temazepam

Adjunctive therapy

Brands: RESTORIL

Last reviewed 2025-12-29

Reviewed by PsychMed Editorial Team.

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Quick answers

What is temazepam?
Temazepam (brand Restoril) is a benzodiazepine hypnotic indicated for the short-term treatment of insomnia (generally 7 to 10 days on label). It can help with sleep onset and nighttime awakenings, but tolerance, dependence, and next-day impairment make it a poor default long-term strategy.
What is RESTORIL?
RESTORIL is a brand name for temazepam.
What is RESTORIL (temazepam) used for?
Label indications include: Short-term treatment of insomnia (generally 7 to 10 days) (label).
What drug class is RESTORIL (temazepam)?
Benzodiazepine hypnotic; GABA-A receptor positive allosteric modulator.
What strengths does RESTORIL (temazepam) come in?
Capsules: 7.5 mg, 15 mg, 22.5 mg, 30 mg.

Snapshot

Class: Adjunctive therapy
Common US brands: RESTORIL
Therapeutic drug monitoring not routinely recommended.
Last reviewed: 2025-12-29

Label indications

Short-term treatment of insomnia (generally 7 to 10 days) (label).

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Clinical Highlights

Temazepam (brand Restoril) is a benzodiazepine hypnotic indicated for the short-term treatment of insomnia (generally 7 to 10 days on label). It can help with sleep onset and nighttime awakenings, but tolerance, dependence, and next-day impairment make it a poor default long-term strategy. Temazepam is often considered “intermediate acting.” Its longer terminal half-life relative to very short-acting hypnotics can reduce late-night rebound, but it also increases morning grogginess, falls, and impaired driving risk—especially in older adults and with polypharmacy.

Use a time-limited plan with a concrete reassessment date; if insomnia is persistent, prioritize CBT-I and treat underlying drivers (mood episodes, pain, substances, sleep apnea) rather than escalating to chronic nightly benzodiazepine use.
Benzodiazepine safety is not “just sedation”: counsel about abuse, misuse, and addiction risk, and avoid co-prescribing opioids whenever possible (boxed warning for opioid combinations).
The compare view and the temazepam evidence feed can help weigh alternatives, and the temazepam print page can support safety counseling.
Best fit is usually severe, time-limited insomnia where a controlled hypnotic is warranted and the team can provide close follow-up and a deprescribing plan.
Generic formulations are widely available; that accessibility makes documentation of indication, duration, and a taper plan especially important to avoid “silent” chronic use.

Dosing & Formulations

Capsules: 7.5 mg, 15 mg, 22.5 mg, 30 mg (label). Usual adult dose is 15 mg at bedtime; some patients respond to 7.5 mg and some may require 30 mg (label).

In older or debilitated patients, start low (often 7.5 mg) to reduce confusion, ataxia, and falls; avoid “catch-up” dosing during the night (label).
Avoid dispensing patterns that imply chronic nightly use; if continued beyond a short course, document a taper plan and monitor for rebound insomnia and withdrawal.

Monitoring & Risks

Boxed warning: Concomitant use with opioids can cause profound sedation, respiratory depression, coma, and death (label). Next-day impairment: assess driving, fall risk, and cognitive slowing, especially after dose increases and in older adults.

Dependence and withdrawal: monitor for tolerance, rebound insomnia, and withdrawal symptoms when stopping; avoid abrupt discontinuation after prolonged use.
Behavioral effects: confusion, anterograde amnesia, and paradoxical agitation can occur—reassess if symptoms worsen rather than improve.

Drug Interactions

Additive CNS and respiratory depression with alcohol, opioids, antihistamines, and sedating antipsychotics—avoid stacking sedatives when possible. Temazepam is largely cleared by conjugation rather than CYP metabolism, so classic “CYP inhibitor” interaction lists are less relevant, but total sedative burden still drives harm.

Diphenhydramine can potentiate sedation; avoid combining multiple over-the-counter sleep aids with temazepam (label).

Practice Notes

Pair any hypnotic prescription with a behavioral plan (CBT-I, stimulus control, sleep window) and a defined endpoint; stop if benefit is marginal. Avoid using temazepam to treat insomnia caused by untreated depression, mania, akathisia, alcohol/cannabis use, pain syndromes, or sleep apnea.

When discontinuing after extended use, taper gradually and follow for rebound insomnia, anxiety, and functional relapse rather than re-upping the dose.
Prefer a single-prescriber/single-pharmacy approach and document a safety screen (opioids, sleep apnea, substance use risk, fall risk) before renewing.

References

Restoril (temazepam) prescribing information — DailyMed (2024)
Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults: An American Academy of Sleep Medicine Clinical Practice Guideline — Journal of Clinical Sleep Medicine (2017)
ASAM guideline on benzodiazepines — Journal of Addiction Medicine (2020)
Efficacy and Acceptability of Pharmacological Interventions for Insomnia in Patients With Severe Mental Illness — Acta Psychiatrica Scandinavica (2025)
Residual effects of medications for sleep disorders on driving performance — European Neuropsychopharmacology (2024)