Patient/caregiver was educated on contraindications for using restoril as follows:
- Avoid taking Restoril with grapefruit juice, as it can also inhibit the enzymes needed for the metabolism of Restoril. Concurrent administration of grapefruit juice with restoril can inhibit the metabolism of restoril. Thus, restoril stays in the body for prolonged duration of time in comparison to normal and stand the risk of causing toxicity.
- Some medications, such as, phenytoin and carbamazepine, induce the enzymes needed for the metabolism of Restoril. Concurrent administration of these medications with Restoril can quicken the metabolism of restoril and clear the medication out of the body quicker. Thus, restoril stays in the body for shorter duration of time in comparison to normal and results in compromised therapeutic benefit. If you are being newly started on Restoril, discuss with your physician regarding all other medications you are currently taking and their safety with Restoril. Also, if you have been taking Restoril for long, discuss with your physician regarding your history of Restoril intake, when you are being started on any new medication.
- Restoril is extensively metabolized in the liver and the metabolites are excreted in the urine. If liver function is deficient, the metabolism of Restoril can be compromised. In individuals with history of compromised renal function, the excretion of restoril can be compromised. In either case, restoril and metabolites stay in the body for prolonged duration of time in comparison to normal leading to increased blood levels of the medication and metabolites for longer periods of time. This can lead to increased risk for side-effects and consequent toxicity. So, Restoril could be cautiously administered or avoided for an alternative medication, in individuals with hepatic and/or renal dysfunction. Periodical labs for liver and/or renal function could be ordered and individuals monitored for development of any toxic symptoms. Discuss with your physician regarding history of compromised liver or kidney function, if any.
