Temazepam
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Temazepam is a benzodiazepine derivate. Temazepam is normally used for short-term treatment of insomnia (generally 7-10 days).
Temazepam Pharmacology
Temazepam is a benzodiazepine used as a hypnotic agent in the management of insomnia. Temazepam produces CNS depression at limbic, thalamic, and hypothalamic levels of the CNS. Temazepam increases the affinity of the neurotransmitter gamma-aminobutyric acid (GABA) for GABA receptors by binding to benzodiazepine receptors. Results are sedation, hypnosis, skeletal muscle relaxation, anticonvulsant activity, and anxiolytic action.
Temazepam Mechanism of Action
Benzodiazepines bind nonspecifically to benzodiazepine receptors, which 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 the inhibitory neurotransmitter GABA to the site opens the chloride channel, resulting in a hyperpolarized cell membrane that prevents further excitation of the cell.
Temazepam Dosage
Capsule: 15 mg, 30 mg Restoril®: 7.5 mg, 15 mg, 30 mg
Recreational Dosage
?
Temazepam Absorption
Well absorbed, minimal first-pass metabolism.
Temazepam Biotransformation
Hepatic. Temazepam is completely metabolized through conjugation prior to excretion. The major metabolite is the O-conjugate of temazepam (90%).
Temazepam Half Life
10-20 hours
Temazepam Food Interactions
- Avoid alcohol.
- Avoid avocado.
- Avoid excessive quantities of coffee or tea (Caffeine).
- Serum levels may be increased by grapefruit juice.
- St John's wort may decrease temazepam levels.
- St John's wort, kava kava, gotu kola may increase CNS depression.
Using Temazepam with other drugs
- Aminophylline Aminophylline may decrease the efficacy of Temazepam. Monitor for changes in the therapeutic effect of Temazepam if Aminophylline is initiated, discontinued or dose changed.
- Clozapine The benzodiazepine, Temazepam, may increase the adverse effects of Clozapine. Monitor for respiratory depression and hypotension if concomitant therapy is initiated.
- Dyphylline Dyphylline may decrease the efficacy of Temazepam. Monitor for changes in the therapeutic effect of Temazepam if Dyphylline is initiated, discontinued or dose changed.
- Ethotoin Possible increased levels of the hydantoin, decrease of benzodiazepine
- Fosphenytoin Possible increased levels of the hydantoin, decrease of benzodiazepine
- Kava Kava increases the effect of the benzodiazepine
- Mephenytoin Possible increased levels of the hydantoin, decrease of benzodiazepine
- Phenytoin Possible increased levels of the hydantoin, decrease of benzodiazepine
- Theophylline Theophylline may decrease the efficacy of Temazepam. Monitor for changes in the therapeutic effect of Temazepam if Theophylline is initiated, discontinued or dose changed.
Temazepam Overdose
Symptoms of overdose include somnolence, confusion, coma, hypoactive reflexes, dyspnea, hypotension, slurred speech, and impaired coordination. Treatment for benzodiazepine overdose is supportive. Flumazenil has been shown to selectively block the binding of benzodiazepines to CNS receptors, resulting in a reversal of benzodiazepine-induced CNS depression but not always respiratory depression due to toxicity.
Brand names for Temazepam
- Apo-Temazepam® (CA)
- CO Temazepam (CA)
- Euhypnos® (AU, BE, HK, IE, LU, NZ, TH)
- Euipnos® (IT)
- Gen-Temazepam (CA)
- Levanxol® (AT, BE, LU)
- Mabertin® (AR)
- Nocturne® (AU)
- Norkotral Tema® (DE)
- Normison® (AU, BE, CH, FI, FR, HK, IE, IT, LU, NL, NZ, ZA)
- Normitab® (NL)
- Nortem® (IE)
- Novo-Temazepam (CA)
- Nu-Temazepam (CA)
- Planum® (DE)
- PMS-Temazepam (CA)
- Pronervon T® (DE)
- ratio-Temazepam (CA)
- Remestan® (AT, DE)
- Restoril® (CA)
- Signopam® (HU, PL)
- Somapam® (NZ)
- Temador® (BE)
- Temaze® (AU)
- Temazepam® (GB)
- temazep von ct® (DE)
- Temtabs® (AU)
- Tenox® (FI, IE)
Slang for Temazepam
- King Kong pills (formerly referred to barbiturates, now more commonly refers to temazepam)
- Jellies
- Jelly
- Edinburgh eccies
- Tams
- Terms
- Mazzies
- Temazies
- Tammies
- Temmies
- Beans
- Eggs
- Green eggs
- Wobbly eggs
- Knockouts
- Hardball
- Norries
- Oranges (common term in Australia and New Zealand)
- Rugby balls
- Ruggers
- Terminators
- Red and blue
- No-gos
- Blackout
- Green devils
- Drunk pills
- Brainwash
- Mind erasers
- Tem-tem's (combined with buprenorphine)
- Mommy's big helper
- Vitamin T
- Big T
- TZ
- On the nod (under the influence of heroin and temazepam together)
References
"American Academy of Pediatrics Committee on Drugs. The Transfer of Drugs and Other Chemicals Into Human Milk,"Pediatrics, 2001, 108(3):776-89.
Divoll M, Greenblatt DJ, Harmatz JS, et al, "Effect of Age and Gender on Disposition of Temazepam,"J Pharm Sci, 1981, 70(10):1104-7.
Grahame-Smith DG, "Misuse of Temazepam,"Br Med J (Clin Res Ed), 1991, 302(6786):1210.
Ho PC, Triggs EJ, Heazlewood V, et al, "Determination of Nitrazepam and Temazepam in Plasma by High Performance Liquid Chromatography,"Ther Drug Monit, 1983, 5(3):303-7.
Klotz U and Kanto J, "Pharmacokinetics and Clinical Use of Flumazenil (Ro 15-1788),"Clin Pharmacokinet, 1988, 14(1):1-12.
Mokhlesi B, Leikin JB, Murray P, et al, "Adult Toxicology in Critical Care: Part II: Specific Poisonings,"Chest, 2003, 123(3):897-922.
Scharf MB, Berkowitz DV, and Brannen DE, "Effectiveness of Low-Dose Temazepam on Sleep Patterns in Geriatric Insomniac Subjects,"Consult Pharm, 1993, 8(12):1367-73.