The amount of medication you use is dependent on the strength of the therapeutic. The number of daily dosages, the treatment schedule and the duration of treatment depends on the medical condition for which you are using the medicine.
Standard Prescription Dosage for Insomnia
Body chemistry and other factors individualised to a person differentiates how a body responds to certain medications. This response dictates the amounts of medicine one may take. The normal adult temazepam dosage is 15 mg at bedtime. There may be circumstances in which this dose should be halved or doubled but that is dependent on the user. A half dose is appropriate for geriatric patients.
Standard Prescription Dosage for anxiety
This dosage is also individualised as when used for sleep disturbances. There is no standard dose prescribed but temazepam tablets can be started off with an initial dose of 7.5 mg daily. The effects of this medication may cause sleepiness and/or drowsiness.
If you have a treatment schedule when using this benzodiazepine, a missed temazepam dosage may be excluded from the routine, especially if it is close to the time of the following dose. Double doses of these sleeping pills are not recommended. It is advised that this medication be used only when you have sleep difficulties and for a short period.
An effective temazepam dosage can start working 30 minutes after administration and the effects can last for seven to eight hours. It is for this reason that this medication be used only when you have this time available to sleep.
The way in which your body metabolises medications dictates on how well these will work for you. Some people have a genetic makeup which causes them to metabolise or process medicines slowly. This means that the active ingredient and metabolites (broken down substances of the therapeutic) may accumulate in the body and this can have negative implications.
If one metabolises the medication at a much faster rate than average, the levels of the therapeutic in the blood may not become high enough for the medicine to be effective or the benefits to be acquired.
Approximately half of the United States population is known to have a liver enzyme called N-acetyltransferase which functions at reduced capacity. This means that they metabolise medications at a slower rate. In people like this, medications such as temazepam, can have a delayed onset of action or not be as effective. These observations in the US are mirrored by similar results in Europe and other parts of the globe.
Ultra-short benzodiazepines can have a half-life of less than five hours. The half-life is the time taken for half of the medication to be eliminated from the body. Short to Intermediary-acting benzodiazepines, like temazepam 20 mg, can have a half-life anywhere from five to 24 hours. A half-life longer than 24 hours can be noticed with long-acting benzodiazepines.
The average half-life following a temazepam dosage is approximately 9 hours.
The factors which affect the half-life of temazepam include:
After being metabolised by the liver to inactive metabolites, this sleep medication is eliminated from the body in the urine with about 20% in the faeces. In an absorption, distribution, metabolism and excretion (ADME) study the blood level of the parent medication was found to be bi-phasic. The short half-life ranged from 0.4 to 0.6 hours and the terminal half-life was found to be an average 8.8 hours. This was dependent on the study patients and the method of determination.
Similar to most benzodiazpeines, administration of a temazepam dosage in excess in the long-term can lead to tolerance and dependence. Withdrawal from sleeping tablets can result in benzodiazepine withdrawal syndrome which has signs and symptoms resembling alcohol or barbiturate withdrawal.
Higher dosages and long-term usage are often related to withdrawal symptoms, but using standard dosages for a short period of time can also result in withdrawal - especially if used in excess.
Withdrawal symptoms may range from mild to more severe. These can include:
In a study conducted by Puustinen et al. (2014) the effect of withdrawal from the long-term use of temazepam was investigated in seniors. This study showed that when the hypnotic agents were used for long periods, prolonged impairment of psychomotor and attentional functioning lasted for at least six months following withdrawal.
A possible dose tapering schedule can be as follows:
Reduce your dose by 2-4 mg for 1 to 2 weeks thereafter,
Reduce your dose by 1-2 mg for 1 to 2 weeks thereafter,
Reduce your dose by 1 mg for 1 to 2 weeks thereafter,
Reduce your dose by 0.5-1 mg for 1 to 2 weeks until the medication is completely stopped
This method of dose tapering is also known as gradual tapering. It can be adjusted according to the amount of medication you specifically use and to meet your needs so as to persist administration of the sleep medication safely.
When a treatment schedule of temazepam is to persist, abrupt discontinuation of the medication is ill-advised. That is for a few reasons:
Your blood pressure levels can surge
This is known as the rebound effect. The rebound effect is the emergence (or re-emergence) of the symptoms that were not present whilst using the medication, but which are known to take effect when the medication is discontinued or lowered in dosage. This is a cause for concern as the severity of these symptoms can be exacerbated in some situations. Hypertension (high blood pressure), if left untreated, can result in serious health concerns such as strokes or heart disease.
There can be a surge in hormones
Stress hormones such as dopamine, epinephrine (adrenaline) and norepinephrine (noradrenaline) can increase in the bloodstream when the medication is stopped abruptly. This can further affect your sleep disorders and make the symptoms therefore worse than before the medication had been initiated.
Withdrawal effects are possible
Withdrawal symptoms are possible when you stop taking your regular temazepam dosage. Although they are uncomfortable, these symptoms are generally temporary. It can become dangerous if the symptoms of withdrawal are prolonged and ignored, as this can lead to mental health issues.
Updated: 22nd January 2021
Review Due: January 2022
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