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- Valium (diazepam) vs. midazolam: What's the difference
- What are diazepam and midazolam?
- What are the side effects of diazepam and midazolam?
- What is the dosage of diazempam vs. midazolam?
- What drugs interact with diazepam and midazolam?
- Are diazepam and midazolam safe to use while pregnant or breastfeeding?
Valium (diazepam) vs. midazolam: What's the difference
- Diazepam (Valium) and midazolam are benzodiazepines used for sedation during surgery and to treat seizures.
- Diazepam is also used to treat anxiety, alcohol withdrawal symptoms, and for relief of muscle spasms in some neurological diseases.
- Brand names for diazepam include Valium, Diastat Acudial, Diastat, and Diazepam Intensol.
- Side effects of diazepam and midazolam that are similar include sedation and drowsiness.
- Side effects of diazepam that are different from midazolam include fatigue, diarrhea, rash, euphoria, loss of balance, excitability, muscle spasm, lack of sleep, rage, confusion, speech problems, and double vision.
- Side effects of midazolam that are different from diazepam include difficulty breathing, nausea, vomiting, and pain at the injection site.
- Withdrawal symptoms such as insomnia, headaches, nausea, vomiting, lightheadedness, sweating, anxiety, fatigue, and seizures (in severe cases) may occur if you suddenly stop taking diazepam or midazolam.
What are diazepam and midazolam?
Diazepam is a benzodiazepine used to treat anxiety, alcohol withdrawal symptoms, seizures, for relief of muscle spasms in some neurological diseases, and for sedation during surgery. 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. Excessive activity in the brain may lead to anxiety or other psychiatric disorders.
Midazolam is a benzodiazepine used for sedation. Excessive activity of nerves in the brain may cause anxiety and other psychological disorders. Gamma-aminobutyric acid (GABA) is a neurotransmitter, a chemical that nerves in the brain use to send messages to one another. GABA reduces the activity of nerves in the brain. Midazolam and other benzodiazepines may act by enhancing the effects of GABA in the brain.
What are the side effects of diazepam and midazolam?
The most common side effects of diazepam are:
Other important side effects include:
- Paradoxical reactions with excitability
- Muscle spasm
- Lack of sleep
- Speech problems
- Double vision
Possible serious side effects:
The most common side effects associated with midazolam are:
- Difficulty breathing
- Pain at the injection site
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What is the dosage of diazempam vs. midazolam?
- 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 to 10 mg given 2 to 4 times daily.
- The usual rectal dose is 0.2 to 0.5 mg/kg and depends on the age of the patient.
Midazolam is given by intramuscular or intravenous injection. The dose for sedation during surgery is 0.5 to 1 mg given over 2 minutes and not to exceed 2.5 mg per dose. Doses may be repeated after 2 to 3 minutes. Total doses greater than 5 mg usually are not needed. The dose for starting anesthesia is 200 to 350 mcg/kg injected intravenously over 20 to 30 seconds.
What drugs interact with diazepam and midazolam?
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)
- clarithromycin (Biaxin)
- darunavir (Prezista)
- fluvoxamine (Luvox)
- fluoxetine (Prozac)
Dosages may need to be decreased when these drugs are used with diazepam.
Midazolam and all benzodiazepines interact with other medications and drugs that slow the brain's processes such as alcohol, barbiturates, narcotics, and tranquilizers. Boceprevir (Victrelis), itraconazole (Sporanox), nelfinavir (Viracept), and telaprevir (Incivek) increase blood level of midazolam by reducing its breakdown in the liver and, therefore, can increase the side effects of midazolam.
Are diazepam and midazolam safe to use while pregnant or breastfeeding?
- 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.
Midazolam and other benzodiazepines have been associated with fetal damage, including congenital malformations, when taken by pregnant women in their first trimester. Midazolam is best avoided if at all possible in the first trimester and probably throughout pregnancy.
Midazolam is secreted in breast milk.
Diazepam (Valium) and midazolam are benzodiazepines used for sedation during surgery and to treat seizures. Diazepam is also used to treat anxiety, alcohol withdrawal symptoms, and for relief of muscle spasms in some neurological diseases.
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Related Disease Conditions
Muscle spasms are involuntary muscle contractions that come on suddenly and are usually quite painful. Dehydration, doing strenuous exercise in a hot environment, prolonged muscle use, and certain diseases of the nervous system may cause muscle spasms. Symptoms and signs of a muscle spasm include an acute onset of pain and a possible bulge seen or felt beneath the skin where the muscle is located. Gently stretching the muscle usually resolves a muscle spasm.
Seizures Symptoms and Types
Seizures are divided into two categories: generalized and partial. Generalized seizures are produced by electrical impulses from throughout the brain, while partial seizures are produced by electrical impulses in a small part of the brain. Seizure symptoms include unconsciousness, convulsions, and muscle rigidity.
Anxiety is a feeling of apprehension and fear characterized by symptoms such as trouble concentrating, headaches, sleep problems, and irritability. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults. Treatment for anxiety may incorporate medications and psychotherapy.
Alcoholism is a disease that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law. It can cause myriad health problems, including cirrhosis of the liver, birth defects, heart disease, stroke, psychological problems, and dementia. Counseling and a few medications can be effective for alcoholism treatment.
Epilepsy is a brain disorder in which the person has seizures. There are two kinds of seizures, focal and generalized. There are many causes of epilepsy. Treatment of epilepsy (seizures) depends upon the cause and type of seizures experienced.
Panic attacks are sudden feelings of terror that strike without warning. These episodes can occur at any time, even during sleep. A person experiencing a panic attack may believe that he or she is having a heart attack or that death is imminent. The fear and terror that a person experiences during a panic attack are not in proportion to the true situation and may be unrelated to what is happening around them. Most people with panic attacks experience several of the following symptoms: racing heartbeat, faintness, dizziness, numbness or tingling in the hands and fingers, chills, chest pains, difficulty breathing, and a feeling of loss or control. There are several treatments for panic attacks.
Seizure vs. Seizure Disorders (Differences and Similarities)
The differences between a seizure, epilepsy, and seizure disorders are confusing to many people. What makes it more confusing, is that they are not the same thing. A seizure begins suddenly, and is a symptom of another disease. When a seizure occurs there is uncontrolled activity in the brain that usually only lasts for a short period. While a seizure disorder is a medical condition, in which the person has episodes of uncontrolled activity in the brain producing symptoms that include one or more seizures. Epilepsy is considered a seizure disorder.There are two types of major seizures, generalized and partial seizure type and the symptoms depend upon the part of the brain affected, and may include: Loss of consciousness Thought disturbances Convulsions Eye rolling Stiff limbs Twitching on only one side or a portion of the body like an arm or leg. Involuntary urination or bowel movement Repetitive shaking or jerking of the body Staring into space, sometimes with eye blinking No loss of consciousness, but the person becomes confused for a few minutes A third type of seizure is called unclassified seizure.Seizure disorders are classified under two types of major seizures (generalized and partial), and a third type called unclassified seizures. There are about 40 types of named seizure disorders. The symptoms and signs are different depending on the part of the brain affected by the seizure. Examples of seizure disorders are: Febrile seizures Benign Rolandic epilepsy Catamenial epilepsy Absence seizures Frontal lobe epilepsy Epilepsy Sometimes there is a known cause for a seizure like alcohol, cocaine or other illegal drug abuse, drug reactions, a severe chemical imbalance in the blood, or medical problems like low blood pressure. Treatment, management, and prevention of seizures include medication and avoiding any known causes or common triggers. REFERENCES: CDC. "Types of Seizures." Updated: Apr 10, 2017.Harvard Health Publications; Harvard Medical School. "Generalized Seizures (Grand Mal Seizures)."
Treatment & Diagnosis
Medications & Supplements
- Benzodiazepines (Benzodiazepine Drug Class)
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