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Temazepam (Monograph)

Brand name: Restoril
Drug class: Benzodiazepines
VA class: CN302
Chemical name: 7-Chloro-1,3-dihydro-3-hydroxy-1-methyl-5-phenyl-2H-1,4-benzodiazepin-2-one
Molecular formula: C16H13ClN2O2
CAS number: 846-50-4

Medically reviewed by on Sep 27, 2022. Written by ASHP.


    Concomitant Use with Opiates
  • Concomitant use of benzodiazepines and opiates may result in profound sedation, respiratory depression, coma, and death.

  • Reserve concomitant use for patients in whom alternative treatment options are inadequate; use lowest effective dosages and shortest possible duration of concomitant therapy and monitor closely for respiratory depression and sedation. (See Specific Drugs under Interactions.)

    Potential for Abuse, Addiction, and Other Serious Risks
  • A boxed warning has been included in the prescribing information for all benzodiazepines describing risks of abuse, misuse, addiction, physical dependence, and withdrawal reactions.

  • Abuse and misuse can result in overdose or death, especially when benzodiazepines are combined with other medicines, such as opioid pain relievers, alcohol, or illicit drugs.

  • Assess a patient’s risk of abuse, misuse, and addiction. Standardized screening tools are available ([Web]).

  • To reduce risk of acute withdrawal reactions, use a gradual dose taper when reducing dosage or discontinuing benzodiazepines. Take precautions when benzodiazepines are used in combination with opioid medications.


Benzodiazepine; sedative and hypnotic.

Uses for Temazepam


Short-term (generally 7–10 days) management of insomnia.

Decreases sleep latency, reduces early morning awakening, and improves sleep maintenance in patients with chronic insomnia; similar effects in patients with transient insomnia.

Temazepam Dosage and Administration


  • Use only when able to get 7–8 hours of sleep before being active again.

  • Generally limit hypnotic therapy to 7–10 days.

  • Avoid abrupt discontinuance; after extended therapy at doses >15 mg, taper dosage gradually.


Oral Administration

Administer at bedtime.




7.5–30 mg; 15 mg is the usual recommended dose. In patients with transient insomnia, 7.5 mg may be sufficient.

Special Populations

Geriatric or Debilitated Patients

Possible increased sensitivity to benzodiazepines. Initially, 7.5 mg.

Cautions for Temazepam


  • Pregnancy.

  • Known hypersensitivity to benzodiazepines.



Concomitant Use with Opiates

Concomitant use of benzodiazepines, including temazepam, and opiates may result in profound sedation, respiratory depression, coma, and death. Substantial proportion of fatal opiate overdoses involve concurrent benzodiazepine use.

Reserve concomitant use of temazepam and opiates for patients in whom alternative treatment options are inadequate. (See Specific Drugs under Interactions.)

Adequate Patient Evaluation

Insomnia may be a manifestation of an underlying physical and/or psychiatric disorder; carefully evaluate patient before providing symptomatic treatment.

Failure of insomnia to remit after 7–10 days of treatment, worsening of insomnia, or emergence of new abnormal thinking or behavior may indicate the presence of an underlying psychiatric and/or medical condition.

Immediately evaluate any new behavioral sign or symptom.

Adverse Psychiatric Events

Abnormal thinking and behavioral changes (e.g., aggressiveness, uncharacteristic extroversion, bizarre behavior, agitation, hallucinations, depersonalization, amnesia) may occur unpredictably in patients receiving benzodiazepines.

Some adverse effects appear to be dose related; use the lowest effective dose.

Complex Sleep-related Behaviors

Potential risk of complex sleep-related behaviors such as sleep-driving (i.e., driving while not fully awake after ingesting a sedative-hypnotic drug, with no memory of the event), making phone calls, or preparing and eating food while asleep.

Abuse Potential

Psychologic and physical dependence may occur following prolonged use.

Patients with a history of drug or alcohol dependence or abuse are at risk of habituation or dependence; use only with careful surveillance in such patients.

Withdrawal Effects

Rapid dosage reduction or abrupt discontinuance may result in signs and symptoms of withdrawal (similar to barbiturates or alcohol).

Sensitivity Reactions

Potential risk of anaphylaxis and angioedema; may occur as early as with the first dose of drug.

General Precautions


Use with caution in depressed patients; potential for suicidal tendencies. Prescribe and dispense drug in the smallest feasible quantity.

CNS Effects

Performance of activities requiring mental alertness and physical coordination may be impaired. In clinical studies, risk of residual daytime sedation and impaired psychomotor and mental performance appeared to be minimal.

Concurrent use of other CNS depressants may potentiate CNS depression. (See Concomitant Use with Opiates under Cautions and also see Specific Drugs under Interactions.)

Respiratory Effects

Use with caution in patients with compromised respiratory function.

Specific Populations


Category X.


Benzodiazepines generally are distributed into milk; not known whether temazepam is distributed into milk.

Caution advised if used in nursing women.

Pediatric Use

Safety and efficacy not established in children <18 years of age.

Geriatric Use

Potential increased sensitivity (increased risk of oversedation, dizziness, confusion, and/or ataxia); use low initial dose and monitor closely. (See Geriatric or Debilitated Patients under Dosage and Administration.)

Common Adverse Effects

Drowsiness, fatigue, lethargy, dizziness, hangover, anxiety, diarrhea, euphoria, weakness, confusion, vertigo.

Interactions for Temazepam

Specific Drugs




CNS depressants (e.g., sedatives, psychotropic drugs, anticonvulsants, antihistamines, alcohol)

Additive depressant effect

Do not use with alcohol; consider dosage reduction if temazepam is administered concomitantly with other CNS depressants


Possible synergistic effect

Concomitant use in a pregnant woman at term was associated with stillbirth 8 hours after administration; causal relationship not established

Opiate agonists and partial agonists

Risk of profound sedation, respiratory depression, coma, or death

Whenever possible, avoid concomitant use

Opiate analgesics: Use concomitantly only if alternative treatment options are inadequate; use lowest effective dosages and shortest possible duration of concomitant therapy; monitor closely for respiratory depression and sedation

In patients receiving temazepam, initiate opiate analgesic, if required, at reduced dosage and titrate based on clinical response

In patients receiving an opiate analgesic, initiate temazepam, if required, at lower dosage than indicated in the absence of opiate therapy and titrate based on clinical response

Opiate antitussives: Avoid concomitant use

Consider offering naloxone to patients receiving benzodiazepines and opiates concomitantly

Temazepam Pharmacokinetics



Well absorbed following oral administration, with peak plasma concentrations achieved in about 1.2–1.6 hours.



Benzodiazepines are widely distributed into body tissues and cross the blood-brain barrier.

Benzodiazepines generally cross the placenta and are distributed into milk; not known whether temazepam distributes into milk.

Plasma Protein Binding




Conjugated in the liver to form inactive metabolites.

Elimination Route

Excreted in urine as inactive metabolites.


About 8 hours.





Tight, light-resistant containers at 20–25°C.


  • Effects appear to be mediated through the inhibitory neurotransmitter GABA; the sites and mechanisms of action within the CNS appear to involve a macromolecular complex (GABAA-receptor-chloride ionophore complex) that includes GABAA receptors, high-affinity benzodiazepine receptors, and chloride channels.

Advice to Patients

  • Provide patient with a copy of manufacturer’s patient information.

  • Importance of taking only as prescribed; do not increase dosage or duration of therapy unless otherwise instructed by a clinician.

  • Risk of potentially fatal additive effects (e.g., profound sedation, respiratory depression, coma) if used concomitantly with opiates either therapeutically or illicitly. Avoid concomitant use of opiate antitussives; also avoid concomitant use of opiate analgesics unless use is supervised by clinician.

  • Importance of informing clinicians of any behavioral or mental changes, memory impairment, tolerance, or dependence/withdrawal symptoms.

  • Importance of taking only when able to get a full night’s sleep (i.e., 7–8 hours) before being active again.

  • Potential for drug to impair mental alertness or physical coordination; use caution when operating machinery or performing hazardous tasks until effects on individual are known.

  • Importance of informing clinicians of existing or contemplated concomitant therapy, including prescriptions and OTC drugs, and of concomitant illnesses, particularly depression.

  • Importance of not consuming alcoholic beverages.

  • Risk of rebound insomnia for 1 or 2 nights after discontinuance.

  • Importance of women informing their clinician if they are or plan to become pregnant or plan to breast-feed.

  • Importance of informing patients of other important precautionary information. (See Cautions.)


Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.

Subject to control under the Federal Controlled Substances Act of 1970 as a schedule IV (C-IV) drug.

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name



Dosage Forms


Brand Names




7.5 mg*

Restoril ( C-IV)


Temazepam Capsules ( C-IV)

15 mg*

Restoril ( C-IV)


Temazepam Capsules ( C-IV)

22.5 mg*

Restoril ( C-IV)


Temazepam Capsules ( C-IV)

30 mg*

Restoril ( C-IV)


Temazepam Capsules ( C-IV)

AHFS DI Essentials™. © Copyright 2023, Selected Revisions September 27, 2022. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.

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