and may contribute to profound and/or prolonged drug effect.midodrineMonitor Closely (1)flurazepam increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.mifepristoneSerious - Use Alternative (1)mifepristone will increase the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.mirtazapineMonitor Closely (1)flurazepam and mirtazapine both increase sedation. Use Caution/Monitor.mitotaneMonitor Closely (1)mitotane decreases levels of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments.modafinilMonitor Closely (1)flurazepam increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.morphineMonitor Closely (1)flurazepam and morphine both increase sedation. Use Caution/Monitor.motherwortMonitor Closely (1)flurazepam and motherwort both increase sedation. Use Caution/Monitor.moxifloxacinMinor (1)moxifloxacin increases levels of flurazepam by decreasing metabolism. Minor/Significance Unknown.moxonidineMonitor Closely (1)flurazepam and moxonidine both increase sedation. Use Caution/Monitor.nabiloneMonitor Closely (1)flurazepam and nabilone both increase sedation. Use Caution/Monitor.nafcillinMonitor Closely (1)nafcillin will decrease the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.nalbuphineMonitor Closely (1)flurazepam and nalbuphine both increase sedation. Use Caution/Monitor.nefazodoneMonitor Closely (1)nefazodone will increase the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.nelfinavirMonitor Closely (1)nelfinavir increases levels of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Use alternatives if available. Consider lowering benzodiazepine dose.norepinephrineMonitor Closely (1)flurazepam increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.nortriptylineMonitor Closely (1)flurazepam and nortriptyline both increase sedation. Use Caution/Monitor.ofloxacinMinor (1)ofloxacin increases levels of flurazepam by decreasing metabolism. Minor/Significance Unknown.olanzapineMonitor Closely (1)flurazepam and olanzapine both increase sedation. Use Caution/Monitor.oliceridineMonitor Closely (1)oliceridine, flurazepam. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.olopatadine intranasalSerious - Use Alternative (1)flurazepam and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. omeprazoleMinor (1)omeprazole increases levels of flurazepam by decreasing metabolism. Minor/Significance Unknown.opium tinctureMonitor Closely (1)flurazepam and opium tincture both increase sedation. Use Caution/Monitor.orphenadrineMonitor Closely (1)flurazepam and orphenadrine both increase sedation. Use Caution/Monitor.oxazepamMonitor Closely (1)flurazepam and oxazepam both increase sedation. Use Caution/Monitor.oxycodoneMonitor Closely (1)flurazepam and oxycodone both increase sedation. Use Caution/Monitor.oxymorphoneMonitor Closely (1)flurazepam and oxymorphone both increase sedation. Use Caution/Monitor.paliperidoneMonitor Closely (1)flurazepam and paliperidone both increase sedation. Use Caution/Monitor.papaveretumMonitor Closely (1)flurazepam and papaveretum both increase sedation. Use Caution/Monitor.papaverineMonitor Closely (1)flurazepam and papaverine both increase sedation. Use Caution/Monitor.pentazocineMonitor Closely (1)flurazepam and pentazocine both increase sedation. Use Caution/Monitor.pentobarbitalMonitor Closely (1)pentobarbital and flurazepam both increase sedation. Use Caution/Monitor.perphenazineMonitor Closely (1)flurazepam and perphenazine both increase sedation. Use Caution/Monitor.phendimetrazineMonitor Closely (1)flurazepam increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phenobarbitalMonitor Closely (1)phenobarbital and flurazepam both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)phenobarbital will decrease the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.phentermineMonitor Closely (1)flurazepam increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phenylephrineMonitor Closely (1)flurazepam increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phenylephrine POMonitor Closely (1)flurazepam increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .phenytoinMonitor Closely (1)phenytoin will decrease the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.pholcodineMonitor Closely (1)flurazepam and pholcodine both increase sedation. Use Caution/Monitor.pimozideMonitor Closely (1)flurazepam and pimozide both increase sedation. Use Caution/Monitor.pirbuterolMonitor Closely (1)flurazepam increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.posaconazoleMonitor Closely (1)posaconazole will increase the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.pregabalinMonitor Closely (1)pregabalin, flurazepam. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.primidoneMonitor Closely (1)primidone and flurazepam both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)primidone will decrease the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.prochlorperazineMonitor Closely (1)flurazepam and prochlorperazine both increase sedation. Use Caution/Monitor.promethazineMonitor Closely (1)promethazine and flurazepam both increase sedation. Use Caution/Monitor.propofolMonitor Closely (1)propofol and flurazepam both increase sedation. Use Caution/Monitor.propylhexedrineMonitor Closely (1)flurazepam increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.protriptylineMonitor Closely (1)flurazepam and protriptyline both increase sedation. Use Caution/Monitor.quazepamMonitor Closely (1)flurazepam and quazepam both increase sedation. Use Caution/Monitor.quetiapineMonitor Closely (1)flurazepam and quetiapine both increase sedation. Use Caution/Monitor.ramelteonMonitor Closely (1)flurazepam and ramelteon both increase sedation. Use Caution/Monitor.remimazolamMonitor Closely (1)remimazolam, flurazepam. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.ribociclibMonitor Closely (1)ribociclib will increase the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.rifabutinMonitor Closely (1)rifabutin will decrease the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Minor (1)rifabutin decreases levels of flurazepam by increasing metabolism. Minor/Significance Unknown.rifampinMonitor Closely (1)rifampin will decrease the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.rifapentineMinor (1)rifapentine will decrease the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.risperidoneMonitor Closely (1)flurazepam and risperidone both increase sedation. Use Caution/Monitor.ritonavirMonitor Closely (1)ritonavir increases levels of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Use alternatives if available. Consider lowering benzodiazepine dose.rucaparibMonitor Closely (1)rucaparib will increase the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP3A4 substrates, if clinically indicated.sageMinor (1)flurazepam and sage both increase sedation. Minor/Significance Unknown.salmeterolMonitor Closely (1)flurazepam increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.saquinavirMonitor Closely (1)saquinavir increases levels of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Use alternatives if available. Consider lowering benzodiazepine dose.scullcapMonitor Closely (1)flurazepam and scullcap both increase sedation. Use Caution/Monitor.secobarbitalMonitor Closely (1)secobarbital and flurazepam both increase sedation. Use Caution/Monitor.selinexorSerious - Use Alternative (1)selinexor, flurazepam. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.sevofluraneMonitor Closely (1)sevoflurane and flurazepam both increase sedation. Use Caution/Monitor.shepherd's purseMonitor Closely (1)flurazepam and shepherd's purse both increase sedation. Use Caution/Monitor.sodium oxybateContraindicated (1)flurazepam, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Coadministration with alcohol or sedative hypnotics are contraindicated because of additive CNS depression.stiripentolMonitor Closely (2)stiripentol, flurazepam. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence. stiripentol, flurazepam. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP3A4 inhibitor and inducer. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. CYP3A4 substrates may require dosage adjustment.sufentanilMonitor Closely (1)flurazepam and sufentanil both increase sedation. Use Caution/Monitor.sufentanil SLSerious - Use Alternative (1)sufentanil SL, flurazepam. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration may result in hypotension, profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.tapentadolMonitor Closely (1)flurazepam and tapentadol both increase sedation. Use Caution/Monitor.tazemetostatMonitor Closely (1)tazemetostat will decrease the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.tecovirimatMonitor Closely (1)tecovirimat will decrease the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Tecovirimat is a weak CYP3A4 inducer. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered.temazepamMonitor Closely (1)flurazepam and temazepam both increase sedation. Use Caution/Monitor.terbutalineMonitor Closely (1)flurazepam increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.thioridazineMonitor Closely (1)flurazepam and thioridazine both increase sedation. Use Caution/Monitor.thiothixeneMonitor Closely (1)flurazepam and thiothixene both increase sedation. Use Caution/Monitor.tipranavirMonitor Closely (1)tipranavir increases levels of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Use alternatives if available. Consider lowering benzodiazepine dose.topiramateMonitor Closely (1)flurazepam and topiramate both increase sedation. Modify Therapy/Monitor Closely.tramadolMonitor Closely (1)flurazepam and tramadol both increase sedation. Use Caution/Monitor.trazodoneMonitor Closely (1)flurazepam and trazodone both increase sedation. Use Caution/Monitor.triazolamMonitor Closely (1)flurazepam and triazolam both increase sedation. Use Caution/Monitor.triclofosMonitor Closely (1)flurazepam and triclofos both increase sedation. Use Caution/Monitor.trifluoperazineMonitor Closely (1)flurazepam and trifluoperazine both increase sedation. Use Caution/Monitor.trimipramineMonitor Closely (1)flurazepam and trimipramine both increase sedation. Use Caution/Monitor.triprolidineMonitor Closely (1)triprolidine and flurazepam both increase sedation. Use Caution/Monitor.tucatinibSerious - Use Alternative (1)tucatinib will increase the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If unavoidable, reduce CYP3A substrate dose according to product labeling.valerianSerious - Use Alternative (1)valerian and flurazepam both increase sedation. Avoid or Use Alternate Drug.vinpocetineMinor (1)flurazepam increases effects of vinpocetine by unspecified interaction mechanism. Minor/Significance Unknown. Desirable interaction enhanced memory improvement (based on preliminary trial).voriconazoleMonitor Closely (1)voriconazole will increase the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.voxelotorSerious - Use Alternative (1)voxelotor will increase the level or effect of flurazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid.xylometazolineMonitor Closely (1)flurazepam increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.yohimbineMonitor Closely (1)flurazepam increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.ziconotideMonitor Closely (1)flurazepam and ziconotide both increase sedation. Use Caution/Monitor.ziprasidoneMonitor Closely (1)flurazepam and ziprasidone both increase sedation. Use Caution/Monitor.zolpidemMinor (1)zolpidem, flurazepam. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.zotepineMonitor Closely (1)flurazepam and zotepine both increase sedation. Use Caution/Monitor. Frequency Not Defined Common Ataxia Dizziness Drowsiness Lethargy Light-headedness Less Common Chest pain, palpitations Headache, irritability, nervousness, weakness GI complaints Myalgia GU complaints Rare Elevations of AST, ALT, bilirubin (T&D), alk phos Black Box Warnings Concomitant use of benzodiazepines and opioids may result in profound respiratory depression, coma, and death; administer concomitantly when there are no alternative options; limit dosages and durations to minimum required; monitor for signs and symptoms of respiratory depression and sedation Addiction, abuse, and misuse On September 2020, FDA addressed serious risks of benzodiazepine addiction, abuse, and misuse, which can lead to overdose and death Physical dependence can occur when taken steadily for several days to weeks, even as prescribed Stopping abruptly or reducing dosage too quickly can result in withdrawal reactions, including seizures, which can be life-threatening Assess each patient’s risk prior to prescribing and monitor regularly for the development of these behaviors or conditions Contraindications Documented hypersensitivity Cautions May impair ability to perform hazardous tasks Benzodiazepines may worsen depression; consequently, appropriate precautions (eg, limiting the total prescription size and increased monitoring for suicidal ideation) should be considered To reduce risk of withdrawal reactions, use a gradual taper to discontinue therapy or reduce dosage (a patient-specific plan should be used to taper the dose); patients at an increased risk of withdrawal adverse reactions after benzodiazepine discontinuation or rapid dosage reduction include those who take higher dosages and those who have had longer durations of use Continued use of this medication may lead to clinically significant physical dependence; abrupt discontinuation or rapid dosage reduction after continued use, or administration of this medication may precipitate acute withdrawal reactions, which can be life-threatening (eg, seizures) In some cases, benzodiazepine users have developed a protracted withdrawal syndrome with withdrawal symptoms lasting weeks to more than 12 months Risks from concomitant use with opioids Concomitant use with opioids may result in profound sedation, respiratory depression, coma, and death; because of these risks, reserve concomitant prescribing of benzodiazepines and opioids in patients for whom alternative treatment options are inadequate Observational studies have demonstrated that concomitant use of opioid