Quazepam

DORAL

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Quazepam ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Quazepam ballicule

Quazepam DORAL mascot mnemonic cartoon — Visual mnemonic: Quazepam mascot
**“Quasi’s all Door”**

What it isLong-acting benzodiazepine GABA-A modulator approved for insomnia.

Why this oneIts long-lived active metabolites can maintain sleep through the night, but it has no routine advantage over shorter-acting hypnotics.

What limits itNext-day impairment, falls, and accumulation are prominent, especially in older adults; tolerance and physical dependence develop.

Quazepam molecular structure (skeletal formula) — Molecular structure: Quazepam

FDA-approved for

insomnia (1985)

FDA label

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BOXED WARNING Concomitant opioid use risks profound sedation, respiratory depression, coma, death; risk of abuse, misuse, addiction; and dependence with withdrawal reactions.

FDA dosing	Population	Start	Target	Max
Insomnia	Adults	7.5 mg QHS	7.5 mg QHS	15 mg QHS

Renal Undefined

Hepatic Undefined

Instructions

Use the lowest effective dose
Split the 15 mg scored tablet to achieve the 7.5 mg dose
Taper gradually to discontinue or reduce; do not stop abruptly
Elderly/debilitated may be more sensitive

Available strengths

tab 15 mg

Contraindications

Established or suspected sleep apnea
Chronic pulmonary insufficiency
Hypersensitivity to other benzodiazepines

Cautions

CNS depression and next-day impairment; caution with driving/tasks needing alertness
Complex sleep behaviors (sleep-driving) while not fully awake
Anaphylaxis and angioedema — do not rechallenge
Worsening depression or suicidal thinking
Neonatal sedation and withdrawal with late-pregnancy use

Adverse reactions

Drowsiness, headache, fatigue, dizziness, dry mouth, dyspepsia

Pregnancy Late-pregnancy use may cause neonatal sedation/withdrawal; observational data show no clear major-birth-defect association.

Lactation Undefined

Cost

Quazepam (DORAL)

Strength		#/mo	generic $/mo	CostPlus
15 mg	tab	30 qd		not offered

NADAC is a voluntary CMS survey of what retail community pharmacies pay for the drugs they stock. Quazepam is dispensed outside retail pharmacies, so it rarely appears on surveyed invoices.

Generic entryBy 2023

⚠ BOXED WARNINGS

Profound sedation, respiratory depression, coma, and death with opioids
Abuse, misuse, and addiction can cause overdose or death
Physical dependence and life-threatening withdrawal with abrupt reduction

Classes and tags

Clinical profile

Therapeutic safety burden2 / 4

Overdose danger2 / 4

Weight-gain liability0 / 4

Sedation liability3 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk2 / 4

Legacy pregnancy categoryC

Defining liabilitySedation, falls, dependence and additive respiratory depression with opioids or other CNS depressants.

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Memory aids: interaction avatars

CYP3A4 substrate

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