Triazolam
HALCION
Pronunciation: trye-AY-zoe-lam (HAL-see-on)
“HAL Tries lamenting”
HAL 9000 from 2001: A Space Odyssey
hot pink → benzo theme
What it isUltra-short-acting benzodiazepine; sleep-onset insomnia.
Why this oneThe shortest action of the benzodiazepine hypnotics, so morning residue is minimal.
What limits itAnterograde amnesia and rebound insomnia are prominent. CYP3A4-dependent; dependence as for the class.
FDA-approved for
- insomnia (1982)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Insomnia (short-term) | Adults | 0.25 mg QHS | 0.25 mg QHS | 0.5 mg QHS |
| Insomnia (short-term) | Geriatric | 0.125 mg QHS | 0.125–0.25 mg QHS | 0.25 mg QHS |
Renal Undefined
Hepatic Undefined
Instructions
- Take once daily before bedtime
- Short-term use (7–10 days); do not prescribe more than a 1-month supply
- Reevaluate if used more than 2–3 weeks
- Taper gradually to discontinue; avoid abrupt cessation
- Avoid alcohol and other CNS depressants
Available strengths
- tab 0.125, 0.25 mg
Contraindications
- Concomitant use with strong CYP3A inhibitors (e.g., ketoconazole, itraconazole, nefazodone, ritonavir, indinavir, nelfinavir, saquinavir, lopinavir)
Cautions
- Profound sedation/respiratory depression with opioids
- Abuse, misuse, and addiction
- Dependence and withdrawal reactions (including seizures)
- Complex sleep behaviors (sleep-driving)
- CNS/behavioral changes; anterograde amnesia
- Worsening depression/suicidal ideation
- Impaired driving and operating machinery
- Neonatal sedation and withdrawal
- Increased triazolam levels with moderate CYP3A inhibitors, macrolides, cimetidine
Adverse reactions
- Drowsiness
- Dizziness
- Light-headedness
- Coordination disorder/ataxia
- Headache
- Nervousness
- Nausea/vomiting
Pregnancy No clear association with major birth defects; late-pregnancy use can cause neonatal sedation and/or withdrawal
Lactation No human milk data; benzodiazepines linked to infant sedation/poor feeding; may pump and discard for 28 hours after a dose
Cost
| Strength | #/mo | generic $/mo | CostPlus | |
|---|---|---|---|---|
| 0.125 mg | tab | 30 qd | $7.88 | not offered |
| 0.25 mg | tab | 30 qd | $9.25 | not offered |
Generic entry1994
⚠ 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.
Open Triazolam in the interactive console ↗
Memory aids: interaction avatars
