Talk to your doctor if you have glaucoma. For people with a history of drug or alcohol abuse: You may have a higher risk for becoming addicted, dependent, or tolerant to diazepam. For people with liver disease: Diazepam is processed by your liver. If you have liver problems, more of this drug may stay in your body, putting you at risk for side effects. Your doctor may adjust your dose of diazepam and monitor you more closely.
For people with mental health issues: Diazepam may make these problems worse. Your doctor will monitor you more closely. For people with myasthenia gravis: Myasthenia gravis is a disease that causes extreme muscle weakness and tiredness. For people with breathing problems: Let your doctor know if you have breathing problems. Diazepam affects your central nervous system and may make it more difficult for you to breathe or cause you to stop breathing.
Your doctor may start you on a lower dose and monitor you more closely. If your breathing problems are severe or if you have sleep apnea, your doctor may prescribe a different medication for you instead. Diazepam is a category D pregnancy drug. That means two things:. Taking this drug during pregnancy may cause babies to be born with deformities, muscle weakness, breathing and eating problems, low body temperatures, and withdrawal symptoms.
Diazepam should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. For women who are breastfeeding: Diazepam passes into breast milk and can cause serious effects in a child who is breastfed. Seniors may have a higher risk of side effects, such as motor ataxia loss of muscle coordination while you move. This drug may also have more of a sedative effect in seniors. You may experience more dizziness, sleepiness, confusion, or a slowing or stopping of breathing.
Your doctor will prescribe the lowest dose possible to control your symptoms. Keep this drug out of the reach of children. This dosage information is for diazepam oral tablet. All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:. The standard dose is 10 mg taken by mouth 3—4 times during the first 24 hours. This will be reduced to 5 mg taken 3—4 times per day as needed. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages.
Always to speak with your doctor or pharmacist about dosages that are right for you. Diazepam oral tablet is used for short-term treatment. If you miss a dose: Never try to catch up by taking two doses at once. This could cause toxic side effects. If you take too much: Taking too much of this drug can cause depression of your central nervous system CNS. This may even be fatal. You may be given the drug flumazenil to reverse a benzodiazepine overdose.
This drug may increase your risk of seizures. How to tell the drug is working: It is not known if diazepam is effective for long-term use specifically longer than 4 months. Your doctor will regularly reassess your condition to see if diazepam is still appropriate for you to take. This drug may be refilled if your doctor authorizes it on the prescription.
It may only be refilled up to five times within 6 months after the prescription was given. Your doctor will decide the right dose for you. If needed, your doctor will slowly and carefully increase your dose to avoid side effects. Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional.
You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects.
The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses. Valium and Xanax are both benzodiazepines, which are minor tranquilizers that can help with anxiety. Though they're similar, they're not exactly alike. Anxiolytics are used to prevent and treat symptoms of acute anxiety related to many conditions.
Learn about these drugs and the special considerations. Muscle relaxers are drugs that can help relieve muscle cramps and spasticity. Learn about the different options. Clonazepam Klonopin is used to treat panic disorder and seizures. Learn about side effects, warnings, dosage, and more. Discover why a class of drugs used to help curb insomnia and anxiety has become an important component of an effective bipolar treatment regimen.
Lorazepam and Xanax are both benzodiazepines that provide a tranquilizing effect. Read about their differences and similarities. Several types of drugs can help relieve anxiety alongside therapy. Learn what drugs are available and how they work. Learn about over 20 different medications used to treat seizures and epilepsy in this list of antiepileptic drugs AEDs.
Diazepam, as with other benzodiazepine drugs, can cause tolerance, physical dependence, substance use disorder , and benzodiazepine withdrawal syndrome. Withdrawal from diazepam or other benzodiazepines often leads to withdrawal symptoms similar to those seen during barbiturate or alcohol withdrawal. The higher the dose and the longer the drug is taken, the greater the risk of experiencing unpleasant withdrawal symptoms.
Withdrawal symptoms can occur from standard dosages and also after short-term use, and can range from insomnia and anxiety to more serious symptoms, including seizures and psychosis. Withdrawal symptoms can sometimes resemble pre-existing conditions and be misdiagnosed. Diazepam may produce less intense withdrawal symptoms due to its long elimination half-life. Benzodiazepine treatment should be discontinued as soon as possible by a slow and gradual dose reduction regimen.
Dose increases may overcome the effects of tolerance, but tolerance may then develop to the higher dose and adverse effects may increase. The mechanism of tolerance to benzodiazepines includes uncoupling of receptor sites, alterations in gene expression , down-regulation of receptor sites, and desensitisation of receptor sites to the effect of GABA. About one-third of individuals who take benzodiazepines for longer than four weeks become dependent and experience withdrawal syndrome on cessation.
Rebound anxiety, more severe than baseline anxiety, is also a common withdrawal symptom when discontinuing diazepam or other benzodiazepines. Improper or excessive use of diazepam can lead to dependence. Patients from the aforementioned groups should be monitored very closely during therapy for signs of abuse and development of dependence. Therapy should be discontinued if any of these signs are noted, although if dependence has developed, therapy must still be discontinued gradually to avoid severe withdrawal symptoms.
Long-term therapy in such instances is not recommended. People suspected of being dependent on benzodiazepine drugs should be very gradually tapered off the drug. Withdrawals can be life-threatening, particularly when excessive doses have been taken for extended periods of time. Equal prudence should be used whether dependence has occurred in therapeutic or recreational contexts.
An individual who has consumed too much diazepam typically displays one or more of these symptoms in a period of approximately four hours immediately following a suspected overdose: Although not usually fatal when taken alone, a diazepam overdose is considered a medical emergency and generally requires the immediate attention of medical personnel. The antidote for an overdose of diazepam or any other benzodiazepine is flumazenil Anexate. This drug is only used in cases with severe respiratory depression or cardiovascular complications.
Because flumazenil is a short-acting drug, and the effects of diazepam can last for days, several doses of flumazenil may be necessary. Artificial respiration and stabilization of cardiovascular functions may also be necessary. Though not routinely indicated, activated charcoal can be used for decontamination of the stomach following a diazepam overdose.
Dialysis is minimally effective. Hypotension may be treated with levarterenol or metaraminol. Overdoses of diazepam with alcohol, opiates or other depressants may be fatal. If diazepam is administered concomitantly with other drugs, attention should be paid to the possible pharmacological interactions. Particular care should be taken with drugs that potentiate the effects of diazepam, such as barbiturates, phenothiazines , opioids , and antidepressants.
Diazepam does not increase or decrease hepatic enzyme activity, and does not alter the metabolism of other compounds. No evidence would suggest diazepam alters its own metabolism with chronic administration. Agents with an effect on hepatic cytochrome P pathways or conjugation can alter the rate of diazepam metabolism.
These interactions would be expected to be most significant with long-term diazepam therapy, and their clinical significance is variable. Diazepam is a long-acting "classical" benzodiazepine. Other classical benzodiazepines include chlordiazepoxide , clonazepam , lorazepam , oxazepam , nitrazepam , temazepam , flurazepam , bromazepam , and clorazepate.
Diazepam inhibits acetylcholine release in mouse hippocampal synaptosomes. This has been found by measuring sodium-dependent high-affinity choline uptake in mouse brain cells in vitro , after pretreatment of the mice with diazepam in vivo. This may play a role in explaining diazepam's anticonvulsant properties. Diazepam binds with high affinity to glial cells in animal cell cultures. Binding of benzodiazepines to this receptor complex promotes binding of GABA, which in turn increases the total conduction of chloride ions across the neuronal cell membrane.
This increased chloride ion influx hyperpolarizes the neuron's membrane potential. As a result, the difference between resting potential and threshold potential is increased and firing is less likely. As a result, the arousal of the cortical and limbic systems in the central nervous system is reduced. Diazepam appears to act on areas of the limbic system , thalamus , and hypothalamus , inducing anxiolytic effects.
Benzodiazepine drugs including diazepam increase the inhibitory processes in the cerebral cortex. The anticonvulsant properties of diazepam and other benzodiazepines may be in part or entirely due to binding to voltage-dependent sodium channels rather than benzodiazepine receptors. Sustained repetitive firing seems limited by benzodiazepines' effect of slowing recovery of sodium channels from inactivation.
The muscle relaxant properties of diazepam are produced via inhibition of polysynaptic pathways in the spinal cord. Diazepam can be administered orally, intravenously must be diluted, as it is painful and damaging to veins , intramuscularly IM , or as a suppository. When administered orally, it is rapidly absorbed and has a fast onset of action. The onset of action is one to five minutes for IV administration and 15—30 minutes for IM administration.
The duration of diazepam's peak pharmacological effects is 15 minutes to one hour for both routes of administration. The half-life of diazepam in general is 30—56 hours. The distribution half-life of diazepam is two to 13 minutes. When diazepam is administered IM, absorption is slow, erratic, and incomplete. Diazepam is highly lipid-soluble, and is widely distributed throughout the body after administration.
It easily crosses both the blood—brain barrier and the placenta , and is excreted into breast milk. After absorption, diazepam is redistributed into muscle and adipose tissue. Continual daily doses of diazepam quickly build to a high concentration in the body mainly in adipose tissue , far in excess of the actual dose for any given day.
Diazepam is stored preferentially in some organs, including the heart. Absorption by any administered route and the risk of accumulation is significantly increased in the neonate , and withdrawal of diazepam during pregnancy and breast feeding is clinically justified. It has several pharmacologically active metabolites. The main active metabolite of diazepam is desmethyldiazepam also known as nordazepam or nordiazepam.
Its other active metabolites include the minor active metabolites temazepam and oxazepam. These metabolites are conjugated with glucuronide, and are excreted primarily in the urine. Because of these active metabolites, the serum values of diazepam alone are not useful in predicting the effects of the drug. Diazepam has a biphasic half-life of about one to three days, and two to seven days for the active metabolite desmethyldiazepam.
Diazepam is a 1,4-benzodiazepine. It is odorless, and has a slightly bitter taste. The British Pharmacopoeia lists it as being very slightly soluble in water, soluble in alcohol, and freely soluble in chloroform. The United States Pharmacopoeia lists diazepam as soluble 1 in 16 ethyl alcohol, 1 in 2 of chloroform, 1 in 39 ether , and practically insoluble in water.
The pH of diazepam is neutral i. The solution for parenteral injection should be protected from light and kept from freezing. The oral forms should be stored in air-tight containers and protected from light. Diazepam can absorb into plastics, so liquid preparations should not be kept in plastic bottles or syringes, etc. As such, it can leach into the plastic bags and tubing used for intravenous infusions. Absorption appears to depend on several factors, such as temperature, concentration, flow rates, and tube length.
Diazepam should not be administered if a precipitate has formed and does not dissolve. Diazepam may be quantified in blood or plasma to confirm a diagnosis of poisoning in hospitalized patients, provide evidence in an impaired driving arrest, or to assist in a medicolegal death investigation. Blood or plasma diazepam concentrations are usually in a range of 0. Most commercial immunoassays for the benzodiazepine class of drugs cross-react with diazepam, but confirmation and quantitation are usually performed using chromatographic techniques.
Diazepam was the second benzodiazepine invented by Leo Sternbach of Hoffmann-La Roche at the company's Nutley, New Jersey , facility  following chlordiazepoxide Librium , which was approved for use in Released in as an improved version of Librium, diazepam became incredibly popular, helping Roche to become a pharmaceutical industry giant. After this initial success, other pharmaceutical companies began to introduce other benzodiazepine derivatives. The benzodiazepines gained popularity among medical professionals as an improvement over barbiturates , which have a comparatively narrow therapeutic index , and are far more sedative at therapeutic doses.
The benzodiazepines are also far less dangerous; death rarely results from diazepam overdose, except in cases where it is consumed with large amounts of other depressants such as alcohol or opioids. Marketed by Roche using an advertising campaign conceived by the William Douglas McAdams Agency under the leadership of Arthur Sackler,  diazepam was the top-selling pharmaceutical in the United States from to , with peak annual sales in of 2.
It is also the first line of defense for a rare disorder called stiff-person syndrome. Diazepam is a drug of potential abuse and can cause drug dependence. Urgent action by national governments has been recommended to improve prescribing patterns of benzodiazepines such as diazepam. Diazepam drug misuse can occur either through recreational misuse where the drug is taken to achieve a high or when the drug is continued long term against medical advice.
Sometimes, it is used by stimulant users to "come down" and sleep and to help control the urge to binge. In this regard, benzodiazepines are second only to opiates , the study found in Males abuse benzodiazepines as commonly as females. Other benzodiazepines and zolpidem and zopiclone also were found in high numbers. Many drivers had blood levels far exceeding the therapeutic dose range, suggesting a high degree of abuse potential for benzodiazepines and zolpidem and zopiclone.
Diazepam was the most commonly detected benzodiazepine. Diazepam is regulated in most countries as a prescription drug:. The states of California and Florida offer diazepam to condemned inmates as a pre-execution sedative as part of their lethal injection program, although the state of California has not executed a prisoner since Diazepam is used as a short-term sedative and anxiolytic for cats and dogs,  sometimes used as an appetite stimulant.
From Wikipedia, the free encyclopedia. D Evidence of risk. S4 Prescription only CA: Archived from the original on Principles of addiction medicine 4 ed. British Journal of Clinical Pharmacology. National Institute of Health: National Library of Medicine. Oral surgery for the general dentist. A Review of the Literature". Archived PDF from the original on 13 December Retrieved 8 December International Drug Price Indicator Guide.
Archived from the original on 28 March Retrieved 2 December Archived from the original on December 24, European Journal of Neurology. Okoromah, Christy AN, ed. Cochrane Database of Systematic Reviews 1: