Sedative-hypnotic (thiamine analogue)

Clomethiazole

Brand names: Heminevrin

Clomethiazole is a sedative and hypnotic used for severe insomnia in the elderly and for acute alcohol withdrawal in a closely supervised setting.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It has sedative, hypnotic and anticonvulsant properties, thought to act largely by enhancing GABA-A receptor activity.

Prescribing in practice

There is a marked risk of dependence and of fatal respiratory depression if combined with alcohol, so it should not be given to patients who continue to drink and should be used only short-term.
Excessive respiratory secretions and sedation can occur, particularly in the elderly and in respiratory disease.
Avoid in acute pulmonary insufficiency and use cautiously in hepatic impairment.

Monitoring

Monitor conscious level, respiratory status and signs of dependence during treatment.

Counselling the patient

Never take this medicine with alcohol.
It causes drowsiness; do not drive if affected.
Use it only for a short time as prescribed.

Evidence & guidelines

Use is guided by the SPC and established practice, with short-term use emphasised because of dependence and interaction risks.

Reference: SmPC Heminevrin; NICE CG115 (Alcohol-Use Disorders Management); BAP Substance Misuse Guidelines 2012; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Pathways