Lormetazepam

Co je Lormetazepam?

Lormetazepam is a short-acting benzodiazepine hypnotic used for the short-term treatment of severe insomnia in adults. It is available under brand names including Noctamid and Loramet in certain European markets. As a prescription-only controlled medicine, it is reserved for cases where insomnia is clinically significant and has not responded to non-pharmacological interventions or less potent treatments.

Benzodiazepines are among the most studied sleep medicines in clinical medicine. They are effective at reducing sleep onset latency and increasing total sleep time, but their use must be carefully managed due to the risk of tolerance, dependence, and withdrawal.

Jak funguje Lormetazepam?

Lormetazepam acts as a positive allosteric modulator of the GABA-A receptor — the primary inhibitory receptor system in the brain. By enhancing the effect of gamma-aminobutyric acid (GABA), lormetazepam increases the frequency of chloride ion channel opening, producing widespread neuronal inhibition. This results in:

• Sedation and hypnosis: Reduced alertness and induction of sleep
• Anxiolysis: Reduction of anxiety
• Muscle relaxation: Reduced muscle tone
• Anticonvulsant effects: Raised seizure threshold

Lormetazepam’s relatively short half-life (approximately 10–12 hours, with active metabolites having shorter durations) makes it more suitable than longer-acting benzodiazepines (such as diazepam) for insomnia, as the risk of significant next-day sedation is comparatively reduced.

Pro koho je určen/a Lormetazepam?

Lormetazepam is indicated for adults with severe insomnia — specifically where the condition is:

• Significantly impacting daytime functioning, occupational performance, or quality of life
• Persistent and has not responded to sleep hygiene measures and other interventions
• Sufficiently severe to warrant a short course of benzodiazepine treatment in the clinical judgement of a doctor

It is not appropriate for mild or moderate sleep difficulties that have not been addressed with non-pharmacological approaches. Clinical guidelines across EU member states consistently recommend cognitive behavioural therapy for insomnia (CBT-I) as the first-line treatment.

Lormetazepam is contraindicated in:

• Adults with sleep apnoea syndrome
• People with myasthenia gravis
• Patients with severe respiratory insufficiency
• Those with severe hepatic impairment
• Patients with a current or prior history of alcohol or drug dependence
• Pregnant or breastfeeding women

Dávkování

Lormetazepam is taken orally, typically as a tablet, approximately 30 minutes before bedtime. Dosing is individualised by the prescribing doctor.

Group	Typical Dose	Notes
Adults (general)	0.5–1 mg at bedtime	Start at lowest effective dose
Older adults	0.5 mg at bedtime	Higher sensitivity; lower dose recommended
Maximum recommended duration	2–4 weeks	Including dose tapering period

Treatment should begin at the lowest effective dose. The prescribing doctor should review treatment regularly and should not prescribe lormetazepam for longer than necessary. Abrupt discontinuation must be avoided.

Vedlejší účinky

Časté vedlejší účinky (mohou postihnout více než 1 z 10 osob)

• Drowsiness or sedation (may persist into the next day)
• Impaired coordination (ataxia)
• Impaired memory (anterograde amnesia — difficulty forming new memories after taking the medicine)
• Confusion, particularly in older adults
• Headache

Serious risks requiring attention

• Physical dependence: Develops with regular use; withdrawal symptoms occur on discontinuation
• Rebound insomnia: Sleep may temporarily worsen upon stopping treatment
• Respiratory depression: Risk is elevated in patients with respiratory compromise or when combined with other CNS depressants
• Paradoxical reactions: Increased anxiety, agitation, and aggression have been reported, particularly in older adults
• Complex sleep behaviours: Including sleep-walking, sleep-driving, and other behaviours with no memory of the event (reported with hypnotic medicines as a class)
• Falls and fractures: Particularly in older adults due to muscle relaxation and impaired coordination

Lormetazepam vs alternativy

Medicine	Class	Dependence Risk	Duration of Action	Rx Required
Lormetazepam	Benzodiazepine	Higher	Intermediate-short	Yes
Zopiclone	Z-drug (non-BZD)	Moderate	Short	Yes
Zolpidem	Z-drug (non-BZD)	Moderate	Short	Yes
Melatonin	Hormone	Minimal	Short	Low dose: No
Diphenhydramine	Antihistamine	Low	Long	No

Clinical guidelines generally recommend Z-drugs (zopiclone, zolpidem) or melatonin before benzodiazepines for most cases of insomnia, given broadly comparable efficacy with potentially more favourable safety profiles. The choice between treatments is a clinical decision for a doctor.

Jak získat Lormetazepam online v Evropě

Lormetazepam is a prescription-only controlled medicine. It cannot be legally dispensed without a valid prescription from a qualified medical professional.

Prescrivia operates as a technology intermediary, connecting patients with independent EU-registered doctors for online health assessments. We do not prescribe medicines, employ doctors, or dispense medicines directly. If an independent doctor determines that lormetazepam or another sleep medicine is clinically appropriate following a thorough assessment, they may issue a prescription. This prescription is fulfilled by a licensed EU pharmacy partner.

Important: Prescrivia does not guarantee that a prescription will be issued. All prescribing decisions are made independently by qualified medical professionals based on individual clinical circumstances, including the appropriateness of benzodiazepine therapy.

Důležité bezpečnostní informace

Do not take Lormetazepam if you have:

• Sleep apnoea syndrome
• Myasthenia gravis
• Severe respiratory insufficiency
• Severe liver disease
• A history of alcohol or drug dependence

Critical interactions: Lormetazepam must not be combined with alcohol, opioids, or other CNS depressants — the combination significantly increases the risk of respiratory depression, which can be fatal. This combination is responsible for a disproportionate share of drug-related fatalities in Europe, per WHO data.

Driving: Do not drive or operate heavy machinery after taking lormetazepam. The sedating effects, combined with anterograde amnesia, render driving dangerous.

Zdroje

Lékařské informace na této stránce vycházejí z následujících zdrojů:

• European Medicines Agency (EMA). Reflection paper on the use of benzodiazepines and Z-drugs. EMA/CHMP/2014.
• World Health Organization (WHO). Benzodiazepines (WHO Drug Information). who.int
• European Sleep Research Society (ESRS). European Guideline for the Diagnosis and Treatment of Insomnia. J Sleep Res. 2017;26(6):675-700.

Tento obsah je pravidelně přezkoumáván s ohledem na aktualizované klinické pokyny. Je poskytován pouze pro informační účely a nepředstavuje lékařské poradenství. Vždy se poraďte s kvalifikovaným zdravotnickým pracovníkem o radě týkající se Vašich individuálních zdravotních okolností.