Contraindication/Precautions

Contraindicated in:

• Hypersensitivity

• Cross-sensitivity with other benzodiazepines may exist

• Pre-existing CNS depression

• Severe uncontrolled pain

• Angle-closure glaucoma, obstructive sleep apnea, pulmonary disease

• Pregnancy and lactation

• Concurrent itraconazole or ketoconazole

• OB: Lactation: Use in pregnancy or lactation may cause CNS depression, flaccidity, feeding difficulties, and seizures in infant

• Renal Impairment, Hepatic dysfunction ( dose required)

• Concurrent use with nefazodone, fluvoxamine, cimetidine, fluoxetine, hormonal contraceptives, propoxyphene, diltiazem, isoniazid, erythromycin, clarithromycin, grapefruit juice ( dose may be necessary)

• History of suicide attempt or alcohol/drug dependence, debilitated patients ( dose required)

• Pedi: Safety and efficacy not established. Decreased dosage and frequent monitoring required

• Geri: Elderly patients have increased sensitivity to benzodiazepines. Appears on Beers list and is associated with increased risk of falls ( dose required) and excessive CNS effects

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