II. Class

  1. Long acting Benzodiazepine

III. Indications

  1. Insomnia
    1. Short-term use only

IV. Dose

  1. Insomnia
    1. Start 7.5 orally at bedtime
    2. Maximum: 15 mg orally at bedtime (7.5 mg in the elderly)

V. Safety

  1. Pregnancy Category X (esp. first trimester)
  2. Avoid in Lactation
  3. Schedule IV Controlled Substance

VI. Pharmacokinetics

  1. Half-Life: 39 hours

VII. Metabolism

  1. Primarily metabolized by CYP3A4 to active metabolites
  2. Also metabolized by CYP2C9 and CYP2C19 to active metabolites

IX. References

  1. (2019) Med Lett Drugs Ther 61(1578): 121-6
  2. (2020) Presc Lett, Resource #361206, Appropriate Use of Benzodiazepines
  3. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 55
  4. Hamilton (2020) Tarascon Pocket Pharmacopoeia

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