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Quazepam

    DEA Class;  Rx

    Common Brand Names; Doral

    • Sedative/Hypnotics

    Long-acting oral benzodiazepine with two active metabolites with long half-lives.
    Used for the short-term treatment of insomnia.
    May cause excessive daytime drowsiness, rarely associated with rebound insomnia upon discontinuation.

    Indicated for the treatment of insomnia characterized by difficulty in falling asleep, frequent nocturnal awakenings, and/or early morning awakenings.

    Documented hypersensitivity

    Acute alcohol intoxication

    Myasthenia gravis (allowable in limited circumstances)

    Narrow angle glaucoma (questionable)

    Severe respiratory depression

    Depressed neuroses, psychotic reactions

    IV use in shock, coma, depressed respiration, patients who recently received other respiratory depressants

    • Drowsiness (12%)
    • Dizziness
    • Xerostomia
    • Dyspepsia
    • Fatigue
    • Headache
    • Hangover

    Use caution in COPD, sleep apnea, renal/hepatic disease, impaired gag reflex, respiratory disease, open-angle glaucoma (questionable), depression, suicide ideation

    Anterograde amnesia reported with benzodiazepine use

    May impair ability to perform hazardous tasks

    Patients particularly the elderly, are at higher risk of falls; therapy can cause drowsiness and decrease level of consciousness

    Paradoxical reactions, including yperactive or aggressive behavior reported

    Sleep-related activities, including sleep-driving, cooking and eating, and making phone calls while asleep may occur; discontinue therapy in these patients

    Use caution in patients with history of drug abuse or acute alcoholism; tolerance, psychological and physical dependence may occur with prolonged use

    Observational studies have demonstrated that concomitant use of opioid analgesics and benzodiazepines increases risk of drug-related mortality compared to use of opioids alone

    If a decision is made to prescribe a benzodiazepine concomitantly with opioids, prescribe the lowest effective dosages and minimum durations of concomitant use, and follow patients closely for signs and symptoms of respiratory depression and sedation; in patients already receiving an opioid analgesic, prescribe a lower initial dose than indicated in the absence of an opioid and titrate based on clinical response

    If an opioid is initiated in a patient already taking a benzodiazepine, prescribe a lower initial dose of the opioid and titrate based upon clinical response

    Pregnancy Category: D

    Lactation: Avoid if breastfeeding

    Adults

    15 mg/day PO.

    Elderly

    15 mg/day PO.

    Adolescents

    Safety and efficacy have not been established.

    Children

    Safety and efficacy have not been established.

    Quazepam

    tablet: Schedule IV

    • 7.5mg
    • 15mg