Quazepam
DORAL
What it isLong-acting benzodiazepine GABA-A modulator approved for insomnia.
Why this oneIts long-lived active metabolites can maintain sleep through the night, but it has no routine advantage over shorter-acting hypnotics.
What limits itNext-day impairment, falls, and accumulation are prominent, especially in older adults; tolerance and physical dependence develop.
FDA-approved for
- insomnia (1985)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Insomnia | Adults | 7.5 mg QHS | 7.5 mg QHS | 15 mg QHS |
Renal Undefined
Hepatic Undefined
Instructions
- Use the lowest effective dose
- Split the 15 mg scored tablet to achieve the 7.5 mg dose
- Taper gradually to discontinue or reduce; do not stop abruptly
- Elderly/debilitated may be more sensitive
Contraindications
- Established or suspected sleep apnea
- Chronic pulmonary insufficiency
- Hypersensitivity to other benzodiazepines
Cautions
- CNS depression and next-day impairment; caution with driving/tasks needing alertness
- Complex sleep behaviors (sleep-driving) while not fully awake
- Anaphylaxis and angioedema — do not rechallenge
- Worsening depression or suicidal thinking
- Neonatal sedation and withdrawal with late-pregnancy use
Adverse reactions
- Drowsiness, headache, fatigue, dizziness, dry mouth, dyspepsia
Pregnancy Late-pregnancy use may cause neonatal sedation/withdrawal; observational data show no clear major-birth-defect association.
Lactation Undefined
⚠ BOXED WARNINGS
- Profound sedation, respiratory depression, coma, and death with opioids
- Abuse, misuse, and addiction can cause overdose or death
- Physical dependence and life-threatening withdrawal with abrupt reduction
Cost, est. cash$30–$250/month
Generic entryBy 2023
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilitySedation, falls, dependence and additive respiratory depression with opioids or other CNS depressants.
Mechanism of action: Quazepam ballicule
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