Flurazepam


Concise Prescribing Info
Indications/Uses
Insomnia.
Dosage/Direction for Use
Adult : PO 15-30 mg at night.
Dosage Details
Oral
Short-term management of insomnia
Adult: 15-30 mg at night.
Child: Contraindicated.
Elderly: Max: 15 mg at night.
Administration
May be taken with or without food.
Contraindications
Patient w/ pre-existing CNS depression or coma, resp depression, acute pulmonary insufficiency, myasthenia gravis, sleep apnoea, chronic psychosis or obsessional states. Pregnancy.
Special Precautions
Patient w/ chronic pulmonary insufficiency, personality disorder, depression, resp disease, impaired gag reflex, history of alcohol or drug addiction. Renal and hepatic impairment. Childn (<15 yr), elderly or debilitated patient. Lactation.
Adverse Reactions
Increased risk of hazardous sleep-related activities (e.g. sleep-driving), drowsiness, light-headedness, dizziness, confusion, anterograde amnesia, headache, fatigue, reduced alertness, numbed emotions, apnoea, dyspnoea, muscle weakness, ataxia, slurred speech, double vision, vertigo, hypotension, skin rashes, GI and visual disturbances, excessive salivation, changes in libido, urinary retention.
Patient Counseling Information
May impair ability to drive or operate machinery.
MonitoringParameters
Monitor resp and CV function.
Overdosage
Symptoms: Mental confusion, somnolence, lethargy, dysarthria, impaired vision, dystonia to ataxia, unconsciousness, central resp and/or circulatory depression, coma. Management: Symptomatic and supportive treatment. Induce vomiting or gastric lavage if taken w/in 1 hr. May admin activated charcoal to reduce absorption. Flumazenil may be used as an adjunct to proper management.
Drug 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.
Food Interaction
May increase CNS depression w/ alcohol and St John's wort. May increase serum levels w/ grapefruit juice.
Action
Description: 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.
Onset: Hypnotic: 15-20 min.
Duration: 7-8 hr.
Pharmacokinetics:
Absorption: Readily absorbed from the GI tract. Time to peak plasma concentration: Approx 30-60 min.
Distribution: Crosses the placenta. Volume of distribution: 3.4 L/kg. Plasma protein binding: Approx 97%.
Metabolism: Undergoes hepatic metabolism to N-desalkylflurazepam (active) and N-hydroxyethylflurazepam.
Excretion: Via urine (mainly as conjugated metabolites). Elimination half-life: 2.3 hr (parent drug).
Storage
Store between 15-30°C.
References
Anon. Flurazepam. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 27/03/2014.

Buckingham R (ed). Flurazepam. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 27/03/2014.

Flurazepam Capsule (West-Ward Pharmaceutical Corp). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 27/03/2014.

McEvoy GK, Snow EK, Miller J et al (eds). Flurazepam HCl. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 27/03/2014.

Disclaimer: This information is independently developed by MIMS based on Flurazepam from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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