Classifications: anxiolytic; sedative-hypnotic; benzodiazepine; Therapeutic:antianxiety; sedative-hypnotic
Pregnancy Category: X
Controlled Substance: Schedule IV
7.5 mg, 15 mg, 30 mg capsules
Benzodiazepine derivative with hypnotic, anxiolytic, sedative effects. Principal effect is significant improvement in sleep
parameters. Minimal change in REM sleep.
Reduces night awakenings and early morning awakenings; increases total sleep times, absence of rebound effects.
To relieve insomnia associated with frequent nocturnal awakenings or early morning awakenings.
Benzodiazepine hypersensitivity; ethanol intoxication; pregnancy (category X); safety in children <18 y is not established;
narrow-angle glaucoma; psychoses; lactation.
Severely depressed patient or one with suicidal ideation; history of drug abuse or dependence, acute intoxication; alcoholism;
COPD; liver or kidney dysfunction; older adults; sleep apnea.
Route & Dosage
Adult: PO 7.530 mg h.s.
Geriatric: PO 7.5 mg h.s.
- Give 2030 min before patient retires.
- Store at 15°30° C (59°86° F) in tight container unless otherwise specified by manufacturer.
Adverse Effects (≥1%)CNS: Drowsiness,
dizziness, lethargy, confusion, headache, euphoria, relaxed feeling, weakness. GI:
Anorexia, diarrhea. CV:
InteractionsDrug: Alcohol, cns depressants
potentiate CNS depression; cimetidine
increases temazepam plasma levels, thus increasing its toxicity; may decrease antiparkinsonism effects of levodopa;
may increase phenytoin
levels; smoking decreases sedative effects. Herbal: Kava, valerian
may potentiate sedation.
Readily from GI tract. Onset:
3050 min. Peak:
23 h. Duration:
1012 h. Distribution:
Crosses placenta; distributed into breast milk. Metabolism:
In liver to oxazepam
In urine. Half-Life:
Assessment & Drug Effects
- Be alert to signs of paradoxical reaction (excitement, hyperactivity, and disorientation) in older adults. Psychoactive drugs
are the most frequent cause of acute confusion in this age group.
- CNS adverse effects are more apt to occur in the patient with hypoalbuminemia, liver disease, and in older adults. Report
promptly incidence of bradycardia, drowsiness, dizziness, clumsiness, lack of coordination. Supervise ambulation, especially
- Lab tests: Obtain liver and kidney function tests during long-term use.
- Be alert to S&S of overdose: Weakness, bradycardia, somnolence, confusion, slurred speech, ataxia, coma with reduced or
absent reflexes, hypertension, and respiratory depression.
Patient & Family Education
- Be aware that improvement in sleep will not occur until after 23 doses of drug.
- Notify physician if dreams or nightmares interfere with rest. An alternate drug or reduced dose may be prescribed.
- Be aware that difficulty getting to sleep may continue. Drug effect is evidenced by the increased amount of rest once asleep.
- Consult physician if insomnia continues in spite of medication.
- Do not smoke after medication is taken.
- Do not use OTC drugs (especially for insomnia) without advice of physician.
- Consult physician before discontinuing drug especially after long-term use. Gradual reduction of dose may be necessary to
avoid withdrawal symptoms.
- Avoid use of alcohol and other CNS depressants.
- Do not drive or engage in other potentially hazardous activities until response to drug is known. This drug may depress
psychomotor skills and cause sedation.