|Apo®-Triazo; Gen-Triazolam; Novo-Triolam;
Short-term treatment of insomnia
Hypersensitivity to this drug or any component of its formulation
(cross-sensitivity with other benzodiazepines may exist); concurrent therapy
with CYP3A4 inhibitors (such as ketoconazole, itraconazole, protease inhibitors
and nefazodone); pregnancy
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.
Causes CNS depression (dose-related) resulting in sedation, dizziness,
confusion, or ataxia which may impair physical and mental capabilities. Patients
must be cautioned about performing tasks which require mental alertness (ie,
operating machinery or driving). Use with caution in patients receiving other
CNS depressants or psychoactive agents. Effects with other sedative drugs or
ethanol may be potentiated. Benzodiazepines have been associated with falls and
traumatic injury and should be used with extreme caution in patients who are at
risk of these events (especially the elderly).
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.
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
>10%: Central nervous system: Drowsiness
1% to 10%:
Central nervous system: Headache, dizziness, nervousness, lightheadedness,
Gastrointestinal: Nausea, vomiting
<1%: Tachycardia, euphoria, fatigue, confusion, depression, memory
impairment, visual disturbance, pain, cramps
Symptoms of overdose include somnolence, confusion, coma, diminished
reflexes, dyspnea, and hypotension
Treatment for benzodiazepine overdose is supportive. Rarely is mechanical
ventilation required. Flumazenil has been shown to selectively block the binding
of benzodiazepines to CNS receptors, resulting in a reversal of
benzodiazepine-induced CNS depression but not always respiratory depression.
CYP3A3/4 and 3A5-7 enzyme substrate
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,
protease inhibitors like amprenavir and ritonavir, verapamil may increase the
serum level and/or toxicity of triazolam; monitor for altered benzodiazepine
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.
Onset of hypnotic effect: Within 15-30 minutes
Duration: 6-7 hours
Distribution: Vd: 0.8-1.8 L/kg
Protein binding: 89%
Metabolism: Extensively in the liver
Half-life: 1.7-5 hours
Elimination: In urine as unchanged drug and metabolites
Onset of action is rapid, patient should be in bed when taking medication
Children <18 years: Dosage not established
Adults: 0.125-0.25 mg at bedtime
Dosing adjustment/comments in hepatic impairment: Reduce dose or
avoid use in cirrhosis
Alcohol: Additive CNS effect, avoid use
Respiratory and cardiovascular status
|Dental Health: Local
No information available to require special precautions
Effects on Dental Treatment|
No effects or complications reported
Take exactly as directed (do not increase dose or frequency); may take 2-3
weeks to achieve desired results; may cause physical and/or psychological
dependence. Do not use excessive alcohol or other prescription or OTC
medications (especially pain medications, sedatives, antihistamines, or
hypnotics) without consulting prescriber. Maintain adequate hydration (2-3 L/day
of fluids unless instructed to restrict fluid intake). You may experience
drowsiness, lightheadedness, impaired coordination, dizziness, or blurred vision
(use caution when driving or engaging in tasks requiring alertness until
response to drug is known); nausea, vomiting, or dry mouth (small frequent
meals, frequent mouth care, chewing gum, or sucking lozenges may help);
constipation (increased exercise, fluids, or dietary fruit and fiber may help);
altered sexual drive or ability (reversible); or photosensitivity (use
sunscreen, wear protective clothing and eyewear, and avoid direct sunlight).
Report persistent CNS effects (eg, memory impairment, confusion, depression,
increased sedation, excitation, headache, agitation, insomnia or nightmares,
dizziness, fatigue, impaired coordination, changes in personality, or changes in
cognition); changes in urinary pattern; muscle cramping, weakness, tremors, or
rigidity; ringing in ears or visual disturbances; chest pain, palpitations, or
rapid heartbeat; excessive perspiration; excessive GI symptoms (cramping,
constipation, vomiting, anorexia); or worsening of condition.
Pregnancy/breast-feeding precautions: Inform prescriber if you are pregnant.
Do not get pregnant during or for 1 month following therapy. Consult prescriber
for instruction on appropriate contraceptive measures. This drug may cause
severe fetal defects. Breast-feeding is not recommended.
Patients may require assistance with ambulation; lower doses in the elderly
are usually effective; institute safety measures
Tablet: 0.125 mg, 0.25 mg
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"Drug Therapy: The Diagnosis and Management of Insomnia," N Engl J Med,
Greenblatt DJ, Harmatz JS, Shapiro L, et al,
"Sensitivity to Triazolam in the Elderly," N Engl J Med, 1991,
Greenblatt DJ, von Moltke LL, Harmatz JS, et al,
"Interaction of Triazolam and Ketoconazole," Lancet, 1995, 345(8943):191.
Hukkinen SK, Varhe A, Olkkola KT, et al,
"Plasma Concentrations of Triazolam Are Increased by Concomitant Ingestion of Grapefruit Juice,"
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Meyer ML, Mourino AP, and Farrington FH,
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Sullivan RJ Jr,
"Respiratory Depression Requiring Ventilatory Support Following 0.5 mg of Triazolam,"
J Am Geriatr Soc, 1989, 37(5):450-2.
Sunter JP, Bal TS, and Cowan WK,
"Three Cases of Fatal Triazolam Poisoning," Br Med J (Clin Res Ed), 1988,
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"Oral Triazolam is Potentially Hazardous to Patients Receiving Systemic Antimycotics Ketoconazole or Itraconazole,"
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