Triazolam discontinuation

Triazolam 125 and 250 microgram tablets (Hypam) are being discontinued

Key points

The supplier of triazolam is no longer making this medicine.
Stock is expected to run out in Aotearoa New Zealand by September/October 2023.
Talk to your healthcare provider or specialist as soon as possible about what this means for you.
You shouldn't stop taking triazolam suddenly. This can cause harmful effects.

Talk to your healthcare provider or specialist. Together, you can work out a plan to slowly reduce your use of triazolam. It is important to do this before the medicine is no longer available.

Long-term use of triazolam is not recommended

Triazolam belongs to a group of medicines called benzodiazepines. Triazolam is mainly used for the treatment of sleep problems (insomnia), but it's also prescribed for severe anxiety, agitation or panic attacks if other treatments aren't working. It's best to use it for a very short period of time, or as a one-off dose.

Ongoing use for longer than 2 to 4 weeks isn't recommended as your body gets used to the medicine quickly and it becomes less effective. After 2 to 4 weeks it's likely triazolam will have little effect. You may also become dependent on it and feel that you can't cope with your day-to-day life unless you take triazolam.

While you might feel ‘normal’ when you take benzodiazepines like triazolam, studies have found people who stopped taking them:

have better memory and reaction times
feel more alert
have more energy and are able to function better.

Stopping benzodiazepines also reduces your risk of falls, accidents, fractures and other injuries.

If you've been taking triazolam regularly and for a long time, you may get withdrawal symptoms if you stop taking it suddenly. Not everyone experiences the same symptoms, but they may be worse or more severe if you stop taking triazolam suddenly.

To safely stop triazolam, you will need to slowly reduce your dose over a few weeks or months with the guidance of your doctor. This doesn’t mean you won’t get withdrawal symptoms, but it will make them less severe. It may also help if you know what to expect and know that the withdrawal symptoms will pass.

Common symptoms of triazolam withdrawal
feeling sick (nausea) tummy problems sleep problems ringing in the ear (tinnitus) problems with concentration sweating tremor	dizziness, weakness loss of appetite rapid heart rate broken sleep with vivid dreams anxiety depression

Rare and more serious symptoms include muscle twitching, confusion or paranoid psychosis, convulsions and hallucinations.

It's important to talk to your doctor about stopping triazolam. Work with your doctor to plan how to reduce your use slowly over a few weeks or months.

Together, you can change the plan if you are finding it difficult, or if you are managing well and your withdrawal period seems too slow.
You may have questions about how to manage any withdrawal symptoms or sleep problems. Although everyone's experience will be different, your doctor will be able to help you with a plan.
Your doctor may suggest changing to a different type of medicine. See the section below: Are there alternative medicines to triazolam?

As well as reducing your dose slowly there are other things you can do to manage your withdrawal better.

Control what you eat and drink

Reduce your intake of food and drinks containing caffeine (coffee, tea, cocoa, chocolate, cola drinks). Having less caffeine may help you through the withdrawal period.
Avoid or limit alcohol. Alcohol can make withdrawal symptoms worse and increase the risk of harmful effects such as falls.
Learn more about how food and drink affects sleep.

Get support

Reach out to whānau, family and friends or anyone you trust to support you through this difficult time.
Contact your healthcare provider if you need more support and feel you're not coping.

Try these tips to improve your sleep

Keep to regular sleeping hours.
Have a good environment for sleep, consider light and temperature levels.
Avoid napping during the daytime.
Don't use the bed or bedroom for anything but sleep (or sex).
Only go to bed when sleepy.
Read more tips to improve your sleep and find out more information and a workbook for keeping track of your sleep and sleep-related behaviour.

There are other medicines that may be used for sleep problems such as zopiclone or temazepam (which is a benzodiazepine). These are best used occasionally and for a short time.

Some research suggests melatonin supplements (tablets or capsules) might be helpful in treating sleep problems. Melatonin is a hormone that plays a role in the sleep-wake cycle and natural levels in your blood are highest at night. Read more about melatonin.

Talk to your healthcare provider about safe and suitable options for you.

Sleep tips
Sleep topics
Te Kete Haerenga – sleep