Diazepam

(dye az' e pam)

PCI  : Contraindicated in pregnancy

LCI  : Contraindicated in lactation

Molecule Info

 | See TERMINOLOGY & ABBREVIATIONS |
Indication(s) & Dosage

Oral route
Severe anxiety
Adult: 2 mg tid. Max: 30 mg daily.

Insomnia associated with anxiety
Adult: 5-15 mg at bedtime.
Child: and adolescents (12-18 yr): 1-5 mg at bedtime to control night terrors and sleepwalking. 

Premedication before anaesthesia
Adult: 5-20 mg given before general anaesthesia.
Child: 1 mth-18 yr: 200-300 mcg/kg, may be given 45-60 min beforehand. Max: 10 mg (up to 12 yr); 20 mg (up to 18 yr). 

Adjunct in seizures
Adult: 2-60 mg daily in divided doses.

Muscle spasms
Adult: 2-15 mg daily in divided doses, may increase up to 60 mg daily in severe spastic disorders e.g. cerebral palsy.
Child: 1-12 mth: 250 mcg/kg; 1-5 yr: 2.5 mg; 5-12 year: 5 mg; 12-18 yr: 10 mg (max: 40 mg/day). Dose can be given twice daily. 

Alcohol withdrawal syndrome
Adult: 5-20 mg repeated after 2-4 hr if necessary. Alternatively, 10 mg 3-4 times daily on the 1st day, reducing to 5 mg 3-4 times daily as required.

Elderly: Dose reduction may be required. 
Renal impairment: Dosage adjustments may be needed.

Parenteral
Muscle spasms
Adult: 10 mg IM/IV repeated if necessary after 4 hr. Higher doses may be used in tetanus: 100-300 mcg/kg every 1-4 hr via IV inj; alternatively 3-10 mg/kg may be given over 24 hr by continuous IV infusion or by nasoduodenal tube using a suitable liquid oral dosage form.
Child: â‰¥1 mth: Higher doses may be used in tetanus: 100-300 mcg/kg every 1-4 hr via IV inj; alternatively 3-10 mg/kg may be given over 24 hr by continuous IV infusion or by nasoduodenal tube using a suitable liquid oral dosage form.
Elderly: Dose reduction may be required. 

Premedication before anaesthesia
Adult: Usual dose: 100-200 mcg/kg.
Child: >1 mth: 100-200 mcg/kg. Max: 1 mth-12 yr: 5 mg/day; 12-18 yr: 20 mg/day.
Elderly: Dose reduction may be required. 

Alcohol withdrawal syndrome

Adult: 10-20 mg IM/IV if symptoms are severe and if delirium tremens has developed.
Elderly: Dose reduction may be required. 

Severe anxiety
Adult: Up to 10 mg may be used, repeat if needed after 4 hr. Dose can be given via IM or IV inj. 

Sedation in minor surgical and medical procedures
Adult: 10-20 mg given via IV inj over 2-4 min. 
Child: â‰¥1 mth: 100-200 mcg/kg via IV inj over 2-4 min, to be given immediately before the procedure. Max: 5 mg (up to 12 yr); 20 mg (up to 18 yr). 

Adjunct in seizures
Adult: 10-20 mg at a rate of 5 mg/min, repeat if needed after 30-60 min. Once the seizures have been controlled, up to 3 mg/kg may be given via slow IV infusion over 24 hr to prevent recurrence. 
Child: 1 mth-12 yr: 300-400 mcg/kg over 3-5 min, repeat after 10 min if needed. 

Renal impairment: Dosage adjustments may be needed.

Rectal route
Severe anxiety
Adult: As rectal solution: 500 mcg/kg, repeated after 12 hr if necessary. As suppository: 10-30 mg.

Premedication before anaesthesia
Adult: As a rectal solution: 500 mcg/kg. 
Child: As a rectal solution: Dose is based on age. 1-3 yr: 5 mg; 3-12 yr: 5-10 mg; 12-18 yr: 10 mg. 

Adjunct in seizures
Adult: As rectal gel: 200-500 mcg/kg, repeated after 4-12 hr if necessary. Rectal solution may be appropriate for febrile convulsions, status epilepticusand convulsions due to poisoning; suppositories are not suitable due to slow absorption. Typical dose for rectal solution: 500 mcg/kg, repeated every 12 hr if needed; use other anticonvulsive measures is recommended if convulsions are not controlled by the 1st dose.
Child: >2 yr: As rectal gel: 200-500 mcg/kg, repeated after 4-12 hr if necessary. Rectal solution may be appropriate for febrile convulsions, status epilepticus and convulsions due to poisoning; suppositories are not suitable due to slow absorption. Typical rectal solution dose for children >10 kg: 500 mcg/kg, repeated every 12 hr if needed; recommended to use other anticonvulsive measures if convulsions are not controlled by the 1st dose.

Muscle spasms
Adult: As a rectal solution: 500 mcg/kg, repeat every 12 hr if needed. 
Child: >10 kg: As a rectal solution: 500 mcg/kg, repeat every 12 hr if needed. 

Elderly: Dose reduction may be required. 
Renal impairment: Dosage adjustments may be needed.
Special Populations: Max dose for elderly and debilitated patients is ½ the adult dose. Reduce dose in patients with liver or kidney dysfunction.

Reconstitution: Do not mix IV product with other medications. 
Incompatibility: Y-site incompatibility: Dexmedetomidine, diltiazem, fluconazole, foscarnet, gatifloxacin, heparin, heparin with hydrocortisone sodium succinate, hetastarch, hydromorphone, potassium chloride, propofol, vecuronium, vitamin B complex with C, amphotericin B cholesteryl sulfate complex, atracurium, cefepime, linezolid, meropenem, pancuronium. Syringe incompatibility: Hydromorphone, nalbuphine, sufentanil, doxapram, glycopyrrolate, heparin. Admixture incompatibility: Furosemide, floxacillin, dobutamine, bleomycin, buprenorphine, doxorubicin, fluorouracil.

Administration May be taken with or without food.
Overdosage Symptoms: Somnolence, confusion, coma, diminished reflexes. Management: treatment is supportive and symptomatic. Gastric lavage may help to reduce absorption. As with the management of intentional overdosage with any drug, it should be borne in mind that multiple agents may have been ingested. Flumazenil may be used for the complete or partial reversal of the sedative effects of benzodiazepines. However, the prescriber should be aware of the risk of seizure associated with flumazenil treatment, especially in long-term benzodiazepine users and in cyclic antidepressant overdose. Refer to flumazenil full package insert before use. Dialysis is of limited value.
Contraindications Hypersensitivity; myasthenia gravis, preexisting CNS depression or coma, respiratory depression; acute pulmonary insufficiency or sleep apnoea syndrome; severe hepatic impairment; acute narrow angle glaucoma; children <6 mth (oral); pregnancy and lactation.
Special Precautions Impaired renal and hepatic function, respiratory disease, organic cerebral changes, elderly, psychotic patients, epileptics, history of alcohol or drug addiction, impaired gag reflux, obese patients. May cause CNS depression. Discontinue treatment if patient develops psychiatric and paradoxical reactions. Caution when used in patients with depression or anxiety associated with depression, especially if patient has suicidal risk. May increase risk of falls. Safety and efficacy of the inj have not been established in children <1 mth of age. Safety and efficacy of oral use have not been established in children <6 mth of age. Safety and efficacy of rectal gel have not been established in children <2 yr of age. Abrupt withdrawal or large dose reduction may cause rebound or withdrawal symptoms.
Adverse Drug Reaction(s) Psychological and physical dependence with withdrawal syndrome, fatigue, drowsiness, sedation, ataxia, vertigo, confusion, depression, GI disturbances, changes in salivation, amnesia, jaundice, paradoxical excitation, elevated liver enzyme values; muscle weakness, visual disturbances, headache, slurring of speech and dysarthria, mental changes, incontinence, constipation, hypotension, tachycardia, changes in libido, pain and thrombophlebitis at inj site (IV).
Potentially Fatal: Respiratory and CNS depression, coma.
Drug Interactions Increased clearance of diazepam when used with phenytoin, carbamazepine and phenobarbital. Reversible deterioration of parkinsonism may occur when given together with levodopa. Combination with lithium may produce hypothermia. May need to reduce dose of narcotics when used concurrently.
Potentially Fatal: Phenothiazines, barbiturates, MAOIs potentiate action of diazepam. Additive CNS depressant effects with alcohol and CNS depressants or psychoactive medications. Mutual potentiation of action with analgesics, anaesthetics and some anticonvulsants.

Food Interaction Grapefruit juice may increase serum levels and toxicity of diazepam. Levels may be reduced by St John's wort. Avoid valerian, kava kava, gotu kola and St John's wort.
Lab Interference False-positive urinary glucose determinations.
Pregnancy Category (FDA) Category D: There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).
Storage Intravenous: Store at 20-25°C. Oral: Store at 15-30°C. Parenteral: Store at 20-25°C. Rectal: Store below 25°C.
Pharmacology Diazepam is a long-acting benzodiazepine with anticonvulsant, anxiolytic, sedative, muscle relaxant and amnestic properties. It increases neuronal membrane permeability to chloride ions by binding to stereospecific benzodiazepine receptors on the postsynaptic GABA neuron within the CNS and enhancing the GABA inhibitory effects resulting in hyperpolarisation and stabilisation.
Absorption: Readily and completely absorbed from the GI tract, peak plasma concentrations after 30-90 min (oral). Rapidly absorbed, peak plasma concentrations after 10-30 min (rectal).
Distribution: Readily crosses the blood-brain barrier; redistributed into fat depots and tissues. Protein-binding: 98-99%.
Metabolism: Extensively hepatic; converted to desmethyldiazepam, oxazepam and temazepam.
Excretion: Urine (as free or conjugated metabolites). Elimination half-life: Rapid (initial), 1-2 days (terminal), 2-5 days (desmethyldiazepam).
ATC Classification N05BA01 - diazepam; Belongs to the class of benzodiazepine derivatives anxiolytics. Used in the management of anxiety, agitation or tension.

Search Google: Diazepam

Brand/Product Info


Total Products : 18                  
Brand Name Manufacturer/Marketer Composition Dosage Form Pack Size & Price
AZEPAM The Acme Laboratories Ltd. Diazepam 5mg Tablet 50's, 200's: 11.00 & 44.00 MRP
D-PAM General Pharmaceuticals Ltd Diazepam 5mg Tablet 100's: 22.00 MRP
DIAZEMET Medimet Pharmaceuticals Ltd Diazepam 5mg Tablet 100's: 22.00 MRP
EASIUM Opsonin Pharma Limited Diazepam 5mg Tablet 200's: 42.00 MRP
EASIUM Injection Opsonin Pharma Limited Diazepam 10mg/2ml Injection 25 amps: 75.00 MRP
EASIUM Suppository Opsonin Pharma Limited Diazepam 10mg Suppository 10's: 30.00 MRP
EVALIN Aristopharma Ltd. Diazepam 5mg Tablet 500's: 105.00 MRP
G-DIAZEPAM Gonoshasthaya Pharmaceuticals Ltd Diazepam 5mg Tablet 100's pot & strip: 15.00 & 25.00 MRP
G-DIAZEPAM Injection Gonoshasthaya Pharmaceuticals Ltd Diazepam 10mg/2ml Injection 10 amps: 30.00 MRP
PHARMAPAM Pharmadesh Laboratories Limited Diazepam 5mg Tablet 250's: 62.50 MRP
RELAXEN Sonear Laboratories Ltd. Diazepam 5mg Tablet 100's: 68.00 MRP
SEDAPAN Amico Laboratories Ltd. Diazepam 5mg Tablet 100's: 21.00 MRP
SEDATAB Supreme Pharmaceuticals Ltd. Diazepam 5mg Tablet 100's: 22.00 MRP
SEDIL 5 Square Pharmaceuticals Ltd. Diazepam 5mg Tablet 25x20's: 345.00 MRP
SEDIL INJ Square Pharmaceuticals Ltd. Diazepam 10mg/2 ml IM/IV Injection 2x5's: 30.50 MRP
SEDUXEN Ambee Pharmaceuticals Ltd. Diazepam 5mg Tablet 200's: 46.00 MRP
SEDUXEN Injection Ambee Pharmaceuticals Ltd. Diazepam 10mg/2ml Injection 10 amps: 36.00 MRP
TENSAREAL Indo-Bangla Pharmaceuticals Works Ltd. Diazepam 5mg Tablet 100's: 25.00 MRP

Gen. MedInfo

Why is Diazepam prescribed?

Diazepam is used to relieve anxiety, muscle spasms, and seizures and to control agitation caused by alcohol withdrawal.

How should Diazepam be used?

Diazepam comes as a tablet, extended-release (long-acting) capsule, and concentrate (liquid) to take by mouth. Do not open, chew, or crush the extended-release capsules; swallow them whole. It is usually taken 1 to 4 times a day and may be taken with or without food. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take diazepam exactly as directed.

Diazepam concentrate (liquid) comes with a specially marked dropper for measuring the dose. Ask your pharmacist to show you how to use the dropper. Dilute the concentrate in water, juice, or carbonated beverages just before taking it. It also may be mixed with applesauce or pudding just before taking the dose.

Diazepam can be habit-forming. Do not take a larger dose, take it more often, or for a longer time than your doctor tells you to. Tolerance may develop with long-term or excessive use, making the drug less effective. Diazepam must be taken regularly to be effective. Do not skip doses even if you feel that you do not need them. Do not take diazepam for more than 4 months or stop taking Diazepam without talking to your doctor. Stopping the drug suddenly can worsen your condition and cause withdrawal symptoms (anxiousness, sleeplessness, and irritability). Your doctor probably will decrease your dose gradually.

Other uses for Diazepam

Diazepam is also used to treat irritable bowel syndrome and panic attacks. Talk to your doctor about the possible risks of using this drug for your condition.

Diazepam is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions to follow?
Before taking diazepam,
    • tell your doctor if you are allergic to diazepam, alprazolam, chlordiazepoxide, clonazepam, clorazepate, estazolam, flurazepam, lorazepam, oxazepam, prazepam, temazepam, triazolam, or any other drugs.
    • tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially antihistamines; cimetidine; digoxin; disulfiram; fluoxetine; isoniazid; ketoconazole (Nizoral); levodopa (Sinemet); medications for depression, seizures, pain, Parkinson's disease, asthma, colds, or allergies; metoprolol; muscle relaxants; oral contraceptives; probenecid; propoxyphene; propranolol; ranitidine (Zantac); rifampin; sedatives; sleeping pills; theophylline; tranquilizers; valproic acid; and vitamins. These medications may add to the drowsiness caused by diazepam.
    • if you use antacids, take diazepam first, then wait 1 hour before taking the antacid.
    • tell your doctor if you have or have ever had glaucoma; seizures; or lung, heart, or liver disease.
    • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking diazepam, call your doctor immediately.

talk to your doctor about the risks and benefits of taking diazepam if you are 65 years of age or older. Older adults should not usually take diazepam because it is not as safe as other medications that can be used to treat the same conditions.

  • if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking diazepam.
  • you should know that this drug may make you drowsy. Do not drive a car or operate machinery until you know how this drug affects you.
  • remember that alcohol can add to the drowsiness caused by this drug.
  • tell your doctor if you use tobacco products. Cigarette smoking may decrease the effectiveness of this drug.

What to do if I forget a dose?

If you take several doses per day and miss a dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can Diazepam cause?
Side effects from diazepam are common and include the following:
  • drowsiness

  • dizziness

  • tiredness

  • weakness

  • dry mouth

  • diarrhea

  • nausea

  • changes in appetite

Tell your doctor if any of these symptoms are severe or do not go away:
  • restlessness or excitement

  • constipation

  • difficulty urinating

  • frequent urination

  • blurred vision

  • changes in sex drive or ability

If you experience any of the following symptoms, call your doctor immediately:
  • seizures

  • shuffling walk

  • persistent, fine tremor or inability to sit still

  • fever

  • difficulty breathing or swallowing

  • severe skin rash

  • yellowing of the skin or eyes

  • irregular heartbeat

What to know about storage and disposal of Diazepam?

Keep Diazepam in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. 

In case of emergency/overdose

In case of overdose, call your doctor. If the victim has collapsed or is not breathing, consult local emergency medical services.

What other information to know?

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to diazepam.

Diazepam can cause false results in urine tests for sugar using Clinistix and Diastix. Diabetic patients should use TesTape to test their urine for sugar.

If you are taking diazepam to control seizures and have an increase in their frequency or severity, call your doctor. Your dose may need to be adjusted. If you use diazepam for seizures, carry identification (Medic Alert) stating that you have epilepsy and that you are taking diazepam.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Ref: MedlinePlus, U.S. Natl. Library of Medicine


This information is provided for reference only and not a replacement for and should only be used in conjunction with full consultation with a registered medical practitioner. It may not contain all the available information you require and cannot substitute professional medical care, nor does it take into account all individual circumstances. Although great effort has been made to ensure content accuracy, mph-bd shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise.