Triazolam
Triazolam (Halcion, Triazolam, Halcion) has a pronounced hypnotic effect. Its effective hypnotic dose is 0.25 – 0.5 mg. It is rapidly absorbed when ingested and is relatively quickly excreted from the body. The half-life is 1.5 – 3 hours. Triazolam acts less long than nitrazepam. Daytime drowsiness and other side effects are less pronounced than when taking nitrazepam, however, when using triazolam, the same precautions should be observed as when using nitrazepam. It should be borne in mind that triazolam is a relatively new drug, and therefore its uncontrolled use should not be allowed.
Abroad, some other benzodiazepine derivatives similar in structure to benzodiazepine tranquilizers are also used as hypnotics: flurazepam, lorazepam. These drugs are similar in structure and action to nitrazepam (the fluorazepam molecule contains a fluorine atom). They differ in the rate of absorption, duration of action, effective doses.
Pharmacological action:
Halcion is a benzodiazepine derivative. It has a pronounced hypnotic effect. In case of sleep disorders, it shortens the period of falling asleep and reduces the number of night awakenings, increases the total duration of sleep. The drug does not significantly affect the III, IV phases of sleep and the phase of rapid eye movement. Pharmacokinetics Halcion is rapidly and almostabsorbed from the gastrointestinal tract . The maximum concentration in plasma is reached after 1-2 hours . Binding to plasma proteins is 89%. The drug is metabolized in the liver. The half-life is 2.7 hours. The drug is excreted in the form of inactive metabolites mainly by the kidneys – 80%, 8% – with feces. Less than 1% is excreted unchanged by the kidneys.
Indications:
– treatment of short-term and transient sleep disorders; – treatment of long-term sleep disorders (as part of combination therapy).
Dosage regimen:
The dose of Halcion is set individually. Adults are recommended an initial dose of 250 mcg 1 time a day before bedtime. Sometimes 125 mcg is enough. The maximum dose is 1 mg. The course of treatment is from 4 days to 3 months. In elderly and weakened patients, it is recommended to start therapy with small doses – 125 mcg. The maximum dose for these patients is 250 mcg.
Side effect:
From the central nervous system and sensory organs: drowsiness, dizziness, deafness, impaired coordination, ataxia. Less often – difficulty concentrating; disorders of consciousness, memory, vision, taste; depression. Cases of aggressiveness, increased excitability, coordination disorders and ataxia, hallucinations, somnambulism, anterograde amnesia are described.
Contraindications:
Hypersensitivity to benzodiazepines.
Special instructions:
With caution, it is prescribed to patients with impaired liver function, severe pulmonary insufficiency, suffering from depression, having suicidal tendencies; persons predisposed to the formation of drug dependence. The drug is not intended for long-term use. It is advisable to limit repeated prescriptions of the drug to persons who are not under the supervision of a doctor. If the drug does not cause daytime drowsiness, it can be prescribed to persons whose profession requires a quick mental and physical reaction. However, patients should be warned about the possibility of reducing the speed of reaction when working with mechanisms and driving a car. In the conducted studies, it was shown that there was no development of pronounced tolerance to the drug, its accumulation in the body or withdrawal syndrome after the end of its administration period, which ranged from 4 days to 3 months. The formation of drug dependence is extremely rare. It is necessary to warn patients about the dangers of taking alcohol against the background of Halcion therapy. The safety of using Triazolam (Halcion) during pregnancy, as well as in children and adolescents under 18 years of age has not been proven. If it is necessary to prescribe Halcyon to nursing mothers, it is not recommended to continue breastfeeding.
Overdose:
The manifestation of an overdose of Halcyon is its main clinical effects: drowsy state and sleep. It is necessary to carefully monitor the indicators of the functional state of the cardiovascular and respiratory systems. Gastric lavage is recommended. Intravenous fluid administration is indicated; if necessary, artificial ventilation of the lungs, intravenous administration of levarterenol or metaraminal.
Drug interaction:
The activity of Halcion (Triazolam) may increase when it is prescribed with sedatives. Co-administration of the drug with cimetidine leads to an increase in the concentration of Halcion in plasma, which may require a reduction in the dose of the drug. The concentration of Triazolam (Halcion) in blood plasma increases by 2 times when it is prescribed simultaneously with antibiotics from the macrolide group, while its half-life also increases.
About Author
