Flurazepam

Introduction: Flurazepam belongs to a class of medicines known as benzodiazepines. It is a prescription medicine used to treat insomnia. It relaxes the brain and helps to treat people who have problems with their sleeping habits.

How it works: Flurazepam is a benzodiazepine that works by increasing the action of GABA in the brain, which suppresses abnormal and excessive activity of nerve cells.

Important Information: This medicine may be taken with or without food. Take it in the dose and duration as advised by your doctor as it has a high potential of habit-forming. Should not be used for more than 4 weeks.

• Insomnia: characterized by difficulty in falling asleep, frequent nocturnal awakenings or early morning awakenings.
• Recurring insomnia or poor sleeping habits
• Acute or chronic medical situations requiring restful sleep

Benzodiazepine hypnotics

Benzodiazepine derivative

Flurazepam is a long-acting benzodiazepine which binds to stereospecific benzodiazepine receptors on the postsynaptic GABA neuron within the CNS. It enhances the inhibitory effect of GABA on neuronal excitability by increasing neuronal membrane permeability to Cl ions, thus resulting in hyperpolarization and stabilisation. It decreases sleep latency and number of awakenings for a consequent increase in total sleep time.

Flurazepam binds to an allosteric site on GABA-A receptors. Binding potentiates the action of GABA on GABA-A receptors by opening the chloride channel within the receptor, causing chloride influx and hyperpolarization.

Adult Dose:

• Short-term management of insomnia: 15-30 mg at night.

Elderly Dose:

• Max: 15 mg at night.

Child Dose:

• >15 years: 15 mg at night.
• <15 years: Not recommended.

Hepatic and Renal Impairment: Dosage may need to be reduced in patients with impaired hepatic or renal function.

* Use as directed by the registered physician

Oral capsule. Can be taken with or without food. Swallow whole, do not chew or crush. Take 30 to 45 minutes before bedtime and only when you have time to sleep for at least 7 hours.

If you miss a dose, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.

Common Side Effects:

• Dizziness
• Drowsiness
• Impaired coordination
• Lightheadedness
• Ataxia (particularly in elderly or debilitated persons)

Severe Side Effects: Severe sedation, lethargy, disorientation and coma have been reported.

Precautions:

• Should not be used for more than 4 weeks.
• Addiction/habit-forming potential is very high - use only as advised.
• Do not drive or do anything that requires mental focus.
• Avoid consuming alcohol.
• Inform your doctor if you are pregnant, planning to conceive or breastfeeding.
• Regular monitoring of blood and liver functions may be required with long-term use.
• Inform your doctor if you experience sleep-driving or memory loss.
• Inform your doctor if you have depression (may worsen symptoms).
• Do not stop suddenly (may cause nausea, anxiety, agitation, flu-like symptoms, sweating, tremor, and confusion).

Contraindications:

• Hypersensitivity
• Porphyria
• Pregnancy (3rd trimester)
• Neonates

Drug Interactions:

• May enhance CNS depressant effect with antidepressants, antipsychotics, general anaesthesia, hypnotics or sedatives, opioid analgesics.
• Flurazepam clearance may be reduced by cimetidine.
• May be increased by rifampicin.

Food Interactions:

• Avoid alcohol as it may cause excessive drowsiness.

Use in Pregnancy: Highly unsafe during pregnancy. Studies have shown significant harmful effects to the developing baby. Seek your doctor's advice.

Use in Lactation: Probably unsafe during breastfeeding. Limited data suggests the drug may pass into breastmilk and harm the baby.

Pediatric Use: Not recommended for children under 15 years of age.

Geriatric Use: Elderly are more susceptible to oversedation, dizziness, confusion and ataxia. Dosage should be limited to 15 mg.

Renal Impairment: Safe in kidney disease. No dose adjustment is recommended. However, talk to your doctor if you have any underlying kidney disease.

Hepatic Impairment: Use with caution in liver disease. Not recommended in severe liver disease.

Overdose: Flurazepam overdosage includes somnolence, confusion and coma. Respiration, pulse and blood pressure should be monitored. General supportive measures should be employed, along with immediate gastric lavage.

Storage: Keep below 30°C, away from light and moisture. Keep out of reach of children.

Flurazepam Capsule