Can a Nurse Practitioner Prescribe Temazepam?
Yes, nurse practitioners can prescribe temazepam in most U.S. states, as it is a Schedule IV controlled substance, but prescribing authority depends on state-specific regulations and scope of practice laws.
Regulatory Framework
The ability of nurse practitioners to prescribe temazepam hinges on two key factors:
Federal Classification: Temazepam is classified as a Schedule IV controlled substance under the DEA (Drug Enforcement Administration) 1. This places it in a category of medications with accepted medical use but some potential for abuse and dependence.
State-Specific Authority: Nurse practitioner prescribing privileges vary significantly by state. In states with full practice authority, NPs can prescribe controlled substances independently after obtaining DEA registration. In restricted or reduced practice states, NPs may require a collaborative agreement with a physician or have limitations on controlled substance prescribing 1.
Practical Requirements for NP Prescribing
To legally prescribe temazepam, a nurse practitioner must:
- Hold an active DEA registration number that permits Schedule IV controlled substance prescribing
- Maintain state licensure with prescriptive authority for controlled substances
- Comply with state-specific regulations, which may include collaborative practice agreements, supervision requirements, or prescription limits
- Follow state prescription drug monitoring program (PDMP) requirements before prescribing
Clinical Context for Temazepam Use
When prescribing temazepam, clinicians should understand its appropriate indications:
- Approved Use: Temazepam is indicated for sleep onset and sleep maintenance insomnia in adults 1
- Recommended Dosing: 15-30 mg at bedtime for most adults, with 7.5 mg for elderly or debilitated patients 1
- Pharmacokinetics: Short- to intermediate-acting benzodiazepine with relatively slower absorption and quicker metabolism compared to flurazepam 1, 2, 3
Important Prescribing Considerations
Safety Profile: Temazepam has demonstrated safety in older adults over 8-week treatment periods with low incidence of adverse effects (7.8% in clinical studies) 4. However, caution is warranted with:
- Elderly patients (increased fall risk, require lower doses of 7.5 mg) 1, 5
- Patients with respiratory compromise, hepatic impairment, or depression 1
- Concurrent use with other CNS depressants or alcohol 1
- Risk of withdrawal symptoms with abrupt discontinuation 1
FDA Warning: All benzodiazepine receptor agonist hypnotics carry warnings about sleep-related behaviors including sleepwalking, sleep-driving, and sleep-eating 1.
Bottom Line
The question of whether an NP can prescribe temazepam is answered affirmatively from a medication classification standpoint, but the practical answer requires verification of the specific state's nurse practice act and the individual NP's scope of practice, DEA registration status, and any collaborative practice requirements.