- Prescribe the lowest possible effective dose
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- Avoid prescribing a dose greater than the maximum recommended dose
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- Avoid providing refills until continued need, efficacy, and tolerability are established
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- Avoid combining with alcohol or other sedatives, including opioids
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- Use increased caution in older adults and patients with renal and liver dysfunction
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- In patients with comorbid depression, assess for suicidal ideation before prescribing and if present, monitor closely while considering other treatment options
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- Instruct patients on proper timing of the drug in relation to desired sleep onset
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- Instruct patients on drug half-life and expected duration of effect
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- Advise against use if there is insufficient time for drug elimination between planned bedtime and rise time
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- Discuss risk of next-day impairment in alertness, memory, coordination, and driving
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- Discuss risk of complex sleep-related behaviors such as sleep walking, eating, and driving
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- Schedule regular follow-up to review efficacy, side effects, non-pharmacologic options, and assess ongoing need for medication
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