Omudhome Ogbru, PharmD
Omudhome Ogbru, PharmD
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Medical and Pharmacy Editor:
GENERIC NAME: diazepam
BRAND NAME: Valium, Diastat
DRUG CLASS: Diazepam is an oral medication that is used to treat anxiety. It belongs to the benzodiazepine family of drugs, 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. The FDA approved diazepam in November 1963.
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 2, 5 and 10 mg. Oral Solution: 1 mg/ml, 5 mg/ml. Injection Solution: 5 mg/ml. Intramuscular Device: 10 mg/2 ml. Rectal Gel: 2.5, 10 and 20 mg.
STORAGE: Diazepam should be stored at room temperature, 15 C to 30 C (59 F to 86 F).
PRESCRIBED FOR: Diazepam is used for the treatment of disorders with anxiety. 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, relief of muscle spasms in some neurological diseases, and for sedation during surgery.
DOSING: Diazepam may be taken with or without food. Diazepam is disposed of 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 for anxiety or seizures 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), itraconazole (Sporanox), omeprazole (Prilosec, Rapinex), erythromycin, clarithromycin (Biaxin), darunavir (Prezista), ( (fluvoxamine (Luvox), and fluoxetine (Prozac) may prolong the effects of diazepam by inhibiting liver enzymes that eliminate diazepam. Dosages may need to be decreased when these drugs are used with diazepam.
PREGNANCY: Benzodiazepines, including 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 also are 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 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 stopped.
Reference: FDA Prescribing Information
Last Editorial Review: 4/1/2013
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