the patient experiences any side effects, including any side effects not listed in this leaflet, they should inform their doctor or pharmacist. See section 4.

Table of contents of the leaflet

• 1. What is Lexotan and what is it used for
• 2. Important information before using Lexotan
• 3. How to use Lexotan
• 4. Possible side effects
• 5. How to store Lexotan
• 6. Contents of the packaging and other information

1. What is Lexotan and what is it used for

Lexotan contains bromazepam, which is an anxiolytic medicine belonging to the group of benzodiazepines.
Lexotan is indicated for the treatment of anxiety disorders, including generalized anxiety disorders, autonomic dysfunction, and anxiety states associated with chronic organic brain diseases.

• generalized anxiety disorders
• autonomic dysfunction, including somatic symptoms such as skin symptoms, gastrointestinal symptoms, cardiovascular symptoms, and genitourinary symptoms
• anxiety states associated with chronic organic brain diseases
• post-traumatic stress disorders with anxiety symptoms
• adjustment disorders

2. Important information before using Lexotan

When not to use Lexotan

• if the patient is allergic to benzodiazepines or any other component of this medicine (listed in section 6)
• if the patient has severe respiratory failure
• if the patient has severe liver failure (benzodiazepines are not recommended for patients with severe liver failure due to the risk of brain damage)
• if the patient has myasthenia gravis
• if the patient has sleep apnea syndrome

Warnings and precautions

The patient should be under the doctor's supervision throughout the treatment period - at the beginning of treatment to determine the minimum effective dose and the frequency of administration, and during treatment to prevent overdose.
Amnesia
Benzodiazepines can cause anterograde amnesia. This condition occurs most often a few hours after taking the medicine. To reduce the risk of anterograde amnesia, the patient should have uninterrupted sleep for several hours. The effect of anterograde amnesia may be associated with abnormal behavior.
Psychological reactions
When using benzodiazepines, reactions such as anxiety, agitation, irritability, aggression, fear, delusions about the external environment or one's own condition, outbursts of anger, nightmares, hallucinations, psychosis, abnormal behavior, and other undesirable behaviors may occur. If such symptoms occur, the doctor should be contacted immediately.
These symptoms may occur with greater probability in children and the elderly.
Duration of treatment
The duration of treatment is limited (not exceeding 8-12 weeks), and the dose of the medicine should be gradually reduced under the doctor's supervision. During the withdrawal of the medicine, a rebound phenomenon may occur (see section 3, "Discontinuation of Lexotan").
Consumption of alcohol or use of medicines that depress the activity of the central nervous system
During the use of Lexotan, the patient should not drink alcohol or take medicines that depress the activity of the central nervous system.
Alcohol may enhance the effect of Lexotan and cause severe sedation symptoms, as well as respiratory or circulatory depression, which may lead to coma or death.
Tolerance
In the case of repeated use of Lexotan for a longer period, the effectiveness of the medicine may decrease.
During treatment with benzodiazepines, if the used medicine is replaced with a benzodiazepine with a significantly shorter half-life, withdrawal symptoms may develop.
Benzodiazepines should not be used as the only medicine in the treatment of depression or anxiety states associated with depression (in the case of these diseases, there may be a greater tendency to commit suicide).
Benzodiazepines should not be used as the first-line treatment for psychotic disorders.
During the use of the medicine, due to its muscle relaxant effect, there is a risk of falls and fractures, especially in older patients, when getting up at night.
History of alcohol, medicine, or drug abuse
The medicine should be used with particular caution, strictly according to the doctor's recommendations.
Dependence on the medicine
Taking medicines from the benzodiazepine group, including Lexotan, or similarly acting medicines, may lead to the development of physical and psychological dependence on these medicines. The risk of dependence increases with the dose and duration of treatment. The increased risk also applies to patients who have abused alcohol, medicines, or drugs, and patients with personality disorders.
Warnings for specific patient groups
Patients with chronic respiratory failure should be monitored closely due to the risk of respiratory depression.
Patients with mild or moderate liver failure should be treated with caution.
Benzodiazepines should not be given to children without careful evaluation of the justification for their use; the duration of treatment should be as short as possible, and the dose should be individualized for each patient.
Older patients should be given the medicine in a reduced dose.

Pregnancy and breastfeeding

Before using any medicine, the patient should consult a doctor or pharmacist.
Pregnancy
The safety of using bromazepam in pregnant women has not been established. Although there are no clinical data on the occurrence of significant congenital malformations in the fetus due to the use of benzodiazepines in the first trimester of pregnancy, some epidemiological studies have shown an increased risk of cleft palate.
Therefore, bromazepam should not be used during pregnancy, unless in exceptional cases and with strict adherence to the dosage regimen.
The patient should contact the doctor regarding the discontinuation of treatment if they plan to become pregnant or suspect that they are pregnant.
The use of bromazepam in the third trimester of pregnancy and during childbirth is allowed only in exceptional cases, as it can be expected to cause adverse reactions in newborns, such as hypothermia, decreased muscle tone, which may manifest as problems with sucking (leading to poor weight gain), and moderate respiratory depression or apnea. Additionally, withdrawal symptoms have been observed in newborns, expressed as excessive irritability, anxiety, and tremors.
In children of mothers who have taken benzodiazepines for a long time in the last period of pregnancy, physical dependence on the medicine and the risk of withdrawal symptoms after birth may occur.
Breastfeeding
Benzodiazepines pass into breast milk, so breastfeeding women should not use Lexotan.

Driving vehicles and operating machines

The patient should not drive vehicles or operate machines, as Lexotan may cause excessive sedation and amnesia, disrupt concentration and muscle function. In case of sleep deprivation, the likelihood of decreased alertness may increase. This effect may be enhanced, especially if the patient has consumed alcohol.

Lexotan and other medicines

The patient should tell the doctor about all medicines they are currently taking or have recently taken, as well as any medicines they plan to take.
Concomitant use of Lexotan with any medicines that depress the activity of the central nervous system (such as antidepressants, sedatives, narcotic analgesics, neuroleptics, anxiolytics, anticonvulsants, sedatives, antihistamines with a sedative effect, anesthetics) and alcohol may enhance the sedative effect of the medicine and increase its inhibitory effect on the respiratory and circulatory systems.
In the case of the use of narcotic analgesics, a state of euphoria may occur, leading to an increased risk of psychological dependence.
Substances that inhibit the activity of certain liver enzymes may affect benzodiazepines that are metabolized by these enzymes. Concomitant administration of Lexotan with cimetidine, fluvoxamine, or (probably) propranolol may cause its stronger or prolonged effect.
Lexotan contains lactose.If the patient has previously been diagnosed with intolerance to some sugars, they should consult their doctor before taking Lexotan.

3. How to use Lexotan

This medicine should always be used according to the doctor's recommendations. In case of doubts, the doctor should be consulted.
In each case, Lexotan should be used under the doctor's supervision.
Usual dose:
Average doses for outpatients: 1.5 mg to 3 mg, three times a day.
Severe cases, especially in hospital treatment: 6 mg to 12 mg, two or three times a day.
The doctor should treat the given dosage as general guidelines and individualize the dose for each patient. Outpatient treatment should be started with small doses, gradually increasing them to the optimal size. Treatment should be as short as possible.
The patient should regularly visit the doctor to assess the need for further administration of the medicine, especially in situations where no symptoms of the disease are observed. The total duration of therapy should not exceed 8 to 12 weeks, including the period of gradual withdrawal of the medicine.
In some cases, therapy may last longer, provided that a specialized assessment of the patient's condition is carried out by the doctor.
Older patients and patients with liver function disorders require smaller doses.
If the patient feels that the effect of Lexotan is too strong or too weak, they should consult their doctor.

Using a higher dose of Lexotan than recommended

In case of taking a higher dose of Lexotan than recommended, the doctor should be contacted immediately.
The doctor will decide on further action.
Common symptoms of benzodiazepine overdose include: drowsiness, coordination disorders, speech disorders, and nystagmus.
Overdose of Lexotan is rarely life-threatening if the medicine is taken alone. However, it may lead to loss of reflexes, apnea, decreased blood pressure, circulatory and respiratory depression, and coma. Coma, if it occurs, usually lasts several hours, but may recur and worsen, especially in older people. Symptoms of respiratory depression are more severe in people with underlying respiratory diseases.
Benzodiazepines enhance the effect of other central nervous system depressants (including alcohol).

Missing a dose of Lexotan

A double dose should not be taken to make up for a missed dose.

Discontinuation of Lexotan

In case of physical dependence, after discontinuation of treatment, withdrawal symptoms (withdrawal syndrome) may occur.
These may include: headaches, diarrhea, muscle pain, increased anxiety, tension, restlessness, disorientation, and irritability. In severe cases, the following symptoms may occur: impaired perception of reality (derealization), impaired sense of one's own identity (depersonalization), increased sensitivity to sounds, feeling of numbness and tingling in the limbs, increased sensitivity to light, noise, and touch, hallucinations, or seizures.
After withdrawal of the medicine, a rebound phenomenon may occur - a transient syndrome in which the symptoms that were the reason for the use of Lexotan recur in an intensified form. Other reactions, such as mood changes, anxiety, or sleep disorders and restlessness, may also occur.
Since the risk of withdrawal syndrome and rebound phenomenon is greater in case of sudden discontinuation of treatment, it is recommended to gradually reduce the dose of Lexotan.
In case of any further doubts related to the use of this medicine, the doctor should be consulted.

4. Possible side effects

Like all medicines, Lexotan can cause side effects, although not everybody gets them.
The following side effects have been reported with an unknown frequency (cannot be estimated from the available data):

• hypersensitivity (allergy), anaphylactic shock, angioedema
• confusion, disorientation, emotional disorders, and mood disorders - mainly at the beginning and usually resolving during treatment
• libido disorders
• drug dependence, drug abuse, withdrawal syndrome
• depression
• paradoxical reactions such as anxiety, agitation, irritability, aggression, delusions, anger, nightmares, hallucinations, psychosis, abnormal behavior, nervousness, anxiety, abnormal dreams, excessive activity, and other behavioral disorders - greater likelihood of these reactions in children and older patients
• anterograde amnesia
• memory impairment
• drowsiness, headaches, dizziness, impaired alertness, coordination disorders, and balance disorders - mainly at the beginning and usually resolving during treatment
• double vision - mainly at the beginning and usually resolving during treatment
• heart failure, including cardiac arrest
• decreased depth and frequency of breathing
• nausea, vomiting - mainly at the beginning and usually resolving during treatment
• constipation
• rash, itching, urticaria
• muscle weakness - mainly at the beginning and usually resolving during treatment
• urinary retention
• fatigue - mainly at the beginning and usually resolving during treatment
• falls, fractures - the risk increases in people using sedatives (including alcoholic beverages) and in older patients

Dependence:
Long-term use of the medicine (even in therapeutic doses) may lead to the development of physical and psychological dependence on the medicine, and discontinuation of treatment - to the occurrence of withdrawal symptoms or rebound anxiety (intensification of disease symptoms - see "Discontinuation of Lexotan").
There have been reports of benzodiazepine abuse .

Reporting side effects

If any side effects occur, including any side effects not listed in the leaflet, the doctor or pharmacist should be informed.
Side effects can be reported directly to the Department of Monitoring of Adverse Reactions to Medicinal Products, Urząd Rejestracji Produktów Leczniczych, Wyrobów Medycznych i Produktów Biobójczych, Al. Jerozolimskie 181C, 02-222 Warszawa, tel.: + 48 22 49 21 301, fax: + 48 22 49 21 309, website: https://smz.ezdrowie.gov.pl
Side effects can also be reported to the marketing authorization holder.
Reporting side effects will help to gather more information on the safety of the medicine.

5. How to store Lexotan

The medicine should be stored in a place inaccessible and invisible to children.
The medicine should be stored at a temperature below 30°C.
The medicine should not be used after the expiry date stated on the packaging.
The expiry date means the last day of the given month.
Medicines should not be disposed of in the sewage system or household waste containers. The pharmacist should be asked what to do with unused medicines. This will help protect the environment.

6. Contents of the packaging and other information

What Lexotan contains

• The active substance of the medicine is bromazepam (Bromazepamum). One tablet contains 3 mg or 6 mg of bromazepam.
• Other ingredients are: microcrystalline cellulose, magnesium stearate, talc, and: 3 mg tablets: lactose monohydrate (94.4 mg in 1 tablet), red iron oxide; 6 mg tablets: lactose monohydrate (90.85 mg in 1 tablet), aluminum lake of indigo carmine, yellow iron oxide.

What Lexotan looks like and what the packaging contains

Lexotan is in the form of tablets.
The packaging contains 30 tablets of 3 mg or 6 mg, in blisters, placed in a cardboard box.

Marketing authorization holder and manufacturer

Marketing authorization holder:

CHEPLAPHARM Arzneimittel GmbH
Ziegelhof 24
17489 Greifswald
Germany

Manufacturer:

Aesica Pharmaceuticals GmbH
Alfred-Nobel-Straße 10
40789 Monheim am Rhein
Germany
Delpharm Milano S.r.l.
Via Carnevale, 1
20054, Segrate (MI)
Italy

Date of last update of the leaflet: April 2024