INDICATIONS AND USAGE Estazolam tablets are indicated for the short-term management of insomnia characterized by difficulty in falling asleep, frequent nocturnal awakenings, and/or early morning awakenings. Agitation in the ICU patient -------------- Continuous infusion: 1 to 10 mg/hr (0.01 to 0.1 mg/kg/hour). V.: 0.02-0.06 mg/kg every 2-6 hours Severe Hyperosmolar Metabolic Acidosis Due to a Large Dose of Intravenous Lorazepam.
Both outpatient studies and a sleep laboratory study have shown that estazolam administered at bedtime improved sleep induction and sleep maintenance SUPPLIED: Tablet: 1 mg, 2 mg Dosing (Adults): Insomnia: Initial: 2 mg before bedtime (maximum dose: 3 mg). ---- Previous cases of propylene glycol toxicity secondary to high-dose lorazepam infusion have occurred in patients with compromised renal function.
Patients with impaired hepatic or renal function demonstrated increased plasma levels and a prolonged half-life of buspirone. during a 6-hour period, but not more than this in any 24-hour period.
Therefore, use in patients with severe hepatic or renal impairment cannot be recommended. V.: Initial: 50-100 mg followed by 25-50 mg 3-4 times/day as needed. M.: 50-100 mg prior to surgery Ethanol withdrawal symptoms: Oral, I. Dosing adjustment in renal impairment: Clcr30 kg body weight: initiate therapy at 10 mg daily and titrate as tolerated up to 40 mg daily.
Following oral administration, plasma concentrations of unchanged buspirone are very low and variable between subjects.
Peak plasma levels of 1 ng/m L to 6 ng/m L have been observed 40 to 90 minutes after single oral doses of 20 mg.
SUPPLIED: Tablet, as hydrochloride: 5 mg, 7.5 mg, 10 mg, 15 mg, 30 mg Dosing (Adults): Anxiety: Oral: 15-100 mg divided 3-4 times/day. V.: 50-100 mg to start, dose may be repeated in 2-4 hours as necessary to a maximum of 300 mg/24 hours Note: Up to 300 mg may be given I. •Doses above 5 mg/day should be administered in two divided doses.
•ONFI tablets can be administered whole, or crushed and mixed in applesauce. Dosage adjustment needed in the following groups: •Geriatric patients •Known CYP2C19 poor metabolizers •Mild or moderate hepatic impairment; no information for severe hepatic impairment Dosing (Adults): Anxiety: Regular release tablets (Tranxene® T-Tab®): 7.5-15 mg 2-4 times/day .
Dosing (Adults): Generalized anxiety disorder: Adults: 15 mg/day (7.5 mg twice daily); may increase in increments of 5 mg/day every 2-4 days to a maximum of 60 mg/day; target dose for most people is 30 mg/day (15 mg twice daily) May take 2-3 weeks to see full effect.
Decrease dose by 0.125 mg twice daily every 3 days until medication is completely withdrawn. V.: 5-10 mg every 10-20 minutes, up to 30 mg in an 8-hour period; may repeat in 2-4 hours if necessary.
Elderly: Initiate with low doses and observe closely SUPPLIED: Tablet: 0.5 mg, 1 mg, 2 mg Tablet, orally-disintegrating [wafer]: 0.125 mg, 0.25 mg, 0.5 mg, 1 mg, 2 mg Dosing (Adults): Anxiety/sedation/skeletal muscle relaxant: Oral: 2-10 mg 2-4 times/day I. V.: 2-10 mg, may repeat in 3-4 hours if needed Sedation in the ICU patient: I. Rapid tranquilization of agitated patient (administer every 30-60 minutes): Oral: 5-10 mg; average total dose for tranquilization: 20-60 mg Elderly: Oral: Initial: Anxiety: 1-2 mg 1-2 times/day; increase gradually as needed, rarely need to use 10 mg/day (watch for hypotension and excessive sedation) Skeletal muscle relaxant: 2-5 mg 2-4 times/day Dosing adjustment in hepatic impairment: Reduce dose by 50% in cirrhosis and avoid in severe/acute liver disease SUPPLIED: Gel, rectal (Diastat®): Adult rectal tip [6 cm]: 5 mg/m L (15 mg, 20 mg) Pediatric rectal tip [4.4 cm]: 5 mg/m L (2.5 mg, 5 mg) Universal rectal tip [for pediatric and adult use; 4.4 cm]: 5 mg/m L (10 mg) Injection, solution: 5 mg/m L (2 m L, 10 m L) Solution, oral: 5 mg/5 m L (5 m L, 500 m L) Solution, oral concentrate (Diazepam Intensol®): 5 mg/m L (30 m L) Tablet (Valium®): 2 mg, 5 mg, 10 mg Dosing (Adults): Short-term management of insomnia: Oral: 1 mg at bedtime, some patients may require 2 mg; start at doses of 0.5 mg in debilitated or small elderly patients.
Buspirone differs from typical benzodiazepine anxiolytics in that it does not exert anticonvulsant or muscle relaxant effects.
It also lacks the prominent sedative effect that is associated with more typical anxiolytics.