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HALCION INFORMATION AND CONSENT FORM

Taking Halcion one hour prior to your dental appointment is an excellent way to minimize or eliminate anxiety that may be associated with going to the dentist. Even though it is safe, effective, and wears off rapidly after the dental visit, you should be aware of some important precautions and considerations.

  1. This consent form and the dental treatment consent form should be signed before you take theHalcion. They are invalid if signed after you take themedication.
  2. The onset of Halcion is 15-30 minutes and the peak effect occurs between 1-2 hours. After that, it starts wearing off and most people feel back to normal after 6-8 hours. For safety reasons and because people react differently to this medication, you should NOT drive a car or operate machinery for the remainder of the day.
  3. The following substances may prolong the effects of the Halcion: Benadryl, Phernegan, Calan (Verapamil), Erythromycin, HIV drugs such as Indinavir and Nelfinovir, and alcohol. There may be unusual and dangerous reactions if you are currently taking illegal drugs.
  4. Side effects may include: light-headedness, headache, dizziness, visual disturbances, amnesia,and nausea.  In some people, oral Halcion may not work as desired.
  5. Smokers will probably notice a decrease in the medication’s ability to achieve desiredresults.
  6. You should NOT eat heavily prior to appointment. You may take the medication with a small amount of food or a beverage such as juice.Taking it with too much food can make absorption into your system unpredictable.
  7. This medication should not be used if:
    • You are hypersensitive to benzodiazepines (Valium, Ativan, Versed,etc.)
    • You are pregnant or breastfeeding
    • You have liver or kidneydisease
    • You are taking any of the following medications: Nefazodone antidepressant (Serzone); Cimetidine (Tagamet, Tagamet HB, Novocimetine, or Peptol); or Levodopa (Dopar or Larodopa) for Parkinson’s disease.

On the way home from the dentist, your seat in the car should be in the reclined position. When at home, lie down with the head slightly elevated. Someone should stay with you for the next several hours because of possible disorientation and possible injury from falling.

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