TEMAZEPAM Drug Interactions
Also known as: temazepam
TEMAZEPAM (brand name: temazepam) is a Benzodiazepines. INDICATIONS & USAGE Temazepam Capsules, USP are indicated for the short-term treatment of insomnia (generally 7 to 10 days). For patients with short-term insomnia, instructions in the prescription should indicate that Temazepam Capsules should be used for short periods of time (7 to 10 days). The…TEMAZEPAM has 10 documented drug interactions in our database, including 8 contraindicated, 2 major, 0 moderate, and 0 minor interactions.
8
Contraindicated
2
Major
0
Moderate
0
Minor
This combination significantly increases the risk of severe respiratory depression, profound sedation, hypotension, psychomotor impairment, coma, and death. Patients may experience decreased level of consciousness, bradycardia, and hypoxemia.
Mechanism
Buprenorphine, a partial opioid agonist, and temazepam, a benzodiazepine, both exert central nervous system (CNS) depressant effects. The co-administration leads to synergistic depression of the CNS, primarily by enhancing GABAergic neurotransmission (benzodiazepines) and inhibiting neuronal activity via opioid receptors (buprenorphine), particularly affecting brainstem respiratory centers.
Clinical Management
Concomitant use of buprenorphine and temazepam is generally contraindicated due to the high risk of severe adverse outcomes, as highlighted by an FDA Black Box Warning. If co-administration is unavoidable, such as in patients already on stable buprenorphine therapy who require a benzodiazepine for a severe, acute indication, extreme caution is warranted. Initiate the benzodiazepine at the lowest effective dose and for the shortest possible duration, with close monitoring for signs of respiratory depression and sedation. Consider non-benzodiazepine alternatives for anxiety or insomnia.
The combination can lead to profound sedation, respiratory depression (decreased respiratory rate and depth), coma, and death. Patients may experience extreme drowsiness, confusion, dizziness, and difficulty breathing. This interaction significantly impairs psychomotor function and decision-making.
Mechanism
Fentanyl, an opioid agonist, binds to mu-opioid receptors, leading to central nervous system (CNS) depression, including respiratory depression. Temazepam, a benzodiazepine, enhances the effect of gamma-aminobutyric acid (GABA) at GABA-A receptors, also resulting in CNS depression. The synergistic CNS depressant effects of both drugs significantly increase the risk of severe adverse outcomes.
Clinical Management
Concomitant use of fentanyl and temazepam is contraindicated due to the high risk of respiratory depression and death. If co-administration is unavoidable, extreme caution, reduced doses of both medications, and close monitoring for respiratory depression and sedation are imperative. Patients and caregivers must be educated on the risks and symptoms, and naloxone should be readily available.
The concurrent use of morphine and temazepam significantly increases the risk of severe adverse effects including profound sedation, respiratory depression, coma, and death. Patients may experience decreased level of consciousness, hypoventilation, hypotension, and psychomotor impairment. This combination can lead to life-threatening respiratory insufficiency.
Mechanism
Morphine, an opioid agonist, binds to mu-opioid receptors in the central nervous system (CNS), leading to CNS depression, analgesia, and respiratory depression. Temazepam, a benzodiazepine, enhances the effect of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) at GABA-A receptors, also resulting in CNS depression, sedation, and anxiolysis. The synergistic CNS depressant effects of both drugs lead to profound respiratory depression.
Clinical Management
Concomitant use of opioids and benzodiazepines should generally be avoided due to the high risk of severe adverse outcomes, including respiratory depression and death. If no alternative treatment options are adequate, the lowest effective doses should be used for the shortest possible duration, with close monitoring for respiratory depression and sedation. Patients should be educated on the risks and signs of overdose, and naloxone should be considered for at-risk patients.
Patients may experience profound sedation, respiratory depression (including apnea), hypotension, psychomotor impairment, coma, and death. The combination significantly increases the risk of accidental overdose and life-threatening adverse events. Impaired cognitive function and motor coordination can also increase the risk of falls and other injuries.
Mechanism
Tramadol, an opioid analgesic, and temazepam, a benzodiazepine, both cause central nervous system (CNS) depression. The co-administration of these agents leads to an additive depressant effect on the CNS, primarily affecting respiratory drive and consciousness. This synergistic effect is due to their distinct but converging actions on GABA-A receptors (benzodiazepines) and opioid receptors (opioids), leading to profound suppression of neural activity.
Clinical Management
Concomitant use of tramadol and temazepam is generally contraindicated due to the high risk of severe adverse outcomes, including respiratory depression and death. If no alternative treatments are adequate, and the benefits outweigh the risks, prescribe the lowest effective doses for the shortest possible duration, and closely monitor patients for signs of respiratory depression and sedation. Educate patients and caregivers about the risks and symptoms to watch for, and ensure naloxone is available if indicated.
The combination significantly increases the risk of severe respiratory depression, profound sedation, coma, and death. Patients may exhibit slowed or shallow breathing, extreme drowsiness, unresponsiveness, and hypoxemia. This interaction can rapidly progress to life-threatening respiratory arrest.
Mechanism
Both codeine (an opioid analgesic) and temazepam (a benzodiazepine) are central nervous system (CNS) depressants. Their co-administration leads to an additive depressant effect on the CNS, particularly affecting the respiratory drive and level of consciousness. This synergistic depression is mediated through different but converging pathways that enhance GABAergic inhibition and opioid receptor agonism.
Clinical Management
Concomitant use of opioids and benzodiazepines should be avoided due to the high risk of severe adverse outcomes, including death. If no alternatives are available, and the benefit outweighs the risks, use the lowest effective doses and shortest possible duration, and closely monitor for respiratory depression and sedation. Educate patients and caregivers on the risks and symptoms of respiratory depression.
The combination significantly increases the risk of severe respiratory depression, profound sedation, coma, and death. Patients may experience decreased level of consciousness, hypoventilation, pinpoint pupils, and hypotension.
Mechanism
Both methadone, an opioid agonist, and temazepam, a benzodiazepine, are central nervous system (CNS) depressants. Their co-administration leads to additive CNS depression by enhancing GABAergic neurotransmission (benzodiazepines) and activating mu-opioid receptors (methadone), resulting in synergistic effects on respiratory drive and sedation.
Clinical Management
Concomitant use of methadone and temazepam should be avoided due to the high risk. If co-prescription is absolutely necessary and no alternative is available, use the lowest effective doses and shortest possible duration, and closely monitor for respiratory depression and sedation. Educate patients and caregivers on the risks and symptoms, and consider prescribing naloxone.
The concurrent use of oxymorphone and temazepam significantly increases the risk of severe adverse effects, including profound sedation, respiratory depression, coma, and death. Patients may experience decreased level of consciousness, hypoventilation, bradycardia, and hypotension, which can progress rapidly.
Mechanism
Oxymorphone, an opioid agonist, and temazepam, a benzodiazepine, both exert central nervous system (CNS) depressant effects by acting on distinct receptors. Oxymorphone primarily acts on mu-opioid receptors, while temazepam enhances the activity of gamma-aminobutyric acid (GABA) at GABA-A receptors. The co-administration leads to an additive and synergistic depression of the CNS, including respiratory drive and consciousness.
Clinical Management
Concomitant use of oxymorphone and temazepam is contraindicated due to the high risk of severe respiratory depression and death. If no alternative treatments are adequate, and co-prescription is deemed absolutely necessary, the lowest effective doses should be used for the shortest possible duration, with close monitoring for respiratory depression and sedation. Patients should be educated on the risks and advised against driving or operating machinery.
The concurrent use of tapentadol and temazepam significantly increases the risk of severe respiratory depression, profound sedation, hypotension, coma, and death. Patients may experience decreased level of consciousness, slowed or shallow breathing, and psychomotor impairment.
Mechanism
Tapentadol, an opioid analgesic, acts as a mu-opioid receptor agonist and norepinephrine reuptake inhibitor, producing central nervous system (CNS) depression. Temazepam, a benzodiazepine, enhances the effect of gamma-aminobutyric acid (GABA) at the GABA-A receptor, also leading to profound CNS depression. The co-administration results in an additive and synergistic depressant effect on the CNS.
Clinical Management
Due to the severe risks, concurrent use of tapentadol and temazepam is generally contraindicated. If co-prescription is absolutely unavoidable, use the lowest effective doses for the shortest possible duration, closely monitor patients for respiratory depression and sedation, and educate patients and caregivers on the signs of CNS depression. Consider alternative non-opioid or non-benzodiazepine treatments.
Patients may experience severe respiratory depression, characterized by decreased respiratory rate and depth, hypoxemia, and hypercapnia. Profound sedation, somnolence, dizziness, impaired psychomotor function, and hypotension are also common. In severe cases, this can progress to coma and death.
Mechanism
Both oxycodone (an opioid analgesic) and temazepam (a benzodiazepine) are central nervous system (CNS) depressants. Their co-administration leads to an additive depressant effect on the CNS, particularly affecting the brainstem respiratory centers and consciousness. This synergistic depression significantly increases the risk of respiratory depression, profound sedation, and coma.
Clinical Management
Avoid concomitant use of oxycodone and temazepam unless the benefits outweigh the risks, and alternative treatment options are inadequate. If co-administration is necessary, prescribe the lowest effective doses and shortest durations possible, and monitor patients closely for respiratory depression and sedation. Educate patients and caregivers on the risks and symptoms, and consider prescribing naloxone for outpatient use.
The combination significantly increases the risk of severe respiratory depression, profound sedation, coma, and death. Patients may experience decreased level of consciousness, hypoventilation, pinpoint pupils, and hypotension.
Mechanism
Both hydromorphone (an opioid agonist) and temazepam (a benzodiazepine) are central nervous system (CNS) depressants. Their co-administration leads to an additive depressant effect on the CNS, primarily by enhancing GABAergic neurotransmission (benzodiazepines) and inhibiting neuronal activity (opioids), resulting in profound respiratory depression and sedation.
Clinical Management
Avoid concomitant use of opioids and benzodiazepines whenever possible due to the high risk. If co-prescription is absolutely necessary, use the lowest effective doses for the shortest possible duration, closely monitor patients for signs of respiratory depression and sedation, and educate patients and caregivers on these risks. Consider alternative non-opioid or non-benzodiazepine therapies.
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