Home Drug Guide Halazepam

Drug Guide

Generic Name

Halazepam

Brand Names Paxipam

Classification

Therapeutic: Anxiolytic, Sedative

Pharmacological: Benzodiazepine

FDA Approved Indications

Short-term management of anxiety disorders

Mechanism of Action

Halazepam enhances the effect of gamma-aminobutyric acid (GABA) at the GABA-A receptor, resulting in sedative, anxiolytic, muscle relaxant, and anticonvulsant properties.

Dosage and Administration

Adult: Typically, 25-50 mg two to three times daily. Dose may be adjusted based on response and tolerability.

Pediatric: Not approved for pediatric use; safety and efficacy not established.

Geriatric: Start at lower doses, e.g., 25 mg at bedtime, and titrate carefully.

Renal Impairment: Use with caution; dose adjustment may be necessary.

Hepatic Impairment: Use with caution; dose reduction may be necessary.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed with high lipid solubility.

Metabolism: Hepatic metabolism to active and inactive metabolites.

Excretion: Excreted primarily via urine.

Half Life: Approximately 24-48 hours, varies among individuals.

Contraindications

Hypersensitivity to benzodiazepines
Acute narrow-angle glaucoma

Precautions

History of substance abuse, respiratory conditions, hepatic impairment, elderly patients, pregnancy and lactation. Use with caution in patients with depression or suicidal ideation.

Adverse Reactions - Common

Drowsiness (Common)
Dizziness (Common)
Impaired coordination (Common)

Adverse Reactions - Serious

Respiratory depression (Rare)
Severe hypersensitivity reactions (Rare)
Dependence and withdrawal symptoms (Potential with prolonged use)

Drug-Drug Interactions

CNS depressants (alcohol, opioids), other benzodiazepines, certain antidepressants, antipsychotics.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for effectiveness, sedation level, and signs of dependency or withdrawal. Evaluate hepatic and renal function as needed.

Diagnoses:

Risk for falls due to sedation
Risk for dependency

Implementation: Administer dose as prescribed, preferably at bedtime to reduce daytime sedation. Taper gradually when discontinuing.

Evaluation: Assess for reduction in anxiety symptoms, sedation, and any adverse effects.

Patient/Family Teaching

Advise against alcohol and other CNS depressants during therapy.
Warn about risk of drowsiness and impaired coordination. Do not operate machinery or drive until response is known.
Instruct about dependence, tapering, and withdrawal symptoms.
Discuss the importance of adherence and not exceeding prescribed dose.

Special Considerations

Black Box Warnings:

Potential for abuse, misuse, and addiction with benzodiazepines.
Risks from concomitant use with opioids, including respiratory depression, coma, and death.

Genetic Factors: Genetic variations may influence metabolism, particularly involving CYP3A4 enzyme.

Lab Test Interference: None known.

Overdose Management

Signs/Symptoms: CNS depression, respiratory depression, hypotension, coma.

Treatment: Supportive care, airway management, activated charcoal if ingestion is recent, and flumazenil may be considered as an antagonist in severe cases.

Storage and Handling

Storage: Store at room temperature, away from moisture, heat, and light.

Stability: Stable under recommended conditions for shelf life.