Home Drug Guide Temazepam

Drug Guide

Generic Name

Temazepam

Brand Names Restoril, Temaz

Classification

Therapeutic: Anxiolytic, Sedative-hypnotic

Pharmacological: Benzodiazepine

FDA Approved Indications

Insomnia, short-term treatment

Mechanism of Action

Enhances the effect of gamma-aminobutyric acid (GABA) at the GABA-A receptor, producing sedative, anxiolytic, anticonvulsant, and muscle relaxant properties.

Dosage and Administration

Adult: Typically 15-30 mg orally at bedtime, adjustable based on response and tolerability.

Pediatric: Not recommended for pediatric use.

Geriatric: Start at lower doses (e.g., 7.5 mg) due to increased sensitivity and risk of adverse effects.

Renal Impairment: Use with caution; dose adjustments may be necessary.

Hepatic Impairment: Use with caution; dose reduction may be necessary.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed; crosses the blood-brain barrier.

Metabolism: Hepatically metabolized via oxidation.

Excretion: Renally excreted primarily as metabolites.

Half Life: Approximately 8-20 hours, extended in elderly patients.

Contraindications

Hypersensitivity to temazepam or other benzodiazepines.
Acute narrow-angle glaucoma.

Precautions

History of substance abuse.
Pregnancy and lactation.
Use with caution in elderly and debilitated patients.
Respiratory impairment.
Hepatic impairment.

Adverse Reactions - Common

Drowsiness (Common)
Dizziness (Common)
Dizziness (Common)
Fatigue (Common)

Adverse Reactions - Serious

Respiratory depression (Rare)
Dependence and withdrawal symptoms (Rare)
Amnesia and complex sleep behaviors (Rare)

Drug-Drug Interactions

Other CNS depressants, sedatives, alcohol, opioids

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for sedation, cognitive impairment, signs of dependence.

Diagnoses:

Risk for injury due to sedation
Risk for dependence

Implementation: Administer dose at bedtime, evaluate effectiveness.

Evaluation: Assess sleep quality, evaluate for adverse effects or signs of dependency.

Patient/Family Teaching

Advise against alcohol and other CNS depressants.
Warn about drowsiness, coordination impairment.
Do not operate machinery until effects are known.
Use short-term only as prescribed.

Special Considerations

Black Box Warnings:

Concurrent use with opioids can result in profound sedation, respiratory depression, coma, and death.
Risk of dependence, abuse, and withdrawal reactions.

Genetic Factors: Pharmacogenetic variations may affect metabolism and response.

Lab Test Interference: None specific.

Overdose Management

Signs/Symptoms: Extreme sedation, confusion, respiratory depression, coma.

Treatment: Supportive care, maintaining airway, monitoring vital signs, activated charcoal if recent ingestion, possibly flumazenil as an antagonist in certain cases.

Storage and Handling

Storage: Store at room temperature, away from moisture, light, and children.

Stability: Stable according to manufacturer instructions.