• Sleep-wake disorders

Sleep-wake disorders:

Indications for HALCION:

Short-term (7–10 days) treatment of insomnia.

Adult:

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/℞.

Children:

Not established.

Contraindications:

Concomitant strong CYP3A inhibitors (eg, ketoconazole, itraconazole, clarithromycin, nefazodone, ritonavir, indinavir, nelfinavir, saquinavir, lopinavir, grapefruit juice).

Boxed Warning:

Risks from concomitant use with opioids.

Warnings/Precautions:

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. Avoid abrupt cessation. Drug or alcohol abuse. Elderly. Pregnancy: monitor neonates (esp. during late stages). Nursing mothers: monitor infants (consider interrupting breastfeeding or pumping/discarding breast milk during and for 28hrs after dose).

Pharmacologic Class:

Benzodiazepine.

Interactions:

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.

Adverse Reactions:

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 phenomena.

Generic Availability:

YES

How Supplied:

Tabs—10, 100, 500

Pricing for HALCION

0.25mg tablet (Qty: 30)
Appx. price $37
GoodRx