[dye-AYZ-eh-pam] Pregnancy Category: D

Apo-Diazepam M, Diastat, Diazemuls M, Diazepam Intensol, Dizac, E Pam M, Meval M, Novo-Dipam M, PMS-Diazepam M, Valium, Valium Roche M, Vivol M [C-IV] [Rx] Classification: Antianxiety agent, anticonvulsant, skeletal muscle relaxant

See also Sedative Hynotics. Action/Kinetics: The skeletal muscle relaxant effect of diazepam may be due to enhancement of GABA-medi-ated presynaptic inhibition at the spinal level as well as in the brain stem reticular formation. Onset: PO, 30-60 min; IM, 15-30 min; IV, more rapid. Peak plasma levels: PO, 0.5-2 hr; IM, 0.5-1.5; IV, 0.25 hr. Duration: 3 hr. tyi: 20-50 hr. Metabolized in the liver to the active metabolites desmethyldiazepam, oxazepam, and temazepam. Diazepam and metabolites are excreted through the urine. Diazepam is 97%-99% bound to plasma protein. Uses: Anxiety, tension (more effective than chlordiazepoxide), alcohol withdrawal, muscle relaxant, adjunct to treat seizure disorders, antipanic drug. Used prior to gastroscopy and esophagoscopy, preoperatively and prior to cardioversion. In dentistry to induce sedation. Treatment of status epilepticus. Relief of skeletal muscle spasm due to inflammation of muscles or joints or trauma; spasticity caused by upper motor neuron disorders such as cerebral palsy and paraplegia; athetotis; and stiff-man syndrome. Relieve spasms of facial muscles in occlusion and temporomandibular joint disorders. IV: Status epilepticus, severe recurrent seizures, and tetanus. Rectal gel: Treat epilepsy in those with stable regimens of anti-convulsant drugs who require intermittent diazepam to control increased seizure activity. Additional Contraindications: Narrow-angle glaucoma, children under 6 months, lactation, and pa-renterally in children under 12 years. Special Concerns: When used as an adjunct for seizure disorders, diazepam may increase the frequency or severity of clonic-tonic seizures, for which an increase in the dose of anticonvulsant medication is necessary. Safety and efficacy of parenteral diazepam have not been determined in neonates less than 30 days of age. Prolonged CNS depression has been observed in neonates, probably due to inability to biotransform diazepam into inactive metabolites.

Additional Drug Interactions: Diaz-epam potentiates antihypertensive effects of thiazides and other diuretics.

Diazepam potentiates muscle relaxant effects of d-tubocurarine and gallamine.

Fluoxetine / T Half-life of diaze-pam.

Isoniazid / T Half-life of diazepam. Ranitidine / l GI absorption of di-azepam.

How Supplied: Concentrate: 5 mg/mL; Injection: 5 mg/mL; Solution: 5 mg/5 mL; Tablet 2 mg, 5 mg, 10 mg


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