diazepam, Valium (cont.)

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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.

Carbamazepine (Tegretol), rifampin (Rifadin), and St. John's Wort decrease levels of diazepam by increasing the elimination of diazepam by liver enzymes.

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.

Medically Reviewed by a Doctor on 4/1/2013


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