Clinical Pharmacology in Sleep Medicine

Table 4

Significant contraindications.

Alprazolam	Ketoconazole, itraconazole, narrow-angle glaucoma, significant sleep apnea, myasthenia gravis, respiratory insufficiency, liver failure, and pregnancy
Amitriptyline	Recent or concurrent MAOI use and acute myocardial infarction
Chloral hydrate	Hepatic or renal impairment, gastritis or ulcer, and severe cardiac disease
Clonazepam	Narrow-angle glaucoma, significant sleep apnea, myasthenia gravis, respiratory insufficiency, liver failure, and pregnancy
Diazepam	Narrow-angle glaucoma, significant sleep apnea, myasthenia gravis, respiratory insufficiency, liver failure, and pregnancy
Dihenhydramine	Acute asthma and breast-feeding
Doxepin	Recent or concurrent MAOI use, narrow angle glaucoma, and urinary retention
Estazolam	Narrow-angle glaucoma, significant sleep apnea, myasthenia gravis, respiratory insufficiency, liver failure, and pregnancy
Eszopiclone	*
Flurazepam	Narrow-angle glaucoma, significant sleep apnea, myasthenia gravis, respiratory insufficiency, liver failure, and pregnancy
Lorazepam	Narrow-angle glaucoma, significant sleep apnea, myasthenia gravis, respiratory insufficiency, liver failure, and pregnancy
Mirtazepine	Recent or concurrent MAOI use
Nefazodone	Active liver disease, recent or concurrent MAOI use, acute myocardial infarction, concurrent use of carbamazepine, cisapride, or pimozide
Nortriptyline	Recent or concurrent MAOI use and acute myocardial infarction
Oxazepam	Narrow-angle glaucoma, significant sleep apnea, myasthenia gravis, respiratory insufficiency, liver failure, and pregnancy
Quetiapine	*
Ramelteon	Concurrent fluvoxamine
Temazepam	Narrow-angle glaucoma, significant sleep apnea, myasthenia gravis, respiratory insufficiency, liver failure, and pregnancy
Trazodone	*
Triazolam	Ketoconazole, itraconazole, narrow-angle glaucoma, significant sleep apnea, myasthenia gravis, respiratory insufficiency, liver failure, and pregnancy
Zaleplon	*
Zolpidem	OSA, repiratory impairment, myasthenia gravis, severe hepatic impairment, and sleepwalking
Caffeine	*
Dexmethylphenidate	Agitation, anxiety, glaucoma, motor tics, history of Tourette’s syndrome, and recent or concurrent MAOI use
Dextroamphetamine	Symptomatic cardiovascular/atherosclerotic disease, moderate or severe hypertension, hyperthyroidism, glaucoma, agitation, history of drug abuse, and recent or concurrent MAOI use
Dextroamphetamine and amphetamine	Symptomatic cardiovascular/atherosclerotic disease, moderate or severe hypertension, hyperthyroidism, glaucoma, agitation, history of drug abuse, and recent or concurrent MAOI use
Lisdexamfetamine	Symptomatic cardiovascular/atherosclerotic disease, moderate or severe hypertension, hyperthyroidism, glaucoma, agitation, history of drug abuse, and recent or concurrent MAOI use
Methylphenidate	Agitation, anxiety, glaucoma, motor tics, history of Tourette’s syndrome, and recent or concurrent MAOI use
Modafinil	*
Gabapentin	*
GHB	Alcohol and other CNS depressants
Pramipexole	*
Ropinirole	*