triazolam (Rx)

Brand and Other Names:Halcion
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablet: Schedule IV

  • 0.125mg
  • 0.25mg

Insomnia

0.125-0.25 mg PO qHS

Maximum dose: 0.5 mg PO qHS

Dosage Modifications

Hepatic impairment: Administer a lower dose; avoid use in cirrhosis

Safety and efficacy not established

Initiate a lower dose of 0.125 mg at bedtime; not to exceed 0.25 mg/day

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Interactions

Interaction Checker

and triazolam

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Drowsiness (14%)

            1-10%

            Headache (5-10%)

            Dizziness (5-10%)

            Nervousness (5-10%)

            Ataxia (4-5%)

            Lightheadedness (4-5%)

            N/V (4-5%)

            <1%

            Anterogade amnesia

            Paradoxical reactions

            Travelers amnesia-especially if combined with EtOH

            Confusion

            Cramps

            Fatigue

            Memory impairment

            Depression

            Visual disturbance

            Xerostomia

            Anterograde amnesia

            Dreaming/nightmares

            Confusion

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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

            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

            Medications that significantly impair oxidative metabolism mediated by cytochrome P450 3A (CYP 3A) including ketoconazole, itraconazole, nefazodone, and several HIV protease inhibitors

            Caution

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

            Anterograde amnesia may occur

            Hypersensitivity reactions reported

            Sleep related activities (sleep driving, sleep-cooking, sleep-eating etc) may occur

            Hyperactive aggressive behavior may occur

            May impair ability to perform hazardous tasks

            Failure of insomnia to remit after 7 - 10 days of treatment may indicate presence of primary psychiatric and/or medical illness that should be evaluated

            Increase in daytime anxiety may occur; consider therapy discontinuation if this occurs

            Use caution and consider appropriate dose reduction when used concomitantly with weak or moderate CYP450 3A inhibitors

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

            Therapy can cause drowsiness and a decreased level of consciousness; patients, particularly the elderly, are at higher risk of falls

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            Pregnancy & Lactation

            Pregnancy Category: X

            Lactation: Avoid if breastfeeding

            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

            Depresses all levels of CNS (eg, limbic and reticular formation), possibly by increasing membrane permeability to chloride ions, which in turn increases the inhibitory activity of GABA on neuronal excitability.

            Pharmacokinetics

            Half-Life: 1.5-5.5 hr

            Peak plasma time: 0.5-2 hr

            Onset of action: 15-30 min

            Vd: 0.8-1.8 L/kg

            Protein binding: 89%

            Duration: 6-7 hr

            Peak plasma concentration: 1-6 ng/mL

            Metabolism: CYP3A4, glucuronic acid conjugation

            Metabolites: Inactive metabolites

            Excretion: Urine

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            Images

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            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.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each 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.