Long-acting benzodiazepine hypnotic
Potentiates GABA-A receptor activity, enhancing inhibitory neurotransmission to induce sedation.
Insomnia characterized by difficulty with sleep onset and/or frequent nighttime awakenings.
None well established; generally reserved for short-term hypnotic use only.
Oral capsules.
15 mg p.o. at bedtime.
15–30 mg nightly.
Metabolized primarily by CYP3A4 to long-acting active metabolites with half-lives extending up to several days, causing prolonged sedation. Parent drug half-life is 2–3 hours. Metabolites accumulate with repeated dosing, especially in elderly or those with impaired metabolism.
Next-day sedation, dizziness, confusion, impaired coordination, risk of falls.
Excessive sedation, respiratory depression, paradoxical reactions (rare).
Assess sedation level, cognition, and fall risk regularly; avoid use beyond short-term.
Risks of concomitant use with opioids leading to respiratory depression and death; use caution
Use caution in older adults, dementia, traumatic brain injury (TBI), or cognitive disorders due to risk of prolonged sedation, confusion, and falls. Flurazepam is not recommended for chronic use in geriatric populations.