Treatment of insomnia
Hypersensitivity to this drug or any component of its formulation
(cross-sensitivity with other benzodiazepines may exist); narrow-angle glaucoma
(not in product labeling, however, benzodiazepines are contraindicated);
Should be used only after evaluation of potential causes of sleep
disturbance. Failure of sleep disturbance to resolve after 7-10 days may
indicate psychiatric or medical illness. A worsening of insomnia or the
emergence of new abnormalities of thought or behavior may represent unrecognized
psychiatric or medical illness and requires immediate and careful evaluation.
Use with caution in elderly or debilitated patients, patients with hepatic
disease (including alcoholics), or renal impairment. Use with caution in
patients with respiratory disease or impaired gag reflex. Avoid use in patients
with sleep apnea.
Use caution in patients with depression, particularly if suicidal risk may be
present. Use with caution in patients with a history of drug dependence.
Benzodiazepines have been associated with dependence and acute withdrawal
symptoms on discontinuation or reduction in dose. Acute withdrawal, including
seizures, may be precipitated after administration of flumazenil to patients
receiving long-term benzodiazepine therapy.
Benzodiazepines have been associated with anterograde amnesia. Paradoxical
reactions, including hyperactive or aggressive behavior have been reported with
benzodiazepines, particularly in adolescent/pediatric or psychiatric patients.
Does not have analgesic, antidepressant, or antipsychotic properties.
Central nervous system: Drowsiness, fatigue, ataxia, memory impairment,
anxiety, depression, headache, confusion, nervousness, dizziness,
incoordination, hypo- and hyperkinesia, agitation, euphoria, paranoid reaction,
nightmares, abnormal thinking
Dermatologic: Dermatitis, pruritus, rash
Endocrine & metabolic: Decreased libido, menstrual irregularities
Gastrointestinal: Xerostomia, constipation, diarrhea, dyspepsia, anorexia,
abnormal taste perception, nausea, vomiting, increased or decreased appetite,
Genitourinary: Impotence, incontinence
Hematologic: Blood dyscrasias
Neuromuscular & skeletal: Dysarthria, rigidity, tremor, muscle cramps,
Ocular: Blurred vision
Miscellaneous: Drug dependence
Decreased therapeutic effect: Carbamazepine, rifampin, rifabutin may enhance
the metabolism of quazepam and decrease its therapeutic effect; consider using
an alternative sedative/hypnotic agent
Increased toxicity: Cimetidine, ciprofloxacin, clarithromycin, clozapine, CNS
depressants, diltiazem, disulfiram, digoxin, erythromycin, ethanol, fluconazole,
fluoxetine, fluvoxamine, grapefruit juice, isoniazid, itraconazole,
ketoconazole, labetalol, levodopa, loxapine, metoprolol, metronidazole,
miconazole, nefazodone, omeprazole, phenytoin, rifabutin, rifampin,
troleandomycin, valproic acid, verapamil may increase the serum level and/or
toxicity of quazepam; monitor for altered benzodiazepine response
Binds to stereospecific benzodiazepine receptors on the postsynaptic GABA
neuron at several sites within the central nervous system, including the limbic
system, reticular formation. Enhancement of the inhibitory effect of GABA on
neuronal excitability results by increased neuronal membrane permeability to
chloride ions. This shift in chloride ions results in hyperpolarization (a less
excitable state) and stabilization.
Absorption: Oral: Rapid
Parent drug: 25-41 hours
Active metabolite: 40-114 hours
Adults: Oral: Initial: 15 mg at bedtime, in some patients the dose may be
reduced to 7.5 mg after a few nights
|Dental Health: Local
No information available to require special precautions
Effects on Dental Treatment|
>10% of patients will experience dry mouth which disappears with cessation
of drug therapy
Avoid alcohol and other CNS depressants; avoid activities needing good
psychomotor coordination until CNS effects are known; drug may cause physical or
psychological dependence; avoid abrupt discontinuation after prolonged
Provide safety measures (ie, side rails, night light, call button); remove
smoking materials from area; supervise ambulation
Monitor respiratory and cardiovascular status
Tablet: 7.5 mg, 15 mg
Chung M, Hilbert JM, Gural RP, et al, "Multiple Dose Quazepam Kinetics,"
Clin Pharmacol Ther, 1984, 35(4):520-4.
Hilbert JM, Gural RP, Symchowicz S, et al,
"Excretion of Quazepam Into Human Breast Milk," J Clin Pharmacol, 1984,
Martinez HT and Serna CT,
"Short-Term Treatment With Quazepam of Insomnia in Geriatric Patients," Clin
Ther, 1982, 5(2):174-8.
Winsauer HJ and O'Hair DE,
"Quazepam: Short-Term Treatment of Insomnia in Geriatric Outpatients," Curr
Ther Res, 1984, 35(2):228-34.
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