Flurazepam HCl

A to Z Drug Facts

(flure-AZE-uh-pam HIGH-droe-KLOR-ide)

Dalmane, Apo-Flurazepam, Novo-Flupam, PMS-Flurazepam, Somnol, Som Pam

Class: Sedative and hypnotic/Benzodiazepine

 Action Potentiates action of gamma-aminobutyric acid, an inhibitory neurotransmitter, resulting in increased neural inhibition and CNS depression, especially in limbic system and reticular formation.

 Indications Treatment of insomnia.

 Contraindications Hypersensitivity to benzodiazepines; pregnancy.

 Route/Dosage

ADULTS: PO 15 to 30 mg at bedtime. ELDERLY OR DEBILITATED PATIENTS: PO 15 mg until individual response is determined.

 Interactions

Alcohol, other CNS depressants: Additive CNS depressant effects; may continue several days after discontinuation. Cimetidine, disulfiram, oral contraceptives, isoniazid, omeprazole: Increased effects of flurazepam. Digoxin: Serum digoxin concentrations may increase. Phenytoin: Serum concentrations may be increased. Rifampin: Decreased effects of flurazepam. Theophyllines: May antagonize sedative effects.

 Lab Test Interferences None well documented.

 Adverse Reactions

CV: Palpitations; chest pains; tachycardia; hypotension (rare). CNS: Dizziness; drowsiness; lightheadedness; staggering; ataxia; falling; lethargy; confusion; impaired memory; headache; weakness; paradoxical excitement; talkativeness; euphoria; apprehension; irritability; hallucinations; slurred speech; depression. DERM: Pruritus; rash. EENT: Difficulty focusing; blurred vision; burning of eyes; taste alterations. GI: Heartburn; nausea and vomiting; diarrhea; constipation; anorexia; upset stomach; GI pain; dry mouth. GU: Urinary incontinence; urinary retention, hesitancy or urgency. HEMA: Leukopenia; granulocytopenia. HEPA: Elevated AST, ALT, bilirubin and alkaline phosphatase; hepatitis. RESP: Shortness of breath. OTHER: Tolerance; physical and psychological dependence; body and joint pains; sweating; flushing.

 Precautions

Pregnancy: Contraindicated. Lactation: Excreted in breast milk. Children: Not recommended in children < 15 yr. Elderly or debilitated patients: Increased side effects; start with lowest dose. Anterograde amnesia: Has occurred with similar drugs. Alcohol may increase risk. Depression: Administer with caution to severely depressed patients or those with suicidal tendencies. Signs and symptoms of depression may be intensified. Renal or hepatic impairment: Use with caution. Abnormal liver function tests and blood dyscrasias have occurred. Withdrawal: Withdrawal symptoms may occur after discontinuation of higher doses taken over long periods.

 Administration/Storage

• Administer at bedtime with fluid.
• Store at room temperature in light-resistant container.

 Assessment/Interventions

• Obtain patient history, including drug history and any known allergies.
• Perform baseline neuro assessment and reassess with initiation of drug.
• Ensure that side rails are raised after administration.
• Assist patient with ambulation after drug administration.
• Assess vision before beginning drug therapy and monitor during initial treatment period.
• Ensure that baseline CBC, liver and kidney function tests have been obtained before beginning therapy, and monitor at regular intervals.
• Assess for signs of bleeding (eg, petechiae, bruising, oozing at puncture sites).
• Assess for right upper quadrant abdominal tenderness or jaundice.

 Patient/Family Education

• Caution patient that this medication must not be taken during pregnancy or when pregnancy is possible. Advise patient to use reliable form of birth control while taking this drug.
• Tell patient to take drug with full glass of water at bedtime.
• Emphasize importance of not exceeding recommended dosage. If symptoms do not improve within 2 to 3 days of beginning drug therapy, or if tolerance develops, notify physician.
• Tell patient not to stop taking drug abruptly to avoid withdrawal symptoms. Explain that nighttime sleep may be disturbed for 1 to 2 nights after gradual discontinuation.
• Instruct patient to monitor weight and to report any excessive gain or loss.
• Advise patient to report the following symptoms to physician: Palpitations or chest pain, signs of bleeding, abdominal pain, jaundice, shortness of breath, rash, confusion, dizziness, nausea or vomiting.
• Instruct patient to take sips of water frequently, suck on ice chips or sugarless hard candy, or chew sugarless gum if dry mouth occurs.
• Advise patient to avoid intake of alcoholic beverages or other CNS depressants.
• Advise patient that drug may cause drowsiness and to use caution while driving or performing other tasks requiring mental alertness.

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Copyright © 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts