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Temazepam (Restoril®) is a prescription sedative-hypnotic medication used to treat insomnia. It belongs to the benzodiazepine class, which means it inhibits neuronal firing in the central nervous system (CNS) in order to promote calmness and sleep.
Temazepam is typically prescribed for short-term relief of severe sleep problems, as it can be habit-forming if used for more extended periods. Misuse, long-term use, or incorrect dosing can lead to dependence, withdrawal, or overdose.
This article provides an overview of temazepam dosage guidelines, including common strengths (7.5 mg vs 15 mg vs 30 mg), safe usage, and precautions to prevent overdose or dangerous drug interactions.
- Temazepam is prescribed primarily for short-term management of insomnia, helping individuals fall asleep more easily and stay asleep through the night.
- Typical dosages range between temazepam 7.5 mg, 15 mg, and 30 mg, but individual needs can differ based on age, health status, the use of other medications, and response to treatment.
- Proper tapering and professional guidance can help manage Restoril misuse.
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What is temazepam used for?
Temazepam is a prescription sedative-hypnotic approved by the U.S. Food and Drug Administration (FDA) for the short-term treatment of insomnia, specifically for difficulty falling asleep, staying asleep, or waking too early without returning to sleep. As a benzodiazepine, temazepam enhances the inhibitory action of gamma-aminobutyric acid (GABA) in the CNS, slowing brain activity and promoting sleep. [1]
While temazepam is most commonly associated with insomnia treatment, healthcare providers may also prescribe this medication off-label for conditions involving severe anxiety or pre-procedure sedation. Short-term, monitored use is emphasized because long-term use or misuse carries a higher risk of dependence or tolerance. [1][2]
In some cases, doctors will recommend alternate strategies for managing insomnia, such as cognitive behavioral therapy (CBT) or other non-benzodiazepine medications, to minimize the risks associated with taking benzodiazepines over extended periods.
Methods of administration
Temazepam is taken as an oral capsule around 30 minutes before sleep. It can be taken simply with water, but if it causes stomach upset, it can be taken with a small snack or milk. [2] The standard approach involves using the lowest effective dose for the shortest duration of time.
Here are some key points regarding administration: [3][4]
- Timing: Because temazepam has a relatively fast onset of action, it is best taken about 30 minutes before bed.
- Food intake: While it can be taken with or without food, taking it on an empty stomach increases the absorption speed.
- Duration: Temazepam is typically prescribed for no more than 7–10 consecutive days as a short-term sleep aid. A healthcare provider should closely monitor extended use.
Temazepam dosage
The dosage for Restoril® is calculated according to individual factors, such as age, health status, and severity of insomnia. Doctors start patients on the lowest dose and adjust it if necessary. Below is a simplified table of temazepam dosing guidelines.
| Patient group | Typical dosage |
|---|---|
| Adults | 7.5 mg to 30 mg once daily at bedtime (often 15 mg) |
| Older adults | 7.5 mg to 15 mg once daily at bedtime |
- Temazepam pills come in doses of 7.5 mg, 15 mg, and 30 mg. [3]
- The usual adult dose for insomnia is 15 mg at bedtime.
- Some people may do well on 7.5 mg at night, while others with more severe insomnia might require 30 mg at night. [5]
- Elderly patients should preferably take 7.5 mg at night to reduce the risk of excessive sedation and medication interactions.
- Doctors aim to prescribe the lowest effective dose for the shortest duration necessary. [4]
Physicians consider factors like one’s medical history, existing medications, and response to lower doses before increasing the dosage of Restoril®. If side effects become problematic, such as excessive daytime drowsiness or confusion, the dose may be lowered, or temazepam may be discontinued entirely.
Is it possible to overdose on temazepam?
While temazepam is considered safe when used as prescribed, an overdose can occur if someone takes more than prescribed or combines it with certain other substances. [5]
Signs of overdose may include: [5]
- Severe confusion or drowsiness
- Loss of coordination
- Respiratory depression (shallow or slowed breathing)
- Coma in extreme cases
However, fatal outcomes are uncommon if temazepam is taken alone. The risk of a life-threatening overdose increases in polysubstance abuse cases, where temazepam is combined with other medications that suppress the CNS. [4]
Tapering temazepam
If temazepam has been used regularly for more than a couple of weeks, the body can become dependent on it. Suddenly stopping Restoril® may cause withdrawal symptoms, such as rebound insomnia, anxiety, irritability, or even seizures in some cases. After taking Restoril® to help with sleep for some time, it can become difficult to sleep without it. [4]
Doctors often advise a gradual dose taper, instead of an abrupt cessation, to reduce the severity of withdrawal symptoms. In a taper, the temazepam dose is slowly reduced so the body can adjust to lower doses. [6]
A “cut and hold” tapering method involves reducing the current dose by a set amount (not more than 5% to 10% of the current dose) and holding the new dose until any withdrawal symptoms subside. The nervous system often settles several weeks after a reduction. [7]
In some cases, healthcare providers may switch to a longer-acting benzodiazepine (such as diazepam) before initiating a taper. Longer-acting benzodiazepines allow for a more gradual approach because they remain active in the body longer, which helps minimize the risk of rebound insomnia, seizures, or other withdrawal complications.
Hazardous combinations
For safety reasons, Restoril® should not be combined with medications or substances without medical guidance, as dangerous interactions can occur. Some examples include:
- Opioids: Concomitant use of opioid pain relievers with benzodiazepines can significantly increase the risk of respiratory depression. [5]
- Alcohol: Alcohol and temazepam depress the CNS, and combining them potentiates dangerous side effects, such as sedation and impaired coordination. [5]
- Other sedatives: Using temazepam alongside other benzodiazepines, barbiturates, antihistamines, or sleep medications may lead to excessive sedation and respiratory depression. [6]
Restoril® should never be mixed with other CNS-depressant drugs unless explicitly directed by a physician.
Temazepam polysubstance use
Polysubstance use refers to taking multiple drugs in combination. Unfortunately, temazepam is sometimes abused in this way. In the early 1990s, there was an upsurge in the literature where Restoril was used in combination with buprenorphine for increased sedation, especially among people who injected drugs at the time. [8]
Today, however, someone might misuse temazepam while also drinking alcohol or taking opioids to intensify the sedative effects. This behavior is hazardous, given that most fatal overdoses involving temazepam occur when it is used with other substances.
Polysubstance abuse that includes temazepam greatly increases the risk of overdose (as compared to temazepam alone) and can lead to multiple drug dependencies. In situations of polysubstance abuse, it is crucial to seek professional help as soon as possible.
Getting help for temazepam misuse
Misuse of temazepam involves taking higher doses than prescribed, using it for non-medical reasons, or combining it with other substances to enhance its sedative effects. Professional support is available for people who struggle with temazepam misuse. Some options include:
- A healthcare provider can evaluate individual circumstances and recommend detox or tapering procedures.
- Cognitive behavioral therapy (CBT), motivational interviewing (MI), or support groups can address the underlying issues contributing to substance misuse.
- Inpatient or outpatient programs are structured treatment environments that offer continual support, medical monitoring, and behavioral therapy strategies.
Early intervention is beneficial in reducing the risk of complications, such as dependence, withdrawal, or severe health consequences from Restoril® misuse.
