Halcion

What you should know before using

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to medicines in this group or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatrics

Most of the side effects of these medicines are more likely to occur in children, especially the very young. These patients are usually more sensitive than adults to the effects of benzodiazepines.

It is possible that using clonazepam for long periods of time may cause unwanted effects on physical and mental growth in children. If such effects do occur, they may not be noticed until many years later. Before this medicine is given to children for long periods of time, you should discuss its use with your child's doctor.

Geriatric

Most of the side effects of these medicines are more likely to occur in the elderly, who are usually more sensitive to the effects of benzodiazepines.

Taking benzodiazepines for trouble in sleeping may cause more daytime drowsiness in elderly patients than in younger adults. In addition, falls and related injuries are more likely to occur in elderly patients taking benzodiazepines.

Chlordiazepoxide and diazepam have been reported to increase the chance of birth defects when used during the first 3 months of pregnancy. Although similar problems have not been reported with the other benzodiazepines, the chance always exists since all of the benzodiazepines are related.

Studies in animals have shown that clonazepam, lorazepam, and temazepam cause birth defects or other problems, including death of the animal fetus.

Too much use of a benzodiazepine during pregnancy may cause the baby to become dependent on the medicine. This may lead to withdrawal side effects after birth. Also, use of benzodiazepines during pregnancy, especially during the last weeks, may cause body temperature problems, breathing problems, difficulty in feeding, drowsiness, or muscle weakness in the newborn infant.

Benzodiazepines given just before or during labor may cause weakness in the newborn infant. When diazepam is given in high doses (especially by injection) within 15 hours before delivery, it may cause breathing problems, muscle weakness, difficulty in feeding, and body temperature problems in the newborn infant.

Breast Feeding

Benzodiazepines may pass into the breast milk and cause drowsiness, difficulty in feeding, and weight loss in nursing babies of mothers taking these medicines.

Drug Interactions

Using medicines in this class with any of the following medicines is not recommended. Your doctor may decide not to treat you with a medication in this class or change some of the other medicines you take.

• Amprenavir
• Atazanavir
• Darunavir
• Delavirdine
• Efavirenz
• Fosamprenavir
• Indinavir
• Itraconazole
• Ketoconazole
• Lopinavir
• Nelfinavir
• Ritonavir
• Saquinavir
• Tipranavir

Using medicines in this class with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Alfentanil
• Amobarbital
• Anileridine
• Aprobarbital
• Buprenorphine
• Butabarbital
• Butalbital
• Carisoprodol
• Chloral Hydrate
• Chlorzoxazone
• Codeine
• Dantrolene
• Digoxin
• Ethchlorvynol
• Fentanyl
• Fluconazole
• Hydrocodone
• Hydromorphone
• Itraconazole
• Ketoconazole
• Levorphanol
• Meperidine
• Mephenesin
• Mephobarbital
• Meprobamate
• Metaxalone
• Methocarbamol
• Methohexital
• Mibefradil
• Morphine
• Morphine Sulfate Liposome
• Omeprazole
• Oxycodone
• Oxymorphone
• Pentobarbital
• Phenobarbital
• Primidone
• Propoxyphene
• Remifentanil
• Secobarbital
• Sodium Oxybate
• Sufentanil
• Thiopental
• Voriconazole

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Other Medical Problems

The presence of other medical problems may affect the use of medicines in this class. Make sure you tell your doctor if you have any other medical problems, especially:

• Alcohol abuse (or history of) or
• Drug abuse or dependence (or history of)—Dependence on benzodiazepines may be more likely to develop.

• Brain disease—CNS depression and other side effects of benzodiazepines may be more likely to occur.

• Difficulty in swallowing (in children) or
• Emphysema, asthma, bronchitis, or other chronic lung disease or
• Hyperactivity or
• Mental depression or
• Mental illness (severe) or
• Myasthenia gravis or
• Porphyria or
• Sleep apnea (temporary stopping of breathing during sleep)—Benzodiazepines may make these conditions worse.

• Epilepsy or history of seizures—Although some benzodiazepines are used in treating epilepsy, starting or suddenly stopping treatment with these medicines may increase seizures.

• Glaucoma, acute narrow angle—Benzodiazepines should NOT be used if you have this condition.

• Kidney or liver disease—Higher blood levels of benzodiazepines may result, increasing the chance that side effects will occur.