from medscape.com's drug information:
Therapeutic class:
BENZODIAZEPINES (ANXIOLYTIC,SEDATIV/HYP)
Dosage and Uses
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Adult Min/Max Dose: 1.0mg/40.0mg
Pediatric Min/Max Dose: 0.12mg/kg/0.8mg/kg
Common Dosages by Indication:
| Alcohol Withdrawal Delirium | take 1 tablet (5mg) by oral route 3 times per day as needed take 1 tablet (5mg) by oral route 4 times per day as needed |
| Anxiety | take 1 tablet (2mg) by oral route 3 times per day take 1 tablet (2mg) by oral route 4 times per day take 2 tablets (4mg) by oral route 3 times per day take 2 tablets (4mg) by oral route 4 times per day take 1 tablet (2mg) by oral route 2 times per day take 2 tablets (4mg) by oral route 2 times per day take 1 tablet (5mg) by oral route 3 times per day take 2 tablets (10mg) by oral route 3 times per day take 1 tablet (5mg) by oral route 2 times per day take 2 tablets (10mg) by oral route 2 times per day take 1 tablet (5mg) by oral route 4 times per day take 2 tablets (10mg) by oral route 4 times per day take 1 tablet (10mg) by oral route 3 times per day take 1 tablet (10mg) by oral route 2 times per day take 1 tablet (10mg) by oral route 4 times per day |
| Muscle Spasm | take 1 tablet (2mg) by oral route 3 times per day take 1 tablet (2mg) by oral route 4 times per day take 2 tablets (4mg) by oral route 3 times per day take 2 tablets (4mg) by oral route 4 times per day take 1 tablet (2mg) by oral route 2 times per day take 2 tablets (4mg) by oral route 2 times per day take 1 tablet (5mg) by oral route 3 times per day take 2 tablets (10mg) by oral route 3 times per day take 1 tablet (5mg) by oral route 2 times per day take 2 tablets (10mg) by oral route 2 times per day take 1 tablet (5mg) by oral route 4 times per day take 2 tablets (10mg) by oral route 4 times per day take 1 tablet (10mg) by oral route 3 times per day take 1 tablet (10mg) by oral route 2 times per day take 1 tablet (10mg) by oral route 4 times per day |
| Myoclonic Epilepsy Adjunct Treatment | take 1 tablet (5mg) by oral route 3 times per day take 2 tablets (10mg) by oral route 3 times per day take 1 tablet (5mg) by oral route 2 times per day take 2 tablets (10mg) by oral route 2 times per day take 1 tablet (5mg) by oral route 4 times per day take 2 tablets (10mg) by oral route 4 times per day take 1 tablet (10mg) by oral route 3 times per day take 1 tablet (10mg) by oral route 2 times per day take 1 tablet (10mg) by oral route 4 times per day |
All Labeled Uses : Alcohol Withdrawal Delirium, Alcohol Withdrawal Syndrome, Anxiety, Insomnia, Muscle Spasm
Unlabeled Uses : Atonic Seizures, Atypical Absence Seizures, Infantile Spasms, Myoclonic Epilepsy Adjunct Treatment, Neonatal Abstinence Syndrome, Night Terrors, Opioid Withdrawal Symptoms, Panic Disorder, Sedation in Pediatric Patients, Tension-Type Headache, Tremors
Drug-Drug Interactions
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Contraindicated Drug Combination: Clearly contraindicated in all cases and should not be dispensed or administered to the same patient:
SEDATIVE HYPNOTICS/SODIUM OXYBATE - Adverse reaction of the latter drug
Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
BENZODIAZEPINES/ETHYL ALCOHOL - Increased effect of the former drug
Moderate Interaction: Assess the risk to the patient and take action as needed.
BENZODIAZEPINES/SSRI'S; NEFAZODONE -
BENZODIAZEPINES/CLOZAPINE - Adverse reaction of the latter drug
BENZODIAZEPINES/CIMETIDINE - Increased effect of the former drug
Label Warnings
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Pediatric Relative Contraindication: INCREASED CNS EFFECTS (PROLONGED IN NEONATES).
Lactation Absolute Contraindication: EFFECT UNKNOWN,MAY BE OF CONCERN PER AAP;POSSIBLE FEEDING DIFFICULTY,SEDATION
Pregnancy Not Recommended: INCREASED RISK OF MALFORMATIONS IF USED IN 1ST TRIMESTER
Geriatric Contraindication: (BEERS02)LONG T1/2;SHORT ACTING BENZODIAZEPINES PREFERRED.
(T½ means half-life, the time it takes for half the drug to exit your system)Adverse Effects
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Most Frequent: Dizziness, Drowsiness, Dyskinesia, Slurred Speech
Less Frequent: Depression, Impaired Cognition
Rare: Abdominal Pain with Cramps, Agranulocytosis, Allergic Reactions, Amnesia, Anemia, Behavioral Disorders, Blood Dyscrasias, Blurred Vision, Concentration Difficulty, Constipation, Diarrhea, Disease of Liver, Dysuria, Extrapyramidal Disease, False Sense of Well-Being, Fatigue, General Weakness, Headache, Hypotension, Increased Bronchial Secretions, Leukopenia, Libido Changes, Muscle Spasm, Muscle Weakness, Nausea, Neutropenic Disorder, Polydipsia, Pruritus of Skin, Seizure Disorder, Sialorrhea, Skin Rash, Tachycardia, Thrombocytopenic Disorder, Tremors, Visual Changes, Vomiting, Xerostomia
Drug-Disease Contraindications
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Most Significant Lactating Mother, Narrow Angle Glaucoma, Pregnancy, Primary Closed Angle Glaucoma, Respiratory Depression
Significant Coma, Depression, Glaucoma, Myasthenia Gravis, Open Angle Glaucoma, Pulmonary Disease, Shock
Possibly Significant Alcohol Intoxication, Disease of Liver, Drug Abuse, Hyperkinesis, Hypoalbuminemia, Organic Mental Disorder, Porphyria, Renal Disease, Sleep Apnea
Patient Education
DIAZEPAM - ORAL IMPORTANT NOTE: The following information is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist or other healthcare professional. It should not be construed to indicate that use of the drug is safe, appropriate, or effective for you. Consult your healthcare professional before using this drug.
DIAZEPAM - ORAL
(dye-AZ-eh-pam)
COMMON BRAND NAME(S): Valium
USES:Diazepam is used to treat anxiety, acute alcohol withdrawal, and seizures. It is also used to relieve muscle spasms and to provide sedation before medical procedures. This medication belongs to a class of drugs called benzodiazepines which act on the brain and nerves (central nervous system) to produce a calming effect. It works by enhancing the effects of a certain natural chemical in the body (GABA).
OTHER USES:This medication may also be used to prevent extremely bad nightmares (night terrors).
HOW TO USE:Take this medication by mouth as directed by your doctor. The dosage is based on your medical condition and response to therapy. If you are using the oral concentrate solution, use the dropper provided to carefully measure out the dose and mix it in liquid or soft food (e.g., applesauce, pudding) just before taking.
Use this medication exactly as prescribed. Do not increase your dose, take it more frequently or use it for a longer period of time than prescribed because this drug can be habit-forming. Also, if used for an extended period of time or for seizure control, do not suddenly stop using this drug without your doctor's approval. Some conditions may become worse when the drug is abruptly stopped. Your dose may need to be gradually decreased.
When used for an extended period, this medication may not work as well and may require different dosing. Talk with your doctor if this medication stops working well.
Avoid eating grapefruit or drinking grapefruit juice while being treated with this medication unless your doctor instructs you otherwise. Grapefruit juice can increase the amount of certain medications in your bloodstream. Consult your doctor or pharmacist for more details.
SIDE EFFECTS:Drowsiness, dizziness, fatigue, constipation, blurred vision, or headache may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.
Tell your doctor immediately if any of these unlikely but serious side effects occur: mental/mood changes, slurred speech, clumsiness, trouble walking, decreased/increased interest in sex, tremor, trouble urinating, sleep disturbances.
Tell your doctor immediately if any of these highly unlikely but very serious side effects occur: stomach/abdominal pain, persistent nausea, vomiting, yellowing eyes or skin, dark urine, persistent sore throat or fever.
A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching, swelling, severe dizziness, trouble breathing.
If you notice other effects not listed above, contact your doctor or pharmacist.
PRECAUTIONS:Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, kidney disease, lung/breathing problems (e.g., COPD, sleep apnea), drug or alcohol abuse, any allergies.
This drug may make you dizzy, drowsy or cause blurred vision; use caution engaging in activities requiring alertness such as driving or using machinery. Limit alcoholic beverages.
Caution is advised when using this drug in the elderly because they may be more sensitive to the effects of the drug, especially the drowsiness effect.
This medication is not recommended for use during pregnancy due to the potential for fetal harm. If you become pregnant or think you may be pregnant, inform your doctor immediately. Consult your doctor for more details.
This drug passes into breast milk and may have undesirable effects on a nursing infant. Therefore, breast-feeding while using this medication is not recommended. Consult your doctor before breast-feeding.
DRUG INTERACTIONS:See also the How to Use section.
This drug should not be used with the following medications because very serious interactions may occur: fluvoxamine, sodium oxybate.
If you are currently using any of these medications, tell your doctor or pharmacist before starting diazepam.
Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: antacids, certain anti-depressants (e.g., fluoxetine, nefazodone), cimetidine, clozapine, digoxin, disulfiram, kava, levodopa.
Tell your doctor or pharmacist if you also take drugs that cause drowsiness such as: antihistamines that cause drowsiness (e.g., diphenhydramine), anti-seizure drugs (e.g., carbamazepine), medicine for sleep (e.g., sedatives), muscle relaxants, narcotic pain relievers (e.g., codeine), psychiatric medicines (e.g., phenothiazines such as chlorpromazine, or tricyclics such as amitriptyline), tranquilizers.
Check the labels on all your medicines (e.g., cough-and-cold products) because they may contain drowsiness-causing ingredients. Ask your pharmacist about the safe use of those products.
This product can affect the results of certain lab tests. Make sure laboratory personnel and your doctors know you use this drug.
Smoking can decrease the effectiveness of this drug (through liver enzyme induction). Tell your doctor if you smoke or if you have recently stopped smoking because your dose may need to be adjusted.
Do not start or stop any medicine without doctor or pharmacist approval.
OVERDOSE:If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly. Symptoms of overdose may include: severe drowsiness, slowed/reduced reflexes, slowed breathing, fainting, loss of consciousness.
NOTES:Do not share this medication with others. It is against the law.
If this drug is used for an extended period of time, laboratory and/or medical tests (e.g., liver function tests, complete blood count) may be performed periodically to check for side effects. Consult your doctor for more details.
MISSED DOSE:If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up. If you are taking this medication for seizures, take it if remembered within 1 hour of the missed dose, but skip it if more than 1 hour has passed.
STORAGE:Store at room temperature between 59 and 86 degrees F (15-30 degrees C) away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets.
MEDICAL ALERT: Your condition can cause complications in a medical emergency. For enrollment information call MedicAlert at 1-800-854- 1166 (USA) or 1-800-668-1507 (Canada).
