Lormetazepam

Lormetazepam is evaluated for the following indications with varying evidence strength: Chronic insomnia in adults under 55 (evidence tier B), Insomnia in older adults (evidence tier D). See the full indication matrix with dosing and citations above on this page.

Common side effects of Lormetazepam (≥ 1 in 100): Daytime drowsiness and residual sedation, Dizziness, Weakness and ataxia, Anterograde amnesia, Dry mouth. See the Safety section for uncommon and serious reactions.

FDA category D. T1 association with cleft lip/palate is weak and not confirmed in large cohorts. T3 use is linked to floppy infant syndrome and neonatal withdrawal. Avoid when possible; for severe pregnancy insomnia, non-pharmacological measures are first-line.

Milk concentrations are low. Single doses pose minimal infant sedation risk. With regular use, monitor infant drowsiness and weight gain.

Lormetazepam is contraindicated in: Benzodiazepine hypersensitivity; Severe respiratory failure; Untreated obstructive sleep apnea; Severe hepatic impairment; Acute alcohol or opioid intoxication. Full list in the Safety section.

FDA boxed warning (2016): concurrent benzodiazepines and opioids carry risk of profound sedation, respiratory depression, and death. Co-prescribe only when alternatives are absent, at lowest effective doses and shortest duration.