Diazepam

Diazepam is a benzodiazepine derivative with anxiolytic, anticonvulsant and central muscle relaxant actions. It attaches to the specific site on the GABA receptor and potentiates the effect of GABA, which acts by opening chloride ion channels into cells.

• Short-term anxiety and agitation
• Alcohol withdrawal
• Muscle spasm
• Epilepsy (status epilepticus, febrile convulsions)
• Premedication for surgical procedures
• Insomnia of hospitalized patients

Diazepam attaches to the specific site on the GABA receptor and potentiates the effect of GABA, which acts by opening chloride ion channels into cells. This results in hyperpolarization and stabilization of the neuronal membrane.

Diazepam potentiates GABA effects, reducing neuronal activity in the CNS, which relieves anxiety, relaxes muscles, and controls seizures.

Adult (Anxiety): 2-10 mg PO q6-12hr OR 2-10 mg IV/IM q6-12hr; no more than 30 mg/8 hours.
Adult (Alcohol Withdrawal): 10 mg PO q6-8hr during first 24hr; then 5 mg PO q6-8hr PRN.
Adult (Muscle Spasm): 2-10 mg PO q6-8hr PRN.
Child (Status Epilepticus): 0.2-0.5 mg/kg PR/IV.
Elderly: Half the adult dose.

Take with or without food, but it is better to take it at a fixed time. Swallow the tablet whole, do not chew, crush or break.

If you miss a dose of Diazepam, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose. Do not double the dose.

Common: Fatigue, impaired coordination, drowsiness, muscle weakness, dizziness, confusion, tremor, double vision, insomnia, dry mouth, headache.
Higher doses: Somnolence, dizziness, lightheadedness, confusion, ataxia.

May affect driving ability (drowsiness, forgetfulness, poor coordination). Do not use for more than 4 weeks (high habit-forming potential). Do not stop abruptly (withdrawal symptoms may occur). Caution in myasthenia gravis, respiratory depression, liver disease, kidney disease.

Hypersensitivity; myasthenia gravis; preexisting CNS depression or coma; respiratory depression; acute pulmonary insufficiency; sleep apnoea syndrome; severe hepatic impairment; acute narrow angle glaucoma; children <6 months (oral); pregnancy and lactation.

Alcohol, anesthetics, narcotic analgesics, antidepressants, antipsychotics, antihistamines: Enhanced CNS depressant effect.
Isoniazid, erythromycin, cimetidine, omeprazole: Decreased clearance.
Rifampicin: Increased clearance.
Disulfiram: Increased serum levels.
Digoxin: Decreased clearance.
Theophylline: Reduced therapeutic effect.

It is unsafe to consume alcohol with Diazepam (enhances CNS depressant effects).

Pregnancy Category D. Diazepam is unsafe during pregnancy. There is definite evidence of risk to the developing baby.

Diazepam is probably unsafe during breastfeeding. The drug may pass into breastmilk and harm the baby.

Oral use is contraindicated in children under 6 months of age.

Elderly patients should receive half the adult dose.

Renal impairment: Use with caution. Dose adjustment may be needed.
Hepatic impairment: Use with caution. Dose adjustment may be needed.

Overdose may cause sedation, muscle weakness, profound sleep, ataxia, hypotonia, hypotension, respiratory depression, coma and death.

Store in a cool (below 25°C) and dry place protected from light.

Diazepam