Geriatric patients and patients with hepatic impairment may have prolonged elimination half-lives of diazepam and its metabolites. Importance of informing clinicians about any concomitant illnesses, particularly depression. Accessed Aug Clinical importance not determined; consider possible need for diazepam dosage reduction Position statement on the use of rectal diazepam in epilepsy.
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|Diazepam 10mg tablets by teva||Use with caution in depressed patients; potential for suicidal tendencies. Drugs for pediatric diazepam. Periodically reassess usefulness for treatment of anxiety. North Potassium, IL; Jan. American Society of Health-System Pharmacists; administration Buccal midazolam and rectal diazepam for treatment of prolonged seizures in childhood and adolescence: Importance of informing patients of other important precautionary information.|
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Potential for drug to impair mental alertness or physical coordination; use caution when operating machinery or performing hazardous tasks until effects on individual are known. Upon receiving Diastat AcuDial from the pharmacy and again prior to administering a dose, importance of verifying accuracy of prescription e. Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs, and alcohol consumption.
Importance of informing clinicians about any concomitant illnesses, particularly depression. Importance of women informing their clinician if they are or plan to become pregnant or plan to breast-feed. Importance of informing patients of other important precautionary information. Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.
Interaction of disulfiram with benzodiazepines. Klotz U, Reimann I. Delayed clearance of diazepam due to cimetidine. N Engl J Med. Influence of cimetidine on oral diazepam elimination with measurement of subsequent cognitive change. Br J Clin Pharmacol. Am J Hosp Pharm. Elevation of steady-state diazepam levels by cimetidine. Digoxin levels and diazepam. Hypnotics and sedatives; ethanol: Neurohumoral transmission and the central nervous system: The GABA-benzodiazepine interaction fifteen years later.
Ann NY Acad Sci. Benzodiazepine receptor subtypes and their possible clinical significance. From binding studies to the molecular biology of GABA receptors. Pharmacology of the benzodiazepine receptor. Eur Arch Psychiatry Neurol Sci. Co-localization of GABA receptors and benzodiazepine receptors in the brain shown by monoclonal antibodies.
Endogenous ligands of the benzodiazepine receptor. Valium diazepam tablets prescribing information. Diazepam in immediate post-myocardial infarct period: Diastat and Diastat AcuDial diazepam rectal gel prescribing information. A single-blind, crossover comparison of the pharmacokinetics and cognitive effects of a new diazepam rectal gel with intravenous diazepam. A comparison of rectal diazepam gel and placebo for acute repetitive seizures.
Special pharmacokinetic considerations in children Epilepsia. Treating repetitive seizures with a rectal diazepam formulation: American Academy of Pediatrics Committee on Drugs. Drugs for pediatric emergencies. Position statement on the use of rectal diazepam in epilepsy. Buccal midazolam and rectal diazepam for treatment of prolonged seizures in childhood and adolescence: Rectal diazepam for prehospital pediatric status epilepticus.
Rectal diazepam gel for treatment of acute repetitive seizures: An open-label study of repeated use of diazepam rectal gel Diastat for episodes of acute breakthrough seizures and clusters: North American Diastat Group. Respiratory depression in children receiving diazepam for acute seizures: Dev Med Child Neurol. Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult.
Am J Health-Syst Pharm. Accessed Aug Dispensing Diastat AcuDial diazepam rectal gel: Diastat AcuDial diazepam rectal gel: US Food and Drug Administration. Information for healthcare professionals: Rockville, MD; Mar Dear pharmacist letter regarding cracks in the plastic tips of some Diastat AcuDial diazepam rectal gel applicators. Valeant Pharmaceuticals; Feb.
Fluvoxamine maleate tablets prescribing information. Ponoma, NY; Jan. Invirase saquinavir mesylate capsules prescribing information. Nutley, NJ; Sep. Norvir ritonavir soft gelatin capsules and oral solution prescribing information. North Chicago, IL; Jan. Lexiva fosamprenavir calcium tablets prescribing information. FDA warns about serious risks and death when combining opioid pain or cough medicines with benzodiazepines; requires its strongest warning.
Silver Spring, MD; Aug Pharmaceutical overdose deaths, United States, Letter to manufacturers of benzodiazepines: Accessed Mar Letter to manufacturers of opioid antitussives: Benzodiazepine prescribing patterns and deaths from drug overdose among US veterans receiving opioid analgesics: Am J Prev Med. New York City emergency department discharge opioid prescribing guidelines. From NYC Health website.
Interagency guideline on prescribing opioids for pain, 3rd ed. AHFS drug information American Society of Hospital Pharmacists; Valium diazepam injection prescribing information. Nutley, NJ; Mar. Handbook on injectable drugs. American Society of Health-System Pharmacists; Siberry GK, Iannone R, eds. The Harriet Lane Handbook. Diazepam oral solution and diazepam Intensol oral solution concentrate prescribing information.
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We comply with the HONcode standard for trustworthy health information - verify here. Warning Concomitant Use with Opiates Concomitant use of benzodiazepines and opiates may result in profound sedation, respiratory depression, coma, and death. Drug or Test Interaction Comments Amitriptyline Possible increased plasma amitriptyline concentrations a Clinical importance not determined a Antacids e. Use concomitantly only if alternative treatment options are inadequate; use lowest effective dosages and shortest possible duration of concomitant therapy; monitor closely for respiratory depression and sedation In patients receiving diazepam, initiate opiate analgesic, if required, at reduced dosage and titrate based on clinical response Reduce opiate dosage by at least one-third and administer in small increments when diazepam is administered IV concurrently with an opiate analgesic b c In patients receiving an opiate analgesic, initiate diazepam, if required for any indication other than epilepsy, at lower dosage than indicated in the absence of opiate therapy and titrate based on clinical response Opiate antitussives: Avoid concomitant use Consider offering naloxone to patients receiving benzodiazepines and opiates concomitantly Mineral oil Possible decreased GI absorption of diazepam a Phenobarbital Possible decreased plasma diazepam concentrations Phenytoin Possible decreased plasma diazepam concentrations Quinidine Possible increased plasma diazepam concentrations Rifampin Possible decreased plasma diazepam concentrations Tests for urinary glucose Possible false positive reactions for glucose with Clinistix and Diastix a Reaction does not occur with Tes-Tape a Tranylcypromine Possible increased plasma diazepam concentrations Troleandomycin Possible increased plasma diazepam concentrations Print this page Add to My Med List.
Diazepam Rating User Reviews 8. Possible increased plasma diazepam concentrations The most common reason for diazepam failing to stop a seizure is that enough was not given. In general, use 1 ml IV for small dogs 5 - 10 kg , 2 ml IV for medium dogs 10 - 20 kg and 3 ml or more IV for large dogs greater than 20 kg. For cats use 0. If you cannot get IV access give double the IV dose rectally. Use a red rubber feeding tube inserted about 4 - 6 inches in the rectum and given as a bolus.
If after giving a dose of diazepam the seizure does not stop within 2 - 3 minutes IV or 5 min rectal then give another dose. It is not that uncommon to have to give 2 - 4 doses of valium before the seizure stops. It sounds like a lot but it is very safe. If an animal has compromised liver function or you are suspicious of liver disease shunt or cirrhosis etc Once the seizure is stopped you can give a loading dose of phenobarbital or potassium bromide.
If you are going to refer the patient immediately, it might be better to wait on the loading dose so a more accurate exam can be performed. If the patient continues to have seizures after the initial doses of valium, they should be placed on a valium constant rate infusion. Use the amount of valium that it took to stop the seizure and give it over one hour as a CRI. Dilute the phenobarbital in 1 part saline to one part phenobarbital and give it IV slowly. There have been anecdotal reports of animals having an anaphylactic reaction to components of the injectable form of phenobarbital.