Diazepam

• Type of Drug: Benzodiazepine tranquilizer.
• Prescribed for: Relief of anxiety, tension, fatigue, agitation, muscle spasm, and seizures; irritable bowel syndrome; panic attacks.

General Information

Diazepam and the other drugs named above are benzodiazepines, used as antianxiety agents, anticonvulsants, or sedatives. Some are more suited to a specific role because of differences in chemical makeup that give them greater activity in a certain area or characteristics that make them more desirable for a certain function. Often, individual drugs are limited by the applications for which their research has been sponsored. Benzodiazepines directly affect the brain. In doing so, they can relax you and make you either more tranquil or sleepier, or can slow nervous system transmissions in such a way as to act as an anticonvulsant, depending on which drug you use and your dosage. Many doctors prefer the benzodiazepines to other drugs that can be used for similar effects because they tend to be safer, have fewer side effects, and are usually as, if not more, effective.

Cautions and Warnings

Do not take Diazepam if you know you are sensitive or allergic to it or to another benzodiazepine drug; including Clonazepam.

Diazepam can aggravate narrow-angle glaucoma. However, if you have open-angle glaucoma, you may take it. Check with your doctor.

Other conditions where Diazepam should be avoided are severe depression, severe lung disease, sleep apnea (intermittent breathing while sleeping), liver disease, drunkenness, and kidney disease. In all of these conditions, the depressive effects of Diazepam may be enhanced and/or could be detrimental to your overall condition.

Diazepam should not be taken by psychotic patients, because it doesn’t work for them and can cause unusual excitement, stimulation, and rage.

Diazepam is not intended for more than 3 to 4 months of continuous use. Your condition should be reassessed before continuing your medicine beyond that time.

Diazepam may be addictive, and you can experience drug- withdrawal symptoms if you suddenly stop taking it after as little as 4 to 6 weeks of treatment. Withdrawal symptoms are increased anxiety, tingling in the extremities, sensitivity to bright light or the Sun, long periods of sleep or sleeplessness, a metallic taste, flulike illness, fatigue, difficulty concentrating, restlessness, loss of appetite, nausea, irritability, headache, dizziness, sweating, muscle tension or cramps, tremors, and feeling uncomfortable. Other major symptoms are confusion, abnormal perception of movement, depersonalization, paranoid delusions, hallucinations, psychotic reactions, muscle twitching, seizures, and memory loss.

Possible Side Effects

• Most common: mild drowsiness during the first few days of therapy. Weakness and confusion may also occur, especially in seniors and those who are more sickly. If these effects persist, contact your doctor.
• Less common: depression, lethargy, disorientation, headache, inactivity, slurred speech, stupor, dizziness, tremors, constipation, dry mouth, nausea; inability to control urination, sexual difficulties, irregular menstrual cycle, changes in heart rhythm, lowered blood pressure, fluid retention, blurred or double vision, itching, rash, hiccups, nervousness, inability to fall asleep, and occasional liver dysfunction. If you have any of these symptoms, stop taking the medicine, and contact your doctor at once.
• Other: diarrhea, coated tongue, sore gums, vomiting, appetite changes, swallowing difficulty, increased salivation, upset stomach, changes in sex drive, urinary difficulties, changes in heart rate, palpitations, swelling, stuffy nose, hearing difficulty, hair loss or gain, sweating, fever, tingling in. the hands or feet, breast pain, muscle disturbances, breathing difficulty, changes in blood components, and joint pain.

Drug Interactions

• Diazepam is a central-nervous-system depressant. Avoid alcohol, other tranquilizers, narcotics, barbiturates, monoamine oxidase {MAO) inhibitors, antihistamines, and antidepressants. Taking Diazepam with these drugs may result in excessive depression, drowsiness, or difficulty breathing.
• Smoking may reduce the effectiveness of Diazepam by increasing the rate at which it is broken down by the body.
• The effects of Diazepam may be prolonged when taken with Cimetidine, oral contraceptives, Disulfiram, Fluoxetine, Isoniazid, Ketoconazole, Rifampin, Metoprolol, Probenecid, Propoxyphene, Propranolol, and Valproic Acid.
• Theophylline may reduce the sedative effects of Diazepam.
• If you take antacids, separate them from your Diazepam dose by at least 1 hour to prevent them from interfering with the passage of Diazepam into the bloodstream.
• Diazepam may increase blood levels of Digoxin and the chances for Digoxin toxicity.
• Levodopa’s effect may be decreased if it is taken with Diazepam.
• Phenytoin blood concentrations may be increased if taken with Diazepam, resulting in possible Phenytoin toxicity.

Food Interactions

Diazepam is best taken on an empty stomach, but it may be taken with food if it upsets your stomach.

Usual Dose

Adult: 2 to 40 mg per day. The dose must be adjusted to Individual response for maximum effect.
Senior: less of the drug is usually required to control tension and anxiety.
Child (6 months and older): 1 to 2.5 mg, 3 or 4 times per day; more may be needed to control anxiety and tension. Infant (under 6 months): do not use.

Overdosage

Symptoms of overdosage are confusion, sleepiness, poor coordination, lack of response to pain (such as a pin prick), loss of reflexes, shallow breathing, low blood pressure/ and coma. The victim should be taken to a hospital emergency room. ALWAYS bring the medicine bottle with you.

Special Information

Diazepam can cause tiredness, drowsiness, inability to concentrate, or similar symptoms. Be careful if you are driving, operating machinery, or performing other activities that require concentration.

People taking Diazepam for more than 3 or 4 months at a time may develop drug-withdrawal reactions if the medication is stopped suddenly (see Cautions and Warnings).

If you forget a dose of Diazepam, take it as soon as you remember. If it is almost time for your next dose, skip the forgotten one and continue with your regular schedule. Do not take a double dose.

Special Populations

Pregnancy/Breast-feeding
Diazepam may cross info the developing fetal circulation and may cause birth defects if taken during the first 3 months of pregnancy. Avoid taking any benzodiazepine if you are or think you might be pregnant.
Diazepam may pass into breast milk. Since infants break the drug down more slowly than adults, the medicine may accumulate and have an undesirable effect on the baby. Nursing mothers who must take this drug should bottle-feed their babies.

Seniors
Older adults, especially those with liver or kidney disease, are more sensitive to the effects of Diazepam and generally require smaller doses to achieve the same effect. Follow your doctor’s directions, and report any side effects at once.