Estazolam

PROSOM

Open Estazolam in the interactive console ↗

Pronunciation: es-TA-zoe-lam

Estazolam ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Estazolam ballicule

Estazolam PROSOM mascot mnemonic cartoon — Visual mnemonic: Estazolam mascot
**“Stay Prostrate & som(nolent)”**
hot pink → benzo theme

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.

Estazolam molecular structure (skeletal formula) — Molecular structure: Estazolam

Estazolam prescription history

Animated chart of estimated U.S. prescriptions per year, Sleep meds (1869–2026). Estazolam enters in 1990 (estimated).

FDA-approved for

insomnia (1990)

Classes and tags

Clinical profile

Therapeutic safety burden2 / 4

Overdose danger2 / 4

Weight-gain liability0 / 4

Sedation liability3 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk2 / 4

Legacy pregnancy categoryX

Defining liabilitySedation, falls, dependence and additive respiratory depression with opioids or other CNS depressants.

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

Available strengths

tab 1, 2 mg

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

Cost

Estazolam (PROSOM)

What pharmacies pay · NADAC 9/30/26

Strength		#/mo	generic $/mo	CostPlus
1 mg	tab	30 qd	$26.52	not offered
2 mg	tab	30 qd	$25.18	not offered

Generic entry1997

Open Estazolam in the interactive console ↗

Memory aids: interaction avatars

CYP3A4 substrate

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Self-check

Does estazolam have the long-lived active metabolites of flurazepam?
No.
What can CYP3A4 inhibition do to estazolam sedation?
Prolong it.