Classes
DEA Class; Rx
Common Brand Names; Doral
- Sedative/Hypnotics
Description
Long-acting oral benzodiazepine with two active metabolites with long half-lives.
Used for the short-term treatment of insomnia.
May cause excessive daytime drowsiness, rarely associated with rebound insomnia upon discontinuation.
Indications
Indicated for the treatment of insomnia characterized by difficulty in falling asleep, frequent nocturnal awakenings, and/or early morning awakenings.
Contraindications
Documented hypersensitivity
Acute alcohol intoxication
Myasthenia gravis (allowable in limited circumstances)
Narrow angle glaucoma (questionable)
Severe respiratory depression
Depressed neuroses, psychotic reactions
IV use in shock, coma, depressed respiration, patients who recently received other respiratory depressants
Adverse Effects
- Drowsiness (12%)
- Dizziness
- Xerostomia
- Dyspepsia
- Fatigue
- Headache
- Hangover
Warnings
Use caution in COPD, sleep apnea, renal/hepatic disease, impaired gag reflex, respiratory disease, open-angle glaucoma (questionable), depression, suicide ideation
Anterograde amnesia reported with benzodiazepine use
May impair ability to perform hazardous tasks
Patients particularly the elderly, are at higher risk of falls; therapy can cause drowsiness and decrease level of consciousness
Paradoxical reactions, including yperactive or aggressive behavior reported
Sleep-related activities, including sleep-driving, cooking and eating, and making phone calls while asleep may occur; discontinue therapy in these patients
Use caution in patients with history of drug abuse or acute alcoholism; tolerance, psychological and physical dependence may occur with prolonged use
Observational studies have demonstrated that concomitant use of opioid analgesics and benzodiazepines increases risk of drug-related mortality compared to use of opioids alone
If a decision is made to prescribe a benzodiazepine concomitantly with opioids, prescribe the lowest effective dosages and minimum durations of concomitant use, and follow patients closely for signs and symptoms of respiratory depression and sedation; in patients already receiving an opioid analgesic, prescribe a lower initial dose than indicated in the absence of an opioid and titrate based on clinical response
If an opioid is initiated in a patient already taking a benzodiazepine, prescribe a lower initial dose of the opioid and titrate based upon clinical response
Pregnancy and Lactation
Pregnancy Category: D
Lactation: Avoid if breastfeeding
Maximum Dosage
15 mg/day PO.
15 mg/day PO.
Safety and efficacy have not been established.
Safety and efficacy have not been established.
How supplied
Quazepam
tablet: Schedule IV
- 7.5mg
- 15mg
