Benzodiazepine Hypnotic
Pregnancy: Avoid in pregnancy; neonatal withdrawal syndrome
Temazepam
Brand names: Normison
Adult dose
Dose: 10-20 mg at bedtime
Route: Oral
Frequency: Once nightly (short-term only — maximum 4 weeks)
Max: 20 mg/night (10 mg in elderly)
Use lowest effective dose for shortest possible time
Paediatric dose
Dose: Not recommended N/A/kg
Route: Oral
Frequency: Not recommended
Max: Not recommended
Not licensed and not recommended in children
Dose adjustments
Renal
Use with caution; reduce dose
Hepatic
Avoid in severe hepatic impairment — risk of precipitating encephalopathy
Paediatric weight-based calculator
Not licensed and not recommended in children
Clinical pearls
- Beers Criteria 2023: All benzodiazepines (regardless of duration of action) are potentially inappropriate in elderly — risk of cognitive impairment, delirium, falls, fractures, and motor vehicle accidents
- STOPP v3: Avoid benzodiazepines in elderly with falls or at risk of falls (increases fracture risk 50%)
- Paradoxical excitation (increased agitation, aggression) occurs in some elderly patients — discontinue if this occurs
- Schedule 3 Controlled Drug in UK — prescription requirements apply
- If already prescribed long-term, gradual tapering is essential — abrupt withdrawal risks seizures and severe anxiety
Contraindications
- Respiratory failure
- Sleep apnoea
- Myasthenia gravis
- Severe hepatic impairment
- Phobic or obsessional states
Side effects
- Excessive sedation
- Falls and fractures
- Cognitive impairment and amnesia
- Paradoxical agitation (elderly)
- Dependence and withdrawal syndrome
- Respiratory depression
Interactions
- CNS depressants (additive)
- Alcohol (markedly enhanced sedation)
- Sodium oxybate (avoid — additive CNS depression)
Monitoring
- Falls risk
- Cognitive function
- Daytime sedation
- Duration of use
Reference: BNFc; BNF 90; AGS Beers Criteria 2023; STOPP/START v3; NICE CG49 (Insomnia). Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
Pathways