Drug Information: Triazolam

Why is this medication prescribed?

Triazolam is used on a short-term basis to treat insomnia (difficulty falling asleep or staying asleep). Triazolam is in a class of medications called benzodiazepines. It works by slowing activity in the brain to allow sleep.

How should this medicine be used?

Triazolam comes as a tablet to take by mouth. It is usually taken as needed before bedtime. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take triazolam exactly as directed.

You will probably become very sleepy soon after you take triazolam and will remain sleepy for some time after you take the medication. Plan to go to bed right after you take triazolam and to stay in bed for 7 to 8 hours. Do not take triazolam if you will be unable to remain asleep for 7 to 8 hours after taking the medication. If you get up too soon after taking triazolam, you may experience memory problems.

Your sleep problems should improve within 7 to 10 days after you start taking triazolam. Call your doctor if your sleep problems do not improve during this time or if they get worse at any time during your treatment.

Triazolam should normally be taken for short periods of time (usually 7 to 10 days). You should not take triazolam for more than 2 to 3 weeks without talking to your doctor. If you take triazolam for 7 to 10 days or longer, triazolam may not help you sleep as well as it did when you first began to take the medication, and you may wake up more easily during the last third of the night. You may also start to feel anxious or nervous during the day. If you take triazolam for 7 to 10 days or longer, you may also develop dependence ('addiction'; a need to continue taking the medication) on triazolam. Talk to your doctor about the risks of taking triazolam for 2 weeks or longer. Do not take a larger dose of triazolam, take it more often, or take it for a longer time than prescribed by your doctor.

Do not stop taking triazolam without talking to your doctor, especially if you have taken it for longer than 2 weeks. Your doctor will probably decrease your dose gradually. If you suddenly stop taking triazolam, you may develop unpleasant feelings or you may experience more severe withdrawal symptoms such as uncontrollable shaking of a part of the body, stomach and muscle cramps, vomiting, sweating, sad mood, seeing things or hearing sounds that do not exist, and rarely, seizures.

You may have more difficulty falling asleep or staying asleep on the first few nights after you stop taking triazolam than you did before you started taking the medication. This is normal and usually gets better without treatment after one or two nights.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

Other uses for this medicine

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before taking triazolam,

• tell your doctor and pharmacist if you are allergic to triazolam; other benzodiazepines such as alprazolam (Xanax, Niravam), chlordiazepoxide (Librium, in Librax), clonazepam (Klonopin), clorazepate (Tranxene), diazepam (Valium), estazolam, flurazepam (Dalmane), lorazepam (Ativan), oxazepam, midazolam, prazepam (Centrax) (not available in the U.S.), quazepam (Doral), and temazepam (Restoril);any other medications; or any of the ingredients in triazolam tablets. Ask your pharmacist for a list of the ingredients.
• tell your doctor if you are taking any of the following medications: certain medications for human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) including amprenavir (Agenerase), atazanavir (Reyataz), delavirdine (Rescriptor), efavirenz (Sustiva), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir, in Kaletra), and saquinavir (Invirase); itraconazole (Sporanox), ketoconazole (Nizoral), and nefazodone. Your doctor will probably tell you not to take triazolam.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: amiodarone (Cordarone, Pacerone); certain antibiotics such as clarithromycin (Biaxin, in Prevpac), erythromycin (Erythrocin, E-mycin), telithromycin (Ketek), and troleandomycin (TAO) (not available in the U.S.); antidepressants; certain antifungal medications; antihistamines; certain calcium channel blockers such as diltiazem (Cardizem, Dilacor, Tiazac, others), nicardipine (Cardene), nifedipine (Adalat, Procardia),and verapamil (Calan, Isoptin, Verelan); cyclosporine (Neoral, Sandimmune); ergotamine (Cafergot, Ergomar, Migranal, others); certain histamine-2 receptor blockers (H2 blockers) such as cimetidine (Tagamet) and ranitidine (Zantac); isoniazid (Nydrazid); medications for anxiety, colds or allergies, mental illness, pain, or seizures; muscle relaxants; hormonal contraceptives (birth control pills, patches, implants, or injections); sedatives; certain selective serotonin reuptake inhibitors (SSRIs) such as fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft); sleeping pills; and tranquilizers. Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with triazolam, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
• tell your doctor if you drink or have ever drunk large amounts of alcohol, use or have ever used street drugs, or have overused prescription medications. Also tell your doctor if you have ever thought about killing yourself or tried to do so, and if you have or have ever had any medical condition especially any condition that affects your breathing; depression; mental illness; sleep apnea (condition in which a person briefly stops breathing many times during the night); seizures; or kidney or liver disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking triazolam, call your doctor immediately. Triazolam may harm the fetus.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking triazolam.
• you should know that triazolam may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
• do not drink alcohol during your treatment with triazolam. Alcohol can make the side effects of triazolam worse.
• you should know that some people who took triazolam got out of bed and drove their cars, prepared and ate food, had sex, made phone calls, or were involved in other activities while partially asleep. After they woke up, these people were usually unable to remember what they had done. Call your doctor right away if you find out that you have been driving or doing anything else while you were sleeping.
• you should know that your mental health may change in unexpected ways while you are taking this medication. It is hard to tell if these changes are caused by triazolam or if they are caused by physical or mental illnesses that you already have or suddenly develop. Tell your doctor right away if you experience any of the following symptoms: aggressiveness, strange or unusually outgoing behavior, hallucinations (seeing things or hearing voices that do not exist), feeling as if you are outside of your body, memory problems, difficulty concentrating, slowed speech or movements, new or worsening depression, thinking about killing yourself, confusion, and any other changes in your usual thoughts, mood, or behavior. Be sure that your family knows which symptoms may be serious so that they can call the doctor if you are unable to seek treatment on your own.

What special dietary instructions should I follow?

Do not eat grapefruit or drink grapefruit juice while taking this medication.

What should I do if I forget a dose?

Triazolam should only be taken at bedtime. If you did not take triazolam at bedtime and you are unable to fall asleep, you may take triazolam if you will be able to remain in bed for 7 to 8 hours afterward. Do not take triazolam if you are not ready to go to sleep right away and stay asleep for at least 7 to 8 hours.

What side effects can this medication cause?

Triazolam may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• drowsiness
• dizziness
• lightheadedness
• headache
• problems with coordination
• nervousness

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:

• rash
• hives
• itching
• swelling of the eyes, face, lips, tongue, or throat
• feeling that the throat is closing
• difficulty breathing or swallowing
• hoarseness
• nausea
• vomiting

Triazolam may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/index.html] or by phone [1-800-332-1088].

What storage conditions are needed for this medicine?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include:

• extreme drowsiness
• confusion
• problems with coordination
• slurred speech
• difficulty breathing
• seizures
• coma (loss of consciousness for a period of time)

What other information should I know?

Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your body's response to triazolam.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

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