ProSom

Brand name of estazolam, a benzodiazepine.

Indications: As the name suggests, ProSom is used to treat insomnia in its various forms, including difficulty falling asleep, frequent nocturnal awakenings, and early waking.

How supplied: 1-mg or 2-mg scored tablets; note that the patient must be able to break the 1-mg tablet in half to take a 0.5 mg dose.

Dosage for adults: 0.5-2 mg.

Dosage for children: Not usually recommended for children.

Contraindications: Pregnant women should not use ProSom, as it can cause fetal damage. Nursing women should not use it either, as it is excreted in breast milk. Benzodiazepines should never be combined with alcohol or other CNS depressants (of which there are many; ask your doctor).

Precautions: Patients with liver, kidney, or other metabolic disorders may be more severely affected by ProSom; they should generally be started on lower doses and should be carefully monitored to ensure that they're not oversedated. Also, ProSom can slow respiration slightly, which isn't usually a problem for healthy people, but may be dangerous in patients with respiratory illnesses. As with all benzodiazepines, ProSom is a dangerous drug to prescribe to depressed or suicidal patients, as they may intentionally overdose; if absolutely necessary, patients should be given only a few pills at a time of the lowest possible dose.

Interactions: ProSom can adversely interact with any other drug that affects the central nervous system, including anticonvulsants, antihistamines, barbiturates, MAO inhibitors, narcotics, phenothiazines, etc.

Common Adverse Reactions: Sleepiness, dizziness, slowness of movement, poor coordination and concentration.

Warnings: As with all benzodiazepines, patients can build up a tolerance to ProSom, and should not take it regularly for long periods of time (in one study, patients who took ProSom for more than 12 weeks experienced rebound insomnia). Benzodiazepines can also slow reaction time and cause drowsiness, so patients must avoid driving, operating dangerous machinery, or engaging in hazardous activity until they know how the drug affects them.

Date of most recent update: 1/30/03