Indications for HALCION:
Short-term (7–10 days) treatment of insomnia.
Use lowest effective dose. ≥18yrs: 0.125–0.25mg at bedtime; max 0.5mg. Elderly and/or debilitated: initially 0.125mg; max 0.25mg. Max 1 month/℞.
<18yrs: not established.
Concomitant ketoconazole, itraconazole, nefazodone, HIV protease inhibitors (eg, ritonavir, indinavir, nelfinavir, saquinavir, lopinavir), other potent CYP3A inhibitors. Pregnancy (Cat.X).
Risks from concomitant use with opioids.
Increased risk of drug-related mortality from concomitant use with opioids. Depression. Suicidal tendencies. Pulmonary, renal, or hepatic disease. Sleep apnea. Discontinue if excitement or daytime anxiety occurs. Drug or alcohol abuse. Overdosage may occur at 2mg. Reevaluate if used ≥2–3 weeks. Avoid abrupt cessation. Monitor periodic CBCs, urinalysis, blood chemistry. Elderly (higher risk of falls). Debilitated. Nursing mothers: not recommended.
See Contraindications; other azole antifungals: not recommended. Increased sedation, respiratory depression, coma, and death with concomitant opioids; reserve use in those for whom alternative treatment options are inadequate; if needed, limit dosages/durations to minimum and monitor. Additive CNS depressant effects with alcohol or other CNS depressants (eg, other benzodiazepines, TCAs, psychotropics, anticonvulsants, antihistamines); consider dose reductions. Potentiated by ranitidine, grapefruit juice, isoniazid, oral contraceptives. Reduce triazolam dose with cimetidine, erythromycin, clarithromycin, other macrolides. Caution with fluvoxamine, diltiazem, verapamil, sertraline, paroxetine, ergotamine, cyclosporine, amiodarone, nicardipine, nifedipine, others metabolized by CYP3A.
Drowsiness, headache, dizziness, nervousness, light-headedness, ataxia, nausea, vomiting; worsening of insomnia, complex behaviors (eg, sleep-driving), paradoxical excitement, anxiety, abnormal behavior, amnesia, anaphylaxis, angioedema.