📋 Indications & Clinical Dosage
*Short-term treatment of anxiety that is severe or disabling, occurring alone or with insomnia:*
Adults: 3-18 mg daily in divided doses.
Elderly: 1.5-9 mg daily in divided doses.
⛔ Contraindications
Respiratory depression, sleep apnoea, phobic or obsessional state, chronic psychosis, acute pulmonary insufficiency, unstable myasthenia gravis, severe hepatic impairment, not recommended as monotherapy to treat depression or anxiety associated with depression.
⚠️ Precautions & Warnings
Chronic pulmonary insufficiency, myasthenia gravis, renal impairment, mild to moderate hepatic impairment, history of drugs or alcohol abuse, personality disorders, elderly, avoid long-term use. Withdraw gradually.
🔄 Drug Interactions
Alcohol, CNS depressants, anticonvulsants,
CYP3A4 inhibitors or inducers (e.g. cimetidine, rifampicin)
⚠️ Adverse Reactions / Side Effects
Anxiety, hypersalivation, drowsiness and light headedness, muscle weakness, ataxia, confusion, vertigo, GI upset, hypotension, visual disturbance, rash, impaired alertness and dexterity, headache, urinary retention. Rare: Blood disorder, jaundice, respiratory depression, abnormal psychological reactions, paradoxical reactions, anterograde, amnesia, dependence.
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
Use only if potential benefit outweighs risk
Lactation / Breastfeeding:
Caution advised
📚 Official Regulatory & Clinical References
- Drug Regulatory Authority of Pakistan (DRAP): Drug Registration, S.R.O. Price Gazettes & National Essential Medicines List (NEML).
- World Health Organization (WHO): Collaborating Centre for Drug Statistics Methodology (ATC/DDD Index).
- Formulary Standards: British National Formulary (BNF) & Pakistan National Formulary (PNF) guidelines.