Triazolam

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Dec 11, 2023

Warnings

Triazolam (Halcion) Risks, Warnings, and Complications

Triazolam can cause or worsen health problems in some people. Talk to your doctor or pharmacist about other medications for insomnia if you are at an increased risk of adverse reactions from this drug.

OPIOID-RELATED RESPIRATORY DEPRESSION: Taking triazolam with opioid pain medications can result in potentially fatal respiratory depression due to the CNS depressant effects of the medications. Doctors reserve concomitant prescribing of these medicines only when absolutely necessary. Do not take triazolam if you are on opioid painkillers (oxycodone, hydrocodone, and other such drugs) without close supervision by a healthcare provider. Before starting treatment with triazolam, tell your doctor if you have any breathing problems, lung conditions, or sleep apnea. Get emergency medical help if you develop extreme drowsiness or slowed breathing while on this medicine.
ABUSE, MISUSE, AND ADDICTION: Taking triazolam for a long time can lead to tolerance, clinically significant physical dependence, and withdrawal symptoms. Triazolam may not work as well as it did before after you’ve used it for more than two weeks because your body gets used to the medicine (this is called tolerance). Additionally, you can develop dependence and withdrawal reactions. Psychological and physical dependence on the medicine can lead to prescription drug addiction. Sudden discontinuation or dosage reduction of triazolam may precipitate acute withdrawal reactions. Withdrawal symptoms (acute withdrawal signs) can include difficulty sleeping (rebound insomnia), anxiety, nervousness, stomach cramps, nausea, vomiting, and seizures. Follow your doctor’s dosing instructions carefully. Do not take triazolam for longer than prescribed. To prevent severe acute withdrawal signs, don’t stop taking this medicine abruptly.
WORSENING INSOMNIA: Talk to your healthcare provider if your insomnia does not improve or gets worse after 7 to 10 days of treatment with triazolam. Your problems with sleep may be related to some other physical or psychiatric disorder that requires a different treatment.
COMPLEX BEHAVIOR CHANGES: There are reports of bizarre or abnormal behavior in people taking triazolam, including driving, preparing food, making phone calls, and having sex while asleep, with no recollection of these activities after waking up. Other behavior changes may include increased anxiety, irritability, decreased inhibition, aggression, being more outgoing than usual, agitation, hallucinations, depersonalization, and suicidal thinking. These changes are more likely if you drink alcohol and take certain other drugs concomitantly, such as sedative-hypnotics, especially at higher doses than prescribed. If you have an episode of unusual behavior, it will require careful and immediate evaluation.
DOSE-RELATED ADVERSE REACTIONS: Some of the side effects of triazolam, such as drowsiness, dizziness, lightheadedness, and memory problems, are dose-related. More serious side effects like agitation, hallucinations, and bizarre behavior may also be dose-related. Your doctor may recommend an appropriate triazolam dose reduction or discontinuing the medicine if you develop these side effects.
IMPAIRED ABILITY TO FOCUS: Patients taking benzodiazepines, including triazolam, can have an impaired ability to focus, think, and react. This can put you in danger while driving, operating heavy machinery, or doing other hazardous activities. Alcohol can make these side effects worse. Avoid any activities that require full alertness until you know how this medicine affects you.
CLINICALLY IMPORTANT DRUG INTERACTIONS: Some medications can increase the levels of triazolam in your body, causing more severe side effects. Give your doctor and pharmacist a full list of your prescription and nonprescription medicines so that they can check for potentially dangerous drug interactions.
SEDATION AND WITHDRAWAL SYMPTOMS IN NEWBORN BABIES: Use of triazolam during late pregnancy can lead to sedation, respiratory depression, lethargy, and low muscle tone in the newborn. It can also cause withdrawal symptoms such as hyperactive reflexes, irritability, restlessness, tremors, inconsolable crying, and poor feeding in the baby. If you take triazolam during pregnancy, talk to your baby’s doctor about what signs to look for and when to seek medical attention.

Precautions Before Starting Triazolam (Halcion)

Tell your doctor if you have ever had an allergic reaction to triazolam, any of the active or inactive ingredients in triazolam tablets, other benzodiazepines, or any other drugs. Your pharmacy can give you a list of ingredients.

Give your doctor and pharmacist a complete list of your medications, including prescription and nonprescription medicines, vitamins, nutritional supplements, and herbal products. This can help avoid possible drug interactions between triazolam and your other medicines.

Give your doctor a complete medical history. Triazolam may not be right for people with certain medical conditions, such as a history of suicidal thinking or behavior, breathing problems, sleep apnea, seizures, kidney disease, or liver disease.

Tell your doctor if you are pregnant, could be pregnant, plan to get pregnant, or are breast-feeding.

Precautions During Use of Triazolam (Halcion)

Keep all your medical and lab appointments while on triazolam. Your doctor may adjust your dose based on your response to the medicine. If you do not get relief from your insomnia or have worsening symptoms, tell your doctor. Do not increase the dose or dosage frequency without your doctor’s approval. Do not take triazolam for more than 7-10 days without consulting your doctor.

Do not eat grapefruit or drink grapefruit juice while on triazolam.

If you are an older adult (65 years of age or older), talk to your doctor about the pros and cons of taking triazolam. There may be other safer medications for insomnia available. Your doctor may prescribe a lower dose of triazolam for you.

Triazolam can cause dizziness and drowsiness and affect your mental alertness the morning after. Be cautious while driving and doing other hazardous activities until you know how the medicine affects you. Get out of bed carefully, especially in the middle of the night.

Call your doctor immediately if you experience any bizarre or abnormal behavior while taking triazolam.

Tell your doctor if you become pregnant while on triazolam.

Tell all your healthcare providers you are on triazolam before any surgery, including dental procedures.

Triazolam (Halcion) Drug Interactions

Concomitant use of certain medicines with triazolam can cause clinically significant drug interactions. Possible interactions with other medicines can increase the risk of severe adverse events. You should not take triazolam with the following medications:

Opiate medications for cough, such as hydrocodone (in Anexsia, in Norco, in Zyfrel), codeine (in Triacin-C, in Tuzistra XR), or for pain such as fentanyl (Actiq, Duragesic, Subsys, others), oxycodone (in Oxycet, in Percocet, in Roxicet, others), codeine (in Fiorinal), methadone (Dolophine, Methadose), hydromorphone (Dilaudid, Exalgo), meperidine (Demerol), morphine (Astramorph, Duramorph PF, Kadian), and tramadol (Conzip, Ultram, in Ultracet)
Antifungal medications such as itraconazole (Onmel, Sporanox) and ketoconazole (Nizoral)
HIV medications such as ritonavir (Norvir, in Kaletra), indinavir (Crixivan), nelfinavir (Viracept), lopinavir (in Kaletra), and saquinavir (Invirase)
Antidepressants such as nefazodone

Triazolam can also have interactions with the following medications:

Certain antibiotics such as erythromycin (Erythrocin, E-mycin), clarithromycin (Biaxin, in Prevpac), and telithromycin (Ketek)
Medications used to treat heart rhythm abnormalities, such as amiodarone (Nexterone, Pacerone)
Certain antifungal medications
Antihistamines
Certain H2 receptor blockers such as cimetidine (Tagamet) and ranitidine (Zantac)
Antidepressants, including certain selective serotonin reuptake inhibitors (SSRIs) such as paroxetine (Paxil, Brisdelle, Pexeva), fluvoxamine (Luvox), and sertraline (Zoloft)
Certain calcium channel blockers, such as nifedipine (Adalat, Procardia, Afeditab), diltiazem (Dilacor, Cardizem, Tiazac, others), nicardipine (Cardene), and verapamil (Calan, Verelan)
Immunosuppressant drugs such as cyclosporine (Gengraf, Sandimmune, Neoral)
Migraine medications, such as ergotamine (Cafergot, Migranal, Ergomar, others)
Hormonal contraceptives (birth control pills, rings, patches, implants, or injections)
Tuberculosis medications such as isoniazid (Laniazid, in Rifamate, in Rifater)
Medications used to treat allergies, colds, anxiety, mental illness, and seizures
Psychiatric medications, sedatives, hypnotics, sleeping pills, tranquilizers, and muscle relaxants

The above list may not include all the potential drug interactions of triazolam. Give your doctor or pharmacist a complete list of your medications, including prescription drugs, over-the-counter medicines, nutritional supplements, and herbal remedies. Also, tell your healthcare professional if you smoke, drink alcohol, or use illegal drugs because some of these substances can cause serious health complications when used with prescription medications.

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