Triazolam Dispensing Guidelines
College of Pharmacists of British Columbia
16 March 1999
Pages 1-1 from The following general guidelines supplement the Health Canada's 1992 announcement regarding triazolam prescribing guidelines, particularly relating to prescriptions for quantities greater than the recommended 14-day maximum duration: EXTERNAL POLICY: POLICY FOCUS: Triazolam Dispensing Guidelines First approved: 29 January 1999 Revised: Reaffirmed: Printed: 16 March 1999 EP-29
The following general guidelines supplement the Health Canada's 1992 announcement regarding triazolam prescribing guidelines, particularly relating to prescriptions for quantities greater than the recommended 14-day maximum duration:
Provide each patient with a patient package insert every time a triazolam prescription is dispensed (including refills) in order to reinforce the information relating to the identified adverse reactions of triazolam. Special 7-tablet unit-of-use packaging, with an attached patient package insert, has been available since August 1992.
Supplement written information for patients with verbal counselling, inquiring particularly about any signs or symptoms of potential adverse effects (memory disturbances, behavioural changes, confusion, anxiety, restlessness or depression).
Consult with the prescriber when new prescriptions for quantities greater than a 14-day supply or for daily dosages greater than 0.25 mg are received, in order to ascertain the prescriber's rationale and exercise appropriate judgement.
In cases where the prescriber has been previously consulted regarding the quantity or dosage and a decision has been made to dispense the prescription without modification, continue to monitor refill patterns, and communicate with the prescriber should increases in frequency or quantity of refills occur, again exercising appropriate judgement based on information provided by the prescriber.
Drug dependence experts recognize that withdrawal from benzodiazepines is difficult and potentially dangerous. Expert help may be required, and the continued use of triazolam may be necessary until the patient can be evaluated. For some patients, particularly geriatrics, withdrawal may not be practical.
For residents of facilities, similar discussions should be undertaken by the medication safety and advisory committee and with the individual prescribers when triazolam prescriptions are received or requested for refill.
Using the reverse of the original hard copy or a special record book, document the outcome of any consultations with either the patient or the prescriber, which result in an unusual outcome.
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