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Benzodiazepines ((ben-zoe-dye-AZ-e-peens)) belong to the group of medicines called central nervous system (CNS) depressants (medicines that slow down the nervous system). Some benzodiazepines are used to relieve anxiety. However, benzodiazepines should not be used to relieve nervousness or tension caused by the stress of everyday life. Some benzodiazepines are used to treat insomnia (trouble in sleeping). However, if used regularly (for example, every day) for insomnia, they usually are not effective for more than a few weeks. Many of the benzodiazepines are used in the treatment of other conditions, also. Diazepam is used to help relax muscles or relieve muscle spasm. Diazepam injection is used before some medical procedures to relieve anxiety and to reduce memory of the procedure. Chlordiazepoxide, clorazepate, diazepam, and oxazepam are used to treat the symptoms of alcohol withdrawal. Alprazolam and clonazepam are used in the treatment of panic disorder. Clobazam, clonazepam, clorazepate, diazepam, and lorazepam are used in the treatment of certain convulsive (seizure) disorders, such as epilepsy. The benzodiazepines may also be used for other conditions as determined by your doctor. In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For benzodiazepines, the following should be considered: Allergies-Tell your doctor if you have ever had any unusual or allergic reaction to benzodiazepines. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes. Certain benzodiazepine products may contain lactose, parabens, or soybean oil. Pregnancy-Chlordiazepoxide and diazepam have been reported to increase the chance of birth defects when used during the first 3 months of pregnancy. Although similar problems have not been reported with the other benzodiazepines, the chance always exists since all of the benzodiazepines are related. Studies in animals have shown that clonazepam, lorazepam, and temazepam cause birth defects or other problems, including death of the animal fetus. Too much use of a benzodiazepine during pregnancy may cause the baby to become dependent on the medicine. This may lead to withdrawal side effects after birth. Also, use of benzodiazepines during pregnancy, especially during the last weeks, may cause body temperature problems, breathing problems, difficulty in feeding, drowsiness, or muscle weakness in the newborn infant. Benzodiazepines given just before or during labor may cause weakness in the newborn infant. When diazepam is given in high doses (especially by injection) within 15 hours before delivery, it may cause breathing problems, muscle weakness, difficulty in feeding, and body temperature problems in the newborn infant. Breast-feeding-Benzodiazepines may pass into the breast milk and cause drowsiness, difficulty in feeding, and weight loss in nursing babies of mothers taking these medicines. Children-Most of the side effects of these medicines are more likely to occur in children, especially the very young. These patients are usually more sensitive than adults to the effects of benzodiazepines. It is possible that using clonazepam for long periods of time may cause unwanted effects on physical and mental growth in children. If such effects do occur, they may not be noticed until many years later. Before this medicine is given to children for long periods of time, you should discuss its use with your child's doctor. Older adults-Most of the side effects of these medicines are more likely to occur in the elderly, who are usually more sensitive to the effects of benzodiazepines. Taking benzodiazepines for trouble in sleeping may cause more daytime drowsiness in elderly patients than in younger adults. In addition, falls and related injuries are more likely to occur in elderly patients taking benzodiazepines. Other medicines-Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking or receiving benzodiazepines it is especially important that your health care professional know if you are taking any of the following: Central nervous system (CNS) depressants (medicines that cause drowsiness)-The CNS depressant effects of either these medicines or benzodiazepines may be increased; your doctor may want to change the dose of either or both medicines Fluvoxamine (e.g., Luvox) or Nefazodone (e.g., Serzone)-Higher blood levels of benzodiazepines may occur, increasing the chance that side effects will occur; your doctor may want to change the dose of either or both medicines, or give you a different medicine Itraconazole (e.g., Sporanox) or Ketoconazole (e.g., Nizoral)-These medicines should NOT be used if you are taking a benzodiazepine. Other medical problems-The presence of other medical problems may affect the use of benzodiazepines. Make sure you tell your doctor if you have any other medical problems, especially: Alcohol abuse (or history of) or Drug abuse or dependence (or history of)-Dependence on benzodiazepines may be more likely to develop Brain disease-CNS depression and other side effects of benzodiazepines may be more likely to occur Difficulty in swallowing (in children) or Emphysema, asthma, bronchitis, or other chronic lung disease or Hyperactivity or Mental depression or Mental illness (severe) or Myasthenia gravis or Porphyria or Sleep apnea (temporary stopping of breathing during sleep)-Benzodiazepines may make these conditions worse Epilepsy or history of seizures-Although some benzodiazepines are used in treating epilepsy, starting or suddenly stopping treatment with these medicines may increase seizures Glaucoma, acute narrow angle-Benzodiazepines should NOT be used if you have this condition. Glaucoma, open angle-Benzodiazepines can be used but your doctor should be monitoring your condition carefully. Kidney or liver disease-Higher blood levels of benzodiazepines may result, increasing the chance that side effects will occur -------------------------------------------------------------------------------- Proper Use of This Medicine For caregivers administering diazepam rectal gel : Discuss with the patient's medical doctor exactly when and how to use diazepam rectal gel. Discuss with the patient's medical doctor when you should call for emergency help. Read the instructions that you received with the medicine before you need to use it. Stay with the patient after administering diazepam rectal gel to check his or her condition as instructed by the doctor. For patients taking clorazepate extended-release tablets : Swallow tablets whole. Do not crush, break, or chew before swallowing. For patients taking alprazolam, diazepam, or lorazepam concentrated oral solution : Measure each dose carefully using the dropper provided with the medicine. It is recommended that each dose be mixed with water, soda or soda-like beverages, or semisolid food such as applesauce or pudding, just before it is taken. Take the entire mixture right away. It should not be saved to be used later. For patients taking lorazepam sublingual tablets : Do not chew or swallow the tablet. This medicine is meant to be absorbed through the lining of the mouth. Place the tablet under your tongue (sublingual) and let it slowly dissolve there. Do not swallow for at least 2 minutes. For patients taking alprazolam oral disintegrating tablets : Make sure your hands are dry. Just prior to taking the tablet, remove the tablet from the bottle. Immediately place the tablet on top of the tongue. The tablet will dissolve in seconds, and you may swallow it with your saliva. You do not need to drink water or other liquid to swallow the tablet. If you have split apart a tablet and only taken one half of the tablet, you should throw away the unused part of the tablet right away because it may not remain stable. Take this medicine only as directed by your doctor . Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. If too much is taken, it may become habit-forming (causing mental or physical dependence). If you think this medicine is not working properly after you have taken it for a few weeks, do not increase the dose . Instead, check with your doctor. For patients taking this medicine on a regular schedule for epilepsy or other seizure disorder : In order for this medicine to control your seizures, it must be taken every day in regularly spaced doses as ordered by your doctor . This is necessary to keep a constant amount of the medicine in the blood. To help keep the amount constant, do not miss any doses. For patients taking this medicine for insomnia : Do not take this medicine when your schedule does not permit you to get a full night's sleep (7 to 8 hours) . If you must wake up before this, you may continue to feel drowsy and may experience memory problems, because the effects of the medicine have not had time to wear off. For patients taking flurazepam : When you begin to take this medicine, your sleeping problem will improve somewhat the first night. However, 2 or 3 nights may pass before you receive the full effects of this medicine . Dosing-The dose of benzodiazepines will be different for different patients. Follow your doctor's orders or the directions on the label . The following information includes only the average doses of benzodiazepines. If your dose is different, do not change it unless your doctor tells you to do so. The number of capsules or tablets, or the amount of solution that you take, or the number of injections you receive, depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are taking benzodiazepines . For alprazolam For oral dosage form (solution or tablets): For anxiety: Adults-At first, 0.25 to 0.5 milligram (mg) three times a day. Your doctor may increase your dose if needed. However, the dose usually is not more than 4 mg a day. Children younger than 18 years of age-Use and dose must be determined by your doctor. Older adults-At first, 0.25 mg two or three times a day. Your doctor may increase your dose if needed. For panic disorder: Adults-At first, 0.5 mg three times a day. Your doctor may increase your dose if needed. However, the dose usually is not more than 10 mg a day. Children younger than 18 years of age-Use and dose must be determined by your doctor. For bromazepam For oral dosage form (tablets): For anxiety: Adults-6 to 30 milligrams (mg) a day, taken in smaller doses during the day. Children younger than 18 years of age-Use and dose must be determined by your doctor. Older adults-At first, up to 3 mg a day. Your doctor may change your dose if needed. For chlordiazepoxide For oral dosage form (capsules): For anxiety: Adults-5 to 25 milligrams (mg) three or four times a day. Children 6 years of age and older-5 mg two to four times a day. Your doctor may increase your dose if needed. Children younger than 6 years of age-Use and dose must be determined by your doctor. Older adults-At first, 5 mg two to four times a day. Your doctor may increase your dose if needed. For sedation during withdrawal from alcohol: Adults-At first, 50 to 100 mg, repeated if needed. However, the dose usually is not more than 400 mg a day. Children-Use and dose must be determined by your doctor. For injection dosage form: For anxiety: Adults-At first, 50 to 100 mg, injected into a muscle or vein. Then, if needed, 25 to 50 mg three or four times a day. Teenagers-25 to 50 mg, injected into a muscle or vein. Children younger than 12 years of age-Use and dose must be determined by your doctor. Older adults-25 to 50 mg, injected into a muscle or vein. For sedation during withdrawal from alcohol: Adults-At first, 50 to 100 mg, injected into a muscle or vein. If needed, the dose may be repeated in two to four hours. Children-Use and dose must be determined by your doctor. For clobazam For oral dosage form (tablets): For control of seizures: Adults-At first, 5 to 15 milligrams (mg) a day. Your doctor may increase your dose if needed. However, the dose usually is not more than 80 mg a day. Children 2 to 16 years of age-At first, 5 mg a day. Your doctor may increase your dose if needed. However, the dose usually is not more than 40 mg a day. Children younger than 2 years of age-Dose is based on body weight and must be determined by your doctor. For clonazepam For oral dosage form (tablets): For control of seizures: Adults-At first, 0.5 milligram (mg) three times a day. Your doctor may increase your dose if needed. However, the dose usually is not more than 20 mg a day. Infants and children younger than 10 years of age-Dose is based on body weight and must be determined by your doctor. For panic disorder: Adults-At first, 0.25 mg two times a day. Your doctor may increase your dose if needed. However, the dose usually is not more than 4 mg a day. Children-Use and dose must be determined by your doctor. For clorazepate For oral dosage form (capsules or tablets): For anxiety: Adults and teenagers-7.5 to 15 mg two to four times a day. Or your doctor may want you to start by taking 15 mg at bedtime. Children younger than 12 years of age-Use and dose must be determined by your doctor. Older adults-At first, 3.75 to 15 mg a day. Your doctor may increase your dose if needed. For sedation during withdrawal from alcohol: Adults and teenagers-At first, 30 mg. Your doctor will set up a schedule that will gradually reduce your dose. Children younger than 12 years of age-Use and dose must be determined by your doctor. For control of seizures: Adults and teenagers-At first, up to 7.5 mg taken three times a day. Your doctor may increase your dose if needed. However, the dose usually is not more than 90 mg a day. Children 9 to 12 years of age-At first, up to 7.5 mg two times a day. Your doctor may increase your dose if needed. However, the dose usually is not more than 60 mg a day. Children younger than 9 years of age-Use and dose must be determined by your doctor. For oral dosage form (extended-release tablets): For anxiety: Adults and teenagers-Your doctor may change your dosage form to the extended-release tablet if you are already taking 3.75 or 7.5 milligrams (mg) of clorazepate three times a day. The extended-release tablet is taken one time each day. Children younger than 12 years of age-Use and dose must be determined by your doctor. For control of seizures: Adults, teenagers, and children 9 to 12 years of age-Your doctor may change your dosage form to the extended-release tablet if you are already taking 3.75 or 7.5 milligrams (mg) of clorazepate three times a day. The extended-release tablet is taken one time each day. Children younger than 9 years of age-Use and dose must be determined by your doctor. For diazepam For oral dosage form (solution or tablets): For anxiety: Adults-2 to 10 mg two to four times a day. Children 6 months of age and older-Dose is based on body weight or size and must be determined by your doctor. Children younger than 6 months of age-Use is not recommended. Older adults-2 to 2.5 mg one or two times a day. Your doctor may increase your dose if needed. For sedation during withdrawal from alcohol: Adults-At first, 10 mg three or four times a day. Your doctor will set up a schedule that will gradually decrease your dose. Children-Use and dose must be determined by your doctor. For control of seizures: Adults-2 to 10 mg two to four times a day. Children 6 months of age and older-Dose is based on body weight or size and must be determined by your doctor. Children younger than 6 months of age-Use is not recommended. Older adults-2 to 2.5 mg one or two times a day. Your doctor may increase your dose if needed. For relaxing muscles: Adults-2 to 10 mg three or four times a day. Children 6 months of age and older-Dose is based on body weight or size and must be determined by your doctor. Children younger than 6 months of age-Use is not recommended. Older adults-2 to 2.5 mg one or two times a day. Your doctor may increase your dose if needed. For injection dosage form: For anxiety: Adults-2 to 10 mg, injected into a muscle or vein. Children-Use and dose must be determined by your doctor. For older adults-2 to 5 mg, injected into a muscle or vein. For sedation during withdrawal from alcohol: Adults-At first, 10 mg injected into a muscle or vein. If needed, 5 to 10 mg may be given three or four hours later. Children-Use and dose must be determined by your doctor. For sedation before surgery or other procedures: Adults-5 to 20 mg, injected into a muscle or vein. Children-Use and dose must be determined by your doctor. Older adults-2 to 5 mg, injected into a muscle or vein. For control of seizures: Adults-At first, 5 to 10 mg, usually injected into a vein every ten to fifteen minutes, stopping if the total dose reaches 30 mg. If needed, this treatment may be repeated in two to four hours. Children 5 years of age and older-At first, 1 mg, usually injected into a vein every two to five minutes, stopping if the total dose reaches 10 mg. This treatment may be repeated in two to four hours. Infants older than 30 days of age and children younger than 5 years of age-At first, 0.2 to 0.5 mg, usually injected into a vein every two to five minutes, stopping if the total dose reaches 5 mg. This treatment may be repeated in two to four hours. Newborns and infants 30 days of age and younger-Use and dose must be determined by your doctor. Older adults-2 to 5 mg, injected into a muscle or vein. For relaxing muscle spasms: Adults-At first, 5 to 10 mg injected into a muscle or vein. The dose may be repeated in three or four hours. Children-Use and dose must be determined by your doctor. Older adults-2 to 5 mg, injected into a muscle or vein. For relaxing muscles in tetanus: Adults-At first, 5 to 10 mg injected into a muscle or vein. Your doctor may increase your dose if needed. Children 5 years of age and older-5 to 10 mg, injected into a muscle or vein. The dose may be repeated every three to four hours if needed. Infants older than 30 days of age and children younger than 5 years of age-1 to 2 mg, injected into a muscle or vein. The dose may be repeated every three to four hours if needed. Newborns and infants 30 days of age and younger-Use and dose must be determined by your doctor. For rectal dosage form (gel or solution): For control of seizures: Adults and teenagers-Dose is based on body weight and must be determined by your doctor. Children-Dose is based on body weight and must be determined by your doctor. For estazolam For oral dosage form (tablets): For trouble in sleeping: Adults-1 milligram (mg) at bedtime. Your doctor may increase your dose if needed. However, the dose usually is not more than 2 mg. Children younger than 18 years of age-Use and dose must be determined by your doctor. For flurazepam For oral dosage form (capsules or tablets): For trouble in sleeping: Adults-15 or 30 milligrams (mg) at bedtime. Children younger than 15 years of age-Use and dose must be determined by your doctor. Older adults-At first, 15 mg at bedtime. Your doctor may increase your dose if needed. For halazepam For oral dosage form (tablets): For anxiety: Adults-20 to 40 milligrams (mg) three or four times a day. Children younger than 18 years of age-Use and dose must be determined by your doctor. Older adults-20 mg one or two times a day. For lorazepam For oral dosage form (concentrate or tablets): For anxiety: Adults and teenagers-1 to 3 milligrams (mg) two or three times a day. Children younger than 12 years of age-Use and dose must be determined by your doctor. Older adults-0.5 to 2 mg a day, taken in smaller doses during the day. For trouble in sleeping: Adults and teenagers-2 to 4 mg taken at bedtime. Children younger than 12 years of age-Use and dose must be determined by your doctor. For sublingual tablet dosage form: For anxiety: Adults-2 to 3 mg a day, in smaller doses placed under the tongue during the day. Your doctor may increase your dose if needed. However, the dose usually is not more than 6 mg a day. Children younger than 18 years of age-Use and dose must be determined by your doctor. Older adults-At first, 0.5 mg a day. Your doctor may increase your dose if needed. For sedation before surgery: Adults-Dose is based on body weight and will be determined by your doctor. However, the dose usually is not more than 4 mg, placed under the tongue, one to two hours before surgery. Children-Use and dose must be determined by your doctor. For injection dosage form: For sedation before surgery or other procedures: Adults-Dose is based on body weight and will be determined by your doctor. However, the dose usually is not more than 4 mg, injected into a muscle or vein. Children younger than 18 years of age-Use and dose must be determined by your doctor. For control of seizures: Adults-At first, 4 mg slowly injected into a vein. The dose may be repeated after ten to fifteen minutes if needed. Children younger than 18 years of age-Use and dose must be determined by your doctor. For nitrazepam For oral dosage form (tablets): For trouble in sleeping: Adults-5 to 10 milligrams (mg) at bedtime. Children-Use and dose must be determined by your doctor. Older adults-At first, 2.5 mg taken at bedtime. Your doctor may increase your dose if needed. For control of seizures: Children less than 30 kilograms (66 pounds) of body weight-Dose is based on body weight and will be determined by your doctor. For oxazepam For oral dosage form (capsules or tablets): For anxiety: Adults-10 to 30 milligrams (mg) three or four times a day. Children younger than 12 years of age-Use and dose must be determined by your doctor. Older adults-At first, 5 mg one or two times a day or 10 mg three times a day. Your doctor may increase your dose if needed. However, the dose usually is not more than 15 mg four times a day. For sedation during withdrawal from alcohol: Adults-15 to 30 mg three or four times a day. Children younger than 12 years of age-Use and dose must be determined by your doctor. For quazepam For oral dosage form (tablets): For trouble in sleeping: Adults-7.5 to 15 milligrams (mg) at bedtime. Children younger than 18 years of age-Use and dose must be determined by your doctor. For temazepam For oral dosage form (capsules): For trouble in sleeping: Adults-15 milligrams (mg) at bedtime. Your doctor may change your dose if needed. Children younger than 18 years of age-Use and dose must be determined by your doctor. Older adults-At first, 7.5 mg at bedtime. Your doctor may increase your dose if needed. For triazolam For oral dosage form (tablets): For trouble in sleeping: Adults-0.125 to 0.25 milligram (mg) at bedtime. Children younger than 18 years of age-Use and dose must be determined by your doctor. Older adults-At first, 0.125 mg at bedtime. Your doctor may increase your dose if needed. Missed dose-If you are taking this medicine regularly (for example, every day as for epilepsy) and you miss a dose, take it right away if you remember within an hour or so of the missed dose. However, if you do not remember until later, skip the missed dose and go back to your regular dosing schedule. Do not double doses. Storage-To store this medicine: Keep out of the reach of children. Overdose of benzodiazepines may be especially dangerous in children. Store away from heat and direct light. Do not store the capsule or tablet form of this medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down. Keep the liquid form of this medicine from freezing. Keep the oral disintegrating tablet form of this medicine in a tightly sealed bottle and discard any cotton that was included in the bottle Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children. -------------------------------------------------------------------------------- Precautions While Using This Medicine If you will be taking a benzodiazepine regularly for a long time : Your doctor should check your progress at regular visits to make sure that this medicine does not cause unwanted effects. If you are taking a benzodiazepine for convulsions (seizures), this is also important during the first few months of treatment. Check with your doctor at regular visits to see if you need to continue taking this medicine. If you are taking a benzodiazepine for epilepsy or another seizure disorder : Your doctor may want you to carry a medical identification card or bracelet stating that you are taking this medicine. If you are taking a benzodiazepine for insomnia (trouble in sleeping): If you think you need this medicine for more than 7 to 10 days, be sure to discuss it with your doctor. Insomnia that lasts longer than this may be a sign of another medical problem. You may have difficulty sleeping (rebound insomnia) for the first few nights after you stop taking this medicine. Benzodiazepines may be habit-forming (causing mental or physical dependence) , especially when taken for a long time or in high doses. Some signs of dependence on benzodiazepines are: A strong desire or need to continue taking the medicine. A need to increase the dose to receive the effects of the medicine. Withdrawal effects (for example, irritability, nervousness, trouble in sleeping, abdominal or stomach cramps, trembling or shaking) occurring after the medicine is stopped. If you think you may have become mentally or physically dependent on this medicine, check with your doctor . Do not stop taking it suddenly. If you have been taking this medicine in large doses or for a long time, do not stop taking it without first checking with your doctor . Your doctor may want you to reduce gradually the amount you are taking before stopping completely. Stopping this medicine suddenly may cause withdrawal side effects, including seizures. Stopping this medicine suddenly is most likely to cause seizures if you have been taking it for epilepsy or another seizure disorder. This medicine will add to the effects of alcohol and other central nervous system (CNS) depressants (medicines that slow down the nervous system, possibly causing drowsiness). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates; medicine for seizures; muscle relaxants; or anesthetics, including some dental anesthetics. This effect may last for a few days after you stop taking this medicine. Check with your doctor before taking any of the above while you are taking this medicine . If you think you or someone else may have taken an overdose of this medicine, get emergency help at once . Taking an overdose of a benzodiazepine or taking alcohol or other CNS depressants with the benzodiazepine may lead to unconsciousness and possibly death. Some signs of an overdose are continuing slurred speech or confusion, severe drowsiness, severe weakness, and staggering. Before you have any medical tests, tell the medical doctor in charge that you are taking this medicine. The results of the metyrapone test may be affected by chlordiazepoxide. If you develop any unusual and strange thoughts or behavior while you are taking this medicine, be sure to discuss it with your doctor. Some changes that have occurred in people taking this medicine are like those seen in people who drink alcohol and then act in a manner that is not normal. Other changes may be more unusual and extreme, such as confusion, agitation, and hallucinations (seeing, hearing, or feeling things that are not there). This medicine may cause some people, especially older persons, to become drowsy, dizzy, lightheaded, clumsy or unsteady, or less alert than they are normally. Even if taken at bedtime, it may cause some people to feel drowsy or less alert on arising. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert . -------------------------------------------------------------------------------- Side Effects of This Medicine Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor as soon as possible if any of the following side effects occur: Less common Anxiety; confusion (may be more common in the elderly); fast, pounding, or irregular heartbeat; lack of memory of events taking place after benzodiazepine is taken (may be more common with triazolam); mental depression Rare Abnormal thinking, including disorientation, delusions (holding false beliefs that cannot be changed by facts), or loss of sense of reality; agitation; behavior changes, including aggressive behavior, bizarre behavior, decreased inhibition, or outbursts of anger; convulsions (seizures); hallucinations (seeing, hearing, or feeling things that are not there); hypotension (low blood pressure); muscle weakness; skin rash or itching; sore throat, fever, and chills; trouble in sleeping; ulcers or sores in mouth or throat (continuing); uncontrolled movements of body, including the eyes; unusual bleeding or bruising; unusual excitement, nervousness, or irritability; unusual tiredness or weakness (severe); yellow eyes or skin Symptoms of overdose Confusion (continuing); convulsions (seizures); drowsiness (severe) or coma; shakiness; slow heartbeat; slow reflexes; slurred speech (continuing); staggering; troubled breathing; weakness (severe) For patients having chlordiazepoxide, diazepam, or lorazepam injected : Check with your doctor if there is redness, swelling, or pain at the place of injection. Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome: More common Clumsiness or unsteadiness; dizziness or lightheadedness; drowsiness; slurred speech Less common or rare Abdominal or stomach cramps or pain; blurred vision or other changes in vision; changes in sexual desire or ability; constipation; diarrhea; dryness of mouth or increased thirst; false sense of well-being; headache; increased bronchial secretions or watering of mouth; muscle spasm; nausea or vomiting; problems with urination; trembling or shaking; unusual tiredness or weakness Not all of the side effects listed above have been reported for each of these medicines, but they have been reported for at least one of them. All of the benzodiazepines are similar, so any of the above side effects may occur with any of these medicines. After you stop using this medicine, your body may need time to adjust. During this time, check with your doctor if you notice any of the following side effects: More common Irritability; nervousness; trouble in sleeping Less common Abdominal or stomach cramps; confusion; fast or pounding heartbeat; increased sense of hearing; increased sensitivity to touch and pain; increased sweating; loss of sense of reality; mental depression; muscle cramps; nausea or vomiting; sensitivity of eyes to light; tingling, burning, or prickly sensations; trembling or shaking Rare Confusion as to time, place, or person; convulsions (seizures); feelings of suspicion or distrust; hallucinations (seeing, hearing, or feeling things that are not there) Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor. -------------------------------------------------------------------------------- Additional Information Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, some of the benzodiazepines are used in certain patients with the following medical conditions: Nausea and vomiting caused by cancer chemotherapy Tension headache Tremors Other than the above information, there is no additional information relating to proper use, precautions, or side effects for these uses. -------------------------------------------------------------------------------- Revised: 02/24/2005 The information contained in the Thomson Healthcare (Micromedex) products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you. The use of the Thomson Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Healthcare does not assume any responsibility or risk for your use of the Thomson Healthcare products. Valium This page contains drug information on Valium. The information provided includes the following: what is Valium the possible side effects of Valium what happens if you miss a dose of Valium what happens if you overdose with Valium the most important information about Valium how to use Valium other drugs that may affect Valium what to avoid while using Valium Generic Name: diazepam (dye AH zeh pam) Brand Names: Diastat, Valium What is the most important information I should know about diazepam? • Use caution when driving, operating machinery, or performing other hazardous activities. Diazepam will cause drowsiness and may cause dizziness. If you experience drowsiness or dizziness, avoid these activities. • Avoid alcohol while taking diazepam. Alcohol may increase drowsiness and dizziness caused by diazepam. Alcohol may also increase the risk of having a seizure if diazepam is being taken for a seizure condition. • Diazepam is habit forming. You can become physically and psychologically dependent on the medication. Do not take more than the prescribed amount of medication or take it for longer than is directed by your doctor. Withdrawal effects may occur if diazepam is stopped suddenly after several weeks of continuous use. Your doctor may recommend a gradual reduction in dose. What is diazepam? • Diazepam is in a class of drugs called benzodiazepines. Diazepam affects chemicals in the brain that may become unbalanced and cause anxiety, seizures, and muscle spasms. • Diazepam is used to relieve anxiety, nervousness, and tension associated with anxiety disorders. It is also used to treat certain types of seizure disorders and muscle spasms. • Diazepam may also be used for purposes other than those listed in this medication guide. What should I discuss with my healthcare provider before taking diazepam? • Do not take diazepam if you have narrow-angle glaucoma. Diazepam may worsen this condition. • Before taking this medication, tell your doctor if you · have kidney disease; · have liver disease; · have asthma, bronchitis, emphysema, or another respiratory disease; or · are depressed or have suicidal thoughts. • You may not be able to take diazepam, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above. • Diazepam is in the FDA pregnancy category D. This means that diazepam is known to harm an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant. • Diazepam passes into breast milk. Do not take diazepam without first talking to your doctor if you are breast-feeding a baby. • If you are over 65 years of age, you may be more likely to experience side effects from diazepam. You may require a lower dose of this medication. How should I take diazepam? • Take diazepam exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you. • Take each oral dose with a full glass of water. • To ensure the correct dose, measure the liquid forms of diazepam with a dose-measuring spoon or cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one. • Your doctor or nurse will give you detailed instructions for administration of the Diastat rectal gel. In general, application of the rectal gel is as follows: · Remove the protective cover from the medication syringe and lubricate the rectal tip with lubricating jelly. · Turn the person on their side facing you. Bend the upper leg forward and separate the buttocks to expose the rectum. · Gently insert the syringe tip into the rectum. The rim should be snug against the rectal opening. Slowly count out loud to three while gently pushing the plunger in until it stops. Slowly count to three before removing the syringe. Slowly count to three and hold the buttocks together to prevent leakage. · Keep the person on their side facing you, note the time the medication was given, and observe the person for signs of seizure, skin color, breathing, or any unusual reaction. • Do not take diazepam more often or in larger doses than is prescribed. • Diazepam is habit forming. You can become physically and psychologically dependent on the medication. Do not take more than the prescribed amount of medication or take it for longer than is directed by your doctor. Withdrawal effects may occur if diazepam is stopped suddenly after several weeks of continuous use. Your doctor may recommend a gradual reduction in dose. • Store diazepam at room temperature away from moisture and heat. What happens if I miss a dose? • Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the dose you missed and take only the next regularly scheduled dose. Do not take a double dose of this medication. A double dose could be dangerous. What happens if I overdose? • Seek emergency medical attention. • Symptoms of a diazepam overdose include sleepiness, dizziness, confusion, a slow heart beat, difficulty breathing, difficulty walking and talking, an appearance of being drunk, and unconsciousness. What should I avoid while taking diazepam? • Use caution when driving, operating machinery, or performing other hazardous activities. Diazepam will cause drowsiness and may cause dizziness. If you experience drowsiness or dizziness, avoid these activities. • Avoid alcohol while taking diazepam. Alcohol may increase drowsiness and dizziness caused by diazepam. Alcohol may also increase the risk of having a seizure if diazepam is being taken for a seizure condition. • Diazepam may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, seizure medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any medicine without first talking to your doctor. What are the possible side effects of diazepam? • If you experience any of the following serious side effects, stop taking diazepam and seek emergency medical attention or contact your doctor immediately: · an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, face, or tongue; or hives); · sores in the mouth or throat; · yellowing of the skin or eyes; · a rash; · hallucinations or severe confusion; or · changes in your vision. • Other, less serious side effects may be more likely to occur. Continue to take diazepam and talk to your doctor if you experience · drowsiness, dizziness, or clumsiness; · depression; · nausea, vomiting, diarrhea, or constipation; · difficulty urinating; · vivid dreams; · headache; · dry mouth; · decreased sex drive; or · changes in behavior. • Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. What other drugs will affect diazepam? • Diazepam may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, seizure medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any medicine without first talking to your doctor. • Antacids may decrease the effects of diazepam. Separate doses of an antacid and diazepam by several hours whenever possible. • Drugs other than those listed here may also interact with diazepam. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines. Where can I get more information? • Your pharmacist has additional information about diazepam written for health professionals that you may read. -------------------------------------------------------------------------------- • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed. • Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/ or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist. Each mL contains 5 mg diazepam compounded with 40% propylene glycol, 10% ethyl alcohol, 5% sodium benzoate and benzoic acid as buffers, and 1.5% benzyl alcohol as preservative. Diazepam is a benzodiazepine derivative developed through original Roche research. Chemically, diazepam is 7-chloro-1,3-dihydro-1-methyl-5-phenyl-2H-1,4-benzodiazepin-2-one. It is a colorless crystalline compound, insoluble in water and has a molecular weight of 284.74. Its structural formula is as follows: Guaranteed Low prices & fast shipping. SAVE $40 OFF as 1st Time Customers, then enjoy 20% reorder discounts. Confidential, easy, and secure. No hidden fees. Order from trusted and caring U.S. licensed doctors and pharmacies. Order Valium Today. Right now at GenericDrugDepot you get an extra 10% OFF Valium with coupon code OFF10. Plus, new customers get $20 off a second order! That's not all, you get free shipping with any purchase of $150 or more. Member BBB.

Each mL contains 5 mg diazepam compounded with 40% propylene glycol, 10% ethyl alcohol, 5% sodium benzoate and benzoic acid as buffers, and 1.5% benzyl alcohol as preservative. Diazepam is a benzodiazepine derivative developed through original Roche research. Chemically, diazepam is 7-chloro-1,3-dihydro-1-methyl-5-phenyl-2H-1,4-benzodiazepin-2-one. It is a colorless crystalline compound, insoluble in water and has a molecular weight of 284.74. Its structural formula is as follows: In animals, diazepam appears to act on parts of the limbic system, the thalamus and hypothalamus, and induces calming effects. Diazepam, unlike chlorpromazine and reserpine, has no demonstrable peripheral autonomic blocking action, nor does it produce extrapyramidal side effects; however, animals treated with diazepam do have a transient ataxia at higher doses. Diazepam was found to have transient cardiovascular depressor effects in dogs. Long-term experiments in rats revealed no disturbances of endocrine function. Injections into animals have produced localized irritation of tissue surrounding injection sites and some thickening of veins after intravenous use. Valium is 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, Valium may be useful in the symptomatic relief of acute agitation, tremor, impending or acute delirium tremens and hallucinosis. As an adjunct prior to endoscopic procedures if apprehension, anxiety or acute stress reactions are present, and to diminish the patient’s Valium 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; stiff-man syndrome; and tetanus. Valium Injection is a useful adjunct in status epilepticus and severe recurrent convulsive seizures. Side effects most commonly reported were drowsiness, fatigue and ataxia; venous thrombosis and phlebitis at the site of injection. Other adverse reactions less frequently reported include: CNS: confusion, depression, dysarthria, headache, hypoactivity, slurred speech, syncope, tremor, vertigo. GI: constipation, nausea. GU: incontinence, changes in libido, urinary retention. Cardiovascular: bradycardia, cardiovascular collapse, hypotension. EENT: blurred vision, diplopia, nystagmus. Skin: urticaria, skin rash. Other: hiccups, changes in salivation, neutropenia, jaundice. Paradoxical reactions such as acute hyperexcited states, anxiety, hallucinations, increased muscle spasticity, insomnia, rage, sleep disturbances and stimulation have been reported; should these occur, use of the drug should be discontinued. Minor changes in EEG patterns, usually low-voltage fast activity, have been observed in patients during and after Valium therapy and are of no known significance. Valium is used in the treatment of anxiety disorders and for short-term relief of the symptoms of anxiety. It belongs to a class of drugs known as benzodiazepines. It is also used to relieve the symptoms of acute alcohol withdrawal, to relax muscles, to relieve the uncontrolled muscle movements caused by cerebral palsy and paralysis of the lower body and limbs, to control involuntary movement of the hands (athetosis), to relax tight, aching muscles, and, along with other medications, to treat convulsive disorders such as epilepsy. Valium Injection should not be administered to patients in shock, coma or in acute alcoholic intoxication with depression of vital signs. As is true of most CNS-acting drugs, patients receiving Valium should be cautioned against engaging in hazardous occupations requiring complete mental alertness, such as operating machinery or driving a motor vehicle. Tonic status epilepticus has been precipitated in patients treated with IV Valium for petit mal status or petit mal variant status. Usage in Pregnancy: An increased risk of congenital malformations associated with the use of minor tranquilizers (diazepam, meprobamate and chlordiazepoxide) during the first trimester of pregnancy has been suggested in several studies. Because use of these drugs is rarely a matter of urgency, their use during this period should almost always be avoided. The possibility that a woman of childbearing potential may be pregnant at the time of institution of therapy should be considered. Patients should be advised that if they become pregnant during therapy or intend to become pregnant they should communicate with their physicians about the desirability of discontinuing the drug. In humans, measurable amounts of diazepam were found in maternal and cord blood, indicating placental transfer of the drug. Until additional information is available, Valium Injection is not recommended for obstetrical use. Withdrawal symptoms of the barbiturate type have occurred after the discontinuation of benzodiazepines (see DRUG ABUSE AND DEPENDENCE section). PRECAUTIONS Although seizures may be brought under control promptly, a significant proportion of patients experience a return to seizure activity, presumably due to the short-lived effect of Valium after IV administration. The physician should be prepared to readminister the drug. However, Valium is not recommended for maintenance, and once seizures are brought under control, consideration should be given to the administration of agents useful in longer term control of seizures. If Valium is to be combined with other psychotropic agents or anticonvulsant drugs, careful consideration should be given to the pharmacology of the agents to be employed—particularly with known compounds which may potentiate the action of Valium, such as phenothiazines, narcotics, barbiturates, MAO inhibitors and other antidepressants. In highly anxious patients with evidence of accompanying depression, particularly those who may have suicidal tendencies, protective measures may be necessary. The usual precautions in treating patients with impaired hepatic function should be observed. Metabolites of Valium are excreted by the kidney; to avoid their excess accumulation, caution should be exercised in the administration to patients with compromised kidney function. Since an increase in cough reflex and laryngospasm may occur with peroral endoscopic procedures, the use of a topical anesthetic agent and the availability of necessary countermeasures are recommended. Until additional information is available, diazepam injection is not recommended for obstetrical use. Valium Injection has produced hypotension or muscular weakness in some patients particularly when used with narcotics, barbiturates or alcohol. Lower doses (usually 2 mg to 5 mg) should be used for elderly and debilitated patients. The clearance of Valium and certain other benzodiazepines can be delayed in association with Tagamet (cimetidine) administration. The clinical significance of this is unclear. Pediatric Use Safety and effectiveness in pediatric patients below the age of 30 days have not been established. Prolonged central nervous system depression has been observed in neonates, apparently due to inability to biotransform Valium into inactive metabolites. In pediatric use, in order to obtain maximal clinical effect with the minimum amount of drug and thus to reduce the risk of hazardous side effects, such as apnea or prolonged periods of somnolence, it is recommended that the drug be given slowly over a 3-minute period in a dosage not to exceed 0.25 mg/kg. After an interval of 15 to 30 minutes the initial dosage can be safely repeated. If, however, relief of symptoms is not obtained after a third administration, adjunctive therapy appropriate to the condition being treated is recommended Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Valium. More common side effects may include: Drowsiness, fatigue, light-headedness, loss of muscle coordination Less common or rare side effects may include: Anxiety, blurred vision, changes in salivation, changes in sex drive, confusion, constipation, depression, difficulty urinating, dizziness, double vision, hallucinations, headache, inability to hold urine, low blood pressure, nausea, overstimulation, rage, seizures (mild changes in brain wave patterns), skin rash, sleep disturbances, slow heartbeat, slurred speech and other speech problems, stimulation, tremors, vertigo, yellowing of eyes and skin Side effects due to rapid decrease in dose or abrupt withdrawal from Valium: Abdominal and muscle cramps, convulsions, sweating, tremors, vomiting If you are sensitive to or have ever had an allergic reaction to Valium, you should not take this medication. Do not take this medication if you have the eye condition known as acute narrow-angle glaucoma. Anxiety or tension related to everyday stress usually does not require treatment with such a powerful drug as Valium. Discuss your symptoms thoroughly with your doctor. Valium should not be prescribed if you are being treated for mental disorders more serious than anxiety. -------------------------------------------------------------------------------- Special warnings about this medication Return to top Valium may cause you to become drowsy or less alert; therefore, you should not drive or operate dangerous machinery or participate in any hazardous activity that requires full mental alertness until you know how this drug affects you. If you have liver or kidney problems, use this medication cautiously. -------------------------------------------------------------------------------- Possible food and drug interactions when taking this medication Return to top Valium slows down the central nervous system and may intensify the effects of alcohol. Do not drink alcohol while taking this medication. If Valium is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Valium with any of the following: Antiseizure drugs such as Dilantin Antidepressant drugs such as Elavil and Prozac Barbiturates such as phenobarbital Cimetidine (Tagamet) Digoxin (Lanoxin) Disulfiram (Antabuse) Fluoxetine (Prozac) Isoniazid (Rifamate) Levodopa (Larodopa, Sinemet) Major tranquilizers such as Mellaril and Thorazine MAO inhibitors (antidepressant drugs such as Nardil) Narcotics such as Percocet Omeprazole (Prilosec) Oral contraceptives Propoxyphene (Darvon) Ranitidine (Zantac) Rifampin (Rifadin) -------------------------------------------------------------------------------- Special information if you are pregnant or breastfeeding Return to top Do not take Valium if you are pregnant or planning to become pregnant. There is an increased risk of birth defects. If this medication is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment is finished. -------------------------------------------------------------------------------- Recommended dosage Return to top ADULTS -------------------------------------------------------------------------------- Treatment of Anxiety Disorders and Short-Term Relief of the Symptoms of Anxiety The usual dose, depending upon severity of symptoms, is 2 milligrams to 10 milligrams 2 to 4 times daily. Acute Alcohol Withdrawal The usual dose is 10 milligrams 3 or 4 times during the first 24 hours, then 5 milligrams 3 or 4 times daily as needed. Relief of Muscle Spasm The usual dose is 2 milligrams to 10 milligrams 3 or 4 times daily. Convulsive Disorders The usual dose is 2 milligrams to 10 milligrams 2 to 4 times daily. CHILDREN -------------------------------------------------------------------------------- Valium should not be given to children under 6 months of age. The usual starting dose for children over 6 months is 1 to 2.5 milligrams 3 or 4 times a day. Your doctor may increase the dosage gradually if needed. OLDER ADULTS -------------------------------------------------------------------------------- The usual dosage is 2 milligrams to 2.5 milligrams once or twice a day, which your doctor will increase as needed. Your doctor will limit the dosage to the smallest effective amount because older people are more apt to become oversedated or uncoordinated. -------------------------------------------------------------------------------- Overdosage Return to top Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately. Symptoms of Valium overdose may include: Coma, confusion, diminished reflexes, sleepiness Amnestic-Diazepam (parenteral only); Lorazepam (parenteral only) Antianxiety agent-Alprazolam; Bromazepam; Chlordiazepoxide; Clorazepate; Diazepam; Halazepam; Ketazolam; Lorazepam; Oxazepam; Prazepam Anticonvulsant-Clobazam; Clonazepam; Clorazepate; Diazepam; Lorazepam (parenteral only); Nitrazepam Antiemetic, in cancer chemotherapy-Lorazepam (parenteral only) Antipanic agent-Alprazolam; Chlordiazepoxide (parenteral only); Clonazepam; Diazepam; Lorazepam Antitremor agent-Alprazolam; Chlordiazepoxide (oral only); Diazepam (oral only); Lorazepam (oral only) Sedative-hypnotic-Alprazolam; Bromazepam; Chlordiazepoxide; Clonazepam; Clorazepate; Diazepam; Estazolam; Flurazepam; Halazepam; Ketazolam; Lorazepam; Nitrazepam; Oxazepam; Prazepam; Quazepam; Temazepam; Triazolam Skeletal muscle relaxant adjunct-Diazepam; Lorazepam -------------------------------------------------------------------------------- Description Benzodiazepines ((ben-zoe-dye-AZ-e-peens)) belong to the group of medicines called central nervous system (CNS) depressants (medicines that slow down the nervous system). Some benzodiazepines are used to relieve anxiety. However, benzodiazepines should not be used to relieve nervousness or tension caused by the stress of everyday life. Some benzodiazepines are used to treat insomnia (trouble in sleeping). However, if used regularly (for example, every day) for insomnia, they usually are not effective for more than a few weeks. Many of the benzodiazepines are used in the treatment of other conditions, also. Diazepam is used to help relax muscles or relieve muscle spasm. Diazepam injection is used before some medical procedures to relieve anxiety and to reduce memory of the procedure. Chlordiazepoxide, clorazepate, diazepam, and oxazepam are used to treat the symptoms of alcohol withdrawal. Alprazolam and clonazepam are used in the treatment of panic disorder. Clobazam, clonazepam, clorazepate, diazepam, and lorazepam are used in the treatment of certain convulsive (seizure) disorders, such as epilepsy. The benzodiazepines may also be used for other conditions as determined by your doctor. Benzodiazepines may be habit-forming (causing mental or physical dependence), especially when taken for a long time or in high doses. These medicines are available only with your doctor's prescription, in the following dosage forms What is the most important information I should know about diazepam? • Use caution when driving, operating machinery, or performing other hazardous activities. Diazepam will cause drowsiness and may cause dizziness. If you experience drowsiness or dizziness, avoid these activities. • Avoid alcohol while taking diazepam. Alcohol may increase drowsiness and dizziness caused by diazepam. Alcohol may also increase the risk of having a seizure if diazepam is being taken for a seizure condition. • Diazepam is habit forming. You can become physically and psychologically dependent on the medication. Do not take more than the prescribed amount of medication or take it for longer than is directed by your doctor. Withdrawal effects may occur if diazepam is stopped suddenly after several weeks of continuous use. Your doctor may recommend a gradual reduction in dose. What is diazepam? • Diazepam is in a class of drugs called benzodiazepines. Diazepam affects chemicals in the brain that may become unbalanced and cause anxiety, seizures, and muscle spasms. • Diazepam is used to relieve anxiety, nervousness, and tension associated with anxiety disorders. It is also used to treat certain types of seizure disorders and muscle spasms. • Diazepam may also be used for purposes other than those listed in this medication guide. What should I discuss with my healthcare provider before taking diazepam? • Do not take diazepam if you have narrow-angle glaucoma. Diazepam may worsen this condition. • Before taking this medication, tell your doctor if you · have kidney disease; · have liver disease; · have asthma, bronchitis, emphysema, or another respiratory disease; or · are depressed or have suicidal thoughts. • You may not be able to take diazepam, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above. • Diazepam is in the FDA pregnancy category D. This means that diazepam is known to harm an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant. • Diazepam passes into breast milk. Do not take diazepam without first talking to your doctor if you are breast-feeding a baby. • If you are over 65 years of age, you may be more likely to experience side effects from diazepam. You may require a lower dose of this medication. How should I take diazepam? • Take diazepam exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you. • Take each oral dose with a full glass of water. • To ensure the correct dose, measure the liquid forms of diazepam with a dose-measuring spoon or cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one. • Your doctor or nurse will give you detailed instructions for administration of the Diastat rectal gel. In general, application of the rectal gel is as follows: · Remove the protective cover from the medication syringe and lubricate the rectal tip with lubricating jelly. · Turn the person on their side facing you. Bend the upper leg forward and separate the buttocks to expose the rectum. · Gently insert the syringe tip into the rectum. The rim should be snug against the rectal opening. Slowly count out loud to three while gently pushing the plunger in until it stops. Slowly count to three before removing the syringe. Slowly count to three and hold the buttocks together to prevent leakage. · Keep the person on their side facing you, note the time the medication was given, and observe the person for signs of seizure, skin color, breathing, or any unusual reaction. • Do not take diazepam more often or in larger doses than is prescribed. • Diazepam is habit forming. You can become physically and psychologically dependent on the medication. Do not take more than the prescribed amount of medication or take it for longer than is directed by your doctor. Withdrawal effects may occur if diazepam is stopped suddenly after several weeks of continuous use. Your doctor may recommend a gradual reduction in dose. • Store diazepam at room temperature away from moisture and heat. What happens if I miss a dose? • Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the dose you missed and take only the next regularly scheduled dose. Do not take a double dose of this medication. A double dose could be dangerous. What happens if I overdose? • Seek emergency medical attention. • Symptoms of a diazepam overdose include sleepiness, dizziness, confusion, a slow heart beat, difficulty breathing, difficulty walking and talking, an appearance of being drunk, and unconsciousness. What should I avoid while taking diazepam? • Use caution when driving, operating machinery, or performing other hazardous activities. Diazepam will cause drowsiness and may cause dizziness. If you experience drowsiness or dizziness, avoid these activities. • Avoid alcohol while taking diazepam. Alcohol may increase drowsiness and dizziness caused by diazepam. Alcohol may also increase the risk of having a seizure if diazepam is being taken for a seizure condition. • Diazepam may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, seizure medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any medicine without first talking to your doctor. What are the possible side effects of diazepam? • If you experience any of the following serious side effects, stop taking diazepam and seek emergency medical attention or contact your doctor immediately: · an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, face, or tongue; or hives); · sores in the mouth or throat; · yellowing of the skin or eyes; · a rash; · hallucinations or severe confusion; or · changes in your vision. • Other, less serious side effects may be more likely to occur. Continue to take diazepam and talk to your doctor if you experience · drowsiness, dizziness, or clumsiness; · depression; · nausea, vomiting, diarrhea, or constipation; · difficulty urinating; · vivid dreams; · headache; · dry mouth; · decreased sex drive; or · changes in behavior. • Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. What other drugs will affect diazepam? • Diazepam may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, seizure medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any medicine without first talking to your doctor. • Antacids may decrease the effects of diazepam. Separate doses of an antacid and diazepam by several hours whenever possible. • Drugs other than those listed here may also interact with diazepam. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines. Where can I get more information? • Your pharmacist has additional information about diazepam written for health professionals that you may read. -------------------------------------------------------------------------------- • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed. • Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/ or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist. Adults-Dose is based on body weight and will be determined by your doctor. However, the dose usually is not more than 4 mg, placed under the tongue, one to two hours before surgery. Children-Use and dose must be determined by your doctor. For injection dosage form: For sedation before surgery or other procedures: Adults-Dose is based on body weight and will be determined by your doctor. However, the dose usually is not more than 4 mg, injected into a muscle or vein. Children younger than 18 years of age-Use and dose must be determined by your doctor. For control of seizures: Adults-At first, 4 mg slowly injected into a vein. The dose may be repeated after ten to fifteen minutes if needed. Children younger than 18 years of age-Use and dose must be determined by your doctor. For nitrazepam For oral dosage form (tablets): For trouble in sleeping: Adults-5 to 10 milligrams (mg) at bedtime. Children-Use and dose must be determined by your doctor. Older adults-At first, 2.5 mg taken at bedtime. Your doctor may increase your dose if needed. For control of seizures: Children less than 30 kilograms (66 pounds) of body weight-Dose is based on body weight and will be determined by your doctor. For oxazepam For oral dosage form (capsules or tablets): For anxiety: Adults-10 to 30 milligrams (mg) three or four times a day. Children younger than 12 years of age-Use and dose must be determined by your doctor. Older adults-At first, 5 mg one or two times a day or 10 mg three times a day. Your doctor may increase your dose if needed. However, the dose usually is not more than 15 mg four times a day. For sedation during withdrawal from alcohol: Adults-15 to 30 mg three or four times a day. Children younger than 12 years of age-Use and dose must be determined by your doctor. For quazepam For oral dosage form (tablets): For trouble in sleeping: Adults-7.5 to 15 milligrams (mg) at bedtime. Children younger than 18 years of age-Use and dose must be determined by your doctor. For temazepam For oral dosage form (capsules): For trouble in sleeping: Adults-15 milligrams (mg) at bedtime. Your doctor may change your dose if needed. Children younger than 18 years of age-Use and dose must be determined by your doctor. Older adults-At first, 7.5 mg at bedtime. Your doctor may increase your dose if needed. For triazolam For oral dosage form (tablets): For trouble in sleeping: Adults-0.125 to 0.25 milligram (mg) at bedtime. Children younger than 18 years of age-Use and dose must be determined by your doctor. Older adults-At first, 0.125 mg at bedtime. Your doctor may increase your dose if needed. Missed dose-If you are taking this medicine regularly (for example, every day as for epilepsy) and you miss a dose, take it right away if you remember within an hour or so of the missed dose. However, if you do not remember until later, skip the missed dose and go back to your regular dosing schedule. Do not double doses. Storage-To store this medicine: Keep out of the reach of children. Overdose of benzodiazepines may be especially dangerous in children. Store away from heat and direct light. Do not store the capsule or tablet form of this medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down. Keep the liquid form of this medicine from freezing. Keep the oral disintegrating tablet form of this medicine in a tightly sealed bottle and discard any cotton that was included in the bottle Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children. -------------------------------------------------------------------------------- Precautions While Using This Medicine If you will be taking a benzodiazepine regularly for a long time : Your doctor should check your progress at regular visits to make sure that this medicine does not cause unwanted effects. If you are taking a benzodiazepine for convulsions (seizures), this is also important during the first few months of treatment. Check with your doctor at regular visits to see if you need to continue taking this medicine. If you are taking a benzodiazepine for epilepsy or another seizure disorder : Your doctor may want you to carry a medical identification card or bracelet stating that you are taking this medicine. If you are taking a benzodiazepine for insomnia (trouble in sleeping): If you think you need this medicine for more than 7 to 10 days, be sure to discuss it with your doctor. Insomnia that lasts longer than this may be a sign of another medical problem. You may have difficulty sleeping (rebound insomnia) for the first few nights after you stop taking this medicine. Benzodiazepines may be habit-forming (causing mental or physical dependence) , especially when taken for a long time or in high doses. Some signs of dependence on benzodiazepines are: A strong desire or need to continue taking the medicine. A need to increase the dose to receive the effects of the medicine. Withdrawal effects (for example, irritability, nervousness, trouble in sleeping, abdominal or stomach cramps, trembling or shaking) occurring after the medicine is stopped. If you think you may have become mentally or physically dependent on this medicine, check with your doctor . Do not stop taking it suddenly. If you have been taking this medicine in large doses or for a long time, do not stop taking it without first checking with your doctor . Your doctor may want you to reduce gradually the amount you are taking before stopping completely. Stopping this medicine suddenly may cause withdrawal side effects, including seizures. Stopping this medicine suddenly is most likely to cause seizures if you have been taking it for epilepsy or another seizure disorder. This medicine will add to the effects of alcohol and other central nervous system (CNS) depressants (medicines that slow down the nervous system, possibly causing drowsiness). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates; medicine for seizures; muscle relaxants; or anesthetics, including some dental anesthetics. This effect may last for a few days after you stop taking this medicine. Check with your doctor before taking any of the above while you are taking this medicine . If you think you or someone else may have taken an overdose of this medicine, get emergency help at once . Taking an overdose of a benzodiazepine or taking alcohol or other CNS depressants with the benzodiazepine may lead to unconsciousness and possibly death. Some signs of an overdose are continuing slurred speech or confusion, severe drowsiness, severe weakness, and staggering. Before you have any medical tests, tell the medical doctor in charge that you are taking this medicine. The results of the metyrapone test may be affected by chlordiazepoxide. If you develop any unusual and strange thoughts or behavior while you are taking this medicine, be sure to discuss it with your doctor. Some changes that have occurred in people taking this medicine are like those seen in people who drink alcohol and then act in a manner that is not normal. Other changes may be more unusual and extreme, such as confusion, agitation, and hallucinations (seeing, hearing, or feeling things that are not there). This medicine may cause some people, especially older persons, to become drowsy, dizzy, lightheaded, clumsy or unsteady, or less alert than they are normally. Even if taken at bedtime, it may cause some people to feel drowsy or less alert on arising. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert . -------------------------------------------------------------------------------- Side Effects of This Medicine Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor as soon as possible if any of the following side effects occur: Less common Anxiety; confusion (may be more common in the elderly); fast, pounding, or irregular heartbeat; lack of memory of events taking place after benzodiazepine is taken (may be more common with triazolam); mental depression Rare Abnormal thinking, including disorientation, delusions (holding false beliefs that cannot be changed by facts), or loss of sense of reality; agitation; behavior changes, including aggressive behavior, bizarre behavior, decreased inhibition, or outbursts of anger; convulsions (seizures); hallucinations (seeing, hearing, or feeling things that are not there); hypotension (low blood pressure); muscle weakness; skin rash or itching; sore throat, fever, and chills; trouble in sleeping; ulcers or sores in mouth or throat (continuing); uncontrolled movements of body, including the eyes; unusual bleeding or bruising; unusual excitement, nervousness, or irritability; unusual tiredness or weakness (severe); yellow eyes or skin Symptoms of overdose Confusion (continuing); convulsions (seizures); drowsiness (severe) or coma; shakiness; slow heartbeat; slow reflexes; slurred speech (continuing); staggering; troubled breathing; weakness (severe) For patients having chlordiazepoxide, diazepam, or lorazepam injected : Check with your doctor if there is redness, swelling, or pain at the place of injection. Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome: More common Clumsiness or unsteadiness; dizziness or lightheadedness; drowsiness; slurred speech Less common or rare Abdominal or stomach cramps or pain; blurred vision or other changes in vision; changes in sexual desire or ability; constipation; diarrhea; dryness of mouth or increased thirst; false sense of well-being; headache; increased bronchial secretions or watering of mouth; muscle spasm; nausea or vomiting; problems with urination; trembling or shaking; unusual tiredness or weakness Not all of the side effects listed above have been reported for each of these medicines, but they have been reported for at least one of them. All of the benzodiazepines are similar, so any of the above side effects may occur with any of these medicines. After you stop using this medicine, your body may need time to adjust. During this time, check with your doctor if you notice any of the following side effects: More common Irritability; nervousness; trouble in sleeping Less common Abdominal or stomach cramps; confusion; fast or pounding heartbeat; increased sense of hearing; increased sensitivity to touch and pain; increased sweating; loss of sense of reality; mental depression; muscle cramps; nausea or vomiting; sensitivity of eyes to light; tingling, burning, or prickly sensations; trembling or shaking Rare Confusion as to time, place, or person; convulsions (seizures); feelings of suspicion or distrust; hallucinations (seeing, hearing, or feeling things that are not there) Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor. -------------------------------------------------------------------------------- Additional Information Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, some of the benzodiazepines are used in certain patients with the following medical conditions: Nausea and vomiting caused by cancer chemotherapy Tension headache Tremors Other than the above information, there is no additional information relating to proper use, precautions, or side effects for these uses. -------------------------------------------------------------------------------- Revised: 02/24/2005 The information contained in the Thomson Healthcare (Micromedex) products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you. The use of the Thomson Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Healthcare does not assume any responsibility or risk for your use of the Thomson Healthcare products. In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For benzodiazepines, the following should be considered: Allergies-Tell your doctor if you have ever had any unusual or allergic reaction to benzodiazepines. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes. Certain benzodiazepine products may contain lactose, parabens, or soybean oil. Pregnancy-Chlordiazepoxide and diazepam have been reported to increase the chance of birth defects when used during the first 3 months of pregnancy. Although similar problems have not been reported with the other benzodiazepines, the chance always exists since all of the benzodiazepines are related. Studies in animals have shown that clonazepam, lorazepam, and temazepam cause birth defects or other problems, including death of the animal fetus. Too much use of a benzodiazepine during pregnancy may cause the baby to become dependent on the medicine. This may lead to withdrawal side effects after birth. Also, use of benzodiazepines during pregnancy, especially during the last weeks, may cause body temperature problems, breathing problems, difficulty in feeding, drowsiness, or muscle weakness in the newborn infant. Benzodiazepines given just before or during labor may cause weakness in the newborn infant. When diazepam is given in high doses (especially by injection) within 15 hours before delivery, it may cause breathing problems, muscle weakness, difficulty in feeding, and body temperature problems in the newborn infant. Breast-feeding-Benzodiazepines may pass into the breast milk and cause drowsiness, difficulty in feeding, and weight loss in nursing babies of mothers taking these medicines. Children-Most of the side effects of these medicines are more likely to occur in children, especially the very young. These patients are usually more sensitive than adults to the effects of benzodiazepines. It is possible that using clonazepam for long periods of time may cause unwanted effects on physical and mental growth in children. If such effects do occur, they may not be noticed until many years later. Before this medicine is given to children for long periods of time, you should discuss its use with your child's doctor. Older adults-Most of the side effects of these medicines are more likely to occur in the elderly, who are usually more sensitive to the effects of benzodiazepines. Taking benzodiazepines for trouble in sleeping may cause more daytime drowsiness in elderly patients than in younger adults. In addition, falls and related injuries are more likely to occur in elderly patients taking benzodiazepines. Other medicines-Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking or receiving benzodiazepines it is especially important that your health care professional know if you are taking any of the following: Central nervous system (CNS) depressants (medicines that cause drowsiness)-The CNS depressant effects of either these medicines or benzodiazepines may be increased; your doctor may want to change the dose of either or both medicines Fluvoxamine (e.g., Luvox) or Nefazodone (e.g., Serzone)-Higher blood levels of benzodiazepines may occur, increasing the chance that side effects will occur; your doctor may want to change the dose of either or both medicines, or give you a different medicine Itraconazole (e.g., Sporanox) or Ketoconazole (e.g., Nizoral)-These medicines should NOT be used if you are taking a benzodiazepine. Other medical problems-The presence of other medical problems may affect the use of benzodiazepines. Make sure you tell your doctor if you have any other medical problems, especially: Alcohol abuse (or history of) or Drug abuse or dependence (or history of)-Dependence on benzodiazepines may be more likely to develop Brain disease-CNS depression and other side effects of benzodiazepines may be more likely to occur Difficulty in swallowing (in children) or Emphysema, asthma, bronchitis, or other chronic lung disease or Hyperactivity or Mental depression or Mental illness (severe) or Myasthenia gravis or Porphyria or Sleep apnea (temporary stopping of breathing during sleep)-Benzodiazepines may make these conditions worse Epilepsy or history of seizures-Although some benzodiazepines are used in treating epilepsy, starting or suddenly stopping treatment with these medicines may increase seizures Glaucoma, acute narrow angle-Benzodiazepines should NOT be used if you have this condition. Glaucoma, open angle-Benzodiazepines can be used but your doctor should be monitoring your condition carefully. Kidney or liver disease-Higher blood levels of benzodiazepines may result, increasing the chance that side effects will occur

Valium is used in the treatment of anxiety disorders and for short-term relief of the symptoms of anxiety. It is also used to relieve the symptoms of acute alcohol withdrawal, to relax muscles, to relieve the uncontrolled muscle movements caused by cerebral palsy and paralysis of the lower body and limbs. Valium can be habit-forming or addictive. You may experience withdrawal symptoms if you stop using this drug abruptly. Discontinue or change your dose only on your doctor's advice. Valium diazepam Brand Names: Diastat, Valium What is the most important information I should know about Valium (diazepam)? • Use caution when driving, operating machinery, or performing other hazardous activities. Valium (diazepam) will cause drowsiness and may cause dizziness. If you experience drowsiness or dizziness, avoid these activities. • Avoid alcohol while taking Valium (diazepam). Alcohol may increase drowsiness and dizziness caused by Valium (diazepam). Alcohol may also increase the risk of having a seizure if Valium (diazepam) is being taken for a seizure condition. • Valium (diazepam) is habit forming. You can become physically and psychologically dependent on the medication. Do not take more than the prescribed amount of medication or take it for longer than is directed by your doctor. Withdrawal effects may occur if Valium (diazepam) is stopped suddenly after several weeks of continuous use. Your doctor may recommend a gradual reduction in dose. What is Valium (diazepam)? • Valium (diazepam) is in a class of drugs called benzodiazepines. Valium (diazepam) affects chemicals in the brain that may become unbalanced and cause anxiety, seizures, and muscle spasms. • Valium (diazepam) is used to relieve anxiety, nervousness, and tension associated with anxiety disorders. It is also used to treat certain types of seizure disorders and muscle spasms. • Valium (diazepam) may also be used for purposes other than those listed in this medication guide. What should I discuss with my healthcare provider before taking Valium (diazepam)? • Do not take Valium (diazepam) if you have narrow-angle glaucoma. Valium (diazepam) may worsen this condition. • Before taking this medication, tell your doctor if you · have kidney disease; · have liver disease; · have asthma, bronchitis, emphysema, or another respiratory disease; or · are depressed or have suicidal thoughts. • You may not be able to take Valium (diazepam), or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above. • Valium (diazepam) is in the FDA pregnancy category D. This means that Valium (diazepam) is known to harm an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant. • Valium (diazepam) passes into breast milk. Do not take Valium (diazepam) without first talking to your doctor if you are breast-feeding a baby. • If you are over 65 years of age, you may be more likely to experience side effects from Valium (diazepam). You may require a lower dose of this medication. How should I take Valium (diazepam)? • Take Valium (diazepam) exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you. • Take each oral dose with a full glass of water. • To ensure the correct dose, measure the liquid forms of Valium (diazepam) with a dose-measuring spoon or cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one. • Your doctor or nurse will give you detailed instructions for administration of the Diastat rectal gel. In general, application of the rectal gel is as follows: · Remove the protective cover from the medication syringe and lubricate the rectal tip with lubricating jelly. · Turn the person on their side facing you. Bend the upper leg forward and separate the buttocks to expose the rectum. · Gently insert the syringe tip into the rectum. The rim should be snug against the rectal opening. Slowly count out loud to three while gently pushing the plunger in until it stops. Slowly count to three before removing the syringe. Slowly count to three and hold the buttocks together to prevent leakage. · Keep the person on their side facing you, note the time the medication was given, and observe the person for signs of seizure, skin color, breathing, or any unusual reaction. • Do not take Valium (diazepam) more often or in larger doses than is prescribed. • Valium (diazepam) is habit forming. You can become physically and psychologically dependent on the medication. Do not take more than the prescribed amount of medication or take it for longer than is directed by your doctor. Withdrawal effects may occur if Valium (diazepam) is stopped suddenly after several weeks of continuous use. Your doctor may recommend a gradual reduction in dose. • Store Valium (diazepam) at room temperature away from moisture and heat. What happens if I miss a dose? • Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the dose you missed and take only the next regularly scheduled dose. Do not take a double dose of this medication. A double dose could be dangerous. What happens if I overdose? • Seek emergency medical attention. • Symptoms of a Valium (diazepam) overdose include sleepiness, dizziness, confusion, a slow heart beat, difficulty breathing, difficulty walking and talking, an appearance of being drunk, and unconsciousness. What should I avoid while taking Valium (diazepam)? • Use caution when driving, operating machinery, or performing other hazardous activities. Valium (diazepam) will cause drowsiness and may cause dizziness. If you experience drowsiness or dizziness, avoid these activities. • Avoid alcohol while taking Valium (diazepam). Alcohol may increase drowsiness and dizziness caused by Valium (diazepam). Alcohol may also increase the risk of having a seizure if Valium (diazepam) is being taken for a seizure condition. • Valium (diazepam) may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, seizure medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any medicine without first talking to your doctor. What are the possible side effects of Valium (diazepam)? • If you experience any of the following serious side effects, stop taking Valium (diazepam) and seek emergency medical attention or contact your doctor immediately: · an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, face, or tongue; or hives); · sores in the mouth or throat; · yellowing of the skin or eyes; · a rash; · hallucinations or severe confusion; or · changes in your vision. • Other, less serious side effects may be more likely to occur. Continue to take Valium (diazepam) and talk to your doctor if you experience · drowsiness, dizziness, or clumsiness; · depression; · nausea, vomiting, diarrhea, or constipation; · difficulty urinating; · vivid dreams; · headache; · dry mouth; · decreased sex drive; or · changes in behavior. • Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. What other drugs will affect Valium (diazepam)? • Valium (diazepam) may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, seizure medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any medicine without first talking to your doctor. • Antacids may decrease the effects of Valium (diazepam). Separate doses of an antacid and Valium (diazepam) by several hours whenever possible. • Drugs other than those listed here may also interact with Valium (diazepam). Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines. Valium Tablets Manufacturer: Roche Products The following text is complete prescribing information based on official labeling in effect June 2001. DESCRIPTION Valium (diazepam) is a benzodiazepine derivative. The chemical name of diazepam is 7-chloro-1,3-dihydro-1-methyl -5- phenyl-2H-1,4-benzodiazepin-2-one. It is a colorless crystalline compound, insoluble in water. The empirical formula is C 16 H 13 CIN 2 O and the molecular weight is 284.75. Valium is available for oral administration as tablets containing 2 mg, 5 mg or 10 mg diazepam. In addition to the active ingredient diazepam, each tablet contains the following inactive ingredients: anhydrous lactose, corn starch, pregelatinized starch and calcium stearate with the following dyes: 5-mg tablets contain FD&C Yellow No. 6 and D&C Yellow No. 10; 10-mg tablets contain FD&C Blue No. 1. Valium 2-mg tablets contain no dye. PHARMACOLOGY In animals, Valium appears to act on parts of the limbic system, the thalamus and hypothalamus, and induces calming effects. Valium, unlike chlorpromazine and reserpine, has no demonstrable peripheral autonomic blocking action, nor does it produce extrapyramidal side effects; however, animals treated with Valium do have a transient ataxia at higher doses. Valium was found to have transient cardiovascular depressor effects in dogs. Long-term experiments in rats revealed no disturbances of endocrine function. Oral LD 50 of diazepam is 720 mg/kg in mice and 1240 mg/kg in rats. Intraperitoneal administration of 400 mg/kg to a monkey resulted in death on the sixth day. Reproduction Studies: A series of rat reproduction studies was performed with diazepam in oral doses of 1, 10, 80 and 100 mg/kg. At 100 mg/kg there was a decrease in the number of pregnancies and surviving offspring in these rats. Neonatal survival of rats at doses lower than 100 mg/kg was within normal limits. Several neonates in these rat reproduction studies showed skeletal or other defects. Further studies in rats at doses up to and including 80 mg/kg/day did not reveal teratological effects on the offspring. In humans, measurable blood levels of Valium were obtained in maternal and cord blood, indicating placental transfer of the drug. INDICATIONS Valium is 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, Valium may be useful in the symptomatic relief of acute agitation, tremor, impending or acute delirium tremens and hallucinosis. Valium 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; and stiff-man syndrome. Oral Valium may be used adjunctively in convulsive disorders, although it has not proved useful as the sole therapy. The effectiveness of Valium in long-term use, that is, more than 4 months, has not been assessed by systematic clinical studies. The physician should periodically reassess the usefulness of the drug for the individual patient. CONTRAINDICATIONS Valium is contraindicated in patients with a known hypersensitivity to this drug and, because of lack of sufficient clinical experience, in pediatric patients under 6 months of age. It may be used in patients with open angle glaucoma who are receiving appropriate therapy, but is contraindicated in acute narrow angle glaucoma. WARNINGS Valium is not of value in the treatment of psychotic patients and should not be employed in lieu of appropriate treatment. As is true of most preparations containing CNS-acting drugs, patients receiving Valium should be cautioned against engaging in hazardous occupations requiring complete mental alertness such as operating machinery or driving a motor vehicle. As with other agents which have anticonvulsant activity, when Valium is used as an adjunct in treating convulsive disorders, the possibility of an increase in the frequency and/or severity of grand mal seizures may require an increase in the dosage of standard anticonvulsant medication. Abrupt withdrawal of Valium in such cases may also be associated with a temporary increase in the frequency and/or severity of seizures. Since Valium has a central nervous system depressant effect, patients should be advised against the simultaneous ingestion of alcohol and other CNS-depressant drugs during Valium therapy. Usage in Pregnancy: An increased risk of congenital malformations associated with the use of minor tranquilizers (diazepam, meprobamate and chlordiazepoxide) during the first trimester of pregnancy has been suggested in several studies. Because use of these drugs is rarely a matter of urgency, their use during this period should almost always be avoided. The possibility that a woman of childbearing potential may be pregnant at the time of institution of therapy should be considered. Patients should be advised that if they become pregnant during therapy or intend to become pregnant they should communicate with their physicians about the desirability of discontinuing the drug. Management of Overdosage: Manifestations of Valium overdosage include somnolence, confusion, coma and diminished reflexes. Respiration, pulse and blood pressure should be monitored, as in all cases of drug overdosage, although, in general, these effects have been minimal following overdosage. General supportive measures should be employed, along with immediate gastric lavage. Intravenous fluids should be administered and an adequate airway maintained. Hypotension may be combated by the use of Levophed® (levarterenol) or Aramine (metaraminol). Dialysis is of limited value. As with the management of intentional overdosage with any drug, it should be borne in mind that multiple agents may have been ingested. Flumazenil, a specific benzodiazepine-receptor antagonist, is indicated for the complete or partial reversal of the sedative effects of benzodiazepines and may be used in situations when an overdose with a benzodiazepine is known or suspected. Prior to the administration of flumazenil, necessary measures should be instituted to secure airway, ventilation, and intravenous access. Flumazenil is intended as an adjunct to, not as a substitute for, proper management of benzodiazepine overdose. Patients treated with flumazenil should be monitored for resedation, respiratory depression and other residual benzodiazepine effects for an appropriate period after treatment. The prescriber should be aware of a risk of seizure in association with flumazenil treatment, particularly in long-term benzodiazepine users and in cyclic antidepressant overdose. The complete flumazenil package insert, including CONTRAINDICATIONS, WARNINGS and PRECAUTIONS, should be consulted prior to use. Withdrawal symptoms of the barbiturate type have occurred after the discontinuation of benzodiazepines. (See DRUG ABUSE AND DEPENDENCE section.) PRECAUTIONS If Valium is to be combined with other psychotropic agents or anticonvulsant drugs, careful consideration should be given to the pharmacology of the agents to be employed--particularly with known compounds which may potentiate the action of Valium, such as phenothiazines, narcotics, barbiturates, MAO inhibitors and other antidepressants. The usual precautions are indicated for severely depressed patients or those in whom there is any evidence of latent depression; particularly the recognition that suicidal tendencies may be present and protective measures may be necessary. The usual precautions in treating patients with impaired renal or hepatic function should be observed. In elderly and debilitated patients, it is recommended that the dosage be limited to the smallest effective amount to preclude the development of ataxia or oversedation (2 mg to 2 1 / 2 mg once or twice daily, initially, to be increased gradually as needed and tolerated). The clearance of Valium and certain other benzodiazepines can be delayed in association with Tagamet (cimetidine) administration. The clinical significance of this is unclear. Information for Patients: To assure the safe and effective use of benzodiazepines, patients should be informed that, since benzodiazepines may produce psychological and physical dependence, it is advisable that they consult with their physician before either increasing the dose or abruptly discontinuing this drug. Pediatric Use: Safety and effectiveness in pediatric patients below the age of 6 months have not been established. ADVERSE REACTIONS Side effects most commonly reported were drowsiness, fatigue and ataxia. Infrequently encountered were confusion, constipation, depression, diplopia, dysarthria, headache, hypotension, incontinence, jaundice, changes in libido, nausea, changes in salivation, skin rash, slurred speech, tremor, urinary retention, vertigo and blurred vision. Paradoxical reactions such as acute hyperexcited states, anxiety, hallucinations, increased muscle spasticity, insomnia, rage, sleep disturbances and stimulation have been reported; should these occur, use of the drug should be discontinued. Because of isolated reports of neutropenia and jaundice, periodic blood counts and liver function tests are advisable during long-term therapy. Minor changes in EEG patterns, usually low-voltage fast activity, have been observed in patients during and after Valium therapy and are of no known significance. DRUG ABUSE AND DEPENDENCE Withdrawal symptoms, similar in character to those noted with barbiturates and alcohol (convulsions, tremor, abdominal and muscle cramps, vomiting and sweating), have occurred following abrupt discontinuance of diazepam. The more severe withdrawal symptoms have usually been limited to those patients who had received excessive doses over an extended period of time. Generally milder withdrawal symptoms (eg, dysphoria and insomnia) have been reported following abrupt discontinuance of benzodiazepines taken continuously at therapeutic levels for several months. Consequently, after extended therapy, abrupt discontinuation should generally be avoided and a gradual dosage tapering schedule followed. Addiction-prone individuals (such as drug addicts or alcoholics) should be under careful surveillance when receiving diazepam or other psychotropic agents because of the predisposition of such patients to habituation and dependence. DOSAGE AND ADMINISTRATION Dosage should be individualized for maximum beneficial effect. While the usual daily dosages given below will meet the needs of most patients, there will be some who may require higher doses. In such cases dosage should be increased cautiously to avoid adverse effects. Valium This page contains drug information on Valium. The information provided includes the following: what is Valium the possible side effects of Valium what happens if you miss a dose of Valium what happens if you overdose with Valium the most important information about Valium how to use Valium other drugs that may affect Valium what to avoid while using Valium Generic Name: diazepam (dye AH zeh pam) Brand Names: Diastat, Valium What is the most important information I should know about diazepam? • Use caution when driving, operating machinery, or performing other hazardous activities. Diazepam will cause drowsiness and may cause dizziness. If you experience drowsiness or dizziness, avoid these activities. • Avoid alcohol while taking diazepam. Alcohol may increase drowsiness and dizziness caused by diazepam. Alcohol may also increase the risk of having a seizure if diazepam is being taken for a seizure condition. • Diazepam is habit forming. You can become physically and psychologically dependent on the medication. Do not take more than the prescribed amount of medication or take it for longer than is directed by your doctor. Withdrawal effects may occur if diazepam is stopped suddenly after several weeks of continuous use. Your doctor may recommend a gradual reduction in dose. What is diazepam? • Diazepam is in a class of drugs called benzodiazepines. Diazepam affects chemicals in the brain that may become unbalanced and cause anxiety, seizures, and muscle spasms. • Diazepam is used to relieve anxiety, nervousness, and tension associated with anxiety disorders. It is also used to treat certain types of seizure disorders and muscle spasms. • Diazepam may also be used for purposes other than those listed in this medication guide. What should I discuss with my healthcare provider before taking diazepam? • Do not take diazepam if you have narrow-angle glaucoma. Diazepam may worsen this condition. • Before taking this medication, tell your doctor if you · have kidney disease; · have liver disease; · have asthma, bronchitis, emphysema, or another respiratory disease; or · are depressed or have suicidal thoughts. • You may not be able to take diazepam, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above. • Diazepam is in the FDA pregnancy category D. This means that diazepam is known to harm an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant. • Diazepam passes into breast milk. Do not take diazepam without first talking to your doctor if you are breast-feeding a baby. • If you are over 65 years of age, you may be more likely to experience side effects from diazepam. You may require a lower dose of this medication. How should I take diazepam? • Take diazepam exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you. • Take each oral dose with a full glass of water. • To ensure the correct dose, measure the liquid forms of diazepam with a dose-measuring spoon or cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one. • Your doctor or nurse will give you detailed instructions for administration of the Diastat rectal gel. In general, application of the rectal gel is as follows: · Remove the protective cover from the medication syringe and lubricate the rectal tip with lubricating jelly. · Turn the person on their side facing you. Bend the upper leg forward and separate the buttocks to expose the rectum. · Gently insert the syringe tip into the rectum. The rim should be snug against the rectal opening. Slowly count out loud to three while gently pushing the plunger in until it stops. Slowly count to three before removing the syringe. Slowly count to three and hold the buttocks together to prevent leakage. · Keep the person on their side facing you, note the time the medication was given, and observe the person for signs of seizure, skin color, breathing, or any unusual reaction. • Do not take diazepam more often or in larger doses than is prescribed. • Diazepam is habit forming. You can become physically and psychologically dependent on the medication. Do not take more than the prescribed amount of medication or take it for longer than is directed by your doctor. Withdrawal effects may occur if diazepam is stopped suddenly after several weeks of continuous use. Your doctor may recommend a gradual reduction in dose. • Store diazepam at room temperature away from moisture and heat. What happens if I miss a dose? • Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the dose you missed and take only the next regularly scheduled dose. Do not take a double dose of this medication. A double dose could be dangerous. What happens if I overdose? • Seek emergency medical attention. • Symptoms of a diazepam overdose include sleepiness, dizziness, confusion, a slow heart beat, difficulty breathing, difficulty walking and talking, an appearance of being drunk, and unconsciousness. What should I avoid while taking diazepam? • Use caution when driving, operating machinery, or performing other hazardous activities. Diazepam will cause drowsiness and may cause dizziness. If you experience drowsiness or dizziness, avoid these activities. • Avoid alcohol while taking diazepam. Alcohol may increase drowsiness and dizziness caused by diazepam. Alcohol may also increase the risk of having a seizure if diazepam is being taken for a seizure condition. • Diazepam may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, seizure medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any medicine without first talking to your doctor. What are the possible side effects of diazepam? • If you experience any of the following serious side effects, stop taking diazepam and seek emergency medical attention or contact your doctor immediately: · an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, face, or tongue; or hives); · sores in the mouth or throat; · yellowing of the skin or eyes; · a rash; · hallucinations or severe confusion; or · changes in your vision. • Other, less serious side effects may be more likely to occur. Continue to take diazepam and talk to your doctor if you experience · drowsiness, dizziness, or clumsiness; · depression; · nausea, vomiting, diarrhea, or constipation; · difficulty urinating; · vivid dreams; · headache; · dry mouth; · decreased sex drive; or · changes in behavior. • Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. What other drugs will affect diazepam? • Diazepam may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, seizure medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any medicine without first talking to your doctor. • Antacids may decrease the effects of diazepam. Separate doses of an antacid and diazepam by several hours whenever possible. • Drugs other than those listed here may also interact with diazepam. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines. VALIUM® brand of diazepam INJECTION For relief of acute anxiety when rapid action is required In acute alcohol withdrawal As a useful adjunct in • endoscopic procedures • skeletal muscle spasm associated with local pathology, cerebral palsy, athetosis, stiff-man syndrome, tetanus • status epilepticus and severe recurrent convulsive seizures As premedication in patients undergoing • surgical procedures • cardioversion DESCRIPTION Each mL contains 5 mg diazepam compounded with 40% propylene glycol, 10% ethyl alcohol, 5% sodium benzoate and benzoic acid as buffers, and 1.5% benzyl alcohol as preservative. Diazepam is a benzodiazepine derivative developed through original Roche research. Chemically, diazepam is 7-chloro-1,3-dihydro-1-methyl-5-phenyl-2H-1,4-benzodiazepin-2-one. It is a colorless crystalline compound, insoluble in water and has a molecular weight of 284.74. Its structural formula is as follows: Buy Valium Online Without Prescription VALIUM - 30 tabs x 2mg for $49; x 5mg $69. International Online Pharmacy. No prescription required, worldwide shipping, discreet packaging, reliable service, low prices. http://www.allmedspharmacy.net Find valium Info Here Looking for valium then Google it! http://google.xrfl.com/ Buy Valium (Diazepam) Online Get the lowest prices on all medications like Valium (Diazepam) from the best online pharmacies. http://www.the-info-planet.com/diazepam.htm valium on The Best Broadband Site on the Internet Heavy.com is the best broadband site on the internet, offering the best free videos, music and so much more. Check it out! http://www.heavy.com Valium (diazepam) is in a class of drugs called benzodiazepines. Valium (diazepam) affects chemicals in the brain that may become unbalanced and cause anxiety, seizures, and muscle spasms. Valium (diazepam) is used to relieve anxiety, nervousness, and tension associated with anxiety disorders. It is also used to treat certain types of seizure disorders and muscle spasms. Valium (diazepam) may also be used for purposes other than those listed in this medication guide. Valium can be habit-forming or addictive. You may experience withdrawal symptoms if you stop using this drug abruptly. Discontinue or change your dose only on your doctor's advice. Special warnings about Valium: Valium may cause you to become drowsy or less alert; therefore, you should not drive or operate dangerous machinery or participate in any hazardous activity that requires full mental alertness until you know how this drug affects you. If you have liver or kidney problems, use this medication cautiously. Valium slows down the central nervous system and may intensify the effects of alcohol. Do not drink alcohol while taking this medication.

Diazepam (pronounced da???z?p?m, marketed under brand names Valium, Stesolid, Seduxen, Bosaurin and Apozepam)[1] is a drug which is a benzodiazepine derivative. It possesses anxiolytic, anticonvulsant, sedative, skeletal muscle relaxant and amnestic properties. This makes it a useful drug for treating anxiety, insomnia, seizures, alcohol withdrawal, and muscle spasms. It is also used before certain medical procedures (such as endoscopies) to reduce tension and anxiety, and in some surgical procedures to induce amnesia.[2][3] Diazepam is a core medicine in the World Health Organization's "Essential Drugs List", which is a list of minimum medical needs for a basic health care system.[4] Diazepam is used to treat a wide range of conditions and is one of the most frequently prescribed benzodiazepines. Contents [hide] 1 Benzodiazapine 2 History 3 Pharmacokinetics 4 Indications 4.1 Veterinary uses 5 Dosage 5.1 Adult dosage recommendations 5.2 Pediatric dosage recommendations 5.3 Availability 6 Side effects 7 Interactions 8 Contraindications 8.1 Special caution needed 8.2 Patients at a high risk for abuse and dependence 9 Withdrawal 10 Overdose 11 Recreational use 12 Legal status 13 Physical properties 14 Trivia 15 External links 16 References 17 Footnotes [edit] Benzodiazapine Diazepam is a benzodiazepine that binds to a specific subunit on the GABAA receptor at a site that is distinct from the endogenous GABA molecule.[5][6]The GABAA receptor is an inhibitory channel which, when activated, decreases neurologic activity. Due to the role of diazepam as a positive allosteric modulator of GABA, when it binds to benzodiazepine receptors it causes inhibitory effects. This arises from the hyperpolarization of the postsynaptic membrane, due to the control exerted over negative chloride ions by GABAA receptors.[5][7] Diazepam appears to act on areas of the limbic system, thalamus and hypothalamus, inducing anxiolytic effects. Its actions are due to the enhancement of GABA activity.[2][5] [edit] History Diazepam was the second benzodiazepine to be invented by Leo Sternbach of Hoffmann-La Roche, and was approved for use in 1963. It is five times more potent than its predecessor, chlordiazepoxide, which it quickly surpassed in terms of sales. After this initial success, other pharmaceutical companies began to introduce other benzodiazepine derivatives.[8] The benzodiazepines gained popularity among medical professionals as an improvement upon barbiturates, which have a comparatively narrow therapeutic index, and are far more sedating at therapeutic doses. The benzodiazepines are also far less dangerous; death rarely results from diazepam overdose, except in cases where it is consumed with large amounts of other depressants (such as alcohol or other sedatives).[9] Diazepam was the top-selling pharmaceutical in the United States from 1969 to 1982, with peak sales in 1978 of 2.3 billion pills.[8] Over the years, physicians, psychiatrists and neurologists have discovered many new off-label uses for diazepam, such as treatment of spastic paresis and palliative treatment of stiff-person syndrome.[10] [edit] Pharmacokinetics Diazepam can be administered orally, intravenously, intramuscularly, or as a suppository.[11] When diazepam is administered orally, it is rapidly absorbed and has a fast onset of action. The onset of action is 1-5 minutes for IV administration and 15-30 minutes for IM administration. The duration of the diazepam's main pharmacological effects is 15 minutes to 1 hour for both routes of administration.[12] Peak plasma levels are achieved 30 minutes to 2 hours after oral administration. When diazepam is administered as an intramuscular injection, absorption is slow, erratic and incomplete.[1][13] Diazepam is highly lipid-soluble, and is widely distributed throughout the body after administration. It easily crosses both the blood-brain barrier and the placenta, and is excreted into breast milk. After absorption, diazepam is redistributed into muscle and adipose tissue. Continual daily doses of diazepam will quickly build up to a high concentration in the body (mainly in adipose tissue), which will be far in excess of the actual dose for any given day.[11][13] Diazepam is metabolised in the liver via the cytochrome P450 enzyme system. It has a biphasic half-life of 1-2 and 2-5 days, and has several pharmacologically active metabolites. The main active metabolite of diazepam is desmethyldiazepam (also known as nordazepam or nordiazepam). Diazepam's other active metabolites include te

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