What Is Temazepam (Restoril)?
In This Article
Temazepam is a prescription drug that is commonly prescribed for the short-term treatment of insomnia. It’s recommended to be taken for a maximum of 7 to 10 days.
The drug is sold under the brand name Restoril and belongs to the benzodiazepine class. There are also generic versions.
Benzos are primarily used to treat anxiety. But they can also be prescribed to treat other conditions like insomnia, seizures, and alcohol withdrawal.1, 2, 3
Temazepam is a Schedule IV controlled substance, which means it has a risk for abuse and addiction. Healthcare providers who prescribe controlled substances such as Temazepam are required to have a special license, called a Drug Enforcement Administration (DEA) license.
However, temazepam’s risk is thought to be lower than Schedule III drugs like ketamine and anabolic steroids.1, 3
How Temazepam Works
Temazepam increases the action of gamma-aminobutyric acid (GABA). This slows down brain activity, which leads to drowsiness and calming effects.
GABA is a substance made in the brain. It’s also found in certain foods. With low GABA activity, you may experience stress, anxiety, depression, or insomnia.4, 5
Falling asleep faster and staying asleep through the night are good signs that Temazepam is working for you.
How Temazepam is Used
Temazepam is available as an oral capsule that comes in a variety of milligram (mg) doses. It shouldn’t be used 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 or read 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.
- Take temazepam before you go to bed. Taking it too early may give you untimely drowsiness, while taking it too late may make you drowsy the following day.
- You might not sleep well if you miss a dose. You can still take it if you have 7 to 8 hours left to sleep.
- Though less common, temazepam may cause short-term memory loss after waking up. 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. These substances can further increase drowsiness.
How to Take Temazepam
Temazepam capsules are available in 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
- Your response to the first dose
The typical dosages are:
- For adults 18 to 65 years old: 7.5 to 30 mg per day
- For older adults: 7.5 mg per day
People are initially given either a 7.5 mg or 15 mg dose. This amount may increase depending on how well the medication works to manage difficulty sleeping and how the person tolerates it.
Temazepam is not prescribed to children. It’s unknown if the drug is safe and effective for them.
Tell your doctor if you: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
- Are allergic or sensitive to temazepam or other benzodiazepines
- Are pregnant, as temazepam may harm an unborn baby
- Are breastfeeding, as temazepam passes into breast milk and may affect the baby
- Have medical conditions that may worsen with temazepam, such as substance use disorder (SUD), sleep apnea, a mental health disorder, or liver, lung, or kidney disease
- Have developed abnormal thoughts and behaviors, like sleepwalking, sleep-driving, or suicidal thoughts
The U.S. Food and Drug Administration (FDA) has issued several warnings about the use of benzodiazepines, including temazepam.1, 4
Abuse, Misuse, and Addiction
Benzodiazepines are widely abused and misused. The risk is higher if you drink alcohol or take drugs like opioids. 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
Dangerous Interactions with Opioids
Combining benzodiazepines with an opioid medication, like hydrocodone or codeine, can have adverse effects. The risk is higher if you take high doses of either drug or take both medications for a long time.
Co-ingestion has worse outcomes than taking benzodiazepines alone. 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
You may experience uncomfortable (and dangerous) withdrawal symptoms if you suddenly stop taking a benzo medication. 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.
Abnormal Thoughts and Behaviors
Temazepam may cause abnormal thoughts and behaviors. There were reports of people driving, preparing food, making phone calls, or having sex while half-awake after taking the drug.
Temazepam may increase suicidal thoughts and behavior among younger users. This is likely to happen more during the first few months of drug use.1, 9
Drowsiness can still occur the next day, even if temazepam is taken as prescribed. This is why it’s advised not to drive, operate machinery, or do other activities that require full attention while taking temazepam.
Severe Allergic Reactions
Benzodiazepines can cause severe allergic reactions, including breathing problems or swelling of the face, tongue, or throat. These allergic reactions can lead to death.1
Side Effects of Temazepam
Common side effects of temazepam include:1, 4, 6, 7, 8, 9
- 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
Rare side effects include:1
- Rapid and uncontrolled eye movement
Temazepam Drug Interactions
Certain substances affect temazepam and may worsen drowsiness. Examples include:1, 6, 7, 9
- Opioid medications
- Opioid-containing drug combination (like cough medicines with codeine)
- 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 (CNS) depressant that helps treat narcolepsy.10
Can You Overdose on Temazepam?
Taking 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 think you’ve taken too much temazepam. If your symptoms are severe, seek emergency medical attention.6
If you’re cautious about taking temazepam, consider 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. 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 are:
- 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 often prescribed to induce sleep.
Unlike temazepam, trazodone is not a controlled substance. But it can still cause unpleasant withdrawal symptoms if discontinued.
Over-The-Counter (OTC) Medications
OTC sleep aids may be used once the underlying causes of insomnia are addressed. These include:14
Diphenhydramine (Benadryl) and doxylamine (Unisom) are the 2 most widely available OTC sleep aids.
Older adults should use these medicines with caution.14
This herb contains valepotriates and valeric acid. These compounds bind to the same receptors as benzodiazepines and trigger GABA release.14
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 cross-allergy to ragweed.14
This is a hormone released at night by the pineal gland.
Several studies have associated oral melatonin supplements with improved sleep quality and the feeling of freshness the following day.14
Call to find out how much your insurance will cover
- “Restoril™ (temazepam) Capsules USP.” U.S. Food and Drug Administration. Sept. 2016.
- Ogbru, Anette, and Marks, Jay (ed.). “BENZODIAZEPINES.” RxList. 1 Apr. 2021
- “Controlled Substance Schedules.” Diversion Control Division, Drug Enforcement Administration, U.S. Department Of Justice.
- “FDA requiring Boxed Warning updated to improve safe use of benzodiazepine drug class.” U.S. Food and Drug Administration. 2 Oct. 2020.
- Hepsomali, Piril et al. “Effects of Oral Gamma-Aminobutyric Acid (GABA) Administration on Stress and Sleep in Humans: A Systematic Review.” Frontiers in neuroscience vol. 14 923. 17 Sept. 2020.
- Healthwise. “Temazepam.” University of Michigan Health. 8 Dec. 2020.
- “Temazepam.” NHS. 12 Mar., 2019.
- “Temazepam.” MedlinePlus, National Library of Medicine. 15 May 2021.
- Sinha, Sanjai. “Temazepam.” Drugs.com. 14 Dec. 2021.
- “Sodium oxybate.” MedlinePlus, National Library of Medicine. 15 Feb. 2021.
- “Sleeping pills and minor tranquillisers: Comparing benzodiazepines.” Mind. Apr. 2021.
- Erman, Milton et al. “Comparative efficacy of zolpidem and temazepam in transient insomnia.” Hum Psychopharmacol vol. 16,2 : 169-176.
- “Restoril Alternatives Compared.” Drugs.com.
- Hulisz, Darell and Christine Duff. “Assisting Seniors With Insomnia: A Comprehensive Approach.” US Pharm vol. 34,6 : 38-43.