Doral

Uses

Doral is a long -acting benzodiazepine used to manage insomnia.

Used to treat insomnia.

Doral is also used to associated treatment for these conditions: Insomnia

Food Interaction

• Avoid alcohol. Ingesting alcohol may increase the drowsiness and CNS depression caused by quazepam.

[Moderate] GENERALLY AVOID: Acute alcohol ingestion may potentiate the CNS depression and other CNS effects of many benzodiazepines.

Tolerance may develop with chronic ethanol use.

The mechanism may be decreased clearance of the benzodiazepines because of CYP450 hepatic enzyme inhibition.

Also, it has been suggested that the cognitive deficits induced by benzodiazepines may be increased in patients who chronically consume large amounts of alcohol.

MONITOR: Grapefruit juice may increase the plasma concentrations of orally administered drugs that are substrates of the CYP450 3A4 isoenzyme.

However, the interaction seems to affect primarily those drugs that undergo significant presystemic metabolism by CYP450 3A4 (i.e., drugs with low oral bioavailability), presumably due to the fact that grapefruit juice inhibits intestinal rather than hepatic CYP450 3A4.

Because pharmacokinetic interactions involving grapefruit juice are often subject to a high degree of interpatient variability, the extent to which a given patient may be affected is difficult to predict.

MANAGEMENT: Patients should be advised to avoid alcohol during benzodiazepine therapy.

Patients who regularly consume grapefruit or grapefruit juice should be monitored for adverse effects and altered plasma concentrations of drugs that undergo significant presystemic metabolism by CYP450 3A4.

Grapefruit and grapefruit juice should be avoided if an interaction is suspected.

Orange juice is not expected to interact with these drugs.

Doral Drug Interaction

Major: acetaminophen / hydrocodoneModerate: aripiprazole, zolpidem, lorazepam, suvorexant, escitalopram, fluoxetine, ramelteon, diazepam, alprazolamUnknown: amphetamine / dextroamphetamine, amphetamine / dextroamphetamine, amphetamine, bifidobacterium infantis, amoxicillin / clavulanate, ibuprofen, vortioxetine, ascorbic acid, cholecalciferol, lisdexamfetamine

Doral Disease Interaction

Major: acute alcohol intoxication, closed-angle glaucoma, drug dependence, renal/liver disease, respiratory depression, seizuresModerate: depression, obesity, paradoxical reactions, sleep disorders

Elimination Route

Bioavailability is 29-35% following oral administration.

Half Life

39 hours

Innovators Monograph

You find simplified version here Doral