Indications for HALCION:
Short-term (7–10 days) treatment of insomnia.
Use lowest effective dose. 0.125–0.25mg at bedtime; max 0.5mg. Elderly: initially 0.125mg; max 0.25mg. Reevaluate if used ≥3 weeks. Max 1 month/℞.
Concomitant strong CYP3A inhibitors (eg, ketoconazole, itraconazole, clarithromycin, nefazodone, ritonavir, indinavir, nelfinavir, saquinavir, lopinavir, grapefruit juice).
Risks from concomitant use with opioids. Abuse, misuse, and addiction. Dependence and withdrawal reactions.
Increased risk of drug-related mortality from concomitant use with opioids. Evaluate for co-morbid diagnoses (eg, physical and/or psychiatric disorders) prior to treatment. Reevaluate if insomnia fails to remit after 7–10 days of use. Depression. Suicidal tendencies. Evaluate any new onset of behavioral changes. Compromised respiratory function (monitor); consider discontinuing if respiratory depression or apnea occurs. Assess patient's risk for abuse, misuse, addiction prior to and during therapy. Avoid abrupt cessation. Withdraw gradually. Drug or alcohol abusers. Elderly (higher risk of falls). Neonates. Pregnancy. Nursing mothers: monitor infants (consider interrupting breastfeeding or pumping/discarding breast milk during and for 28hrs after dose).
See Contraindications. Increased sedation, respiratory depression, coma, and death with concomitant opioids; reserve use in those for whom alternative treatment options are inadequate; if needed, limit dosages/durations to minimum and monitor. Additive CNS depressant effects with alcohol or other CNS depressants (eg, other benzodiazepines, psychotropics, anticonvulsants, antihistamines); consider dose reductions. Potentiated by moderate/weak CYP3A inhibitors (eg, erythromycin, cimetidine, isoniazid, oral contraceptives, ranitidine); consider reducing triazolam dose. Caution with fluvoxamine, diltiazem, verapamil, sertraline, paroxetine, ergotamine, cyclosporine, amiodarone, nicardipine, nifedipine.
Drowsiness, headache, dizziness, nervousness, light-headedness, ataxia, nausea, vomiting; worsening of insomnia, complex behaviors (eg, sleep-driving), daytime anxiety (discontinue if worsens), anterograde amnesia, paradoxical reactions, withdrawal reactions.
Generic Drug Availability: