What Is Temazepam (Restoril)?
In This Article
Temazepam is a prescription medication that treats short-term insomnia. It is a type of medication called benzodiazepines that healthcare providers often prescribe under the brand name Restoril.
Benzodiazepines, or benzos, primarily treat anxiety, but they can also work on other conditions, such as:1,2,3
- Alcohol withdrawal
- Temazepam is a benzodiazepine medication for short-term treatment of insomnia.
- Temazepam increases the effects of the neurotransmitter GABA, producing relaxation and sleepiness.
- Temazepam has potential risks and side effects, such as overdose.
- Abruptly stopping this medication can also lead to withdrawal symptoms, including vomiting, sweating, and seizures.
- If you’ve developed an addiction to temazepam, seek professional help is important.
Is Temazepam A Controlled Drug?
Temazepam is a Schedule IV controlled substance with a risk of abuse and addiction. Because of this, healthcare providers who prescribe temazepam must have a special Drug Enforcement Administration (DEA) license.
The addiction risk for temazepam is considered lower compared to Schedule III drugs like ketamine and anabolic steroids.1,3 However, the risk increases when temazepam is mixed with other opioid medication.
How Does Temazepam Work?
Temazepam causes drowsiness and calming effects, which can help you fall asleep. It’s widely used for its calming effects on the central nervous system.
Temazepam enhances gamma-aminobutyric acid (GABA) activity, which slows down brain activity and prevents overexcitation. GABA is a neurotransmitter naturally occurring in the brain. GABA is also present in certain foods, including:
- Green tea
- Whole grains
If you have low GABA activity, you may experience:4, 5
If you notice improved onset and duration of sleep, it's a sign that temazepam works for you. However, if you experience any adverse side effects, call your doctor.
Temazepam typically exhibits its effects within 30 to 60 minutes after administration, and its sedative properties may persist for about 6 to 8 hours.
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How Addictive is Temazepam?
The U.S. Food and Drug Administration (FDA) has issued several warnings about using benzodiazepines such as Restoril.1,4 Users often abuse and misuse benzos, such as temazepam.
Long-term temazepam use can also lead to physical dependence, but the risk of drug abuse with temazepam is higher if you drink alcohol or take other drugs. This is a significant concern, especially in people with a history of drug abuse.
Here are some figures from the FDA:4
- From 2015 to 2016, half a million Americans had a benzodiazepine use disorder.
- In 2016, benzodiazepines led to more visits to the E.R. than prescription opioids.
- In 2017, 18% of admissions to public-funded treatment centers used benzodiazepines at various levels.
- By comparison, 3.6% used prescription opioids, 12% used marijuana, and 31% used heroin.
- In 2018, 5.4 million Americans 12 years and older abused or misused benzodiazepines.
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What Are The Side Effects of Temazepam?
Like some drugs, temazepam can have common and uncommon side effects.1,6,7,8,9 Common side effects of temazepam include:
- Muscle weakness
- Abdominal discomfort
- Dry mouth
- Blurred vision
Less common side effects include:1
- Uncoordinated movement
- Equilibrium loss
- Increased dreaming
- Shortness of breath
- Excessive sweating
- Burning eyes
What Are The Rare Side Effects of Temazepam?
The rare side effects of temazepam use include:1
- Rapid and uncontrolled eye movement
When Should You Call Your Doctor After Taking Temazepam?
Tell your doctor if you experience the following conditions:1, 6, 7, 8, 9
- Still have insomnia after 7 to 10 days of treatment
- Feel temazepam stopped working, especially if you’ve taken it for a long time
- Become too drowsy during the day or experience extreme drowsiness
- Have abnormal thoughts or behavior, like performing tasks while half awake
- Experience suicidal thoughts or ideation
If you experience a severe allergic reaction from Restoril (temazepam), seek medical help immediately. This is a serious side effect that requires emergency medical attention.
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What Is Temazepam’s Recommended Dosage?
Temazepam is used as an oral capsule in various milligram (mg) doses. These capsules are available in the following 4 doses:1,9
- 7.5 mg
- 15 mg
- 22.5 mg
- 30 mg
The dosage for insomnia treatment will depend on several factors, including:
- Presence of other medical conditions
- Individual response to medication
The starting dose for people over 18 can range between 15 to 30 mg daily. Meanwhile, for older adults, the starting dose is 7.5 mg daily.
How Do You Safely Use Temazepam?
Temazepam's dosage depends on your doctor's prescription. The recommended dosing schedule is typically 7 to 10 days. You shouldn't use it for more than 10 days to treat insomnia.
Here are a few guidelines for the safe use of temazepam:4,6,7,8
- Follow your doctor’s instructions.
- Read the drug information contained in the prescription label.
- Don’t increase or decrease the dose or frequency without your doctor’s confirmation.
- Don’t share temazepam with others.
- Keep your prescription in a safe place so that other people can’t misuse or abuse it.
- Don’t take it at night if you have less than 7 to 8 hours left to sleep.
- Don’t drive or operate machinery until you are fully alert.
- Don’t drink alcohol or use recreational drugs like marijuana while taking temazepam.
You should also avoid taking temazepam before you go to bed. Taking it too early may make you drowsy before your bedtime, while taking it too late can make you drowsy the following day. If you miss a dose, you might not sleep well.
Who Is At Risk When Taking Temazepam?
Certain people should avoid using temazepam. When used incorrectly, the medication can interact with your condition and increase the risk of adverse effects.
You should be cautious about using temazepam if you:
- Are pregnant, as temazepam may harm an unborn baby
- Are breastfeeding, as temazepam passes into breast milk and may affect the baby
- Have sleep apnea or other sleep disorders
- Have liver, lung, or kidney disease
- Have a substance use disorder (SUD)
- Have a history of mental illness
- Are allergic or sensitive to temazepam or other benzodiazepines
- Have developed abnormal thoughts and behaviors, like sleepwalking, sleep-driving, or suicidal thoughts
Can You Overdose on Temazepam?
Yes, too much temazepam can lead to harmful drug levels in the body. This increases the risk of overdose.
Overdose symptoms include:1,8
- Excessive sleepiness
- Reduced or no reflexes
- Respiratory depression
- Loss of consciousness
Call your doctor or the local poison control center if you’ve taken too much temazepam. If you or someone you know is experiencing an overdose, seek emergency medical attention immediately.6
What Drugs Can Interact With Temazepam?
Combining temazepam with opioids and other central nervous system depressants can significantly enhance its sedative effects. This potentially results in heightened risks and adverse outcomes such as extreme drowsiness, respiratory depression, and even fatal overdose.
Substances that can interact with temazepam include:1,6,7,9
- Other benzodiazepines (like lorazepam and alprazolam)
- Other sleep or anti-anxiety drugs (like zolpidem)
- Muscle relaxants (like carisoprodol and cyclobenzaprine)
- Allergy, cough, and cold medications
Temazepam can also interact with sodium oxybate and cause severe breathing problems. Sodium oxybate is a central nervous system depressant that helps treat narcolepsy.10
Talking to your doctor about any over-the-counter and prescription medications you take before using temazepam is essential.
Dangerous Interactions with Opioids
Using temazepam with other opioids can lead to worse outcomes than taking benzodiazepines alone. Combining benzodiazepines with an opioid medication, like hydrocodone or codeine, can have adverse effects due to the combined depressant action on the central nervous system.
From 2013 to 2017, 55% of benzodiazepine overdose deaths involved prescription opioids. In 2017, 63% of benzodiazepine-related calls to the U.S. poison control center involved opioids, alcohol, or stimulants.4
What Are Temazepam Withdrawal Symptoms?
If you stop taking temazepam abruptly, you may experience uncomfortable and life-threatening withdrawal symptoms. These symptoms can include:6
- Trouble sleeping
- Depressed mood
- Stomach and muscle cramps
Never stop taking medication abruptly without consulting your doctor first. Your doctor will provide the safest way to stop taking medication.
What Are The Treatment Options for Temazepam Addiction?
If you’ve developed a restoril addiction, you can choose from several solutions to your drug addiction. Talk to your doctor to explore different treatment options catering to your needs. These may include:
- Medical detox: Medically supervised detox avoids harmful withdrawal effects.
- Inpatient treatment: Involves checking yourself into a rehab facility for 24-hour medical supervision.
- Outpatient treatment: A treatment program where you’re freely allowed to leave the rehab facility.
- Partial hospitalization programs (PHPs): A treatment program where you stay at a rehab facility for a day and return home at night.
- Cognitive behavioral treatment (CBT): A short-term therapy technique that explores the link between thought patterns and addiction.
- Medication-assisted treatment: Involves using medication, counseling, and therapy to treat addiction and its withdrawal symptoms.
- 12-step programs: Support groups that follow a 12-step process that helps guide people through the recovery process and maintain sobriety.
What Are Temazepam Alternatives?
If you’re reconsidering taking temazepam due to concerns about Restoril abuse, you may opt for the following alternatives:
If you want something close to temazepam, ask your healthcare provider about loprazolam or lormetazepam. Like temazepam, these drugs are intermediate-acting benzodiazepines. Keep in mind that they also have some drawbacks and dangers, like withdrawal.11
In one study, 10 mg of zolpidem (Ambien) provided greater sleep-inducing performance than 15 mg of temazepam.12 However, like temazepam, zolpidem may lead to next-day sluggishness and abnormal behaviors like sleep-driving.13
Other non-benzodiazepine drugs approved for the short-term treatment of insomnia include:
- Eszopiclone (Lunesta)
- Ramelteon (Rozerem)
- Zaleplon (Sonata)
In higher doses, these drugs have less potential for drug tolerance than temazepam. They also don’t have anticonvulsant or sedative properties.14
Trazodone is an antidepressant that induces sleep. Unlike temazepam, trazodone isn’t a controlled substance. However, it can still cause unpleasant withdrawal symptoms if discontinued abruptly.
Over-the-Counter (OTC) Alternatives
OTC sleep aids can help once the underlying causes of insomnia are addressed. These include:14
- Antihistamines: Diphenhydramine (Benadryl) and doxylamine (Unisom) are the 2 most widely available OTC sleep aids. Older adults should use these medicines with caution.14
- Valerian Root: This herb contains valepotriates and valeric acid. These compounds bind to the same receptors as benzodiazepines and trigger GABA release.14
- Chamomile: Apigenin, the active component of chamomile, binds to the same receptors as benzodiazepines. The FDA considers chamomile as safe. But people should use this herb with caution due to the cross-allergy to ragweed.14
- Melatonin: This is a hormone that the pineal gland releases at night. Several studies have associated oral melatonin supplements with improved sleep quality and freshness the following day.14
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- “Restoril™ (temazepam) Capsules USP.” U.S. Food and Drug Administration, 2016.
- Ogbru, A. “BENZODIAZEPINES DRUG CLASS.” RxList, 2022.
- U.S. Department of Justice, Drug Enforcement Administration. “Controlled Substance Schedules.” Diversion Control Division.
- “FDA requiring Boxed Warning updated to improve safe use of benzodiazepine drug class.” U.S. Food and Drug Administration, 2020.
- Hepsomali et al. “Effects of Oral Gamma-Aminobutyric Acid (GABA) Administration on Stress and Sleep in Humans: A Systematic Review.” Frontiers in Neuroscience, 2020.
- University of Michigan. “Temazepam.” University of Michigan Health.
- “Temazepam.” U.K. National Health Service, 2019.
- U.S. National Library of Medicine. “Temazepam.” MedlinePlus, National Library of Medicine, 2021.
- “Temazepam.” Drugs.com, 2021.
- U.S. National Library of Medicine. “Sodium oxybate.” MedlinePlus, 2023.
- “Sleeping pills and minor tranquillisers.” Mind, 2021.
- “RESTORIL VS. AMBIEN.” RxList.
- “Restoril Alternatives Compared.” Drugs.com, 2023.
- Hulisz et al. “Assisting Seniors With Insomnia: A Comprehensive Approach.” U.S. Pharmacist, 2009.