Restoril (Temazepam) - Oral

What Is Restoril?

Restoril (temazepam) is a pill used to treat short-term (acute) insomnia. It is a prescription medication in the benzodiazepine class of drugs.  

Benzodiazepines like Restoril are very commonly prescribed drugs. They affect a certain receptor found in the brain, called gamma-aminobutyric acid (GABA) receptors. When Restoril binds to these receptors, it has a calming effect on the brain.

Restoril is categorized as a Schedule IV controlled substance. Taking Restoril can potentially lead to physical dependence, misuse, or abuse. 

What Is Restoril Used For?

The Food and Drug Administration (FDA) approved Restoril to treat insomnia. Specifically, it is meant to only be used short-term (for seven to 10 days).

How to Take Restoril

Take Restoril exactly as prescribed by your healthcare provider. This will mean taking it when you are ready to go to bed in most cases. It is not necessary to take it with food. Do not take Restoril unless you know you can allow the next seven to eight hours for sleep. 

Do not crush the drug and snort it up your nose. This is not a safe way to use the drug.

If you take Restoril for an extended period, you may be more likely to experience withdrawal symptoms once you stop taking it. Talk to your healthcare provider about how to safely stop taking this medication. 

Storage

Store at room temperature, away from heat and light. As with all medications, keep safe away from children. 

When traveling, only take a little more than you think you’ll need during your trip. If flying, take your pills on your carry-on baggage in the original bottles. 

If going abroad, check with the embassy of the country you are visiting to see if there are any special requirements for traveling. It may also be helpful to carry your prescription with you and a letter from your physician.

Off-Label Uses

The American Academy of Sleep Medicine notes that Restoril is an option for people who have chronic insomnia. It can be effective for people who have trouble getting to sleep or wake up too early. However, Restoril is not FDA-approved for long periods of use.

Benzodiazepines such as Restoril are sometimes used to treat other conditions as well. For example, they can help prevent seizures and muscle spasms.

Because benzodiazepines have a calming effect on the brain, healthcare providers have also sometimes prescribed them for psychiatric problems. For example, these include:

• General anxiety disorders
• Obsessive compulsive disorder
• Other psychiatric disorders, like schizophrenia

What Are the Side Effects of Restoril?

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

Restoril can sometimes cause side effects, although not everyone will experience them. Some of the most common side effects are:

• Drowsiness
• Headache
• Nervousness
• Nausea

You also might feel fatigued, tired, or sleepy the next day after using it.

Severe Side Effects

Risk of Dependence, Addiction, and Abuse

Like other benzodiazepine drugs, Restoril can lead to physical dependency if you take it for more than a short period. You’ll experience withdrawal symptoms if you stop taking the drug. 

Usually, these symptoms are mild, such as insomnia, restlessness, or poor mood. However, you are more likely to get severe symptoms if you suddenly stop taking a large dose you’ve been taking for a while. Then, you might get symptoms like:

• Vomiting
• Muscle cramps or spasms
• Intense sweating
• Tremors
• Seizures

A certain amount of physical dependency happens in most people who take the drug for an extended period. But for some people, this issue becomes much more severe, leading to actual psychological dependence and addiction to benzodiazepine drugs. In some cases, people are using other addictive drugs as well. This dramatically increases the chance of drug overdose and death. 

However, this risk is relatively low. You may need to be more cautious if you have a previous history of addiction or addiction in your family.

Risk of Slowed Breathing, Coma, and Death

Like other benzodiazepine drugs, Restoril may cause your breathing to slow or even stop (this is sometimes called respiratory depression). This can cause a coma or even death.

This risk is much higher if you take a larger than normal dose of the drug or take certain other medicines along with Restoril. For example, combining Restoril with opioid drugs, like OxyContin (oxycodone) or alcohol is dangerous.

Call 911 if someone taking Restoril is breathing more slowly than usual or if they seem to be unresponsive.

Risk of Mood/Behavior Changes and “Sleep Driving”

Occasionally, Restoril can have an unexpected effect on mood or behavior. For example, a person might act aggressive.

Rarely, people who use Restoril may perform complex tasks while not fully awake. Afterward, they usually don’t remember the event. This can be dangerous if the person participates in potentially unsafe activities, such as driving a vehicle, while in this state. This is most likely to happen if a person has used Restoril with another drug, like alcohol.

If something like this happens, contact your healthcare provider immediately. You will probably need to stop taking Restoril. 

Risk of Severe Allergic Reaction

Allergic reactions are another rare but potentially serious side effect of this medication. This might cause swelling of the tongue or throat or difficulty breathing. Call 911 if a person experiences any of these symptoms after taking Restoril.

Dosage: How Much of Restoril Should I Take?

Modifications

Restoril should also be used cautiously in older adults (65 and older). These individuals may be more at risk from side effects from Restoril, especially if they are taking other medications. They might need a smaller dose of the drug.

Missed Dose

If you are taking Restoril for short-term treatment of insomnia, you probably won’t have any problems if you miss a dose. If you get to sleep without taking it, you can take it the next night, if needed.

If you take Restoril over the long term, you might notice some mild withdrawal symptoms if you miss a dose, like nervousness. Take it as soon as you remember. However, do not double up if it is very close to your next scheduled dose.

Overdose: What Happens If I Take Too Much Restoril?

People who take more Restoril than prescribed can overdose on the drug, potentially leading to death. This is more likely in people who take Restoril along with opioid drugs (like OxyContin) or with alcohol. 

Overdose symptoms might include:

• Confusion
• Dizziness
• Fainting
• Drowsiness
• Slowed breathing
• Loss of consciousness

Precautions

What Are Reasons I Shouldn’t Take Restoril?

Certain people should use caution in taking benzodiazepines like Restoril. Although it may make sense for you to take this medication, you’ll still want to weigh the risks and benefits with your healthcare provider. For example, it might not be a good choice for people with any of the following:

• Depression or other mental illness
• Previous addition problems
• Lung disease

You shouldn’t take Restoril if you are pregnant. The drug may increase the risk of birth defects in the fetus. Discuss the risks and benefits with your healthcare providers if you are breastfeeding.

Do not take Restoril if you are allergic to it or any of its ingredients.

What Other Medications Interact With Restoril?

Restoril can heighten the risks of using opioid drugs like OxyContin (oxycodone) or Vicodin (hydrocodone). In 2019, of the people who overdosed from opioid drugs, 16% were also taking a benzodiazepine drug such as Restoril. Using alcohol with Restoril also greatly increases your risk of accidental overdose. 

Restoril can also interfere with how some drugs are broken down in your body. In some cases, it might make these drugs less or more potent. Alternatively, some medications can do the same for Restoril, affecting how well Restoril works for you and your risk for side effects.

Even if Restoril interacts with another drug, you may still be able to use it. However, you'll need to discuss this with your healthcare provider. Some examples of these drug interactions include:

• Birth control pills
• Drug therapies for yeast infections, like Nizoral (ketoconazole)
• Certain antibiotics, like Ery-Tab (erythromycin)
• Certain drugs for seizures, like Dilantin (phenytoin)  
• St. John’s Wort herb

Talk to your healthcare provider about all your medications, including over-the-counter products and any herbal preparations. 

What Medications Are Similar?

Several other medications can help treat insomnia. Some other alternatives are:

• Halcion (triazolam)
• Ambien (zolpidem)
• Lunesta (eszopiclone)
• Sonata (zaleplon)

According to the American Academy of Sleep Medicine, these are all potentially effective options for managing insomnia. However, you should only take one of these treatments. These should be used at the same time.

Like Restoril, Halcion is a benzodiazepine drug. It is similarly effective and has very similar risks in terms of side effects. Zolpidem, Lunesta, and Sonata are newer therapies for sleep that do not belong to the benzodiazepine class. These drugs also affect GABA receptors in the brain, but they do so slightly differently. Because of this, they may be somewhat safer than benzodiazepine drugs like Restoril. However, they still carry some risks and may be more expensive than the older drugs.

Healthcare providers prescribe other drugs for insomnia as well, sometimes off-label.Cognitive behavioral therapies for insomnia can also be very effective. These might be worth trying before you consider pharmacologic treatment. Talk to your healthcare provider about all your treatment options.

How Can I Stay Healthy While Taking Restoril?

If you are dealing with insomnia, taking Restoril might help you get needed sleep. However, you’ll probably only want to take it short-term. Your healthcare provider can give you other non-pharmacologic suggestions to improve your sleep.

Make sure to take Restoril exactly as prescribed. Talk to your healthcare provider about all your other medications and over-the-counter products. Avoid alcohol and any opioid drugs while you are taking the medication. If you do so, your risks should be minimal.