Temazepam (Restoril)
A benzodiazepine used for the short-term treatment of insomnia, with real dependence and withdrawal risks.
What it treats
Temazepam is approved by the U.S. Food and Drug Administration for the short-term treatment of insomnia. Most benzodiazepines are used mainly for anxiety. Temazepam is one of the exceptions: its main use is sleep.
The word "short-term" in the approval is doing real work. Temazepam is not designed to be a nightly medication for months on end. It is intended for limited stretches, often a week or two, while a sleep problem is being addressed.
How it works
Like other benzodiazepines, temazepam strengthens the effect of GABA, the brain's main calming chemical messenger. GABA slows nerve activity. When temazepam boosts that effect, the result is sedation and, at bedtime, sleep.
Temazepam is intermediate-acting, with a half-life of roughly 8 to 15 hours. That length is part of why it helps with both falling asleep and staying asleep through the night. The same long action has a downside, though: it can leave some people with next-morning grogginess.
What to expect
Temazepam works the same night it is taken. There is no weeks-long wait, because the sedating effect is immediate.
Two things are worth expecting over time. First, tolerance can build, meaning the same dose works less well the longer it is used. Second, because it is intended for short-term use, the plan from the start should include how long it will be taken and how it will be stopped. Both of those are reasons it is not meant to drift into open-ended nightly use.
Common side effects
Most people get some side effects. The common ones include:
- Drowsiness.
- Next-day grogginess.
- Dizziness.
- Headache.
- A feeling of being less sharp or slowed down.
If a side effect is severe, or it isn't improving, that's a conversation to have with the prescriber rather than a reason to stop on your own.
Serious side effects and warnings
Temazepam carries two FDA boxed warnings, the agency's most serious form of caution. Both apply to all benzodiazepines.
Boxed warning. Temazepam carries an FDA boxed warning about the risk of abuse, misuse, addiction, physical dependence, and withdrawal. Even when taken as prescribed, benzodiazepines can lead to physical dependence, and stopping suddenly can cause serious withdrawal. A separate FDA boxed warning covers the serious danger of combining a benzodiazepine with an opioid pain medication. Taken together, the two can cause heavy sedation, dangerously slowed breathing, coma, and death. This combination should be avoided unless a prescriber has specifically judged it necessary and is monitoring closely.
Beyond the boxed warnings, older adults are more sensitive to temazepam, with a higher risk of falls, confusion, and memory problems. Temazepam is on the Beers list, a set of medications to use with caution in older adults. PsychiatryRx has a fuller class page on benzodiazepines with more on dependence, tolerance, and tapering.
Sexual side effects
Temazepam does not typically cause sexual side effects such as reduced sex drive or delayed orgasm. Its effects are centered on sedation rather than on the systems that drive sexual function.
Weight, appetite, and sleep
Temazepam is essentially weight-neutral. It does not tend to change appetite or body weight. It is taken at bedtime, where the sedating effect is the point and helps bring on sleep.
Starting and dosing basics
This section is general background, not a dosing instruction for any individual. The right dose is a decision for a prescriber.
Temazepam comes as a capsule, taken once at bedtime. Prescribers generally use the lowest dose that works and keep the course short, often a week or two. Older adults are usually started at a lower dose because they are more sensitive to it. The prescriber sets the dose and the length of treatment together.
Missed doses and interactions
Temazepam is taken only at bedtime, so a missed dose is simple to handle. If a night is missed, it is just not taken that night. It should never be taken without a full night of sleep available ahead, because grogginess and impairment become more likely otherwise.
Interactions matter here. Alcohol and other sedatives add to temazepam's effect and to its danger, including the risk of slowed breathing. Combining temazepam with opioid pain medications is covered by the boxed warning above and should be avoided unless a prescriber has specifically judged it necessary. Give every prescriber and pharmacist a full list of your medications and supplements, including over-the-counter ones.
Stopping and tapering
Physical dependence can develop with temazepam even when it is taken exactly as prescribed. That is a normal physical adjustment by the body, not a sign of misuse. Stopping abruptly after regular use can cause withdrawal, including rebound insomnia, anxiety, and, in serious cases, seizures.
For that reason, coming off temazepam after regular use means a slow taper planned with a prescriber, stepping the dose down over time. This is not a medication to stop on your own. Deciding to stop is reasonable, but the safe way to do it is gradually and with guidance. PsychiatryRx has a fuller class page on benzodiazepines with more detail on tapering.
Pregnancy and breastfeeding
This is an area where individual circumstances matter and the decision belongs with a clinician. Benzodiazepines can affect a developing baby, and temazepam also passes into breast milk. Poor sleep carries its own burden as well. None of that adds up to one answer that fits everyone. Anyone who is pregnant, planning a pregnancy, or breastfeeding should talk it through with their prescriber so the specific risks and benefits can be weighed for their situation.
Cost and generic availability
Temazepam has been available as a generic for many years and is inexpensive. Generic temazepam contains the same active medication as the brand name Restoril and works the same way. Most insurance plans cover it, and for people paying out of pocket it is among the lower-cost sleep medications.
Common questions
Is temazepam addictive? It can be. Temazepam is a controlled substance, and physical dependence can develop even with regular prescribed use. That is why it is meant for short-term use and why stopping should be gradual.
How long am I supposed to take it? It is intended for short-term use, often a week or two. The length of the course is something to set with the prescriber from the start.
Will I feel groggy in the morning? Some people do. Temazepam is intermediate-acting, and that longer action can leave next-morning grogginess for some.
Why can't I drink alcohol with it? Alcohol adds to temazepam's sedating effect and its danger, including the risk of dangerously slowed breathing.
What happens if I stop suddenly? Stopping abruptly after regular use can cause withdrawal, including rebound insomnia, anxiety, and, in serious cases, seizures. Coming off it should be a slow taper planned with a prescriber.
Questions to ask your prescriber
- How long do you expect me to take temazepam, and what is the plan to stop it?
- Given my age and health, is this a safe choice for me?
- Which of my other medications could interact with it?
- What withdrawal signs should I watch for, and how would we taper?
- Are there non-medication options we should try alongside or instead?
Sources
This guide draws on current prescribing information and public health references. It is reviewed for clinical accuracy and updated as guidance changes.
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