Drug Index

GENERIC NAME :
diazepam
BRAND NAMES :
Diastat Gel, rectal (2.5 mg, 10 mg, 15 mg, 20 mg), Diazepam oral solution (1 mg/mL), Diazepam injection (5 mg/mL), Diazepam Intensol Solution (5 mg/mL), Valium (2mg, 5mg, 10 mg), Apo-Diazepam (Canada), Deazemuls (Canada)
STREET NAMES :
downers, benzo’s, tranq’s, V
BRIEF DESCRIPTION :
Diazepam is categorized as a central nervous system sedative/hypnotic. It belongs to a class of drugs known as benzodiazepines, which are the most widely prescribed medications that affect central nervous system function.  Peak concentrations in the bloodstream occur one to two hours following oral administration.  The half-life (t ½) is 20 to 80 h (i.e., the time it takes for the body to remove half of the concentration of the drug in the blood stream).
Diazepam interacts with the ?-aminobutyric acid (GABA)-benzodiazepine receptor complex in the brain (primarily in the limbic system and reticular formation), resulting in increased neural inhibition and CNS (central nervous system) depression.
The pharmacodynamic consequences of benzodiazepine agonist actions include antianxiety effects, sedation, and reduction of seizure activity. The intensity of action is directly related to the degree of benzodiazepine receptor occupancy.
Diazepam is categorized as a central nervous system sedative/hypnotic. It belongs to a class of drugs known as benzodiazepines, which are the most widely prescribed medications that affect central nervous system function.  Peak concentrations in the bloodstream occur one to two hours following oral administration.  The half-life (t ½) is 20 to 80 h (i.e., the time it takes for the body to remove half of the concentration of the drug in the blood stream).
Diazepam interacts with the ?-aminobutyric acid (GABA)-benzodiazepine receptor complex in the brain (primarily in the limbic system and reticular formation), resulting in increased neural inhibition and CNS (central nervous system) depression.
The pharmacodynamic consequences of benzodiazepine agonist actions include antianxiety effects, sedation, and reduction of seizure activity. The intensity of action is directly related to the degree of benzodiazepine receptor occupancy.
INDICATIONS FOR USE :
Diazepam Tablets USP are indicated for the management of anxiety disorders or for the short-term relief of the symptoms of anxiety. Anxiety or tension associated with the stress of everyday life usually does not require treatment with an anxiolytic. In acute alcohol withdrawal, diazepam may be useful in the symptomatic relief of acute agitation, tremor, impending or acute delirium tremens and hallucinations. Diazepam is a useful adjunct for the relief of skeletal muscle spasm due to reflex spasm to local pathology (such as inflammation of the muscles or joints, or secondary to trauma); spasticity caused by upper motor neuron disorders (such as cerebral palsy and paraplegia); athetosis (a nervous disorder that is marked by continual slow movements especially of the extremities and is usually due to a brain lesion); and stiff-man syndrome. Oral diazepam may be used adjunctively in convulsive disorders, although it has not proved useful as the sole therapy.

ABUSE AND ADDICTIVE POTENTIAL :
Diazepam demonstrates potential for dependence (addiction). This is especially true in individuals with a history of drug addiction or alcoholism. Dependence can occur even after relatively short term therapy in the recommended dosage. In general, benzodiazepines should be prescribed for short periods only (e.g. 2- 4 weeks). Extension of the treatment period should not take place without reevaluation of the need for continued therapy. Withdrawal can appear following cessation of recommended doses, even after using the medication less than 30 days. . Abrupt discontinuation should be avoided if it has been used for several consecutive weeks. Tolerance can occur in some individuals after taking the medication for several weeks or months. This means that dosages prescribed for treatment may need to be increased some over time to achieve the therapeutic response. It also means that individuals who have become addicted to diazepam will need to progressively increase the dosage to achieve the desired mood state that the addict is seeking. Addicted individuals often take several times the recommended dosage. Significantly adverse clinical events, some life-threatening, can be a direct consequence of physical dependence to diazepam. Rebound (a return of symptoms of anxiety or panic disorder to a level substantially greater in frequency and, or more severe in intensity than before taking diazepam) are often observed after taking the medication for a few weeks or months. Symptoms noted in withdrawal from diazepam may include:

• heightened sensory perception

• impaired concentration

• clouded sensorium (confusion or difficulty thinking)

• paresthesias (tingling, pricking, or numbness of the skin)

• muscle cramps

• muscle twitch

• diarrhea

• blurred vision

• decrease appetite and weight loss

• anxiety

• insomnia (difficulty sleeping)

• seizure (convulsions)

Discontinuation of diazepam should be done under the supervision of a physician often involves tapering the medication slowly and/or use of other medications to manage withdrawal symptoms.

OVERDOSAGE :
Manifestations of overdoseage may include:

• somnolence (extreme drowsiness or deep, prolonged sleep)

• confusion

• slurred speech

• impaired coordination

• diminished reflexes

• coma

• death

Emergency medical treatment is advised if overdose is suspected.

CAUTIONS :
Individuals taking diazepam should be cautioned about engaging in hazardous operations or activities that require complete mental alertness. Diazepam should not be used simultaneously with alcohol or any other central nervous system depressant drugs. Taken together, these drugs can potentiate the potency and effect of each drug. Precaution should be observed in using this medication in patients who have impaired kidney, liver, or lung function. Changes in the absorption, distribution, metabolism and excretion of benzodiazepines have been reported in disease states including alcoholism, impaired liver function, in impaired kidney function. Also, in geriatric patients the half-life of elimination of the drug may be extended several hours, requiring careful monitoring and possibly a lower dosage range of prescribing medication. Side effects most commonly reported were drowsiness, fatigue and ataxia (difficulty with balance). Infrequently encountered were confusion, constipation, depression, diplopia (double vision), dysarthria (difficulty in articulating words), headache, hypotension (abnormally low blood pressure), incontinence (urine leakage), jaundice (yellow skin), changes in libido (sex drive), nausea, changes in salivation, skin rash, slurred speech, tremor, urinary retention, vertigo (dizziness), and blurred vision. Paradoxical reactions (occasional “opposite” reactions to those expected) such as acute hyperexcited states, anxiety, hallucinations, increased muscle spasticity, insomnia, rage, sleep disturbances and stimulation have been reported. Because of isolated reports of neutropenia (low white blood cell count) and jaundice, periodic blood counts and liver function tests are advisable during long-term therapy. A child born of a mother who is taking benzodiazepines maybe at some risk for withdrawal symptoms following birth. Benzodiazepines are also known to be excreted in human milk.

SIDE EFFECTS :
* See Cautions

FOR MORE INFORMATION :
This is a brief description for Diazepam. For more information contact your physician, pharmacist, or refer to the Physicians' Desk Reference or http://www.drugs.com


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