Flurazepam
Flurazepam
Definition
Flurazepam is a benzodiazepine hypnotic (sleeping medication) that is given by mouth. It is sold in the United States under the brand name of Dalmane, but is also manufactured and sold by several companies under its generic name.
Purpose
Flurazepam is used for the short-term treatment of insomnia , which is a sleep disorder characterized by difficulty in falling or staying asleep.
Description
Flurazepam is a benzodiazepine, which means that it belongs to a class of drugs whose primary actions are to reduce the patient’s anxiety , relax the skeletal muscles, and bring on sleep. Flurazepam is chemically and pharmacologically related to such other benzodiazepine hypnotics as temazepam (Restoril), triazolam (Halcion), quazepam (Doral), and estazolam. All the benzodiazepines work by enhancing the effects of a naturally occurring chemical in the body called gamma-aminobutyric acid (GABA). GABA is a neurotransmitter, or chemical that helps to conduct nerve impulses across the tiny gaps between nerve cells. GABA acts to lower the level of activity in the central nervous system; it is involved in muscle relaxation, sedation, and sleep, and plays a role in preventing seizure activity.
Flurazepam decreases the time it takes the patient to fall asleep, thus reducing the number of nighttime awakenings and increasing the length of total sleep time. The difference between a benzodiazepine like flurazepam that is used to help patients fall asleep and those that are used as tranquilizers is the way that each type acts in the brain. The sleep-inducing benzodiazepines are faster in getting to the part of the brain that controls sleep. They also reach higher levels of concentration there than the benzodiazepines that are used as tranquilizers.
Flurazepam is available in 15- and 30-mg capsules.
Recommended dosage
The usual dose of flurazepam is 15–30 mg taken by mouth at bedtime. Older or physically weakened patients are usually given the lower dose. Children younger than 15 and women who are pregnant or nursing a baby should not be given flurazepam. In addition, the drug should not be used for longer than four weeks.
Precautions
Some of the flurazepam is metabolized (broken down) in the body to form another compound called desalkylflurazepam, which can also cause drowsiness the next day because it remains in the body for hours. This “hangover” effect is most common in people who are taking flurazepam on a daily basis. People who are taking flurazepam may not be able to safely operate machinery or drive a car the next day.
Patients who take flurazepam for several days or weeks may experience a reaction called rebound insomnia when they stop taking it. When a person takes a medication for sleep on a regular basis, the body adjusts to the presence of the drug. It tries to counteract the effects of the medication. As a result, when the person stops taking the sleeping medication, the body will take a few nights to return to its normal condition.
KEY TERMS
Benzodiazepines —A group of central nervous system depressants used to relieve anxiety or to induce sleep.
Central nervous system depressant —Any drug that lowers the level of stimulation or excitement in the central nervous system.
Central nervous system stimulant —Any drug that raises the level of activity in the central nervous system.
Gamma-aminobutyric acid (GABA) —A neuro-transmitter that helps to lower or reduce the level of excitement in the nerves, leading to muscle relaxation, calmness, sleep, and the prevention of seizures.
Hypnotic —A type of medication that induces sleep.
Metabolism —The group of biochemical processes within the body that release energy in support of life.
Neurotransmitter —A chemical in the brain that transmits messages between neurons, or nerve cells.
Rebound effect —A physical reaction to stopping a medication characterized by the reappearance of the symptom that the medication was given to suppress. For example, people who stop taking flurazepam may experience rebound insomnia.
During this period of readjustment, the person may experience a few sleepless hours each night.
The sleepiness that flurazepam brings about may be intensified if the patient drinks alcoholic beverages or takes other medications that contain central nervous system depressants. Common types of medications that may cause problems when combined with flurazepam include tranquilizers and antihistamines (allergy medications).
Elderly patients who are taking flurazepam should be monitored for signs of dizziness or loss of coordination. They are at increased risk of falling if they wake up and get out of bed during the night to get a drink of water or use the bathroom.
Side effects
Some people experience dizziness, daytime drowsiness, and loss of coordination while they are taking flurazepam. Elderly patients may lose their balance and fall. Less common side effects include blurred vision, nausea and vomiting, diarrhea or constipation, nightmares, and a feeling of depression.
Interactions
The effects of flurazepam are increased by other central nervous system depressants. These types of chemicals include alcohol, sedatives , and antihistamines. In addition, flurazepam may interact with antiseizure medications.
See alsoSedatives and related drugs; Sleep disorders.
Resources
BOOKS
American Society of Health-System Pharmacists. AHFS Drug Information 2002. Bethesda, MD: American Society of Health-System Pharmacists, 2002.
Preston, John D., John H. O’Neal, and Mary C. Talaga. Handbook of Clinical Psychopharmacology for Therapists, 4th ed. Oakland, CA: New Harbinger Publications, 2004.
PERIODICALS
Blin, Olivier, and others. “A Double-Blind, Placebo- and Flurazepam-Controlled Investigation of the Residual Psycho-motor and Cognitive Effects of Modified Release Zolpidem in Young Healthy Volunteers.” Journal of Clinical Psycho-pharmacology 26.3 (June 2006): 284–89.
Rosenberg, Russell P. “Sleep Maintenance Insomnia: Strengths and Weaknesses of Current Pharmacologic Therapies.” Annals of Clinical Psychiatry 18.1 (Jan.-Mar. 2006): 49–56.
Rowlett, James K., and others. “Anti-Conflict Effects of Benzodiazepines in Rhesus Monkeys: Relationship with Therapeutic Doses in Humans and Role of GABA-Sub (A) Receptors.” Psychopharmacology 184.2 (Jan. 2006): 201–11.
Tamblyn, Robyn, and others. “A 5-Year Prospective Assessment of the Risk Associated with Individual Benzodiazepines and Doses in New Elderly Users.” Journal of the American Geriatrics Society 53.2 (Feb. 2005): 233–41.
Thomas, Sandra P. “From the Editor—Caution Urged in Prescribing Psychotropic Drugs for Older Patients.” Issues in Mental Health Nursing 26.4 (May 2005): 357–58.
Jack Raber, Pharm.D.
Ruth A. Wienclaw, PhD
Flurazepam
Flurazepam
Definition
Flurazepam is a benzodiazepine hypnotic (sleeping medication) that is given by mouth. It is sold in the United States under the brand name of Dalmane, but is also manufactured and sold by several companies under its generic name.
Purpose
Flurazepam is used for the short-term treatment of insomnia , which is a sleep disorder characterized by difficulty in falling or staying asleep.
Description
Flurazepam is a benzodiazepine, which means that it belongs to a class of drugs whose primary action is to reduce the patient'sanxiety, relax the skeletal muscles, and bring on sleep. Flurazepam is chemically and pharmacologically related to such other benzodiazepine hypnotics as temazepam (Restoril), triazolam (Halcion), quazepam (Doral), and estazolam . All the benzodiazepines work by enhancing the effects of a naturally occurring chemical in the body called gamma-aminobutyric acid (GABA). GABA is a neurotransmitter, or chemical that helps to conduct nerve impulses across the tiny gaps between nerve cells. GABA acts to lower the level of activity in the central nervous system; it is involved in muscle relaxation, sedation, and sleep, and plays a role in preventing seizure activity.
Flurazepam decreases the time it takes the patient to fall asleep, thus reducing the number of nighttime awakenings and increasing the length of total sleep time. The difference between a benzodiazepine like flurazepam that is used to help patients fall asleep and those that are used as tranquilizers is the way that each type acts in the brain . The sleep-inducing benzodiazepines are faster in getting to the part of the brain that controls sleep. They also reach higher levels of concentration there than the benzodiazepines that are used as tranquilizers.
Flurazepam is available in 15- and 30-mg capsules.
Recommended dosage
The usual dose of flurazepam is 15–30 mg taken by mouth at bedtime. Older or physically weakened patients are usually given the lower dose. Women who are pregnant or nursing a baby, and children younger than 15 should not be given flurazepam. In addition, the drug should not be used for longer than four weeks.
Precautions
Some of the flurazepam is metabolized (broken down) in the body to form another compound called desalkylflurazepam, which can also cause drowsiness the next day because it remains in the body for hours. This "hangover" effect is most common in people who are taking flurazepam on a daily basis. People who are taking flurazepam may not be able to operate machinery safely or drive a car the next day.
Patients who take flurazepam for several days or weeks may experience a reaction called rebound insomnia when they stop taking it. When a person takes a medication for sleep on a regular basis, the body adjusts to the presence of the drug. It tries to counteract the effects of the medication. As a result, when the person stops taking the sleeping medication, the body will take a few nights to return to its normal condition. During this period of readjustment, the person may experience a few sleepless hours each night.
The sleepiness that flurazepam brings about may be intensified if the patient drinks alcoholic beverages or takes other medications that contain central nervous system depressants. Common types of medications that may cause problems when combined with flurazepam include tranquilizers and antihistamines.
Elderly patients who are taking flurazepam should be monitored for signs of dizziness or loss of coordination. They are at increased risk of falling if they wake up and get out of bed during the night to get a drink of water or use the bathroom.
Side effects
Some people experience dizziness, daytime drowsiness, and loss of coordination while they are taking flurazepam. Elderly patients may lose their balance and fall. Less common side effects include blurred vision, nausea and vomiting, diarrhea or constipation, nightmares, and a feeling of depression.
Interactions
The effects of flurazepam are increased by other central nervous system depressants. These types of chemicals include alcohol, sedatives, and antihistamines (allergy medications). In addition, flurazepam may interact with anti-seizure medications.
See also Sedatives and related disorders; Sleep disorders
Resources
BOOKS
American Society of Health-System Pharmacists. AHFS Drug Information 2002. Bethesda, MD: American Society of Health-System Pharmacists, 2002.
DeVane, C. Lindsay, Pharm.D. "Drug Therapy for Mood Disorders." In Fundamentals of Monitoring Psychoactive Drug Therapy. Baltimore, MD: Williams and Wilkins, 1990.
Jack Raber, Pharm.D.