Estazolam
PROSOM
Pronunciation: es-TA-zoe-lam
“Stay Prostrate & som(nolent)”
hot pink → benzo theme
What it isIntermediate benzodiazepine; insomnia.
Why this oneUnlike flurazepam and quazepam, it lacks long-lived active metabolites that accumulate with repeated use.
What limits itOpioids or other depressants can cause fatal respiratory depression; CYP3A4 inhibitors prolong sedation, and dependence develops.
FDA-approved for
- insomnia (1990)
FDA label
Read the full label on DailyMed ↗
BOXED WARNING Concomitant use with opioids may cause profound sedation, respiratory depression, coma, and death; risks of abuse, misuse, and addiction; dependence and withdrawal reactions.
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Insomnia | Adults | 1 mg QHS | 1 mg QHS (some need 2 mg) | 2 mg QHS |
| Insomnia | Elderly / small or debilitated | 0.5-1 mg QHS | 1 mg QHS | 2 mg QHS |
Renal Undefined
Hepatic Undefined
Instructions
- Take at bedtime
- Use a gradual taper to discontinue or reduce dosage to limit withdrawal reactions
Available strengths
- tab 1, 2 mg
Contraindications
- Concomitant ketoconazole or itraconazole (potent CYP3A inhibitors)
Cautions
- CNS depression, especially with opioids/other CNS depressants
- Abuse, dependence, and withdrawal reactions
- Complex sleep behaviors
- Next-day psychomotor/cognitive impairment
Adverse reactions
- Somnolence
- Hypokinesia
- Dizziness
- Abnormal coordination
- Headache
- Asthenia
- Nervousness
Pregnancy Undefined
Lactation Undefined
Cost
Estazolam (PROSOM)
What pharmacies pay · NADAC 9/30/26
| Strength | #/mo | generic $/mo | CostPlus | |
|---|---|---|---|---|
| 1 mg | tab | 30 qd | $26.52 | not offered |
| 2 mg | tab | 30 qd | $25.18 | not offered |
Generic entry1997
⚠ BOXED WARNINGS
- Risk from concomitant use with opioids
- Abuse, misuse and addiction
- Dependence and withdrawal reactions
Classes and tags
Clinical profile
Legacy pregnancy categoryX
Defining liabilitySedation, falls, dependence and additive respiratory depression with opioids or other CNS depressants.
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