flurazepam (Rx)

Brand and Other Names:
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

capsule: Schedule IV

  • 15mg
  • 30mg

Insomnia

15-30 mg PO qHS

<15 years old: not recommended

Not drug of choice in elderly because of long-acting metabolite; associated with increased falls

Insomnia

15 mg PO qHS

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Interactions

Interaction Checker

and flurazepam

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            Contraindicated (2)

            • calcium/magnesium/potassium/sodium oxybates

              flurazepam, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Coadministration with alcohol or sedative hypnotics are contraindicated because of additive CNS depression.

            • sodium oxybate

              flurazepam, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Coadministration with alcohol or sedative hypnotics are contraindicated because of additive CNS depression.

            Serious - Use Alternative (24)

            • abametapir

              abametapir will increase the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

            • apalutamide

              apalutamide will decrease the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.

            • benzhydrocodone/acetaminophen

              benzhydrocodone/acetaminophen, flurazepam. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

            • conivaptan

              conivaptan will increase the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

            • enzalutamide

              enzalutamide will decrease the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

            • fentanyl

              fentanyl, flurazepam. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.

            • fentanyl intranasal

              fentanyl intranasal, flurazepam. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.

            • fentanyl transdermal

              fentanyl transdermal, flurazepam. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.

            • fentanyl transmucosal

              fentanyl transmucosal, flurazepam. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.

            • fexinidazole

              fexinidazole will increase the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Fexinidazole inhibits CYP3A4. Coadministration may increase risk for adverse effects of CYP3A4 substrates.

            • hydrocodone

              hydrocodone, flurazepam. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

            • idelalisib

              idelalisib will increase the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Idelalisib is a strong CYP3A inhibitor; avoid coadministration with sensitive CYP3A substrates

            • ivosidenib

              ivosidenib will decrease the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternate therapies. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs.

            • lemborexant

              lemborexant, flurazepam. Either increases effects of the other by sedation. Avoid or Use Alternate Drug. Use of lemborexant with other drugs to treat insomnia is not recommended.

            • metoclopramide intranasal

              flurazepam, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.

            • mifepristone

              mifepristone will increase the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

            • olopatadine intranasal

              flurazepam and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.

            • phenobarbital

              phenobarbital will decrease the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

            • primidone

              primidone will decrease the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

            • selinexor

              selinexor, flurazepam. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.

            • sufentanil SL

              sufentanil SL, flurazepam. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration may result in hypotension, profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

            • tucatinib

              tucatinib will increase the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If unavoidable, reduce CYP3A substrate dose according to product labeling.

            • valerian

              valerian and flurazepam both increase sedation. Avoid or Use Alternate Drug.

            • voxelotor

              voxelotor will increase the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid.

            Monitor Closely (231)

            • albuterol

              flurazepam increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • alfentanil

              flurazepam and alfentanil both increase sedation. Use Caution/Monitor.

            • alprazolam

              alprazolam and flurazepam both increase sedation. Use Caution/Monitor.

            • amitriptyline

              flurazepam and amitriptyline both increase sedation. Use Caution/Monitor.

            • amobarbital

              amobarbital and flurazepam both increase sedation. Use Caution/Monitor.

            • amoxapine

              flurazepam and amoxapine both increase sedation. Use Caution/Monitor.

            • apomorphine

              flurazepam and apomorphine both increase sedation. Use Caution/Monitor.

            • arformoterol

              flurazepam increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • aripiprazole

              flurazepam and aripiprazole both increase sedation. Use Caution/Monitor.

            • armodafinil

              flurazepam increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • atazanavir

              atazanavir increases levels of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Potential for increased toxicity. Use alternatives if available. Consider lowering benzodiazepine dose.

            • azelastine

              azelastine and flurazepam both increase sedation. Use Caution/Monitor.

            • baclofen

              flurazepam and baclofen both increase sedation. Use Caution/Monitor.

            • belladonna and opium

              flurazepam and belladonna and opium both increase sedation. Use Caution/Monitor.

            • belzutifan

              belzutifan will decrease the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. If unable to avoid coadministration of belzutifan with sensitive CYP3A4 substrates, consider increasing the sensitive CYP3A4 substrate dose in accordance with its prescribing information.

            • benperidol

              flurazepam and benperidol both increase sedation. Use Caution/Monitor.

            • benzphetamine

              flurazepam increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • bosentan

              bosentan will decrease the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • brexanolone

              brexanolone, flurazepam. Either increases toxicity of the other by sedation. Use Caution/Monitor.

            • brompheniramine

              brompheniramine and flurazepam both increase sedation. Use Caution/Monitor.

            • buprenorphine

              flurazepam and buprenorphine both increase sedation. Use Caution/Monitor.

            • buprenorphine buccal

              flurazepam and buprenorphine buccal both increase sedation. Use Caution/Monitor.

            • buprenorphine subdermal implant

              flurazepam increases toxicity of buprenorphine subdermal implant by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Studies have shown that the combination of benzodiazepines and buprenorphine altered the usual ceiling effect on buprenorphine-induced respiratory depression, making the respiratory effects of buprenorphine appear similar to those of full opioid agonists. There have been postmarketing reports of coma and death with coadministration of buprenorphine and benzodiazepines. In many, but not all of these cases, buprenorphine was misused by self-injection. If a benzodiazepine must be used for an indication other than seizures, lower the benzodiazepine initial dose and cautiously titrate to clinical response.

            • buprenorphine, long-acting injection

              flurazepam increases toxicity of buprenorphine, long-acting injection by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of buprenorphine and benzodiazepines or other CNS depressants increases risk of adverse reactions including overdose, respiratory depression, and death. Cessation of benzodiazepines or other CNS depressants is preferred in most cases. In some cases, monitoring at a higher level of care for tapering CNS depressants may be appropriate. In others, gradually tapering a patient off of a prescribed benzodiazepine or other CNS depressant or decreasing to the lowest effective dose may be appropriate.

            • butabarbital

              butabarbital and flurazepam both increase sedation. Use Caution/Monitor.

            • butalbital

              butalbital and flurazepam both increase sedation. Use Caution/Monitor.

            • butorphanol

              flurazepam and butorphanol both increase sedation. Use Caution/Monitor.

            • caffeine

              flurazepam increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • carbamazepine

              carbamazepine will decrease the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • carbinoxamine

              carbinoxamine and flurazepam both increase sedation. Use Caution/Monitor.

            • carisoprodol

              flurazepam and carisoprodol both increase sedation. Use Caution/Monitor.

            • cenobamate

              cenobamate will decrease the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate.

            • ceritinib

              ceritinib will increase the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • chloral hydrate

              flurazepam and chloral hydrate both increase sedation. Use Caution/Monitor.

            • chlordiazepoxide

              chlordiazepoxide and flurazepam both increase sedation. Use Caution/Monitor.

            • chlorpheniramine

              chlorpheniramine and flurazepam both increase sedation. Use Caution/Monitor.

            • chlorpromazine

              flurazepam and chlorpromazine both increase sedation. Use Caution/Monitor.

            • chlorzoxazone

              flurazepam and chlorzoxazone both increase sedation. Use Caution/Monitor.

            • cinnarizine

              cinnarizine and flurazepam both increase sedation. Use Caution/Monitor.

            • clarithromycin

              clarithromycin will increase the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • clemastine

              clemastine and flurazepam both increase sedation. Use Caution/Monitor.

            • clomipramine

              flurazepam and clomipramine both increase sedation. Use Caution/Monitor.

            • clonazepam

              clonazepam and flurazepam both increase sedation. Use Caution/Monitor.

            • clonidine

              clonidine, flurazepam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration enhances CNS depressant effects.

            • clorazepate

              clorazepate and flurazepam both increase sedation. Use Caution/Monitor.

            • clozapine

              flurazepam and clozapine both increase sedation. Use Caution/Monitor.

            • cobicistat

              cobicistat will increase the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • codeine

              flurazepam and codeine both increase sedation. Use Caution/Monitor.

            • crizotinib

              crizotinib increases levels of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.

            • crofelemer

              crofelemer increases levels of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Crofelemer has the potential to inhibit CYP3A4 at concentrations expected in the gut; unlikely to inhibit systemically because minimally absorbed.

            • cyclizine

              cyclizine and flurazepam both increase sedation. Use Caution/Monitor.

            • cyclobenzaprine

              flurazepam and cyclobenzaprine both increase sedation. Use Caution/Monitor.

            • cyproheptadine

              cyproheptadine and flurazepam both increase sedation. Use Caution/Monitor.

            • dabrafenib

              dabrafenib will decrease the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

            • dantrolene

              flurazepam and dantrolene both increase sedation. Use Caution/Monitor.

            • daridorexant

              flurazepam and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.

            • darunavir

              darunavir increases levels of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Use alternatives if available. Consider lowering benzodiazepine dose.

            • desflurane

              desflurane and flurazepam both increase sedation. Use Caution/Monitor.

            • desipramine

              flurazepam and desipramine both increase sedation. Use Caution/Monitor.

            • deutetrabenazine

              flurazepam and deutetrabenazine both increase sedation. Use Caution/Monitor.

            • dexchlorpheniramine

              dexchlorpheniramine and flurazepam both increase sedation. Use Caution/Monitor.

            • dexfenfluramine

              flurazepam increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dexmedetomidine

              flurazepam and dexmedetomidine both increase sedation. Use Caution/Monitor.

            • dexmethylphenidate

              flurazepam increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dextroamphetamine

              flurazepam increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dextromoramide

              flurazepam and dextromoramide both increase sedation. Use Caution/Monitor.

            • diamorphine

              flurazepam and diamorphine both increase sedation. Use Caution/Monitor.

            • diazepam

              diazepam and flurazepam both increase sedation. Use Caution/Monitor.

            • diazepam intranasal

              diazepam intranasal, flurazepam. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may potentiate the CNS-depressant effects of each drug.

            • diethylpropion

              flurazepam increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • difelikefalin

              difelikefalin and flurazepam both increase sedation. Use Caution/Monitor.

            • difenoxin hcl

              flurazepam and difenoxin hcl both increase sedation. Use Caution/Monitor.

            • dimenhydrinate

              dimenhydrinate and flurazepam both increase sedation. Use Caution/Monitor.

            • diphenhydramine

              diphenhydramine and flurazepam both increase sedation. Use Caution/Monitor.

            • diphenoxylate hcl

              flurazepam and diphenoxylate hcl both increase sedation. Use Caution/Monitor.

            • dipipanone

              flurazepam and dipipanone both increase sedation. Use Caution/Monitor.

            • dobutamine

              flurazepam increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dopamine

              flurazepam increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dopexamine

              flurazepam increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dosulepin

              flurazepam and dosulepin both increase sedation. Use Caution/Monitor.

            • doxepin

              flurazepam and doxepin both increase sedation. Use Caution/Monitor.

            • doxylamine

              flurazepam and doxylamine both increase sedation. Use Caution/Monitor.

            • droperidol

              flurazepam and droperidol both increase sedation. Use Caution/Monitor.

            • duvelisib

              duvelisib will increase the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Coadministration with duvelisib increases AUC of a sensitive CYP3A4 substrate which may increase the risk of toxicities of these drugs. Consider reducing the dose of the sensitive CYP3A4 substrate and monitor for signs of toxicities of the coadministered sensitive CYP3A substrate.

            • efavirenz

              efavirenz will decrease the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • elagolix

              elagolix decreases levels of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Elagolix is a weak-to-moderate CYP3A4 inducer. Monitor CYP3A substrates if coadministered. Consider increasing CYP3A substrate dose if needed.

            • elvitegravir/cobicistat/emtricitabine/tenofovir DF

              elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Cobicistat is a CYP3A4 inhibitor; consider benzodiazepine dose reduction.

            • encorafenib

              encorafenib, flurazepam. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. Coadministration of encorafenib with sensitive CYP3A4 substrates may result in increased toxicity or decreased efficacy of these agents.

            • ephedrine

              flurazepam increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • epinephrine

              flurazepam increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • epinephrine racemic

              flurazepam increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • esketamine intranasal

              esketamine intranasal, flurazepam. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.

            • estazolam

              estazolam and flurazepam both increase sedation. Use Caution/Monitor.

            • ethanol

              flurazepam and ethanol both increase sedation. Use Caution/Monitor.

            • etomidate

              etomidate and flurazepam both increase sedation. Use Caution/Monitor.

            • etravirine

              etravirine will decrease the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • fedratinib

              fedratinib will increase the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP3A4 substrates as necessary.

            • fenfluramine

              flurazepam increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • flibanserin

              flurazepam and flibanserin both increase sedation. Modify Therapy/Monitor Closely. Risk for sedation increased if flibanserin is coadministration with other CNS depressants.

            • fluphenazine

              flurazepam and fluphenazine both increase sedation. Use Caution/Monitor.

            • formoterol

              flurazepam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • fosamprenavir

              fosamprenavir increases levels of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Use alternatives if available. Consider lowering benzodiazepine dose.

            • fosphenytoin

              fosphenytoin will decrease the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • gabapentin

              gabapentin, flurazepam. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

            • gabapentin enacarbil

              gabapentin enacarbil, flurazepam. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

            • ganaxolone

              flurazepam and ganaxolone both increase sedation. Use Caution/Monitor.

            • haloperidol

              flurazepam and haloperidol both increase sedation. Use Caution/Monitor.

            • hydromorphone

              flurazepam and hydromorphone both increase sedation. Use Caution/Monitor.

            • hydroxyzine

              hydroxyzine and flurazepam both increase sedation. Use Caution/Monitor.

            • iloperidone

              flurazepam and iloperidone both increase sedation. Use Caution/Monitor.

              iloperidone increases levels of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Iloperidone is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4.

            • imipramine

              flurazepam and imipramine both increase sedation. Use Caution/Monitor.

            • indinavir

              indinavir increases levels of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Potential for increased toxicity. Use alternatives if available. Consider lowering benzodiazepine dose.

            • isoproterenol

              flurazepam increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • istradefylline

              istradefylline will increase the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. This effect was not observed with istradefylline 20 mg/day. Consider dose reduction of sensitive CYP3A4 substrates.

            • itraconazole

              itraconazole will increase the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • ketamine

              ketamine and flurazepam both increase sedation. Use Caution/Monitor.

            • ketoconazole

              ketoconazole will increase the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • ketotifen, ophthalmic

              flurazepam and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.

            • lasmiditan

              lasmiditan, flurazepam. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.

            • letermovir

              letermovir increases levels of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • levalbuterol

              flurazepam increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • levoketoconazole

              levoketoconazole will increase the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • levorphanol

              flurazepam and levorphanol both increase sedation. Use Caution/Monitor.

            • lisdexamfetamine

              flurazepam increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • lofepramine

              flurazepam and lofepramine both increase sedation. Use Caution/Monitor.

            • lofexidine

              flurazepam and lofexidine both increase sedation. Use Caution/Monitor.

            • lopinavir

              lopinavir increases levels of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Use alternatives if available. Consider lowering benzodiazepine dose.

            • loprazolam

              flurazepam and loprazolam both increase sedation. Use Caution/Monitor.

            • lorazepam

              flurazepam and lorazepam both increase sedation. Use Caution/Monitor.

            • lorlatinib

              lorlatinib will decrease the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • lormetazepam

              flurazepam and lormetazepam both increase sedation. Use Caution/Monitor.

            • loxapine

              flurazepam and loxapine both increase sedation. Use Caution/Monitor.

            • loxapine inhaled

              flurazepam and loxapine inhaled both increase sedation. Use Caution/Monitor.

            • lurasidone

              lurasidone, flurazepam. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.

            • maprotiline

              flurazepam and maprotiline both increase sedation. Use Caution/Monitor.

            • marijuana

              flurazepam and marijuana both increase sedation. Use Caution/Monitor.

            • melatonin

              flurazepam and melatonin both increase sedation. Use Caution/Monitor.

            • meperidine

              flurazepam and meperidine both increase sedation. Use Caution/Monitor.

            • meprobamate

              flurazepam and meprobamate both increase sedation. Use Caution/Monitor.

            • metaproterenol

              flurazepam increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • metaxalone

              flurazepam and metaxalone both increase sedation. Use Caution/Monitor.

            • methadone

              flurazepam and methadone both increase sedation. Use Caution/Monitor.

            • methamphetamine

              flurazepam increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • methocarbamol

              flurazepam and methocarbamol both increase sedation. Use Caution/Monitor.

            • methylenedioxymethamphetamine

              flurazepam increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • midazolam

              flurazepam and midazolam both increase sedation. Use Caution/Monitor.

            • midazolam intranasal

              midazolam intranasal, flurazepam. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.

            • midodrine

              flurazepam increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • mirtazapine

              flurazepam and mirtazapine both increase sedation. Use Caution/Monitor.

            • mitotane

              mitotane decreases levels of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments.

            • modafinil

              flurazepam increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • morphine

              flurazepam and morphine both increase sedation. Use Caution/Monitor.

            • motherwort

              flurazepam and motherwort both increase sedation. Use Caution/Monitor.

            • moxonidine

              flurazepam and moxonidine both increase sedation. Use Caution/Monitor.

            • nabilone

              flurazepam and nabilone both increase sedation. Use Caution/Monitor.

            • nafcillin

              nafcillin will decrease the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • nalbuphine

              flurazepam and nalbuphine both increase sedation. Use Caution/Monitor.

            • nefazodone

              nefazodone will increase the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • nelfinavir

              nelfinavir increases levels of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Use alternatives if available. Consider lowering benzodiazepine dose.

            • norepinephrine

              flurazepam increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • nortriptyline

              flurazepam and nortriptyline both increase sedation. Use Caution/Monitor.

            • olanzapine

              flurazepam and olanzapine both increase sedation. Use Caution/Monitor.

            • oliceridine

              oliceridine, flurazepam. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

            • opium tincture

              flurazepam and opium tincture both increase sedation. Use Caution/Monitor.

            • orphenadrine

              flurazepam and orphenadrine both increase sedation. Use Caution/Monitor.

            • oxazepam

              flurazepam and oxazepam both increase sedation. Use Caution/Monitor.

            • oxycodone

              flurazepam and oxycodone both increase sedation. Use Caution/Monitor.

            • oxymorphone

              flurazepam and oxymorphone both increase sedation. Use Caution/Monitor.

            • paliperidone

              flurazepam and paliperidone both increase sedation. Use Caution/Monitor.

            • papaveretum

              flurazepam and papaveretum both increase sedation. Use Caution/Monitor.

            • papaverine

              flurazepam and papaverine both increase sedation. Use Caution/Monitor.

            • pentazocine

              flurazepam and pentazocine both increase sedation. Use Caution/Monitor.

            • pentobarbital

              pentobarbital and flurazepam both increase sedation. Use Caution/Monitor.

            • perphenazine

              flurazepam and perphenazine both increase sedation. Use Caution/Monitor.

            • phendimetrazine

              flurazepam increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • phenobarbital

              phenobarbital and flurazepam both increase sedation. Use Caution/Monitor.

            • phentermine

              flurazepam increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • phenylephrine

              flurazepam increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • phenylephrine PO

              flurazepam increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

            • phenytoin

              phenytoin will decrease the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • pholcodine

              flurazepam and pholcodine both increase sedation. Use Caution/Monitor.

            • pimozide

              flurazepam and pimozide both increase sedation. Use Caution/Monitor.

            • pirbuterol

              flurazepam increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • posaconazole

              posaconazole will increase the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • pregabalin

              pregabalin, flurazepam. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

            • primidone

              primidone and flurazepam both increase sedation. Use Caution/Monitor.

            • prochlorperazine

              flurazepam and prochlorperazine both increase sedation. Use Caution/Monitor.

            • promethazine

              promethazine and flurazepam both increase sedation. Use Caution/Monitor.

            • propofol

              propofol and flurazepam both increase sedation. Use Caution/Monitor.

            • propylhexedrine

              flurazepam increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • protriptyline

              flurazepam and protriptyline both increase sedation. Use Caution/Monitor.

            • quazepam

              flurazepam and quazepam both increase sedation. Use Caution/Monitor.

            • quetiapine

              flurazepam and quetiapine both increase sedation. Use Caution/Monitor.

            • ramelteon

              flurazepam and ramelteon both increase sedation. Use Caution/Monitor.

            • remimazolam

              remimazolam, flurazepam. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.

            • ribociclib

              ribociclib will increase the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • rifabutin

              rifabutin will decrease the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • rifampin

              rifampin will decrease the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • risperidone

              flurazepam and risperidone both increase sedation. Use Caution/Monitor.

            • ritonavir

              ritonavir increases levels of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Use alternatives if available. Consider lowering benzodiazepine dose.

            • rucaparib

              rucaparib will increase the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP3A4 substrates, if clinically indicated.

            • salmeterol

              flurazepam increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • saquinavir

              saquinavir increases levels of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Use alternatives if available. Consider lowering benzodiazepine dose.

            • scullcap

              flurazepam and scullcap both increase sedation. Use Caution/Monitor.

            • secobarbital

              secobarbital and flurazepam both increase sedation. Use Caution/Monitor.

            • sevoflurane

              sevoflurane and flurazepam both increase sedation. Use Caution/Monitor.

            • shepherd's purse

              flurazepam and shepherd's purse both increase sedation. Use Caution/Monitor.

            • stiripentol

              stiripentol, flurazepam. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP3A4 inhibitor and inducer. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. CYP3A4 substrates may require dosage adjustment.

              stiripentol, flurazepam. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.

            • sufentanil

              flurazepam and sufentanil both increase sedation. Use Caution/Monitor.

            • tapentadol

              flurazepam and tapentadol both increase sedation. Use Caution/Monitor.

            • tazemetostat

              tazemetostat will decrease the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • tecovirimat

              tecovirimat will decrease the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Tecovirimat is a weak CYP3A4 inducer. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered.

            • temazepam

              flurazepam and temazepam both increase sedation. Use Caution/Monitor.

            • terbutaline

              flurazepam increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • thioridazine

              flurazepam and thioridazine both increase sedation. Use Caution/Monitor.

            • thiothixene

              flurazepam and thiothixene both increase sedation. Use Caution/Monitor.

            • tipranavir

              tipranavir increases levels of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Use alternatives if available. Consider lowering benzodiazepine dose.

            • topiramate

              flurazepam and topiramate both increase sedation. Modify Therapy/Monitor Closely.

            • tramadol

              flurazepam and tramadol both increase sedation. Use Caution/Monitor.

            • trazodone

              flurazepam and trazodone both increase sedation. Use Caution/Monitor.

            • triazolam

              flurazepam and triazolam both increase sedation. Use Caution/Monitor.

            • triclofos

              flurazepam and triclofos both increase sedation. Use Caution/Monitor.

            • trifluoperazine

              flurazepam and trifluoperazine both increase sedation. Use Caution/Monitor.

            • trimipramine

              flurazepam and trimipramine both increase sedation. Use Caution/Monitor.

            • triprolidine

              triprolidine and flurazepam both increase sedation. Use Caution/Monitor.

            • voriconazole

              voriconazole will increase the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • xylometazoline

              flurazepam increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • yohimbine

              flurazepam increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • ziconotide

              flurazepam and ziconotide both increase sedation. Use Caution/Monitor.

            • ziprasidone

              flurazepam and ziprasidone both increase sedation. Use Caution/Monitor.

            • zotepine

              flurazepam and zotepine both increase sedation. Use Caution/Monitor.

            Minor (19)

            • acetazolamide

              acetazolamide will increase the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • anastrozole

              anastrozole will increase the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • brimonidine

              brimonidine increases effects of flurazepam by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

            • ciprofloxacin

              ciprofloxacin increases levels of flurazepam by decreasing metabolism. Minor/Significance Unknown.

            • cyclophosphamide

              cyclophosphamide will increase the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • esomeprazole

              esomeprazole increases levels of flurazepam by decreasing metabolism. Minor/Significance Unknown.

            • eucalyptus

              flurazepam and eucalyptus both increase sedation. Minor/Significance Unknown.

            • fleroxacin

              fleroxacin increases levels of flurazepam by decreasing metabolism. Minor/Significance Unknown.

            • gemifloxacin

              gemifloxacin increases levels of flurazepam by decreasing metabolism. Minor/Significance Unknown.

            • larotrectinib

              larotrectinib will increase the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • levofloxacin

              levofloxacin increases levels of flurazepam by decreasing metabolism. Minor/Significance Unknown.

            • moxifloxacin

              moxifloxacin increases levels of flurazepam by decreasing metabolism. Minor/Significance Unknown.

            • ofloxacin

              ofloxacin increases levels of flurazepam by decreasing metabolism. Minor/Significance Unknown.

            • omeprazole

              omeprazole increases levels of flurazepam by decreasing metabolism. Minor/Significance Unknown.

            • rifabutin

              rifabutin decreases levels of flurazepam by increasing metabolism. Minor/Significance Unknown.

            • rifapentine

              rifapentine will decrease the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • sage

              flurazepam and sage both increase sedation. Minor/Significance Unknown.

            • vinpocetine

              flurazepam increases effects of vinpocetine by unspecified interaction mechanism. Minor/Significance Unknown. Desirable interaction enhanced memory improvement (based on preliminary trial).

            • zolpidem

              zolpidem, flurazepam. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

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            Adverse Effects

            Frequency Not Defined

            Common

            • Ataxia
            • Dizziness
            • Drowsiness
            • Lethargy
            • Light-headedness

            Less Common

            • Chest pain, palpitations
            • Headache, irritability, nervousness, weakness
            • GI complaints
            • Myalgia
            • GU complaints

            Rare

            • Elevations of AST, ALT, bilirubin (T&D), alk phos
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            Warnings

            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

            Contraindications

            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

            Lactation

            Cautions

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

            May impair ability to perform hazardous tasks

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

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            Pregnancy & Lactation

            Pregnancy Category: X

            Lactation: Excretion in milk unknown; not recommended

            Minor tranquilizers should be avoided in 1st trimester of pregnancy due to increased risk of congenital malformations

            Maternal use shortly before delivery is associated with floppy infant syndrome (good and consistent evidence)

            Prenatal benzodiazepine exposure slightly increased oral cleft risk (limited or inconsistent evidence)

            Pregnancy Categories

            A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA: Information not available.

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            Pharmacology

            Mechanism of Action

            Long-acting benzodiazepine that depresses all levels of CNS (eg, limbic and reticular formation), possibly by increasing activity of GABA.

            Pharmacokinetics

            Metabolism: Glucuronic acid conjugation

            Metabolites: Desalkylflurazepam, N-1-hydroxyethylflurazepam

            Excretion: Urine

            Half-life elimination: 48-120 h

            Peak plasma time: 0.5-3 hr

            Peak plasma concentration: 0.5-4 ng/mL

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            Patient Handout

            No Patient Handout Available
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            Formulary

            FormularyPatient Discounts

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.