Flurazepam

Indications

Flurazepam is used for: Insomnia

Adult Dose

Oral Short-term management of insomnia Adult: 15-30 mg at night. Elderly: Max: 15 mg at night.

Child Dose

Oral Short-term management of insomnia Child: >15 yr 15 mg at night. Elderly: Max: 15 mg at night.

Renal Dose

Administration

May be taken with or without food.

Contra Indications

Hypersensitivity; porphyria. Pregnancy (3rd trimester); neonates.

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. Lactation: Excretion in milk unknown; not recommended

Pregnancy-Lactation

Pregnancy Category: X Lactation: Excretion in milk unknown; not recommended Minor tranquilizers should be avoided in 1st trimester of pregnancy due to increased risk of congenital malformations Maternal use shortly before delivery is associated with floppy infant syndrome (good and consistent evidence) Prenatal benzodiazepine exposure slightly increased oral cleft risk (limited or inconsistent evidence)

Interactions

May enhance CNS depressant effect w/ antidepressants, antipsychotics, general anaesth, hypnotics or sedatives, opioid analgesics. Flurazepam clearance may be reduced by cimetidine, and may be increased by rifampicin.

Adverse Effects

Side effects of Flurazepam : Common Ataxia, Dizziness, Drowsiness, Lethargy, Light-headedness Less Common Chest pain, palpitations, Headache, irritability, nervousness, weakness, GI complaints, Myalgia, GU complaints Rare Elevations of AST, ALT, bilirubin (T&D), alk phos

Mechanism of Action

Flurazepam is a long-acting benzodiazepine which binds to stereospecific benzodiazepine receptors on the postsynaptic GABA neuron w/in the CNS, including the limbic system, reticular formation. It enhances the inhibitory effect of GABA on neuronal excitability by increasing neuronal membrane permeability to Cl ions, thus resulting in hyperpolarisation and stabilisation.