Flurazepam Shortage: What Providers and Prescribers Need to Know in 2026

Flurazepam — a long-acting benzodiazepine hypnotic historically available as Dalmane — has had severely constrained availability in the United States for several years. As of December 2025, the ASHP Drug Shortage bulletin confirms that only one manufacturer (Chartwell Rx) currently produces the drug domestically, with a second manufacturer (Rising Pharmaceuticals) yet to provide an estimated launch date. This clinical brief is designed to help prescribers understand the current supply landscape, manage transitions for affected patients, and document clinical decisions appropriately.

Current Supply Status

As of the ASHP update dated December 16, 2025:

Mylan (Viatris) has permanently discontinued flurazepam capsules (15 mg and 30 mg).

Chartwell Rx is the sole domestic manufacturer of flurazepam capsules; currently supplying the 30 mg capsule in 90-count bottles (NDC 62135-0737-90).

Rising Pharmaceuticals has announced plans to enter the flurazepam market but has not provided a projected launch date.

Distribution is uneven: not all wholesalers and pharmacy chains have incorporated Chartwell's product into their standard inventory.

Pharmacological Profile: Key Prescribing Considerations

Flurazepam is a long-acting benzodiazepine hypnotic that produces an active metabolite — N-desalkylflurazepam — with an elimination half-life of 40–114 hours. This extended half-life distinguishes flurazepam from most other sleep medications in the following ways:

Accumulation: With nightly dosing, active metabolite levels accumulate over multiple days before reaching steady state. Sedation effects may intensify over the first week of treatment.

Next-day impairment: Residual sedation, cognitive impairment, and psychomotor slowing are common — particularly in elderly patients. This significantly increases fall risk.

Elderly populations: The Beers Criteria classifies flurazepam as potentially inappropriate for older adults due to prolonged sedation and increased fall/fracture risk. Clinicians should exercise particular caution.

Withdrawal risk: Because of the long half-life, physical dependence may develop more insidiously than with short-acting benzodiazepines. Abrupt discontinuation carries significant risk of withdrawal syndrome including seizures.

Managing Patients Who Cannot Find Flurazepam

When a patient reports being unable to fill their flurazepam prescription, the clinical priority is preventing abrupt discontinuation. Recommended steps:

Assess the patient's current supply — how many days remain? Establish urgency.

Direct the patient to independent pharmacies and recommend they ask specifically for Chartwell Rx product. Independent pharmacies with specialty wholesaler access often have better luck sourcing it.

If transition becomes necessary, cross-taper to temazepam rather than making an abrupt switch. Utilize benzodiazepine equivalency tables: flurazepam 30 mg is approximately equivalent to temazepam 30 mg and diazepam 10 mg, though individual response varies.

Document the reason for any medication change in the chart — i.e., shortage-related transition rather than clinical failure or adverse event — to avoid any future confusion about the patient's medication history.

Clinical Alternatives: Comparison Table

The following alternatives are widely available and may be appropriate depending on the clinical context:

Temazepam (Restoril) 15–30 mg: Intermediate-acting benzodiazepine (t½ 8–20 hrs); Schedule IV; most similar pharmacological profile; widely available generic; appropriate for both sleep onset and maintenance.

Zolpidem IR (Ambien) 5–10 mg / ER (Ambien CR) 6.25–12.5 mg: Non-benzodiazepine GABA agonist; Schedule IV; most widely prescribed and stocked sleep medication in the US; shorter t½ reduces next-day impairment.

Eszopiclone (Lunesta) 1–3 mg: Non-benzodiazepine cyclopyrrolone; Schedule IV; unique in having no labeled time limitation on use; appropriate for chronic insomnia.

Suvorexant (Belsomra) 10–20 mg: Dual orexin receptor antagonist (DORA); Schedule IV; different mechanism with lower physical dependence risk; preferred for patients with a history of benzodiazepine misuse; brand only, higher cost.

Low-dose doxepin (Silenor) 3–6 mg: Histamine H1 antagonist; not a controlled substance; particularly effective for sleep maintenance insomnia; no dependence or withdrawal risk; suitable for patients where avoiding schedule IV drugs is a priority.

How medfinder Can Help Your Patients

Rather than sending patients on a frustrating pharmacy search, you can recommend medfinder. Patients provide their medication, strength, and ZIP code; medfinder calls pharmacies near them to find which ones can fill the prescription; results are texted back. This removes the burden from patients and can reduce unnecessary medication switches when flurazepam actually is available locally.

Regulatory and DEA Prescribing Notes

As a Schedule IV controlled substance, flurazepam prescriptions are subject to federal and state regulations. Key points:

Federal law permits up to 5 refills within 6 months from the date of issue for Schedule IV substances.

Many states have more restrictive requirements — verify your state's specific rules for CIV prescribing, including e-prescribing mandates and quantity limits.

Early refills for controlled substances require documented clinical justification. A shortage is a legitimate reason, but ensure documentation is explicit.

Telehealth prescribing of Schedule IV benzodiazepines remains restricted under current DEA rules except in specific circumstances. In-person evaluation is generally required for new benzodiazepine starts.

For a practical guide to patient communication during the shortage, see our post: How to Help Your Patients Find Flurazepam in Stock: A Provider's Guide.