II. Indications

  1. Insomnia
    1. Short-term use only

III. Dosing: Adults

  1. Dose: 15-30 mg at bedtime as needed for Insomnia
  2. Max Daily Dose: 30 mg (15 mg in elderly or debilitated)

IV. Dosing: Equivalents with other Benzodiazepines

  1. Valium = Flurazepam Dose x 0.6
  2. Phenobarbital = Flurazepam Dose x2.0

V. Precautions

  1. Drug accumulation in elderly

VI. Pharmacokinetics

  1. Half-Life: 24 to 100 hours
  2. Metabolized by CYP3A4 and CYP2C9 to active metabolites

VII. Adverse Effects

VIII. Advantages

  1. Long half life prevents rebound Insomnia
    1. Rebound is often seen in other Benzodiazepines used >30 days

IX. Safety

  1. Pregnancy Category X (all trimesters)
  2. Avoid in Lactation
  3. Schedule IV Controlled Substance

XI. References

  1. (2019) Med Lett Drugs Ther 61(1578): 121-6
  2. (2020) Presc Lett, Resource #361206, Appropriate Use of Benzodiazepines
  3. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 55
  4. Hamilton (2020) Tarascon Pocket Pharmacopoeia

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