Restoril

Res·to·ril (rst-rl)

A trademark for the drug temazepam.

---

Restoril,

trademark for a hypnotic agent (temazepam).

---

temazepam

Restoril

Pharmacologic class: Benzodiazepine

Therapeutic class: Sedative-hypnotic

Controlled substance schedule IV

Pregnancy risk category X

Action

Depresses CNS at limbic, thalamic, and hypothalamic levels. Enhances effects of gamma-aminobutyric acid, resulting in sedation, hypnosis, skeletal muscle relaxation, and anticonvulsant and anxiolytic activity.

Availability

Capsules: 7.5 mg, 15 mg, 30 mg

⊘Indications and dosages

➣ Insomnia

Adults: 15 mg P.O. at bedtime p.r.n. Range is 7.5 to 30 mg.

Dosage adjustment

• Elderly or debilitated patients

Contraindications

• Hypersensitivity to drug or other benzodiazepines
• Pregnancy

Precautions

Use cautiously in:
• chronic pulmonary insufficiency, hepatic dysfunction, renal disease, psychoses, drug abuse
• history of suicide attempt or drug abuse
• elderly or debilitated patients
• breastfeeding patients
• children younger than age 15.

Administration

• Give at bedtime with or without food.

Route	Onset	Peak	Duration
P.O.	30 min	1.2-1.6 hr	Unknown

Adverse reactions

CNS: hangover, headache, dizziness, drowsiness, lethargy, fatigue, paradoxical stimulation, light-headedness, talkativeness, irritability, nervousness, confusion, euphoria, relaxed feeling, tremor, incoordination, impaired memory, nightmares, paresthesia

CV: chest pain, palpitations, tachycardia

EENT: eye irritation, pain, and swelling; photophobia; tinnitus

GI: nausea, vomiting, constipation, diarrhea, heartburn, abdominal pain, dry mouth, anorexia

Musculoskeletal: joint pain

Other: altered taste, body pain, physical or psychological drug dependence, drug tolerance

Interactions

Drug-drug. Antidepressants, antihistamines, opioid analgesics, other sedative-hypnotics: additive CNS depression

Digoxin: increased digoxin blood level, greater risk of toxicity

Probenecid: faster temazepam onset and prolonged effects

Theophylline: antagonism of temazepam's sedative effects

Drug-herbs. Chamomile, hops, kava, skullcap, valerian: increased CNS depression

Drug-behaviors. Alcohol use: additive CNS depression

Smoking: increased drug metabolism

Patient monitoring

• Monitor neurologic status carefully. Check for paradoxical reactions, especially in elderly patient.
• Watch for signs and symptoms of physical and psychological drug dependence. Stay alert for drug hoarding.

Patient teaching

• Advise patient to establish effective bedtime routine, to minimize insomnia.
• Inform patient (and significant other if appropriate) that drug may cause psychological and physical dependence and should be used only as prescribed and needed.
• Caution patient to avoid driving and other hazardous activities on day after taking drug, until he knows how it affects concentration and alertness.
• Instruct patient not to drink alcohol.
• Advise patient not to smoke or use herbs without consulting prescriber.
• Instruct patient to report suspected pregnancy.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs, herbs, and behaviors mentioned above.

---

Restoril®

Temazepam, see there