Flurazepam

Indications
 Oral
Short-term management of insomnia
Adult: 15-30 mg once at night.
Child: ≥15 yr: 15 mg at bedtime.
Elderly: Max initial dose: 15 mg at night.

Special Populations: Start with small doses in renal impairment and liver disease.
Contraindications
 Hypersensitivity; porphyria. Pregnancy (3rd trimester); neonates.
Warnings / Precautions
 Chronic pulmonary insufficiency; elderly or debilitated patients; muscle weakness, impaired liver or kidney function; drowsiness may affect skilled tasks; monitor cardio-respiratory function when used for deep sedation; personality disorders or organic brain changes; history of alcohol or drug addiction. Respiratory depression and hypotension with parenteral admin. Dependence; lactation. Safety and efficacy are not proven in children <15 yr.
Adverse Reactions
 Drowsiness and lightheadedness, sedation, muscle weakness and ataxia; less frequently vertigo, headache, confusion, depression, slurred speech, changes in libido, tremor, visual disturbances, urinary retention, GI disturbances, changes in salivation and amnesia.
Overdose Reactions
 Overdosage may lead to somnolence, confusion and coma. Treatment is supportive. Monitor respiration, pulse and BP. Gastric lavage may be used. Administer IV fluids and maintain an adequate airway. Flumazenil may be used as an adjunct to the proper management of benzodiazepine overdose.
Drug Interactions
 Antidepressants, antihistamines, antipsychotics, general anesthetics, other hypnotics or sedatives, opioid analgesics and cisapride. Increased toxicity by amprenavir, cimetidine, ciprofloxacin, clarithromycin, clozapine, CNS depressants, diltiazem, disulfiram, digoxin, erythromycin, ethanol, levodopa, loxapine, metoprolol, metronidazole, miconazole, nefazodone, nelfinavir, omeprazole, phenytoin, rifabutin, rifampicin, ritonavir, troleandromycin, valproic acid and verapamil. Effect is decreased by carbamazepine, rifampicin and rifabutin. Alcohol.
See Below for More flurazepam Drug Interactions
Food Interactions
 Serum levels increased by grapefruit juice. Herbs such as valerian, St John's wort, kava kava, gotu kola may increase CNS depression.
Mechanism of Actions
 Flurazepam is a long-acting benzodiazepine. It binds to stereospecific benzodiazepine receptors on the postsynaptic GABA neuron within the CNS, including the limbic system, reticular formation. It enhances the inhibitory effect of GABA on neuronal excitability by increasing neuronal membrane permeability to chloride ions, thus resulting in hyperpolarisation and stabilisation.
Onset: Hypnotic: 15-20 minutes.
Duration: 7-8 hr.
Absorption: Readily absorbed from the GI tract.
Metabolism: Metabolised in the liver to N-desalkylflurazepam (active) and N-hydroxyethylflurazepam.
Excretion: Elimination half-life: 2.3 hr (parent drug). Urine, mainly as conjugated metabolites.
Administration
 May be taken with or without food.
Storage Conditions
 Oral: Store at 15-30°C.
ATC Classification
 N05CD01 - flurazepam ; Belongs to the class of benzodiazepine derivatives. Used as hypnotics and sedatives.
Storage
 Oral: Store at 15-30°C.
Available As
  • Flurazepam 10 mg
  • Flurazepam 15 mg
  • Flurazepam 5 mg

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