Temazepam

Oral
Short-term management of insomnia

Oral
Premedication in surgery

Short-term management of insomnia: 5 mg at bedtime. May be increased to 10-20 mg in severe cases.

Short-term management of insomnia: 5 mg at bedtime. May be increased to 10-20 mg in severe cases. Severe: Contraindicated.
Premedication in surgery: Severe: Contraindicated.

May be taken with or without food.

Acute pulmonary insufficiency, resp depression, sleep apnoea, obsessional states, myasthenia gravis, severe hepatic impairment. Pregnancy.

Patient w/ severe depression, chronic pulmonary insufficiency, personality disorders, history of alcohol or drug addiction. Avoid abrupt withdrawal. Renal and hepatic impairment. Elderly or debilitated patient. Lactation.

Complex behaviour (e.g. sleep-driving, making phone calls, preparing and eating food). Dyspnoea, nausea and vomiting, throat closing, anterograde amnesia, agitation, restlessness, irritability, excitement, aggressiveness, rage, delusions, confusion, nightmares, psychoses, hallucinations, nervousness, dizziness, drowsiness, fatigue, headache, lethargy, hangover, anxiety, depression, euphoria, ataxia, anorexia, tremor and backache.
Potentially Fatal: Angioedema involving glottis, tongue or larynx.

PO: X

May impair ability to perform tasks that require alertness (e.g. driving or operating machinery).

Monitor resp and CV status.

Symptoms: Somnolence, confusion, coma, reduced or absent reflexes, resp depression, and hypotension. Management: Supportive and symptomatic treatment. Empty stomach by vomiting or gastric lavage. Treat hypotension w/ IV pressor agents. IV fluids should be given to induce diuresis. Flumazenil may be used for the complete or partial reversal of the sedative effects but there is a risk of seizure esp in long-term benzodiazepine users and in cyclic antidepressant overdose.

May enhance CNS depressant effect w/ Na oxybate, antipsychotics, tranquilisers, neuroleptics, antidepressants, hypnotics, anaesth, analgesics, sedative antihistamines, barbiturates. Effect may be reduced w/ theophylline.

May enhance sedative effect w/ alcohol.

Description: Temazepam is a short-acting benzodiazepine w/ anxiolytic, hypnotic/sedative, muscle relaxant properties. It increases neuronal membrane permeability to Cl ions by binding to stereospecific benzodiazepine receptors on the postsynaptic GABA neuron w/in the CNS and enhancing the GABA inhibitory effects resulting in hyperpolarisation and stabilisation.
Pharmacokinetics:
Absorption: Readily absorbed from the GI tract. Time to peak plasma concentration: 1.2-1.6 hr.
Distribution: Enters breast milk. Volume of distribution: 1.4 L/kg. Plasma protein binding: Approx 96%.
Metabolism: Minimal first-pass metabolism (8%). Completely metabolised through conjugation to inactive metabolite.
Excretion: Via urine (80-90% as inactive metabolites). Elimination half-life: Approx 8-15 hr.

Store at ≤25°C. Protect from light.

Hypnotics & Sedatives

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