Formerly available as Dalmane

Name: Formerly available as Dalmane

Formerly available as Dalmane Dosage and Administration

General

  • Use hypnotics only when able to get a full night’s sleep before being active again.e

  • Use the smallest effective dose (especially in geriatric or debilitated patients and in those with liver disease or low serum albumin).a b d

  • Avoid prolonged administration.a d

  • Reevaluate patient’s condition if hypnotic use exceeds 2–3 weeks.207

  • Avoid abrupt discontinuance in patients who have received prolonged therapy (e.g., several months) because of potential for precipitating withdrawal manifestations.a b d Gradually taper dosage.a d

Administration

Oral Administration

Administer at bedtime.a d

Dosage

Available as flurazepam hydrochloride; dosage expressed in terms of the salt.d

Adults

Insomnia Oral

Usual dosage is 30 mg at bedtime.a d In some patients, 15 mg may be adequate.a d

Special Populations

Hepatic Impairment

Reduce dosage.b Use smallest effective dosage.a

Renal Impairment

No specific dosage recommendations.d

Geriatric or Debilitated Patients

Initial dose of 15 mg at bedtime.a d Use smallest effective dosage.a

Interactions for Formerly available as Dalmane

Specific Drugs

Drug

Interaction

Comments

Cimetidine

Possible decreased plasma clearance of flurazepam200 625

Use with caution; consider flurazepam dosage reduction200 372 610

Clozapine

Severe hypotension, respiratory or cardiac arrest, and loss of consciousness reported when benzodiazepines (including flurazepam) were given with or within 24 hours before clozapine529 591 592 593 595 597 598 600

Use with caution435 591 599

Some clinicians recommend discontinuance of benzodiazepine therapy ≥1 week prior to initiation of clozapine597 598

CNS depressants (alcohol, anticonvulsants, sedatives)

Additive CNS depressant effectsb d

Do not use alcohol concomitantly with hypnotics;700 e caution if other CNS depressants are used concomitantly with flurazepamb d

Disulfiram

Possible inhibition of flurazepam metabolism200

Observe closely for enhanced benzodiazepine response200

Consider possible need for flurazepam dosage reduction200

Opiate agonists and partial agonists

Risk of profound sedation, respiratory depression, coma, or death700 701 703 705 706 707

Whenever possible, avoid concomitant use708 709 710 711

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 sedation700 703

In patients receiving flurazepam, initiate opiate analgesic, if required, at reduced dosage and titrate based on clinical response700

In patients receiving an opiate analgesic, initiate flurazepam, if required, at lower dosage than indicated in the absence of opiate therapy and titrate based on clinical response700

Opiate antitussives: Avoid concomitant use700 704

Consider offering naloxone to patients receiving benzodiazepines and opiates concomitantly709 712

Stability

Storage

Oral

Capsules

25°C (may be exposed to 15–30°C).d

Actions

  • 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.313 320 358 359 360 361 362 363 364 365 366 367 368 369 370

Preparations

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.a d

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

Flurazepam Hydrochloride

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Oral

Capsules

15 mg*

Flurazepam Hydrochloride Capsules (C-IV)

30 mg*

Flurazepam Hydrochloride Capsules (C-IV)
Share
(web3)