Medication Guide App

Triazolam

Pronunciation

Pronunciation: try-AZE-oh-lam
Class: Benzodiazepine

Trade Names

Halcion
- Tablets 0.25 mg

Triazolam
- Tablets 0.125 mg
- Tablets 0.25 mg

Apo-Triazo (Canada)
Gen-Triazolam (Canada)

Pharmacology

Potentiates action of GABA, an inhibitory neurotransmitter, resulting in increased neuronal inhibition and CNS depression, especially in limbic system and reticular formation.

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Pharmacokinetics

Absorption

Triazolam's T max is 2 h; C max is 1 to 6 ng/mL. Plasma levels achieved are proportional to the dose given.

Metabolism

Metabolites are mainly conjugated glucuronides presumably inactive.

Elimination

Triazolam plasma t ½ is 1.5 to 5.5 h. Metabolites are primarily excreted in urine (79.9%). Urinary excretion is biphasic in its time course.

Indications and Usage

Treatment of insomnia.

Contraindications

Hypersensitivity to benzodiazepines; pregnancy.

Dosage and Administration

Adults

PO 0.125 to 0.5 mg at bedtime.

Elderly or debilitated patients

Initiate with 0.125 mg until individual response is determined.

Storage/Stability

Store at room temperature in a tight, light-resistant container.

Drug Interactions

Alcohol, CNS depressants (eg, narcotic sedatives)

May cause additive CNS depressant effects.

Cimetidine, disulfiram, omeprazole, oral contraceptives

Triazolam effects may increase.

Digoxin

Serum digoxin concentrations may be increased.

Theophylline

May antagonize sedative effects.

Laboratory Test Interactions

None well documented.

Adverse Reactions

CNS

Anterograde amnesia; headache; nervousness; drowsiness; confusion; talkativeness; apprehension; irritability; euphoria; weakness; tremor; incoordination; memory impairment; depression; ataxia; dizziness; dreaming/nightmares; hallucinations; paradoxical reactions (eg, anger, hostility, mania, muscle spasms).

Dermatologic

Rash; photosensitivity.

EENT

Visual or auditory disturbances; depressed hearing; taste disturbances.

GI

Heartburn; nausea; vomiting; diarrhea; constipation; dry mouth; anorexia.

Hematologic

Blood dyscrasias including agranulocytosis; anemia; thrombocytopenia; leukopenia; neutropenia.

Hepatic

Hepatic dysfunction including hepatitis and jaundice.

Miscellaneous

Dependence/withdrawal syndrome (eg, confusion, abnormal perception of movement, depersonalization, muscle twitching, psychosis, paranoid delusions, seizures). Rebound sleep disorder (recurrence of insomnia worse than before treatment) may occur during first 3 nights after abrupt discontinuation.

Precautions

Pregnancy

Category X .

Lactation

Undetermined.

Children

Not for use in children younger than 18 yr of age.

Special Risk Patients

Use drug with caution in elderly patients and patients with renal or hepatic function impairment, depression or suicidal tendencies, drug abuse and dependence, chronic pulmonary insufficiency or apnea, seizure disorder.

Dependence

Prolonged use (more than 1 to 2 wk) can lead to dependence. Withdrawal syndrome may occur; taper dose gradually.

Overdosage

Symptoms

Somnolence, confusion, delirium, lack of coordination, ataxia, slurred speech, respiratory depression, coma, seizures.

Patient Information

  • Caution patient that this medication must not be taken during pregnancy or when pregnancy is possible. Advise patient to use reliable form of birth control while taking this drug.
  • Remind patient that medication should not be abruptly discontinued.
  • Review with patient and family other general sleep promotion measures, as well as what to avoid, such as caffeine and excessive exercise at bedtime.
  • Explain that medication may cause morning drowsiness or tiredness.
  • Caution patient regarding dependence potential.
  • Explain potential side effects and what to report to health care provider (eg, confusion, paradoxical excitement, headache, bleeding, recurrent sleep disorder).
  • Instruct patient to avoid intake of alcoholic beverages or other CNS depressants.
  • Advise patient to use caution while driving or performing other tasks requiring mental alertness.

Copyright © 2009 Wolters Kluwer Health.

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