II. Class
- Medium Acting Benzodiazepine
III. Indications
-
Insomnia with frequent awakening
- Short-term use only (7 to 10 days)
IV. Dosing: General
- Start 15 mg orally taken 1 to 2 hours before bedtime (7.5 mg in elderly or debilitated)
- Maximum Dose: 30 mg at bedtime (15 mg in elderly)
V. Pharmacokinetics
- Onset: 30-60 minutes
- Serum Peak Level: 2-3 hours after oral dose
- Duration: 6-8 hours
-
Half-Life: 8-15 hours
- May be as long as 25 hours in some patients due to potentially active metabolites
- Metabolism to Glucuronidation
VI. Dosing: Equivalent dosing (for Benzodiazepine Withdrawal)
- Valium = Dose x1.0
- Phenobarbital = Dose x3.0
VII. Advantages
- Less daytime sedation or accumulation
VIII. Disadvantages
- More risk of rebound Insomnia
IX. Resources
X. References
- (2019) Med Lett Drugs Ther 61(1578): 121-6
- (2020) Presc Lett, Resource #361206, Appropriate Use of Benzodiazepines
- Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 55
- Hamilton (2020) Tarascon Pocket Pharmacopoeia