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All about: Flurazepam Hydrochloride

Big Image Pronouncation: (flure-AZE-uh-pam HIGH-droe-KLOR-ide)
Class: Benzodiazepine

Trade Names:
- Capsules 15 mg
- Capsules 30 mg

Apo-Flurazepam (Canada)
Novo- Flupam (Canada)

Mechanism of 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.



T max is 0.5 to 1 h (parent) and 7.6 to 13.6 h (active metabolite). It is rapidly and completely absorbed.


Protein binding is 97%. Flurazepam crosses the placenta and is secreted into breast milk. It has a high lipid:water distribution coefficient in the nonionized form.


The major metabolite is N-desalkylflurazepam (active).


The t 1/ 2 is 2 to 3 h and 47 to 100 h for the active metabolite. Less than 1% is excreted unchanged in the urine.

Indications and Usage

Treatment of insomnia.


Hypersensitivity to benzodiazepines; pregnancy.

Dosage and Administration


PO 15 to 30 mg at bedtime.


PO 15 mg until individual response is determined.

Debilitated patients

PO 15 mg until individual response is determined.


Store at room temperature in light-resistant container.

Drug 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.


Serum digoxin concentrations may increase.


Serum concentrations may be increased.


Decreased effects of flurazepam.


May antagonize sedative effects.

Laboratory Test Interactions

None well documented.

Adverse Reactions


Palpitations; chest pains; tachycardia; hypotension (rare).


Dizziness; drowsiness; lightheadedness; staggering; ataxia; falling; lethargy; confusion; impaired memory; headache; weakness; paradoxical excitement; talkativeness; euphoria; apprehension; irritability; hallucinations; slurred speech; depression.


Pruritus; rash.


Difficulty focusing; blurred vision; burning of eyes; taste alterations.


Heartburn; nausea and vomiting; diarrhea; constipation; anorexia; upset stomach; GI pain; dry mouth.


Urinary incontinence; urinary retention, hesitancy, or urgency.


Leukopenia; granulocytopenia.


Elevated AST, ALT, bilirubin and alkaline phosphatase; hepatitis.


Shortness of breath.


Tolerance; physical and psychological dependence; body and joint pains; sweating; flushing.





Excreted in breast milk.


Not recommended in children younger than 15 yr of age.


Increased adverse reactions; start with lowest dose.

Renal Function

Use with caution. Abnormal LFTs and blood dyscrasias have occurred.

Hepatic Function

Use with caution. Abnormal LFTs and blood dyscrasias have occurred.

Debilitated patients

Increased adverse reactions; start with lowest dose.

Anterograde amnesia

Has occurred with similar drugs. Alcohol may increase risk.


Administer with caution to severely depressed patients or those with suicidal tendencies. Signs and symptoms of depression may be intensified.


Withdrawal symptoms may occur after discontinuation of higher doses taken over long periods.



Somnolence, confusion, respiratory depression, apnea, hypotension, impaired coordination, slurred speech, seizures, coma.

Patient Information

  • 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 health care provider.
  • 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 health care provider: palpitations or chest pain, signs of bleeding, abdominal pain, jaundice, shortness of breath, rash, confusion, dizziness, nausea, 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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