An 82-year-old white female developed a 36-hour episode of unresponsiveness/drowsiness after a single dose of triazolam 0.5 mg in combination with cimetidine. This case illustrates the need for careful dose-titration of drug therapy in the elderly, particularly when a drug with the potential to impair drug metabolism is coadministered. Cimetidine, when coadministered with triazolam, may increase the intensity and duration of action of single doses of triazolam.
BreimerDD. Pharmacokinetics and metabolism of various benzodiazepines used as hypnotics. Br J Clin Pharmacol1979; 8: 7–13S.
6.
Halcion monograph (Upjohn).Compendium of pharmaceuticals and specialties, 17th ed.Toronto: Canadian Pharmaceutical Association, 1982: 239–40.
7.
GreenblattDHDivollMAbernethyDRReduced clearance of triazolam in old age: Relation to antipyrine oxidizing capacity. Br J Clin Pharmacol1983; 15: 303–9.
8.
SmithRBDivollMGillespieWREffect of subject age and gender on the pharmacokinetics of oral triazolam and temazepam. J Clin Psychopharmacol1983; 3: 172–6.
9.
SedmanAJ. Cimetidine drug interactions. Am J Med1984; 76: 109–14.
10.
SorkinEMDarveyDL. Review of cimetidine drug interactions. Drug Intell Clin Pharm1983; 17: 110–20.
11.
FeelyJWilkinsonGRWoodAJJ. Reduction of liver blood flow and propranolol metabolism by cimetidine. N Engl J Med1981; 304: 692–5.
12.
AbernethyDRGreenblattDJDivollMInteraction of cimetidine with the triazolo benzodiazepines alprazolam and triazolam. Psychopharmacology1983; 80: 275–8.
