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How does it work?
Temazepam is a type of medicine called a benzodiazepine. Benzodiazepines are used for their sedative and anxiety-relieving effects.
Benzodiazepines work by acting on receptors in the brain called GABA receptors. This causes the release of a neurotransmitter called GABA (gamma amino butyric acid) in the brain.
Neurotransmitters are chemicals that are stored in nerve cells in the brain and nervous system. They are involved in transmitting messages between the nerve cells. GABA is a neurotransmitter that acts as a natural 'nerve-calming' agent. It helps keep the nerve activity in the brain in balance, and is involved in inducing sleepiness, reducing anxiety and relaxing muscles.
Temazepam can be used as a short-term treatment for sleeping problems (insomnia) that are causing severe distress. This includes difficulty falling asleep, waking in the night and waking early in the morning.
Temazepam decreases the time taken to fall asleep and night-time awakenings, as well as increasing the total amount of time spent sleeping. However, it is only suitable for short-term treatment of insomnia (up to four weeks), as when used for longer periods it has a potential for dependence and addiction.
As temazepam relieves anxiety as well as causing sleepiness, it is also used as a pre-medication before minor surgery or other minor medical procedures.
What is it used for?
- Short-term (two to four weeks only) treatment of severe insomnia that is disabling or subjecting the individual to extreme distress.
- Relieving anxiety and causing sedation before minor surgery or medical procedures (pre-medication).
How do I take it?
- Temazepam is taken by mouth as tablets or liquid. It can be taken either with or without food.
- Always take the medicine as directed by your doctor. Do not exceed the dose prescribed by your doctor.
- For sleeping problems (insomnia) you should only take this medicine before going to bed at night. If you forget to take it at bedtime don't take it at any other time, or you will end up feeling drowsy, dizzy and confused during the day.
- This medicine causes drowsiness and impairs concentration and alertness. These effects may continue into the following day and are made worse by drinking alcohol. If you are affected you should not drive or operate machinery. Do not drink alcohol while taking this medicine.
- From March 2015 a new 'drug driving' law comes into force, which makes it an offence to drive with certain drugs or prescription medicines above specified limits in your body. The list includes temazepam, which means it may be an offence to drive while you are taking this medicine. The new law will allow police to use roadside drug tests to check for the presence of the prohibited drugs in a driver's saliva. There are very low limits for illegal drugs, but higher limits for prescribed medicines. This should mean that most people taking temazepam as prescribed will not be breaking the law, provided they are not driving dangerously. If you are found to be above the limit for temazepam there is a medical defence if you are taking the medicine as prescribed, as long as your driving is not impaired. If you are taking a high dose of temazepam it may therefore be sensible to carry your prescription with you when driving, in case you are asked to take a test by the police. However, if you are driving dangerously while taking this medicine you will be breaking the law. You should not drive if you think this medicine affects your ability to drive safely, for example if it makes you feel sleepy, dizzy, unable to concentrate or make decisions, or if you have blurred or double vision. You should not drive home if you have taken temazepam as a pre-med before surgical or other medical procedures.
- Benzodiazepines can sometimes cause unexpected reactions in certain people. If you experience any unusual feelings, thoughts or behaviour after starting treatment with this medicine, for example feeling restless, agitated, irritable or aggressive, or experiencing delusions, rages, nightmares or hallucinations, you should consult your doctor, as this medicine may not be suitable for you or the dose may be too high.
- This medicine is generally only suitable for short-term use (less than four weeks). If it is used for longer periods or in high doses, dependence upon the medicine may develop and withdrawal symptoms such as headaches, muscle pain, sweating, tremor, anxiety, tension, restlessness, confusion and irritability and may then occur if treatment is stopped suddenly. Your body may also become tolerant to the medicine, with higher doses needed to achieve the same effect. For this reason, you should not exceed the dose of this medicine prescribed by your doctor, or take it for longer than recommended. If you are still having trouble sleeping after this time you should consult your doctor for further advice.
- Depending on how long you have been taking this medicine for, your doctor may suggest that you stop taking it gradually to avoid withdrawal effects or a return in your sleeping problems. Follow the instructions given by your doctor.
Use with caution in
- Children. This medicine should not be used for treating sleeping problems in children.
- Elderly people.
- Weak or debilitated people.
- Decreased kidney function.
- Decreased liver function.
- People with disease affecting the lungs and airways (respiratory disease).
- People with a history of alcoholism or drug abuse.
- People with personality disorders.
- It is important to tell your doctor if you have recently suffered a loss or bereavement, for example the death of a close friend or relative, before taking this medicine. Benzodiazepines such as this one can affect the way you adjust psychologically to events like this.
Not to be used in
- People who are allergic to other benzodiazepines.
- People with a sudden worsening of any underlying lung disease (acute pulmonary insufficiency).
- People with slow, shallow breathing (respiratory depression).
- People who suffer from sleep apnoea syndrome, which is a problem involving short spells when breathing stops during sleep.
- People with abnormal muscle weakness due to the condition myasthenia gravis.
- Long-term psychotic illness.
- Phobias or obsessional states.
- Severely decreased liver function.
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
Pregnancy and breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
- This medicine may be harmful to a developing baby and it should be avoided during pregnancy unless considered essential by your doctor. This is particularly important during the first and third trimesters of pregnancy and before or during labour. Regular use during pregnancy should especially be avoided, as the baby could become dependent on the medicine and then suffer withdrawal symptoms after the birth. If this medicine is used in late pregnancy or during labour it may cause floppiness, low body temperature and breathing or feeding difficulties in the baby after birth. Ask your doctor for further information.
- This medicine passes into breast milk. It should not be used by mothers who are breastfeeding as it may be harmful to the nursing infant. Seek further medical advice from your doctor.
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.
- Drowsiness and sedation, including drowsiness the next day - see warnings above.
- Feeling light-headed or dizzy.
- Numbed emotions.
- Reduced alertness.
- Muscle weakness.
- Shaky movements and unsteady walk (ataxia).
- Blurred vision.
- Slurred speech.
- Slow, shallow breathing.
- Difficulty in passing urine (urinary retention) or urinary incontinence.
- Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain.
- Skin rashes.
- Low blood pressure (hypotension).
- Loss of memory (amnesia).
- Changes in sex drive.
- Increased salivation or dry mouth.
- Blood disorders.
- Unexpected effects such as increase in aggression, excitement, restlessness, irritability, rages, nightmares, hallucinations, psychotic reactions (see warning section above).
The side effects listed above may not include all of the side effects reported by the medicine's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
If you think you have experienced a side effect from a medicine or vaccine you should check the patient information leaflet. This lists the known side effects and what to do if you get them. You can also get advice from your doctor, nurse or pharmacist. If they think its necessary they'll report it for you.
You can also report side effects yourself using the yellow card website: www.mhra.gov.uk/yellowcard.
How can this medicine affect other medicines?
It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you use this medicine. Similarly, check with your doctor or pharmacist before using any new medicines while using this one, to make sure that the combination is safe.
The sedative effect of this medicine will be increased if it is taken with any of the following, which can also cause drowsiness:
- antipsychotics, eg chlorpromazine, clozapine
- barbiturates, eg phenobarbital, amobarbital
- other benzodiazepines, eg diazepam
- MAOI antidepressants, eg phenelzine
- sedating antihistamines, eg chlorphenamine, hydroxyzine, promethazine
- other sleeping tablets, eg zopiclone
- strong opioid painkillers, eg morphine, codeine, dihydrocodeine
- tricyclic and related antidepressants, eg amitriptyline, mirtazapine.
Disulfiram may increase the amount of temazepam in your blood and this could increase its sedative effect, as well as increase the risk of its side effects. As a result, your doctor may need to prescribe a lower dose of temazepam if you are taking disulfiram.
Temazepam may enhance the blood pressure lowering effect of medicines that lower blood pressure, particularly medicines used to treat high blood pressure (antihypertensives), diuretic medicines and nitrates for angina. This may cause dizziness, which can usually be relieved by lying down until the symptoms pass.
Temazepam may affect (increase or decrease) the blood level of the anti-epileptic medicine phenytoin.
Caffeine and theophylline may reduce the sedative and anxiety-reducing effects of temazepam.
Other medicines containing the same active ingredient
Temazepam tablets and oral solution are only available generically. There are no branded versions of the medicine currently available.
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