Prescribing
FDA Schedule IVForms: 0.125, 0.25mg tablet
Dose Range: 0.125-0.25 mg/day
Starting: 0.125-0.25 mg po qhs
Stopping: Abrupt discontinuation should be avoided. Daily dose may be decreased by 0.5 mg q3 days; however, some patients may require a slower reduction.
Precautions
Serious Side Effects: Overdose can result in hypotension, respiratory depression, and comaSide Effects: constipation, dysarthria, sedation/somnolence, dizziness, confusion, disequilibrium, ataxia, lightheadedness, weakness/asthenia, decreased libido, increased appetite, weight gain
Pharmacokinetics
t½: 2 (1.5-5)° TMAX: 1-4°Absorption Rate: Fast
Lipid Solubility: Moderate
Substrate of: 3A4
Inhibits: ∅ ; Induces: ∅
Active Metabolites: ∅
DDIs
- - CNS depression with combined use of opioids
- - 3A4 inhibitors can ↑ levels; likewise, 3A4 inducers can ↓ levels
Misc
- - extremely short t½ gives it a unique profile of being able to hasten sleep onset but not provide effective sedation during the night for patients who either have middle of the night awakening or need to prolong total sleep time
- - shorter t½ should prevent impairments in cognitive and motor performance during the day as well as daytime sedation
- - rebound insomnia can occur
- - the risk of unusual behaviors or hallucinations may be greater with triazolam than with other sedative benzodiazepines
Special Populations
Category X—Limited Human Data—Animal Data Suggest Low Risk
No reports describing the use of triazolam during human lactation or measuring the amount excreted into milk have been located. The molecular weight is low enough that passage into human milk should be expected. The effect of this exposure on a nursing infant is unknown, but closely related drugs are classified by the American Academy of Pediatrics as agents that may be of concern during breastfeeding.
Initial dose of 0.125 mg orally at bed time. Max dose of 0.25 mg daily
2019 BEE℞S Recommendation: Avoid. Older adults have increased sensitivity to benzodiazepines and decreased metabolism of long- acting agents; in general, all benzodiazepines increase risk of cognitive impairment, delirium, falls, fractures, and motor vehicle crashes in older adults. May be appropriate for seizure disorders, RBD, benzodiazepine withdrawal, EtOH withdrawal, severe GAD, and periprocedural anesthesia.
No adjustment provided in package insert; use with caution
No adjustment provided in package insert; use with caution