Triazolam

DEA Class;  Rx

Common Brand Names; Halcion

Documented hypersensitivity

Acute alcohol intoxication

Myasthenia gravis (allowable in limited circumstances)

Narrow angle glaucoma (questionable)

Severe respiratory depression

Depressed neuroses, psychotic reactions

IV use in shock, coma, depressed respiration, patients who recently received other respiratory depressants

Medications that significantly impair oxidative metabolism mediated by cytochrome P450 3A (CYP 3A) including ketoconazole, itraconazole, nefazodone, and several HIV protease inhibitors

• Drowsiness (14%)
• Headache (5-10%)
• Dizziness (5-10%)
• Nervousness (5-10%)
• Ataxia (4-5%)
• Lightheadedness (4-5%)
• N/V (4-5%)
• Anterogade amnesia
• Paradoxical reactions
• Travelers amnesia-especially if combined with EtOH
• Confusion
• Cramps
• Fatigue
• Memory impairment
• Depression
• Visual disturbance
• Xerostomia
• Anterograde amnesia
• Dreaming/nightmares
• Confusion

Use caution in COPD, sleep apnea, renal/hepatic disease, open-angle glaucoma (questionable), impaired gag reflex, depression, suicide ideation

Benzodiazepines may worsen depression; take appropriate precautions (e.g., limiting total prescription size and increased monitoring for suicidal ideation) in patients with depression

Anterograde amnesia may occur

Hypersensitivity reactions reported

Sleep related activities (sleep driving, sleep-cooking, sleep-eating etc) may occur

Hyperactive aggressive behavior may occur

May impair ability to perform hazardous tasks

Failure of insomnia to remit after 7 – 10 days of treatment may indicate presence of primary psychiatric and/or medical illness that should be evaluated

Increase in daytime anxiety may occur; consider therapy discontinuation if this occurs

Use caution and consider appropriate dose reduction when used concomitantly with weak or moderate CYP450 3A inhibitors

Therapy can cause drowsiness and a decreased level of consciousness; patients, particularly the elderly, are at higher risk of falls

There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to drug during pregnancy

There are no data on presence of drug in human milk or effects on milk production