diazepam

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)

• Valium, Diastat Acudial, Diastat, and Diazepam Intensol are the brand names for diazepam available in the US.
• Dizac, Qpam, and Valrelease brand names have been discontinued in the US.

Yes

Yes

• 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.

Warning: 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 such as:

• Insomnia
• Headaches
• Nausea
• Vomiting
• Lightheadedness
• Sweating
• Anxiety
• 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.

The most common side effects of diazepam are:

• Drowsiness
• Fatigue
• Diarrhea
• Rash
• Euphoria
• Ataxia (loss of balance)

Other important side effects include:

• Paradoxical reactions with excitability
• Muscle spasm
• Lack of sleep
• Rage
• Confusion
• Speech problems
• Double vision

Possible serious side effects:

• Respiratory depression
• Neutropenia
• Depression

• 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.

Alcohol or medications that cause sedation may add to the sedative effects of diazepam. Patients taking benzodiazepines should avoid such combinations.

The following drugs may prolong the effects of diazepam by inhibiting liver enzymes that eliminate diazepam:

• cimetidine (Tagamet)
• ketoconazole (Nizoral)
• itraconazole (Sporanox)
• omeprazole (Prilosec, Rapinex)
• erythromycin
• clarithromycin (Biaxin)
• darunavir (Prezista)
• fluvoxamine (Luvox)
• fluoxetine (Prozac)

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.

• Benzodiazepines, including diazepam, can cause fetal abnormalities and should not be used during pregnancy.
• Diazepam is excreted in breast milk and can affect nursing infants. Therefore, diazepam should not be used by women who are nursing.

What preparations of Valium (diazepam) are available?

• 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.

How should I keep Valium (diazepam) stored?

• Diazepam should be stored at room temperature, 15 C to 30 C (59 F to 86 F).

How does Valium (diazepam) work?

• 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.

When was Valium (diazepam) approved by the FDA?

• The FDA approved diazepam in November 1963.