TRIAZOLAM

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TRIAZOLAM

  • [HALCION]

DEA CODE 2887: Schedule 4

Triazolam is a short-acting benzodiazepine used as a hypnotic agent in the treatment of insomnia. Some countries temporarily withdrew triazolam from the market because of concerns about adverse reactions, mostly psychological, associated with higher dose ranges. Its use at lower doses with appropriate care and labeling has been reaffirmed by the FDA and most other countries. Triazolam has a shorter half-life than chlordiazepoxide, flurazepam, and prazepam and does not generate active metabolites. Benzodiazepines bind nonspecifically to bezodiazepine receptors BNZ1, which mediates sleep, and BNZ2, which affects affects muscle relaxation, anticonvulsant activity, motor coordination, and memory. As benzodiazepine receptors are thought to be coupled to gamma-aminobutyric acid-A (GABAA) receptors, this enhances the effects of GABA by increasing GABA affinity for the GABA receptor. Binding of GABA to the site opens the chloride channel, resulting in a hyperpolarized cell membrane that prevents further excitation of the cell. Triazolam is used for the short-term treatment of insomnia. Triazolam`s original brand name is Halcion. Triazolam is withdrawn in the United Kingdom due to risk of psychiatric adverse drug reactions. This drug continues to be available in the U.S. Internationally, triazolam is a Schedule IV drug under the Convention on Psychotropic Substances.

Triazolam drug usage

280th most prescribed medicine in the United States for 2017

Uses:
This medication is used to treat a certain sleep problem (insomnia). It may help you fall asleep faster, stay asleep longer, and lessen how often you wake up during the night, so you can get a better night's rest. Triazolam belongs to a class of drugs called benzodiazepines. It acts on your brain to produce a calming effect.

Use of this medication is usually limited to short treatment periods of 1 to 2 weeks or less. If your insomnia continues for a longer time, talk to your doctor to see if you need other treatment.

Used for:

Difficulty sleeping

Before Using:
Tell your doctor or pharmacist your medical history, especially of:

  • kidney disease
  • liver disease
  • lung/breathing problems (such as chronic obstructive pulmonary disease-COPD, sleep apnea)
  • mental/mood problems (such as depression, thoughts of suicide)
  • personal or family history of a substance use disorder (such as overuse of or addiction to drugs/alcohol)
  • personal or family history of sleepwalking
  • a certain muscle disease (myasthenia gravis)

Precautions:

Since this drug makes you drowsy, do not drive, use machinery, or do anything that needs alertness until you can do it safely.

Alcohol or marijuana (cannabis) can make you more drowsy.

Avoid alcoholic beverages.

Talk to your doctor if you are using marijuana (cannabis).

WARNINGS: Taking triazolam with opioid medications (such as codeine, hydrocodone) may increase your risk of very serious side effects, including death. To lower your risk, your doctor should have you take the smallest dose of triazolam that works, and take it for the shortest possible time.

Get medical help right away if any of these very serious side effects occur:
  • Slow/shallow breathing
  • Unusual lightheadedness
  • Severe drowsiness/dizziness
  • Difficulty waking up

User Reviews:

69 Total User Reviews
Triazolam Oral Read Reviews
Condition: Cronic Trouble Sleeping (45 Reviews):
Effectiveness(3.76)

Ease of Use(4.29)

Satisfaction(3.47)

Class Name: Sedative/Hypnotics
Most Common Used Sedative/Hypnotics

ESTAZOLAM | FLURAZEPAM | TRIAZOLAM | TEMAZEPAM | LORAZEPAM


Liver:
As with most benzodiazepines, triazolam therapy has not been associated with serum aminotransferase or alkaline phosphatase elevations, and clinically apparent liver injury from triazolam has been reported but is very rare.

Triazolam Hepatotoxicity:
Triazolam, like other benzodiazepines, is rarely associated with serum ALT elevations, and clinically apparent liver injury from triazolam is rare. There have been no well described case reports of acute liver injury from triazolam, except for a single report of a fatality after a severe and prolonged cholestatic liver injury. Cases of clinically apparent hepatitis have been reported with other benzodiazepines including alprazolam, chlordiazepoxide, clonazepam, diazepam, and flurazepam. The clinical pattern of acute liver injury from benzodiazepines is typically cholestatic and mild-to-moderate in severity with a latency of 1 to 6 months. Fever and rash are uncommon as is autoantibody formation.

E Likelihood score: E (unlikely cause of clinically apparent liver injury).


Important Information:

Do not use if you are pregnant.

Serious drug interactions can occur when certain medicines are used together with triazolam. Tell each of your healthcare providers about all medicines you use now, and any medicine you start or stop using.

Avoid drinking alcohol. Dangerous side effects could occur.

Triazolam may impair your thinking or reactions. You may still feel sleepy the morning after taking triazolam. Wait until you are fully awake before you drive, operate machinery, or do anything that requires you to be awake and alert.

Grapefruit and grapefruit juice may interact with triazolam and lead to unwanted side effects. Avoid the use of grapefruit products while taking triazolam.

Interactions:

Drug Interactions (442) Alcohol/Food Interactions (2) Disease Interactions (9)


What other drugs will affect Triazolam?
Taking triazolam with other drugs that make you sleepy or slow your breathing can cause dangerous side effects or death. Ask your doctor before taking a sleeping pill, narcotic pain medicine, prescription cough medicine, a muscle relaxer, or medicine for anxiety, depression, or seizures. Many drugs can interact with triazolam, and some drugs should not be used together. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Tell your doctor about all medicines you use, and those you start or stop using during your treatment with triazolam. Give a list of all your medicines to any healthcare provider who treats you.

A total of 442 drugs are known to interact with Triazolam.

  • 50 major drug interactions
  • 355 moderate drug interactions
  • 37 minor drug interactions

Halcion (triazolam)
Side Effects:
Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
RxList
Call your doctor at once if you have
  • unusual changes in mood or behavior
  • confusion, memory loss (amnesia), hallucinations
  • depression, suicidal thoughts
Some people using triazolam have engaged in activity such as driving, eating, making phone calls, or sleep-walking and later having no memory of the activity. If this happens to you, stop taking triazolam and talk with your doctor.
The sedative effects of triazolam may last longer in older adults. Accidental falls are common in elderly patients who take benzodiazepines. Use caution to avoid falling or accidental injury while you are taking triazolam.
Common side effects may include:
  • dizziness, daytime drowsiness (or during hours when you are not normally sleeping)
  • loss of coordination
  • headache
  • tingling or prickly feeling on your skin
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Halcion (triazolam)
Maximum Dosage:
Prescribers Digital Reference
Adults:0.5 mg/day PO.
Elderly0.25 mg/day PO.
Adolescents:Safety and efficacy have not been established.
Children:Safety and efficacy have not been established.

Halcion (triazolam) (Rx)
Black Box Warnings:

Concomitant use of benzodiazepines and opioids may result in profound respiratory depression, coma, and death; administer concomitantly when there are no alternative options; limit dosages and durations to minimum required; monitor for signs and symptoms of respiratory depression and sedation

Addiction, abuse, and misuse

  • On September 2020, FDA addressed serious risks of benzodiazepine addiction, abuse, and misuse, which can lead to overdose and death
  • Physical dependence can occur when taken steadily for several days to weeks, even as prescribed
  • Stopping abruptly or reducing dosage too quickly can result in withdrawal reactions, including seizures, which can be life-threatening
  • Assess each patient's risk prior to prescribing and monitor regularly for the development of these behaviors or conditions

Triazolam
Duration:

An uncommon and very short acting benzodiazepine. Sedating and hypnotic, and may induce amnesia and lowered inhibitions at high doses.

RouteOnsetDurationAfter Effects
Tripsit Factsheets
Oral:10-20 minutes4-7 hours1-6 hours
Insufflated:10-20 minutes3-5 hours1-6 hours
Triazolam Duration
Effects:
Anxiolytic, but primarily sedative or hypnotic.
Avoid:
All other CNS depressants

Triazolam Pharmaceutical Chemical Safety Information
Chemical Safety Summary:
INCHEM
Main risks and target organs:
Central nervous system, causing depression of respiration and consciousness.
Summary of clinical effects:
Central nervous system (CNS) depression and coma, or paradoxical excitation, but deaths are rare when benzodiazepines are taken alone. Deep coma and other manifestations of severe CNS depression are rare. Sedation, somnolence, diplopia, dysarthria, ataxia and intellectual impairment are the most common adverse effects of benzodiazepines. Overdose in adults frequently involves co- ingestion of other CNS depressants, which act synergistically to increase toxicity. Elderly and very young children are more susceptible to the CNS depressant action. Intravenous administration of even therapeutic doses of benzodiazepines may produce apnoea and hypotension. Dependence may develop with regular use of benzodiazepines, even in therapeutic doses for short periods. If benzodiazepines are discontinued abruptly after regular use, withdrawal symptoms may develop. The amnesia produced by benzodiazepines can have medico-legal consequences.
Diagnosis:
The clinical diagnosis is based upon the history of benzodiazepine overdose and the presence of the clinical signs of benzodiazepine intoxication. Benzodiazepines can be detected or measured in blood and urine using standard analytical methods. This information may confirm the diagnosis but is not useful in the clinical management of the patient. A clinical response to flumazenil, a specific benzodiazepine antagonist, also confirms the diagnosis of benzodiazepine overdose, but administration of this drug is rarely justified.
First aid measures and management principles:
Most benzodiazepine poisonings require only clinical observation and supportive care. It should be remembered that benzodiazepine ingestions by adults commonly involve co- ingestion of other CNS depressants and other drugs. Activated charcoal normally provides adequate gastrointestinal decontamination. Gastric lavage is not routinely indicated. Emesis is contraindicated. The use of flumazenil is reserved for cases with severe respiratory or cardiovascular complications and should not replace the basic management of the airway and respiration. The routine use of flumazenil is contraindicated because of potential complications, including seizures. Renal and extracorporeal methods of enhanced elimination are not effective.

Pediatric:
Appropriate studies have not been performed on the relationship of age to the effects of triazolam in the pediatric population.

Safety and efficacy have not been established.

Geriatric:
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of triazolam in the elderly. However, severe drowsiness, dizziness, confusion, clumsiness, or unsteadiness are more likely to occur in the elderly, which may require an adjustment in the dose for patients receiving triazolam.

Breastfeeding:

Summary of Use During Lactation:
Because little information is available on the use of triazolam during breastfeeding, an alternate hypnotic may be preferred, especially while nursing a newborn or preterm infant. Triazolam has a relatively short half-life, so occasional use while breastfeeding an older infant should pose little risk to the infant, but monitor the infant for excessive drowsiness.

Effects in Breastfed Infants:
In a telephone follow-up study, 124 mothers who took a benzodiazepine while nursing reported whether their infants had any signs of sedation. One mother took triazolam while breastfeeding and reported no sedation in her infant.

Alternate Drugs to Consider:

  
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Friday June 07, 2024 - everydayhealth.com

Is It Safe to Take Quetiapine to Help You Sleep? - Quetiapine hasn’t been approved by the Food and Drug Administration (FDA) to treat insomnia. However, due to its sedative effects, it’s still sometimes prescribed off-label as a short-term ...
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Two Popular Classes of Drugs Linked to Higher Dementia Risk and Memory Problems, Possible Alternatives - Benzodiazepines and anticholinergic drugs are common classes of medications. Doctors already knew that some of their side effects were memory and confusion, but research suggests it can be much worse.
Thursday October 24, 2024 - msn.com

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Wednesday October 16, 2024 - healthline.com

Paxlovid Drug Interactions - Paxlovid is a treatment for the respiratory virus COVID-19. The U.S. Food and Drug Administration (FDA) has approved it for adults with mild to moderate COVID-19 who risk developing severe illness.
Tuesday February 06, 2024 - msn.com

Acebrophylline Interaction with other Drugs - Acebrophylline is prescribed to reduce the irritation, swelling, and narrowing of the bronchial tubes in patients with asthma, severe or chronic bronchitis, chronic obstructive pulmonary disease ...
Tuesday April 21, 2020 - medindia.net

Doctoral dissertations - Vilja Palkama, Studies on drug interactions between CYP3A4 inhibitors and anaesthetic ... Anu Varhe, Interactions of triazolam with inhibitors of CYP3A enzymes. Sirkka Elfving, Studies on the ...
Wednesday August 24, 2022 - helsinki.fi

Consensus on Drug Treatment, Definition and Diagnosis for Insomnia - Drug treatment should never be an isolated measure ... clorazepate and bromazepam (category C) and flurazepam and triazolam (category X: have caused fetal malformations and irreversible lesions.
Thursday October 31, 2024 - medscape.com

The Older Brain on Drugs: Substances That May Cause Cognitive Impairment - Polypharmacy (defined as use of five or more drugs) is found in as many as 40% of those older than 65 years.
Monday October 28, 2024 - medscape.com

Stahl's Essential Psychopharmacology - With the range of psychotropic drugs expanding and the usages of existing medications diversifying, we are pleased to present this very latest edition of what has become the indispensable formulary in ...
Thursday December 14, 2023 - cambridge.org

  
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