Bromazolam

Substance identification

Bromazolam (IUPAC name: 8-bromo-1-methyl-6-phenyl-4H-[1,2,4]triazolo[4,3-a][1,4]benzodiazepine)
is a triazolobenzodiazepine. Bromazolam has been described as a white or crystalline solid and has
been identified in tablets, capsules, powders, solutions and chewable candy products (“gummies”).
Bromazolam has been identified in falsified pharmaceutical benzodiazepine products.

WHO review history
Bromazolam was critically reviewed at the 45th ECDD meeting. Because of lack of information on its
pharmacological effects, it was not recommended for international control but was placed undersurveillance. New information on such effects was brought to WHO’s attention, in addition to ongoing
evidence that this substance is manufactured clandestinely, poses a risk to public health and has no
recognized therapeutic use.

Similarity to known substances and effects on the central nervous system
Bromazolam is a benzodiazepine with relatively high potency and a short–intermediate duration of
action. It is structurally related to alprazolam. Like other benzodiazepines, bromazolam binds to γ-
aminobutyric acid (GABA A) receptors, and its effects can be reversed by administration of the
benzodiazepine receptor antagonist flumazenil.
Unconfirmed online reports by people who use bromazolam describe benzodiazepine-like effects,
including hypnotic, sedative, muscle relaxant and euphoric effects.

Dependence potential
No controlled studies in experimental animals or in humans have examined the dependence potential
of bromazolam. In view of its pharmacological effects and similarity to other benzodiazepines,
however, it would be expected to produce dependence. Online self-reports describe withdrawal
symptoms after cessation of chronic use

Actual abuse and/or evidence of likelihood of abuse

No studies in humans were found of the abuse liability of bromazolam. In an animal model predictive
of abuse liability, bromazolam had effects similar to those of midazolam and diazepam, which are
controlled under Schedule IV of the Convention on Psychotropic Substances of 1971. The effects were
attenuated by pre-administration of the benzodiazepine receptor antagonist flumazenil, confirming
bromazolam’s action as a benzodiazepine.
Seizures of bromazolam have been reported increasingly in many countries in various regions.
Bromazolam has been analytically confirmed as a causal or contributory agent in several deaths and
non-fatal intoxications, and its presence has been confirmed in instances of driving under the
influence of drugs. These harms have been reported in multiple countries and regions.

Therapeutic use
Bromazolam is not known to have any therapeutic use, is not listed on the WHO Model Lists of
Essential Medicines and has never been marketed as a medicinal product.

Rationale and recommendation
The mechanism of action and ill effects of bromazolam are similar to those of other benzodiazepines,
such as alprazolam and diazepam, that are listed under Schedule IV of the Convention on
Psychotropic Substances of 1971. Reports of seizures and detection in fatal and non-fatal
intoxications have increased over time. There is sufficient evidence of its abuse to conclude that it
constitutes a significant risk to public health and has no known therapeutic use.
The Committee recommended that bromazolam (IUPAC name: 8-bromo-1-methyl-6-phenyl-4H-
[1,2,4]triazolo[4,3-a][1,4]benzodiazepine) be added to Schedule IV of the Convention on Psychotropic
Substances of 1971.