Medications and Drugs
Pharmacy Author: Omudhome Ogbru, PharmD
Medical and Pharmacy Editor: Jay W. Marks, MD
GENERIC NAME: diazepam
BRAND NAME: Valium, Diastat
DRUG CLASS: Diazepam is an anti-anxiety medication in the benzodiazepine
family, the same family that includes alprazolam (Xanax), clonazepam (Klonopin),
lorazepam (Ativan), flurazepam (Dalmane), and others. Diazepam and other
benzodiazepines act by enhancing the effects of gamma-aminobutyric acid (GABA)
in the brain. GABA is a neurotransmitter (a chemical that nerve cells use to
communicate with each other) that inhibits activity in the brain. It is believed
that excessive activity in the brain may lead to anxiety or other psychiatric
disorders.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 2, 5, and 10 mg. Solution: 5 mg/ml. Injection: 5
mg/ml. Rectal Gel: 2.5, 10, and 20 mg.
STORAGE: Diazepam should be stored at room temperature, 15-30°C (59-86°F).
PRESCRIBED FOR: Diazepam is used for the treatment of anxiety disorders.
Diazepam also is used for the treatment of agitation,
tremors, delirium,
seizures, and hallucinations resulting from
alcohol withdrawal. It is used for
the treatment of seizures and relief of muscle spasms in some neurological
diseases.
DOSING: Diazepam may be taken with or without food. Diazepam is metabolized
by the liver and excreted mainly by the kidney. Dosages of diazepam may need to
be lowered in patients with abnormal kidney function. The usual oral diazepam
dose is 2-10 mg given 2-4 times daily. The usual rectal dose is 0.2-0.5 mg/kg
and depends on the age of the patient.
DRUG INTERACTIONS: Alcohol or medications that cause sedation may add to the
sedative effects of diazepam. Patients taking benzodiazepines should avoid such
combinations.
Cimetidine (Tagamet), ketoconazole
(Nizoral), omeprazole
(Prilosec, Rapinex), fluvoxamine
(Luvox), and fluoxetine
(Prozac) may prolong
the effects of diazepam by inhibiting liver enzymes that break down diazepam.
Dosages may need to be decreased when these drugs are used with diazepam.
PREGNANCY: Benzodiazepines, such as diazepam, can cause fetal abnormalities
and should not be used during pregnancy.
NURSING MOTHERS: Diazepam is excreted in
breast milk and can affect nursing
infants. Therefore, diazepam should not be used by women who are nursing.
SIDE EFFECTS: The most frequent side effects of diazepam are drowsiness,
fatigue, and ataxia (loss of balance). Rarely, diazepam causes a paradoxical
reaction with excitability, muscle spasm, lack of sleep, and rage.
Confusion,
depression, speech problems, and double vision are also rare side effects of
diazepam.
Diazepam can lead to addiction (dependency), especially when higher dosages
are used over prolonged periods of time. In patients addicted to diazepam or
after prolonged use, abrupt discontinuation of the medicine may cause symptoms
of withdrawal (insomnia,
headaches,
nausea,
vomiting, lightheadedness, sweating,
anxiety, and fatigue). Seizures can occur in more severe cases of withdrawal.
Therefore, after extended use, diazepam should be slowly tapered under a
doctor's supervision rather than abruptly stopping the medication.
Reference: FDA Prescribing Information
Last Editorial Review: 1/30/2008
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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