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PubMedDate not supplied

Studies on metabolism of bromazepam. VI. Reduction of 2-(2-amino-5-bromobenzoyl)pyridine, a metabolite of bromazepam, in the rabbit, rat, and guinea pig.

Three urinary metabolites that were formed by cleavage of the benzodiazepine ring of bromazepam, 2-(2-amino-5-bromobenzoyl)pyridine (ABBP), 2-(2-amino-5-bromo-3-hydroxybenzoyl)pyridine (3-OH-ABBP), and 2-amino-5-bromo-2'-azabenzhydrol (ABAB), were measured in urine of rabbits, rats, and guinea pigs. The major metabolite was 3-OH-ABBP in all animals given bromazepam orally. ABAB was also excreted in major amounts in the guinea pig, but was excreted in minor amounts in the rabbit and rat. Moreover, ABAB was excreted in the urine of all animals given ABBP orally. It may be concluded that ABAB was formed by reduction of the carbonyl group of ABBP. ABBP reduction was catalyzed by NADPH-dependent enzymes occurring in rabbit liver cytoplasm, and rat liver microsomes, and guinea pig liver cytoplasm and microsomes. The reductases were inhibited by sulfhydryl group reagents. The optimum pH of the cytoplasmic enzyme ranged from 7.2 to 7.8, and that of the microsomal enzyme was 6.5. The apparent KM value for the reduction of ABBP by guinea pig liver microsomes was the lowest among all of the liver preparations.

Animals↗
PubMed1983

[Pharmacological action of bromazepam suppository].

Differences between the pharmacological effects of bromazepam given by oral and rectal administration were investigated in mice and rats. 1) Bromazepam dose-dependently prolonged the sleeping time induced by thiopental-Na, ethanol and ether by both administration routes. 2) The analgesic action of bromazepam was recognized by the hot-plate method and the algolytic test. In the hot-plate test, analgesic actions of morphine and pentazocine were potentiated by bromazepam in a dose of 0.5 mg/kg by both routes. 3) The muscle relaxant effect of bromazepam administered rectally was more potent than that administered orally in the inclined screen test and the rotarod test. This effect of bromazepam by rectal administration was approximately 2 times as potent as that by oral administration. 4) Bromazepam inhibited the convulsion induced by maximum electric shock, pentylenetetrazol and picrotoxin. In pentylenetetrazol-induced convulsion, the inhibitory effect of bromazepam administered rectally was 2 times as potent as that administered orally. In the other convulsion test, no significant differences between oral and rectal administration could be recognized. 5) Hyperemotionality and muricide (mouse-killing behaviour) of rats with bilateral olfactory bulb ablations (OB rat) were reduced by oral and rectal administrations of bromazepam in a dose-dependent manner. The effects by rectal administration were more potent than that by oral administration. Bromazepam was approximately 20 times as potent as diazepam administered by the same route. Fighting behaviour in mice subjected to footshock was suppressed by rectal administration of bromazepam, and this effect was as same as that by oral administration. 6) The rate of lever pressing response in the lateral hypothalamic self-stimulation test in the Skinner box was markedly increased by rectal administration of 0.2 mg/kg bromazepam. 7) Methamphetamine-induced hyperactivity of mice was significantly suppressed only by bromazepam administered rectally in a dose of 5 mg/kg. 8) The falling effect of bromazepam on body temperature in normal rats was the same in both administration routes and was dose-dependent. From these data, significant differences of the pharmacological effects between oral and rectal administration of bromazepam were recognized in the duration of action and, in part, potencies; and therefore, rectal administration of bromazepam may be a useful dosage form for clinical use.

Administration, Oral↗
PubMed2003

The effect of itraconazole on the pharmacokinetics and pharmacodynamics of bromazepam in healthy volunteers.

RATIONALE AND OBJECTIVE: Bromazepam, an anti-anxiety agent, has been reported to be metabolized by cytochrome P(450) (CYP). However, the enzyme responsible for the metabolism of bromazepam has yet to be determined. The purpose of this study was to examine whether the inhibition of CYP3A4 produced by itraconazole alters the pharmacokinetics and pharmacodynamics of bromazepam. METHODS: Eight healthy male volunteers participated in this randomized double-blind crossover study. The subjects received a 6-day treatment of itraconazole (200 mg daily) or its placebo. On day 4 of the treatment, each subject received a single oral dose of bromazepam (3 mg). Blood samplings for drug assay were performed up to 70 h after bromazepam administration. The time course of the pharmacodynamic effects of bromazepam on the central nervous system was assessed using a subjective rating of sedation, continuous number addition test and electroencephalography up to 21.5 h after bromazepam administration. RESULTS: Itraconazole caused no significant changes in the pharmacokinetics and pharmacodynamics of bromazepam. The mean (+/-SD) values of area under the plasma concentration-time curve and elimination half-life for placebo versus itraconazole were 1328+/-330 ng h/ml versus 1445+/-419 ng h/ml and 32.1+/-9.3 h versus 31.1+/-8.4 h, respectively. CONCLUSION: The pharmacokinetics and pharmacodynamics of bromazepam were not affected by itraconazole, suggesting that CYP3A4 is not involved in the metabolism of bromazepam to a major extent. It is likely that bromazepam can be used in the usual doses for patients receiving itraconazole or other CYP3A4 inhibitors.

Adult↗
PubMed2002

Effect of fluconazole on the pharmacokinetics and pharmacodynamics of oral and rectal bromazepam: an application of electroencephalography as the pharmacodynamic method.

Quantitative analysis of electroencephalography (EEG) is used increasingly to evaluate the pharmacodynamics of benzodiazepines. The present study aimed to apply the EEG method as well as more traditional approaches to an interaction study of bromazepam and fluconazole. Twelve healthy male volunteers participated in a randomized, double-blind, four-way crossover study. The subjects received single oral or rectal doses of bromazepam (3 mg) after 4-day pretreatment of oral fluconazole (100 mg daily) or its placebo. Plasma bromazepam concentrations were measured before and 0.5, 1, 2, 3, 4, 6, 12, 22, 46, and 70 hours after bromazepam administration. Pharmacodynamic effects of bromazepam were assessed using self-rated drowsiness, continuous number addition test, and EEG. Fluconazole caused no significant changes in pharmacokinetics and pharmacodynamics of oral or rectal bromazepam. Rectal administration significantly increased AUC (1.7-fold, p < 0.0001) and Cmax (1.6-fold, p < 0.0001) of bromazepam. These changes following rectal dose may be due to avoidance of degradation occurring in the gastrointestinal tract. Rectal bromazepam also increased the area under the effect curves assessed by EEG (p < 0.05) and subjective drowsiness (p < 0.05). EEG effects were closely correlated with mean plasma bromazepam concentrations (r = 0.92, p < 0.001 for placebo; r = 0.89, p < 0.0001 for fluconazole). Thus, the EEG method provided pharmacodynamic data that clearly reflected the pharmacokinetics of bromazepam.

Administration, Oral↗
PubMed1987

Bromazepam pharmacokinetics: influence of age, gender, oral contraceptives, cimetidine, and propranolol.

Pharmacokinetics of the benzodiazepine bromazepam were evaluated in volunteer subjects who received single 6 mg oral doses followed by blood sampling during the next 48 hours. Age and gender effects were studied in 32 subjects, divided into young (aged 21 to 29 years) and elderly (aged 60 to 81 years) groups. Compared with young subjects, the elderly had significantly higher peak serum bromazepam concentrations (132 vs. 82 ng/ml), smaller volume of distribution (0.88 vs. 1.44 L/kg), lower oral clearance (0.41 vs. 0.76 ml/min/kg), and increased serum free fraction (34.8% vs. 28.8% unbound). However, gender had no significant influence on bromazepam kinetics. In 11 young female users of oral contraceptive steroids, compared with seven age- and weight-matched control women not using oral contraceptives, no differences in bromazepam kinetics were observed. Coadministration of cimetidine (1.2 gm daily) significantly reduced bromazepam clearance (0.41 vs. 0.82 ml/min/kg) and prolonged elimination half-life (29 vs. 23 hours). Propranolol (160 mg daily) significantly prolonged bromazepam half-life (28 vs. 23 hours), but the reduction in clearance associated with propranolol (0.65 vs. 0.82 ml/min/kg) did not reach significance. Bromazepam has the pharmacokinetic characteristics of benzodiazepines with half-life values between 20 and 30 hours. Consistent with its biotransformation pathway by hepatic microsomal oxidation, bromazepam clearance is significantly impaired in elderly individuals, by coadministration of cimetidine and possibly propranolol.

Administration, Oral↗
PubMed1977

The antihypertensive effect of lexotan (bromazepam)- a new benzodiazepine derivative.

Clinical observations led to the assumption that there is an antihypertensive effect of bromazepam in patients suffering from mild benign hypertension. Because of this observation we studied the antihypertensive effect of bromazepam by means of a standardized simple submaximal ergometric load performed weekly over a 4-week period of observation. A control group of 68 hypertensive patients without any drug therapy but under active physical training combined with physiotherapy and medicinal baths showed only a slight decrease in systolic and diastolic blood pressure at rest (about 4%). Furthermore, the pulse frequency did not change. In contrast, there was a distinct and significant decrease in blood pressure at rest and during exercise after a 3-week period of additional treatment with bromazepam, especially in hypertensive patients. One group of 68 hypertensive patients receiving 9 mg bromazepam daily showed a mean reduction in blood pressure by 14.4% systolic and 12.7% diastolic at rest, and during exercise by 7.5% systolic and 6.8% diastolic. The heart remained practically unchanged. A somewhat slighter decrease of the blood pressure values was seen in an additional group of 31 hypertensive patients receiving 6 mg bromazepam per day and in a group of 30 normotensive patients receiving 9 mg bromazepam daily. The calculated indices such as the product of heart rate and mean systolic pressure and the tension time index in the groups receiving bromazepam pointed to a better economic work performance under reduced myocardial pressure effort and reduced oxygen demand on the myocardium. The possible action of bromazepam in reducing blood pressure will be discussed.

Anti-Anxiety Agents↗
PubMed2001

Effect of bromazepam on stress-induced gastric ulcer in rats and its relation to brain neurotransmitters.

The possible antiulcer potential of bromazepam was investigated in relation to its effect on the levels of central neurotransmitters in rats. Peptic ulcer was induced by cold-restraint stress, by immobilizing the animals in open wire restraint cages placed for 2 h at 4 degrees C. Bromazepam (1 and 2 mg x kg(-1), i.p.) was given as prophylactic regimens, either as a single (2 h before ulcer induction) or repeated (twice daily for 15 days) administration. Results revealed that single (1 mg x kg(-1)) and repeated (1 and 2 mg x kg(-1)) dose regimens of bromazepam succeeded in preventing gastric ulceration, without significant effects on the protein-bound hexose content of gastric mucus. Increases in gamma-aminobutyric acid (GABA) concentrations in almost all tested brain regions were observed in bromazepam-treated groups, as compared to the control stressed group. Cortical dopamine (D) concentrations were reduced following single (2 mg x kg(-1)) as well as repeated administration of bromazepam. Similarly, norepinephrine (NE) concentrations were decreased in the cerebral cortex and thalamus/hypothalamus by repeated doses of bromazepam. Cortical 5-hydroxytryptamine (5-HT) was elevated by single (1 mg x kg(-1)) and repeated (1 mg x kg(-1)) doses of the drug. It could be concluded that bromazepam affords a good gastroprotective potential against cold-restraint stress-induced gastric ulceration and the possible mechanisms might involve an increase in the inhibitory GABA and a suppression of the stimulatory NE and D in central regions, especially the cerebral cortex and/or thalamus/hypothalamus.

Animals↗
PubMed1991

Interaction of metoprolol with lorazepam and bromazepam.

The interaction between metoprolol and bromazepam and lorazepam was studied in 12 healthy male volunteers aged 21-37 years. Metoprolol had no significant effect on the pharmacokinetics of bromazepam or lorazepam. However, bromazepam AUC was 35% higher in the presence of metoprolol. Bromazepam enhanced the effect of metoprolol on systolic blood pressure but not on diastolic blood pressure or pulse rate. Lorazepam had no effect on either blood pressure or pulse. Metoprolol did not enhance the effect of bromazepam on the psychomotor tests used in this study. Metoprolol caused a small increase in critical flicker fusion threshold with lorazepam but had no effect on the other tests. Lorazepam (2 mg) was more potent than bromazepam (6 mg) in the doses used in this study. The interaction of metoprolol with bromazepam and lorazepam is unlikely to be of clinical significance. No change in dose is necessary when using these drugs together.

Administration, Oral↗
PubMed1990

Bromazepam in generalized anxiety. Randomized, multi-practice comparisons with both chlorprothixene and placebo.

Bromazepam was compared with placebo and with chlorprothixene in a randomized, double-blind group-comparative multicenter trial in general practice. Two hundred and forty-five patients with generalized anxiety disorder (DSM-III 1980) were treated for 2 weeks with two daily doses of bromazepam, 3 mg or chlorprothixene, 15 mg or placebo. Median reductions in Hamilton Anxiety rating were 12 (bromazepam), 10.3 (chlorprothixene) and 7.3 (placebo). The study revealed significant superiority of bromazepam over placebo (median differences 3.3, 95% confidence limits: 0.3 and 6.1) but not over chlorprothixene (median difference 1.4, 95% confidence limits -0.8 and +3.5). Significantly higher rates of tiredness, sedation and hypersomnia were found on bromazepam and chlorprothixene compared to placebo. Tolerance was rated as "at least good" in 85.6% on bromazepam, in 86% on chlorprothixene and in 87.8% on placebo. Neither previous psychopharmacological treatment nor presence of psychosocial stress were of perceptible influence. Bromazepam and chlorprothixene are both superior to placebo in generalized anxiety states treated in general practice, but spontaneous improvements/placebo effects are substantial.

Adolescent↗
PubMed2004

Hair to document drug-facilitated crimes: four cases involving bromazepam.

The use of a drug to modify a person's behavior for criminal gain is not a recent phenomenon. However, the recent increase in reports of drug-facilitated crimes (sexual assault, so-called DFSA, robbery) has caused alarm in the general public. Drugs used can be difficult to detect (active products at low dosages, chemical instability), possess amnesic properties, and can be quickly cleared from body fluids. In case of long delay between the alleged crime and clinical examination, collection of blood or even urine can be of little value. This is the reason why this laboratory developed an original approach based on hair testing by liquid chromatography-tandem mass spectrometry. To explore the detectability of a single absorption of bromazepam in hair, two volunteers (male and female) received a 6-mg dose. A strand of hair was sampled about one month after exposure and was cut into three segments of 2-cm long. After pulverization, 20 mg of hair was incubated overnight in a phosphate buffer (pH 8.4). The aqueous phase was extracted with 5 mL of a mixture of diethyl ether/methylene chloride (80:20) in the presence of diazepam-d5, which was used as internal standard (IS). Hair extract was separated on a XTerra MS C18 column using a gradient of acetonitrile and formate buffer. Detection was based on two daughter ions: transitions m/z 316.0 to 182.2 and 209.3 and m/z 290.1 to 154.1 and 198.2 for bromazepam and the IS, respectively. In the hair of the two subjects, bromazepam was detected in the proximal segment at 0.8 and 4.7 pg/mg, respectively. Hair analysis was applied to four authentic criminal cases. In the two first cases, bromazepam tested positive in the corresponding hair segment at 5.7, and 10.3 pg/mg. In another case, head hair was sampled 19 weeks after the alleged offense, and its length (< 4 cm) did not allow analysis of the corresponding period. However, 4.1 pg/mg of bromazepam was quantified in the victim's pubic hair. In these three cases, concentrations were consistent with a single exposure to bromazepam. In the last case, bromazepam was detected at 15 pg/mg in the segment corresponding to the period of the alleged offence but also in the range 2 to 7 pg/mg in the four other consecutive segments, making a single exposure statement difficult.

Adult↗
PubMed1978

Effect of a new benzodiazepine bromazepam on locomotor performance and brain monoamine metabolism.

Administration of a single dose (10 mg/kg) of a relatively new benzodiazepine, bromazepam to rats markedly suppressed their spontaneous locomotor activity. Hypomobility became apparent 15 min after the injection and remained significantly lower during the period of observation for 6 hours when locomotor activity was 27% of controls. Following 2 hours after bromazepam treatment, no change was noted in tyrosine levels and tyrosine hydroxylase activity in striatum or rate of catecholamine synthesis in synaptosomal preparation (P2 pellet). However, the endogenous levels of norepinephrine, dopamine and 5-hydroxytryptamine were significantly increased not only in several brain areas examined, but also in P2 pellet. Bromazepam failed to change 3H-norepinephrine and 3H-5-hydroxytryptamine uptake in synaptosomes suggesting that the increased levels of monoamines are not related to laterations in uptake mechanisms, but probably to a diminished release. This is supported by the data on striatal homovanillic acid and whole brain 4-hydroxy-3-methoxyphenyl glycol whose concentrations were significantly lowered following a single injection of this benzodiazepine. However, bromazepam increased 5-hydroxyindole-acetic acid levels in hypothalamus, mid-brain and pons-medulla. The present study demonstrates that bromazepam elicits its tranquilizing action by lowering the release of catecholamines in brain; however, its anti-anxiety action might be associated with a reduction in 5-hydroxytryptamine turn over. Our data also suggest that bromazepam is almost as potent as diazepam in altering the metabolism of certain putative neurotransmitters in brain.

Amines↗
PubMed2002

Quantitation using GC-TOF-MS: example of bromazepam.

Time-of-flight mass spectrometry (TOF-MS) offers new perspectives for forensic toxicology. Qualitative and quantitative analyses of a mixture of three selected benzodiazepines (diazepam, nordazepam and bromazepam) were used to compare gas chromatography (GC-TOF-MS, quadrupole GC-MS, GC-ECD) and liquid chromatography (HPLC-DAD) data. Method validation parameters like LOD, LOQ, S/N-ratios reflect the capabilities of GC-TOF-MS. Five-point calibrations for bromazepam in human peripheral blood (50, 100, 160, 200, 300 ng/ml) using medazepam as internal standard (1000 ng/ml) were performed. The calibrations using GC-TOF-MS (using the fragments of m/z 236 and 288), GC-ECD (dual system) and HPLC-DAD (at 235 nm) all showed correlation coefficients close or superior to 0.99. Quadrupole GC-MS data was not used in the comparison of extracted samples due to the low sensitivity in the full scan mode. Two analyses of real cases concerning bromazepam are presented. In the first case, the presence or absence of bromazepam could not be established with both HPLC-DAD and GC-ECD due to background signals. The extracted ion chromatograms and spectrum traces after the analysis with the GC-TOF-MS could clearly excluded the presence of bromazepam. The second case illustrates the quantitation of bromazepam, where both HPLC-DAD and GC-ECD were unable to give satisfactory results, again due to interfering background signals. The analyses performed on the GC-TOF-MS-system demonstrated high sensitivity and also high selectivity due to the high quality of mass spectra obtained. The advantages of GC-TOF-MS make it a promising analytical technique for forensic toxicology.

Anti-Anxiety Agents↗
PubMed1989

Effects of single oral doses of bromazepam, buspirone and clobazam on performance tasks and memory.

Three anxiolytic drugs (bromazepam 3 mg, buspirone 10 mg, and clobazam 10 mg p.o.) were evaluated for their effects on memory, psychomotor performance and subjective response in a double-blind, placebo-controlled, crossover study in 20 healthy volunteers. At each session, measurements were made before and 2 and 6 h after drug administration. The psychometric tests used were the images test, digit/symbol substitution test (DSST), choice reaction time (CRT), and critical fusion frequency (CFF). Free recall after 30 s in the 2-hour session was altered for all 3 drugs as compared to placebo (p less than 0.01), but in the 6-hour session only bromazepam showed a significant difference (p less than 0.05). The number of symbols reproduced by subjects during DSST was significantly decreased by bromazepam and buspirone as compared to placebo (p less than 0.05), whereas clobazam showed no differences with placebo. Analysis of variance for all four treatments (the 3 drugs and the placebo) showed no differences at recognition time or for motor response in CRT, except between bromazepam and clobazam after 6 h (p less than 0.05). None of the drugs altered performance during CFF (except bromazepam), and clobazam actually improved performance. All the drugs studied disturbed acquisition phenomena or restitution of memory; however, only bromazepam and buspirone significantly modified performance during DSST and disturbed the recognition and processing of sensory data.

Administration, Oral↗
PubMed2003

[Pharmacokinetics of bromazepam in 57 patients with acute drug intoxication].

Pharmacokinetic parameters of bromazepam were analyzed by 57 cases. The patients were admitted 7.3 +/- 8.9 hours (mean +/- S.D.) after ingestion of 88 +/- 127 mg bromazepam. Most patients had taken several drugs other than bromazepam and the number was 5.5 +/- 2.6 drugs. The serum bromazepam levels were 1,871 +/- 2,428 ng/ml and the elimination half-lives were 29 +/- 4 hours. Increased serum bromazepam levels were followed by extended elimination half-lives. There was no bromazepam toxic sign under 2,300 ng/ml. One case was treated with direct hemoperfusion and the therapy was effective.

Acute Disease↗
PubMedDate not supplied

[Efficacy and tolerance of alprazolam and bromazepam in flexible doses. Double-blind study in 119 ambulatory anxious patients].

Double-blind study comparing efficacy and safety of alprazolam and bromazepam in 119 ambulatory anxious patients receiving flexible dosage. 119 ambulatory anxious patients (global score on the Hamilton anxiety rating scale between 18 and 35) have been included in this double-blind trial (duration 4 weeks) comparing alprazolam and bromazepam given at flexible dosage. The global score on the Hamilton anxiety rating scale improved by 57.8% and 55.3% for alprazolam and bromazepam respectively. The percentage of therapeutic success according to the psychiatrist and the patient were respectively 82.7% and 79.3% for alprazolam compared to 74.1% and 71.9% for bromazepam. Fewer side-effects were recorded in the alprazolam group (97) than in the bromazepam group (120) and global safety of alprazolam seemed superior (p = 0.07). At trial-end, mean dosage reached 1.70 mg/day for alprazolam and 10.35 mg for bromazepam, but no correlation was found between anxiety intensity and optimal daily dosage used; however, a correlation has been found between the improvement of the overall Hamilton rating scale score and the dosage given (p = 0.02). The overall results suggest that the efficacy/safety ratio is better for alprazolam.

Adolescent↗
PubMed1984

[Effects of bromazepam on responses of mucosal blood flow of the gastrointestinal tract and the gastric motility to stimulation of the amygdala and hypothalamus in conscious cats].

Electrical stimulation (ES) of the nucleus amygdaloideus centralis ( NAmC ) and basolateralis ( NAmBL ), like norepinephrine, decreased mucosal blood flow of the gastric antrum and duodenum and decreased antral motility amplitude in gallamine-immobilized cats. ES of the nucleus lateralis hypothalami (NHL) less extensively produced a similar action. The NAmC stimulation elevated BP and renal sympathetic discharges, whereas the NAmBL stimulation lowered BP. These findings indicate that the gastric and pressor responses to the NAmC stimulation may be attributed to an increase in cerebral sympathetic outflow. Bromazepam dose-dependently (0.1 approximately 1.0 mg/kg, i.v.) prevented these gastric, pressor and renal sympathetic responses to the NAmC stimulation, but it did not alter the depressor response to the NAmBL stimulation or the norepinephrine-induced reactions. Bromazepam less extensively attenuated the gastric and pressor responses to the NHL stimulation. Moreover, bromazepam inhibited stress-induced gastric ulcer formation in rats more markedly than cimetidine, sulpiride and metoclopramide. Bromazepam markedly decreased stress-induced selective increase in the glucose utilization rate in the NAmC among various amygdala nuclei. These results indicate that effects of bromazepam on the gastric and pressor responses to the NAmC stimulation may be due to the inhibition of central sympathetic outflow, and the NAmC are more sensitive to bromazepam than the NHL and other amygdala nuclei.

Amygdala↗