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temazepam (tem-az-a-pam)



Therapeutic: sedative/hypnotics

Pharmacologic: benzodiazepines

Schedule IV


Short-term management of insomnia (<4 wk).


Acts at many levels in the CNS, producing generalized depression. Effects may be mediated by gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter. Therapeutic Effects: Relief of insomnia.

Adverse Reactions/Side Effects

CNS: abnormal thinking, behavior changes, hangover, dizziness, drowsiness, hallucinations, lethargy, paradoxic excitation, sleep driving. EENT: blurred vision. GI: constipation, diarrhea, nausea, vomiting. Derm: rashes. Misc: physical dependence, psychologic dependence, tolerance.


Examination and Evaluation

  • Monitor daytime drowsiness, short-term memory deficits, and “hangover” symptoms (headache, nausea, lethargy, irritability, dysphoria). Repeated or excessive symptoms may require change in dose or medication.

  • Assess dizziness that might affect gait, balance, and other functional activities (See Appendix C). Report balance problems and functional limitations to the physician, and caution the patient and family/caregivers to guard against falls and trauma.

  • Report any behavioral or personality changes such as excessive excitation, hallucinations, or expression of abnormal thoughts.


  • Guard against falls and trauma (hip fractures, head injury, and so forth). Implement fall-prevention strategies, especially in older adults or if drowsiness and dizziness carry over into the daytime (See Appendix E).

  • Help patient explore nonpharmacologic methods to improve sleep, such as relaxation techniques, regular exercise, avoid caffeine, and so forth.

Patient/Client-Related Instruction

  • Instruct patients on prolonged treatment not to discontinue medication without consulting their physician. Long-term use can cause tolerance and physical/psychologic dependence, and increased sleep problems (rebound insomnia) can occur when the drug is suddenly discontinued.

  • Advise patient to avoid alcohol and other CNS depressants because of the increased risk of sedation and adverse effects.

  • Caution patient and family/caregivers to guard against complex motor behaviors that can occur while asleep, including driving a car.

  • Instruct patient to report other bothersome side effects including severe or prolonged blurred vision, skin rash, or GI problems (nausea, vomiting, constipation, diarrhea).


Absorption: Well absorbed after oral administration.

Distribution: Widely distributed; crosses blood-brain barrier. Probably crosses the placenta and enters breast milk. Accumulation of drug occurs with chronic dosing.

Protein Binding: 96%.

Metabolism and Excretion: Metabolized by the liver.

Half-life: 10–20 hr.

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PO 30 min 2–3 hr 6–8 hr


Contraindicated in: Hypersensitivity; Cross-sensitivity with other benzodiazepines may exist; Preexisting CNS depression; Severe uncontrolled pain; Angle-closure glaucoma; Impaired respiratory function; Sleep apnea; OB: Neonates born to mothers ...

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