Estazolam
PROSOM
What it isIntermediate benzodiazepine; insomnia.
Why this oneUnlike flurazepam and quazepam, it lacks long-lived active metabolites that accumulate with repeated use.
What limits itOpioids or other depressants can cause fatal respiratory depression; CYP3A4 inhibitors prolong sedation, and dependence develops.
FDA-approved for
- insomnia (1990)
FDA label
Read the full label on DailyMed ↗
BOXED WARNING Concomitant use with opioids may cause profound sedation, respiratory depression, coma, and death; risks of abuse, misuse, and addiction; dependence and withdrawal reactions.
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Insomnia | Adults | 1 mg QHS | 1 mg QHS (some need 2 mg) | 2 mg QHS |
| Insomnia | Elderly / small or debilitated | 0.5-1 mg QHS | 1 mg QHS | 2 mg QHS |
Renal Undefined
Hepatic Undefined
Instructions
- Take at bedtime
- Use a gradual taper to discontinue or reduce dosage to limit withdrawal reactions
Contraindications
- Concomitant ketoconazole or itraconazole (potent CYP3A inhibitors)
Cautions
- CNS depression, especially with opioids/other CNS depressants
- Abuse, dependence, and withdrawal reactions
- Complex sleep behaviors
- Next-day psychomotor/cognitive impairment
Adverse reactions
- Somnolence
- Hypokinesia
- Dizziness
- Abnormal coordination
- Headache
- Asthenia
- Nervousness
Pregnancy Undefined
Lactation Undefined
⚠ BOXED WARNINGS
- Risk from concomitant use with opioids
- Abuse, misuse and addiction
- Dependence and withdrawal reactions
Cost, est. cash$10–$300/month
Generic entry1997
Classes and tags
Clinical profile
Legacy pregnancy categoryX
Defining liabilitySedation, falls, dependence and additive respiratory depression with opioids or other CNS depressants.
Mechanism of action: Estazolam ballicule
Open Estazolam in the interactive console ↗
Memory aids: mascots and interaction avatars
hot pink → benzo theme
