Temazepam: Uses, Side Effects, Dosages, and More
Dr. Gerardo Sison, Pharm.D.
Insomnia is an incredibly common condition, affecting at least 30 percent of adults in the United States on an occasional basis. Sleep disruptions are inconvenient and frustrating, but they can also have lasting health implications. Insomnia is known to increase your risk of experiencing certain medical conditions, including stroke, seizures, pain sensitivity, obesity, high blood pressure, asthma attacks, weakened immune system, inflammation, diabetes mellitus, and heart disease.
Patients who experience chronic insomnia may not be able to resolve their condition through sleep hygiene and lifestyle changes alone, and may turn to prescription drugs like temazepam for help in getting a good night’s rest.
What is temazepam?
Temazepam is a generic prescription medication that belongs to a class of drugs called benzodiazepines.
Also sold under the brand name Restoril, temazepam is considered a Schedule IV controlled substance by the U.S. Drug Enforcement Administration due to its potential to be habit forming and potentially cause issues with physical and psychological dependence.
Temazepam was first approved by the U.S. Food and Drug Administration (FDA) in 1981 under its brand name, Restoril.
What is temazepam used to treat?
Temazepam is one of several different medications used to treat insomnia, or difficulty falling asleep or staying asleep.
Prescription drugs like temazepam are intended to be used as a last resort to help people suffering from insomnia if counseling, behavioral, and sleep hygiene changes have been unsuccessful in improving their sleep.
While other benzodiazepines are commonly used to treat symptoms of acute anxiety or panic disorder, temazepam is not used for these purposes and is solely prescribed for the treatment of insomnia.
What is insomnia and what causes it?
Insomnia is a common sleep disorder that can cause difficulty in falling asleep or staying asleep. It is estimated that approximately 30 percent of adults in the United States regularly experience disrupted sleep and 10 percent of the population meets the clinical criteria for insomnia. Although it has been well established that adults between the ages of 18 and 64 need to get 7 to 9 hours of sleep per night in order to function properly, more than 35 percent of adults report sleeping an average of less than seven hours per night.
Insomnia is characterized by symptoms like difficulty falling asleep, waking up multiple times throughout the night, waking up too early and being unable to fall back asleep, and waking up feeling tired. While everyone experiences these symptoms from time to time, insomnia is diagnosed when these symptoms have occurred at least a few nights per week within the past year. Insomnia can appear for only a short period of time, such as one night to a few weeks at a time, which typically corresponds to a stressful life event or period of time. The condition can also be chronic, occurring three or more nights per week for three months or more.
The amount of sleep that our bodies need changes as we age, with babies needing the most sleep and adults needing less sleep over time. Unfortunately, people are more likely to experience insomnia when they are younger, with the condition declining with age. The National Sleep Foundation reports that 68 percent of adults between the ages of 18 and 29 report experience symptoms of insomnia, while adults between the ages of 30 and 64 experience occasional insomnia symptoms at a rate of 59 percent. Approximately 44 percent of older adults over age 65 experience occasional insomnia symptoms. The condition is about 40 percent more likely to occur in women than in men.
How does temazepam work to treat insomnia?
Temazepam belongs to a class of medications called benzodiazepines. This class of drug works by increasing the action of a neurotransmitter called gamma aminobutyric acid (GABA) in the brain. GABA inhibits or slows nerve activities in the brain. People who have insomnia may have a chemical imbalance of GABA that causes difficulty sleeping.
Temazepam binds to GABA receptors in the brain and promotes the effects of the GABA neurotransmitter, which works against the increased nerve activity that is associated with insomnia. As a result, the activity of the brain starts to slow down, making you feel more drowsy and sleepy.
What is the cost of temazepam?
Temazepam is available in the form of an oral capsule at strengths of 7.5 mg, 15 mg, 22.5 mg, and 30 mg, as is the brand name version of the medication, Restoril. The costs of Restoril and temazepam are compared below for reference.
Approximate Costs of Restoril and Temazepam
Per 30-Day Supply
Restoril 7.5 mg
Temazepam 7.5 mg
Restoril 15 mg
Temazepam 15 mg
Restoril 22.5 mg
Temazepam 22.5 mg
Restoril 30 mg
Temazepam 30 mg
As evident in the table above, the brand-name version of the drug is many times more expensive than the generic version of the drug. For this reason, Restoril is rarely prescribed. The generic form of the medication is covered by nearly all commercial and Medicare drug insurance plans, and pharmacy discount cards can offer savings as well.
How do I know what dose of temazepam to take?
Both generic temazepam and brand-name Restoril come in oral capsules with doses of 7.5 mg, 15 mg, 22.5 mg, and 30 mg. The medication is only intended for the treatment of insomnia in adults and should not be used in children.
The typically starting dose of temazepam for patients between the ages of 18 and 64 is one 15 mg capsule per day, taken at bedtime. The standard maintenance dose of temazepam ranges between 7.5 mg and 30 mg per day but should not exceed 30 mg per day.
Adults over the age of 65 may process the medication at a slower rate and should take a lower dose of the medication. The typical starting dose of temazepam for people ages 65 and older is 7.5 mg per day, taken right before bed.
Are there any side effects associated with temazepam?
Like other popular sleep medications like Ambien and Lunesta, temazepam is associated with certain side effects.
The most common side effects associated with temazepam use include:
- Blurred vision
- Dry mouth
Temazepam use can also cause serious side effects, and the drug can cause potentially life-threatening allergic reactions. Some of these effects involve short-term memory loss.
Serious side effects of temazepam use include:
- Doing things while partially asleep or with no memory of the event occurring, including:
- Having sex
- Driving a car
- Abnormal thoughts and behavior, including:
- Aggressive or outgoing behavior
- Worsening depression
- Suicidal thoughts or actions
- Severe allergic reaction, as evidenced by:
- Swelling of the face, lips, tongue, or throat
- Trouble breathing or breathing problems
Seek immediate medical attention if you suspect your or a loved one is having an allergic reaction to temazepam.
Are there any warnings associated with temazepam use?
Temazepam has received a black box warning from the FDA, which is the most serious warning issued by the agency. The warning from the FDA concerns the potentially dangerous interaction between temazepam and opioid drugs, including painkillers like oxycodone, codeine, tramadol, and similar narcotic pain medications.
When combined with opioid drugs, temazepam can cause dangerous side effects, including:
- Severe drowsiness
- Slowed breathing or respiratory distress
In addition to the black box warning from the FDA, there are other risks and warnings associated with temazepam. People taking temazepam should use caution, particularly when getting used to how the medication affects them.
Temazepam comes with the following warnings for use:
- Temazepam can cause a severe allergic reaction in patients who are allergic to the drug or other medications that are closely related to it, such as lorazepam, diazepam, oxazepam, and clonazepam.
- Temazepam treats insomnia by promoting feelings of drowsiness that help you fall asleep. Do not take temazepam unless you have a full seven to eight hours to sleep, and make sure to take the drug right before bed.
- Do not drink alcohol while using temazepam, as using the substances together can cause an increased risk of side effects and can potentially be life-threatening.
- People who have been diagnosed with depression may be more likely to experience severe symptoms of depression, including suicidal thoughts and behaviors. Patients with depression who choose to use temazepam should use the lowest dose of the drug possible to control their insomnia symptoms.
- Pregnant women should never use temazepam due to the potential for serious birth defects and withdrawal symptoms to occur.
- Adults over the age of 65 may process temazepam more slowly and require a lower dose of the medication than younger patients. The maximum starting dose for patients ages 65 and older should be 7.5 mg per day.
- Children under the age of 18 should not take temazepam.
What does the research say about taking temazepam while pregnant or breastfeeding?
Temazepam is classified as a Category X drug by the FDA for use during pregnancy, which means the medication should never be used by pregnant women due to the risk of congenital birth defects, including cleft lip and palate, and serious withdrawal symptoms in newborns.
If you are pregnant or planning to become pregnant, you should not use temazepam.
However, temazepam can cause severe withdrawal symptoms in women who stop taking the medication abruptly or dramatically reduce their dose. If you are taking temazepam and become pregnant, make sure to talk to your doctor right away about how best to gradually reduce your dose of the drug.
Women who are breastfeeding should speak to their doctor before using temazepam. It is unknown if temazepam passes through breast milk to an infant, so the medication should be used with caution.
Who should not take temazepam?
Some people should not take temazepam, while others may need to use caution when taking the medication. Speak to a health care professional to determine whether temazepam is right for you.
People who should not take temazepam include:
- People who are allergic to temazepam or other benzodiazepines that are closely related to the drug
- Women who are pregnant or planning to become pregnant
- People taking opioid drugs, including morphine, oxycodone, hydrocodone, and codeine
- People who drink alcohol regularly
People who need to use temazepam with caution include:
- People who have been diagnosed with depression or who have experienced depression in the past
- Adults over the age of 65
- Women who are breastfeeding
Temazepam causes drowsiness, and sleep problems can worsen when the medication is combined with certain other medications. Make sure to tell your doctor and pharmacist about all of the medications you are taking, including over-the-counter drugs, prescription medications, and dietary supplements.
Potential drug interactions associated with temazepam include:
- Phenothiazines, such as promethazine, chlorpromazine, fluphenazine, and thioridazine
- Sedatives or hypnotics, such as zaleplon, eszopiclone, and zolpidem
- Anxiolytics, such as lorazepam, midazolam, alprazolam, clonazepam, and triazolam
- Antidepressants, such as fluoxetine, fluvoxamine, and nefazodone
- Barbiturates, such as butabarbital, amobarbital, and pentobarbital
- Sedative antihistamines, such as dimenhydrinate, diphenhydramine, brompheniramine, chlorpheniramine, and doxylamine
- Anesthetics, such as propofol, etomidate, and ketamine
- Narcotic analgesics, such as oxymorphone, tapentadol, dihydrocodeine, fentanyl, hydrocodone, buprenorphine, codeine, hydromorphone, meperidine, methadone, morphine, oxycodone, and tramadol
Temazepam is a prescription benzodiazepine that is commonly used for the treatment of insomnia in adults. The medication is associated with adverse effects that include drowsiness, dizziness, sleepiness, shakiness, and headache, and it should only be taken right before bed when you have at least seven to eight hours to sleep before being active again. Doses of the drug range from 7.5 mg to 30 mg per day, with older adults typically prescribed lower starting doses of the medication.
Seek medical advice from your healthcare provider to determine whether temazepam is right for you.
Temazepam is much less expensive than the brand name version of the drug, Restoril, but patients can save on either form of the medication with a pharmacy discount card from USA Rx.