Triazolam

Triazolam, marketed as Halcion, belongs to a class of drugs called benzodiazepines, and due to its effect as a central nervous system depressant, it is used to treat insomnia.

Overview

Triazolam increases the efficiency of a chemical in the brain called “GABA,” whose role is to reduce the communication between brain cells. Triazolam therefore has a calming effect on the brain and the nervous system, so much so that individuals taking it quickly become drowsy and readily fall asleep.

Triazolam is short-acting, and the effects of the drug wear off relatively quickly, usually between 1 and 2 hours depending on factors such as body weight and tolerance to the drug. Because of its short period of action, triazolam is generally prescribed for patients who have trouble falling asleep initially, but once they do they are able to stay asleep until their required waking time. For these patients, Triazolam is ideal because they generally wake up feeling less drowsiness than if they had used a drug with a longer half-life -- although some drowsiness may still be experienced.

Triazolam’s short period of action means it is not suitable for sleep disorders in which the patient has trouble sleeping for longer periods, such as patients who awaken frequently throughout the night, or those who awaken too early and have difficulty falling back to sleep. For such patients, other benzodiazepines such as quazepam are usually preferred.

Although triazolam is primarily prescribed for insomnia, it is also, if more rarely, given for some other conditions. It is sometimes prescribed for other sleep problems, such as circadian rhythm sleep disorders like jet lag, and as a sleep aid for people on short to medium length flights. It is also occasionally used to reduce anxiety in people who become anxious during other medical procedures such as MRI scans.

Triazolam has a powerful effect on the central nervous system and has a high potential or addiction, withdrawal symptoms, and tolerance. For this reason, it is prescribed only for short periods, usually a maximum of 14 days.

Condition Treated

  • Insomnia
  • Circadian rhythm sleep disorders (e.g. jet lag)
  • Anxiety

Type of Medicine

  • Central nervous system depressant
  • Benzodiazepine
  • Sedative-hypnotic

Side Effects

In addition to its desired effect of helping patients fall asleep, triazolam can also trigger some undesired side effects. Contact your doctor promptly if you experience any of the symptoms listed below:

  • Drowsiness or sleepiness through the daytime
  • Dizziness, lightheadedness, fainting or feeling faint
  • Poor coordination, including unsteadiness, trembling, problems with muscle control, shaking, or an unsteady walk
  • Mental changes, including memory loss, abnormal thoughts, thoughts of self-harm or suicide, hallucinations, confusion, trouble concentrating
  • Emotional changes, including changes in mood, depression, aggression, or anxiety
  • Strange sensations on the skin such as burning, prickling, itching or tingling
  • Changes to your hearing, including ringing in the ears or hearing loss
  • Loss of vision or worsened vision
  • Additional sleep problems, such as nightmares, or continued trouble getting to sleep

In addition to the above, some people also report they performing activities in the morning while still asleep or partly asleep. These activities can be quite complex such as cooking and eating breakfast, driving a vehicle, or having a conversation over the phone. Patients typically do not remember these activities. These behaviors appear to be more common in patients who take higher doses, drink alcohol, or take other depressant drugs alongside triazolam. Speak to your doctor if you experience this yourself.

Although allergic reactions to triazolam are very rare, they have been reported. If you experience any symptoms associated with an allergic reaction, seek emergency medical assistance immediately. These symptoms can include:

  • A rash, hives, or redness of the skin
  • Itching skin
  • Swelling in the face, particularly around the lips, tongue, throat or eyes
  • Any problems breathing or swallowing, or a feeling that the through is blocked
  • Wheezing, coughing or hoarseness

Drugs interact with people in unpredictable ways and while triazolam is considered safe within prescribed doses, some unusual or unexpected side effects can occur. If you notice any side effects while you are taking triazolam, consult your doctor, pharmacist or other healthcare professional. They may be able to offer solutions such as adjusting your dose, prescribing another medication to relieve the side effects, or moving you to another medication altogether.

Dosage

Because of the potential for addiction, withdrawal symptoms, and side effects when taking triazolam, you should only take the drug exactly as directed by your doctor. The dosage of triazolam you are given may depend on several factors including your medical history, past usage of the drug, and severity of your condition. However, the typical dosage prescribed is as follows:

Children - The dose given to children will be determined by your doctor and will usually be related to the body weight of the child, such as 0.03 mg per kg of body weight.

Adults - adults usually start with a slightly higher dose of 0.25 mg and then drop to a maintenance dose of between 0.125 mg and 0.25 mg per day, or in some cases the daily dose will be increased. Adults are rarely prescribed doses higher than 0.5 mg per day.

Older Adults - older adults are usually given a starting dose of 0.125 mg per day, and this is then adjusted by the doctor as necessary. Older adults are rarely prescribed doses higher than 0.25 mg per day.

A course of treatment with triazolam will typically run from 7 to 10 days, with the maximum length of a course being 14 days.

Triazolam should only be taken at bedtime, directly before you are ready to go to sleep. Although the drug only has a short period of action, in some people, it can trigger a longer period of sleep. Therefore you should only take triazolam if you are free to stay asleep for 8 hours. For example, if you forget to take triazolam one night, and you are still awake at 2 AM when you need to awaken at 6 AM, it is best to simply skip this dose as you not only run the risk of sleeping past your intended wake time, but you may also experience drowsiness the next morning.

Triazolam is administered orally via a tablet, and should be taken on an empty stomach, or at least 2 hours after you last ate. This will help your body to better absorb the drug.

Overdose

Triazolam has a strong effect on the central nervous system and overdosing on the drug is potentially very dangerous. Typical symptoms of an overdose of triazolam include the following:

  • Confusion
  • Excessive drowsiness
  • Difficulty coordinating
  • Deep sleep/inability to awaken the individual
  • Loss of consciousness
  • Seizures
  • Slurred speech
  • Slow breathing or difficulties in breathing

If you believe someone has overdosed on triazolam, you can call your local poison control center for advice on 1-800-222-1222. However, if the individual has fainted or is having trouble breathing, call the emergency services immediately on 911.

Interactions

You should discuss with your doctor all other medicines, supplements and over the counter remedies that you plan to take at the same time as triazolam, because when combined with certain other medications, triazolam can cause serious medical issues and can even be fatal. The main concerns arise from opiate drugs and other central nervous system depressants, as the combined effect of the two such drugs can cause breathing problems or place an individual into a coma. Some medications of particular concern are listed below.

If you take any of the below medications, this does not necessarily mean you will not be prescribed triazolam. However, your dosage of each medication may need to be adjusted, and you will likely be monitored closely by your doctor to ensure that there are no adverse reactions to the drugs.

Opiate Medications

Examples of prescription drugs with potentially dangerous interactions are listed below, along with some examples of branded products containing each compound:

  • Methadone - this is found in Dolophine, Methadose among others.
  • Morphine - for example, Astramorph, Duramorph PF, and Kadian.
  • Fentanyl - as found in Actiq, Duragesic, Subsys and other products.
  • Hydromorphone - such as Dilaudid, Exalgo, and others.
  • Meperidine - e.g., Demerol.
  • Oxycodone - such as in Oxycet, Percocet, and Roxicet.
  • Tramadol - found in Conzip, Ultracet, and Ultram.
  • Codeine - check the ingredients on your cough medications and painkillers, as many of these contain codeine, for example, Triacin-C, Tuzistra XR, Fiorinal.
  • Hydrocodone - Norco, Zyfrel, and Anexsia.

Prescription Drugs and Other Products

Consult your doctor if you are taking any of the following types of drugs:

  • Muscle relaxants
  • Sedatives
  • Sleeping pills
  • Tranquilizers
  • Seizure medication
  • Anxiety medications
  • Antidepressants including selective serotonin reuptake inhibitors (SSRIs)
  • Calcium channel blockers
  • Cyclosporine
  • Ergotamine
  • Histamine-2 receptor blockers
  • Antibiotics
  • Hormonal contraceptives no matter how they are administered
  • Cold or allergy medications
  • Vitamins
  • Nutritional supplements
  • Herbal products, particularly kava and St.John’s Wort

Alcohol and Recreational Drugs

It is very important that you do not drink any alcohol or use any recreational drugs while you are taking triazolam. If you do so, this will increase the likelihood that you will encounter severe or life-threatening side effects from triazolam.

Warnings

Only take triazolam as directed by your doctor. Taking higher or more frequent doses than prescribed can be very dangerous and in extreme cases, can be fatal.

This drug should only be taken under the supervision of a medical professional. It is illegal to share your drugs with anyone else.

Do not eat grapefruit, drink grapefruit juice, or consume any product containing grapefruit while you are taking triazolam. Grapefruit contains a compound that stops triazolam from breaking down as quickly, effectively increasing the level of the drug in the bloodstream. Even one grapefruit or one glass of juice can cause dangerous levels of the drug in the blood.

Triazolam can cause drowsiness through the day. You should avoid driving, using heavy machinery, or performing any task that requires high levels of concentration until you are certain that you are able to do so.

Older adults are at greater risk of side effects when taking triazolam. If you are older the age of 65, discuss any special precautions that you may need to take with your doctor, and report any side effects you experience promptly.

Inform your doctor if you have had an allergic reaction to any medications, particularly triazolam or any other benzodiazepines. Ask for a list of ingredients in the tablets to ensure that you are not allergic to any of the other inactive or filler materials in the tablets.

It is very dangerous to consume alcohol while taking triazolam. Consult your doctor if you normally drink a large amount of alcohol, or if you think you would have difficulty abstaining from alcohol during the course of your treatment with triazolam.

Triazolam has a high potential for addiction (craving the drug and feeling strong urges to continue taking it), and is a commonly abused drug. For this reason, courses are usually limited to 10 days, but in some people, symptoms of addiction can develop within this time period. If you experience these symptoms consult your doctor for further advice. If you have previously suffered from problems with addiction, you should also make your doctor aware of this.

Triazolam can lead to potential withdrawal symptoms (negative side effects after discontinuing the drug). This is particularly common when triazolam is taken in higher than prescribed doses or for extended periods of time. Some withdrawal symptoms can include rebound insomnia, anxiety, panic attacks, depression and memory loss.

It is possible to develop a tolerance to triazolam, meaning greater and greater doses are required to achieve the same effect. If you feel that your prescribed dose stops working, it is important that you do not increase the dose. Instead, discuss the matter with your doctor or pharmacist.

If your condition has not improved after 7 days, or if you believe that triazolam is making your condition worse, consult your doctor for further advice.

If you receive any dental treatment, inform your dentist that you are taking triazolam, particularly if they will be administering anesthetic to you as part of the treatment.

Talk through your medical history with your doctor before you take triazolam, in particular, discuss any of the following issues if you have experienced them:

  • Mental health issues, particularly depression
  • Sleepwalking and any other sleep issues
  • Substance abuse disorder, including alcohol and recreational drugs
  • Kidney disease or other kidney issues
  • Liver disease or other liver issues
  • Breathing problems or lung problems
  • Myasthenia gravis

Inform your doctor if you are pregnant, intend to become pregnant, or if you will be breastfeeding at the same time as taking triazolam. There is some evidence to suggest that exposure to triazolam during the first trimester increases the risk of certain birth defects such as cleft lip and heart problems.

Storage

The way that you store triazolam can not only affect its strength, but also how safe it is to take. Observe the following guidelines for storage.

Avoid cold: Do not store your medication in a freezer or a refrigerator. Many people believe that doing so can make medications last longer, however, this can actually damage the tablets and shorten their lifespan.

Avoid heat: Keep your tablets away from heat sources. This includes the stove and other cooking equipment, heaters, and sunlight. Your bathroom is also a poor place to store medications because the heat from the shower can damage the tablets. Likewise, your glove compartment can also become too warm to be a suitable place to store medication.

Avoid moisture: Store your medication in a dry place. Your bathroom is not a suitable location for this reason. Also, if your medicine bottle came with a cotton ball inside, remove it, as it can transfer moisture from the environment into the bottle.

Safe location: It is very important to keep any medication in a place that children cannot access. Keep them in a child-resistant container, and if you move your medications to a separate container such as a weekly pill minder, get one that is also childproof. In terms of location, keep your medication in a location that is out of sight, and too high for children to reach.

Medication that has been stored incorrectly or that is beyond its shelf life may be less potent, or harmful. Look for signs of damage on your tablets - these include:

  • Different color
  • Noticeable odor
  • Tablets stuck together
  • Cracked, chipped or broken tablets

If any of these signs are present, do not take the medication.

If you have any medication that has been damaged or that is passed its expiration date, consult your doctor or pharmacist for instructions on the best way to dispose of it. Do not flush medications down the toilet. There may be a “take-back” program operated by local government or pharmacies. The U.S. Food & Drug Administration can advise you on whether this is a take back scheme operating in your local area.

Summary

Triazolam, a benzodiazepine, is a potent central nervous system depressant that will trigger sleep in most people for a period of 1 to 2 hours. This makes it very effective as a treatment for people who have a form of insomnia in which they have difficulty falling asleep. Its short duration of action means it is not ideal for people who can fall asleep, but cannot stay asleep for the whole night.

Like all benzodiazepines, triazolam has a high potential for addiction. People may experience a dependency on the drug, and feel cravings to continue taking the drug at the end of the course. Addiction can develop in as little as two weeks, so courses of triazolam are usually limited to between 7 and 10 days.

Although triazolam is generally considered safe when taken as prescribed, some people do experience side effects. These may include drowsiness, trouble concentrating, and lack of coordination or muscle control.

It is very important to make sure your doctor is aware of any drugs or supplements that you take or intend to take while using triazolam. Because triazolam has a strong depressant action on the central nervous system, it is dangerous when combined with other drugs that have similar effects. These include all opiates, painkillers, sedatives, and many recreational drugs. Triazolam can also be dangerous when combined with some herbal supplements and over the counter remedies.

https://womensmentalhealth.org/posts/benzodiazepines-and-pregnancy/?doing_wp_cron=1510179104.8503320217132568359375

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Last Reviewed:
December 23, 2017
Last Updated:
December 22, 2017
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