CLINICAL USE

Hypnotic

DOSE IN NORMAL RENAL FUNCTION

3.75–7.5 mg at night

PHARMACOKINETICS

  • Molecular weight                           : 388.8
  • %Protein binding                           : 45–80
  • %Excreted unchanged in urine     : <5
  • Volume of distribution (L/kg)       : 91.8–104.6 litres
  • half-life – normal/ESRD (hrs)      : 3.5–6.5/Unchanged

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50     : Dose as in normal renal function
  • 10 to 20     : Dose as in normal renal function
  • <10           : Start with lower dose

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                : Dialysed. Dose as in GFR <10 mL/min
  • HD                     : Dialysed. Dose as in GFR <10 mL/min
  • HDF/high flux   : Dialysed. Dose as in GFR <10 mL/min
  • CAV/VVHD      : Dialysed. Dose as in normal renal function

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs

  • Antibacterials: metabolism inhibited by erythromycin and quinupristin/ dalfopristin; concentration significantly reduced by rifampicin
  • Antipsychotics: enhanced sedative effects
  • Antivirals: concentration possibly increased by ritonavir

    ADMINISTRATION

    Reconstition

    –

    Route

    Oral

    Rate of Administration

    –

    Comments

    –

    OTHER INFORMATION

    It is recommended that elderly patients and those with severe renal disease should start treatment with 3.75 mg; however, accumulation has not been observed .

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