Temazepam dosage, forms, and strengths

Temazepam, generic for Restoril, is a prescription drug that is approved by the Food and Drug Administration (FDA) to provide short-term treatment of insomnia. Additionally, healthcare professionals may prescribe it for off-label uses, such as night terrors or confusional arousal, a sleep disorder in which people wake up and act strangely for several minutes or hours. Temazepam belongs to a family of sedatives called benzodiazepines, which include Valium (diazepam), Xanax (alprazolam), and Ativan (lorazepam). Benzodiazepines have serious drug abuse, dependency, withdrawal, and overdose risks. For this reason, healthcare professionals are reluctant to prescribe them for more than a few days. Healthcare providers will ask that a temazepam capsule be taken right at bedtime for people with insomnia. The dose varies between 7.5 and 30 milligrams (mg), but people usually start with a 15 mg dose.

Temazepam forms and strengths

Temazepam and its brand-name version, Restoril, come in only one dosage format:

• Capsules: 7.5 mg, 15 mg, 22.5 mg, 30 mg

Temazepam dosage for adults

The FDA has approved temazepam only as a short-term treatment of insomnia. Doses are taken before bedtime.

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Temazepam dosage for insomnia

The FDA has approved temazepam to treat insomnia in adults, but only on a short-term basis. Temazepam works quickly at inducing sleep, so it should be taken when retiring for the night. The recommended dose is taking a 15 mg capsule before lying down to sleep. A smaller dose is appropriate for transient insomnia or older adults. The FDA advises that treatment should not last longer than seven to 10 days. If insomnia is still a problem, people should be evaluated by a healthcare professional for medical conditions that could be causing trouble sleeping.

Standard adult dosage for insomnia: 7.5–30 mg taken once daily at bedtime

Temazepam dosage for children

Temazepam is not FDA-approved for pediatric patients. The safety and effectiveness of temazepam in children and teens have not yet been determined.

Temazepam dosage restrictions

Temazepam does not have dosage restrictions or reductions for people with kidney dysfunction or liver disease. However, the FDA recommends that prescribers be cautious when prescribing temazepam to people with kidney, liver, or lung disease. The FDA also recommends that healthcare professionals limit dosages to the lowest dose of 7.5 mg in older adults because they may become oversedated, increasing the risk of falls or injuries.

Temazepam is never prescribed or given to pregnant women or those planning to get pregnant because of the risk of birth defects. Temazepam is also contraindicated in any person who has had an allergic reaction to the drug.

Temazepam dosage for pets

Benzodiazepines, such as diazepam, alprazolam, oxazepam, clorazepate, or clonazepam, are used in dogs and cats for many medical conditions, including anxiety, muscle spasms, and seizure disorders, as well as sedation before veterinary procedures. Temazepam is not included in veterinary drug manuals, so it’s not a drug that pet owners should expect to give to their pets. If a pet accidentally ingests the human version of temazepam, contact the animal’s veterinarian or call a pet poison helpline for medical advice.

How to take temazepam

Temazepam is taken only at night to induce sleep. Because it can cause significant impairment, understand how to take it safely. Here are some guidelines:

• Take this medicine as directed. The dose may change if needed.

• Do not take a larger dose than prescribed or more than one dose per day.

• Do not take temazepam for longer than prescribed. This medicine is not intended for long-term use.

• Read the medication guide that came with temazepam. Ask your prescriber or pharmacist if you have any questions about it.

• Use this medicine only for its prescribed purpose. 

• Take this medicine just before bedtime or when having trouble falling asleep. 

• To avoid impairment, do not take this medicine if seven to eight hours of sleep or rest are unavailable before the need to be active again.

• If temazepam is being taken on a schedule and a dose is missed, skip the missed dose.

• If temazepam is not being taken on a schedule, take a missed dose only if there is enough time for a full night’s sleep (seven to eight hours) before waking.

• Store the medicine in a child-proof, closed container at room temperature, away from direct light. Keep out of reach of children and pets.

Temazepam dosage FAQs

How long does it take temazepam to work?

Temazepam begins to induce sleep quickly after a capsule is taken. People may notice themselves becoming drowsy 10 or 20 minutes after taking the drug. The peak effects occur in a little more than an hour.

How long does temazepam stay in your system?

In clinical studies, temazepam had a widely varying half-life ranging from 3.5 to 18 hours. The average half-life was 8.8 hours in clinical trials and 10.5 hours in another study. With a short half-life, people are likely to wake up in the early morning and stay awake. With a long half-life of around eight hours, people will likely sleep through the night without waking. With an even longer half-life, people will sleep through the night but feel drowsy and impaired during the day. Because the half-life of temazepam can vary so greatly, individuals may have different experiences with the drug. Always inform the prescribing healthcare provider about problems falling asleep, staying asleep, or daytime impairment.

What happens if I miss a dose of temazepam?

If a doctor has prescribed a fixed schedule for taking temazepam and a dose is missed, skip the missed dose and take the next dose as scheduled. If there is no fixed schedule and temazepam is being taken as needed, a forgotten dose can be taken if there’s enough time to get a full night’s sleep (seven to eight hours). If not, skip the missed dose. Otherwise, there’s a risk of waking up drowsy and unable to function.

How long can you take temazepam?

Temazepam is only appropriate for short-term use because of the risk of side effects, drug dependency, and withdrawal symptoms. The FDA recommends that temazepam only be taken for seven to 10 days.

How do I stop taking temazepam?

When taken as directed for only a few days, people should be able to stop temazepam without using a gradually decreasing dose. A tapering dose at discontinuation is not recommended in the FDA drug information. However, if temazepam is used longer than advised, stopping temazepam can cause benzodiazepine withdrawal syndrome. The mildest symptoms are usually insomnia and feeling unhappy. More serious symptoms include convulsions, muscle cramps, abdominal cramps, tremors, vomiting, and sweating. If temazepam has been used too long or at high doses, a healthcare provider will prescribe a gradually decreasing dose to prevent withdrawal reactions.

Temazepam is only intended for short-term use, so after seven to10 days, it’s necessary to get a more detailed evaluation to determine the cause of insomnia, such as asthma, GERD, or chronic pain. That underlying cause may need to be treated separately from the insomnia symptoms.

Other prescription drugs that can provide symptomatic relief of insomnia are also intended for short-term or occasional use, such as sedatives and barbiturates. Over-the-counter antihistamines like Benadryl (diphenhydramine) or supplements like melatonin are safer for long-term use to help with trouble sleeping. A sleep dosage guide for melatonin can be found here. 

Some doctors may suggest lifestyle or behavior changes as an effective and safe way to address sleep problems. These include sleep hygiene habits, dietary changes, exercise, and other positive changes.

What is the maximum dosage for temazepam?

The FDA has not specified a maximum dosage for temazepam. However, the highest recommended dosage is 30 mg, taken once daily at bedtime. Even so, the prescribed dose should never be exceeded.

Can you overdose on temazepam?

Like all benzodiazepines, a temazepam overdose can cause serious or life-threatening problems. The signs of an overdose include extreme drowsiness, confusion, coma, slowed reflexes, low blood pressure, and trouble breathing. Respiratory depression can be fatal and is more likely if temazepam has been taken with another CNS depressant, such as alcohol or opioids. If too much temazepam has been taken or the medicine has been taken along with other CNS depressants, get emergency medical attention.

What interacts with temazepam?

As with all benzodiazepines, temazepam has potentially serious drug interactions of which people should be aware before using the drug. It is important to inform the prescribing healthcare provider about all prescription drugs, over-the-counter medications, and dietary supplements that they’re taking.

The most risky drugs to take with temazepam are other drugs that slow down the brain, called central nervous system depressants. The most dangerous of these drugs are opioids because temazepam can greatly increase the effects of them. Other risky drugs include other benzodiazepines, other sedatives like Ambien (zolpidem), barbiturates, alcohol, and monoamine oxidase inhibitors. Additionally, antihistamines, antipsychotics, anxiety drugs, tricyclic antidepressants, and anticonvulsants may increase the CNS depressant effects of temazepam. Dietary supplements commonly used to induce sleep, such as melatonin, licorice, kratom, and kava, should also be avoided in combination with temazepam.

What happens when you mix temazepam and alcohol?

Do not drink alcohol before or after taking a temazepam capsule. The combination will significantly increase drowsiness and impairment. It also risks causing breathing problems, respiratory depression, respiratory arrest, and death.

Is it safe to take temazepam during pregnancy?

Temazepam is never given or prescribed to pregnant women or women planning on becoming pregnant. Temazepam can cause birth defects, especially when taken in the first trimester.

Is it safe to take temazepam while breastfeeding?

The FDA does not warn against using temazepam while breastfeeding. Studies have determined that temazepam levels in breast milk are most likely low. If doses are taken at night, before bedtime, and after a baby’s last feeding, healthcare providers don’t believe that it will affect a nursing infant.

What are the most common side effects of temazepam?

Outside of drowsiness, side effects of temazepam are relatively uncommon. In clinical trials, the most common side effect of temazepam was drowsiness. Other less common side effects include dizziness, lethargy, confusion, anxiety, weakness, euphoria, memory loss, and vertigo. 

What are the most serious side effects of temazepam?

The most serious adverse effect of temazepam is respiratory depression. Breathing becomes slower and shallower. Severe respiratory depression can be fatal if breathing stops altogether. Respiratory depression is especially risky if other CNS depressants are combined with temazepam. 

Two other significant risks with temazepam are drug abuse and drug addiction. Physical dependency can make it hard to quit taking the drug. Drug abuse greatly increases the risk of overdose or respiratory depression.

Other severe side effects of temazepam include suicidality, low blood pressure, complex sleep disorders, such as sleepwalking or sleep-driving, and severe allergic reactions. 

Sources

• Changes in behavior to improve sleep, Merck Manual Consumer Version (2023)

• Is temazepam an accumulating hypnotic?, Journal of Clinical Pharmacology (1984)

• Psychotropic agents, Merck Veterinary Manual (2022)

• Temazepam, Drugs and Lactation Database (2023)

• Temazepam capsule prescribing information, NIH National Library of Medicine (2023)