Diazepam injection usp

By | 28.03.2018

diazepam injection usp

Skin and subcutaneous tissue disorders: Enhanced CNS depressant effects of sodium oxybate with concomitant benzodiazepines. Intravenous injection may be associated with local reactions and thrombophlebitis and venous thrombosis may occur. It should not be used, especially in the first and third trimesters, unless the benefit is considered to outweigh the risk. Diazepam Solution Read Reviews 7.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction , including: This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. Call your doctor for medical advice about side effects. In Canada - Call your doctor for medical advice about side effects.

You may report side effects to Health Canada at List Diazepam Syringe side effects by likelihood and severity. Before using diazepam , tell your doctor or pharmacist if you are allergic to it; or to oxazepam or temazepam ; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details. Before using this medication , tell your doctor or pharmacist your medical history, especially of: This drug may make you dizzy or drowsy or blur your vision.

Alcohol or marijuana can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Talk to your doctor if you are using marijuana. Older adults may be more sensitive to the side effects of this drug, especially drowsiness and loss of coordination. These side effects can increase the risk of falling. This medication is not recommended for use during pregnancy.

It may harm an unborn baby. If you become pregnant or think you may be pregnant, tell your doctor right away. Consult your doctor for more details. This drug passes into breast milk and may have undesirable effects on a nursing infant. Breast -feeding while using this medication is not recommended. Consult your doctor before breast-feeding. What should I know regarding pregnancy, nursing and administering Diazepam Syringe to children or the elderly? Drug interactions may change how your medications work or increase your risk for serious side effects.

This document does not contain all possible drug interactions. Do not start, stop, or change the dosage of any medicines without your doctor's approval. Some products that may interact with this drug include: Tell your doctor or pharmacist if you are taking other products such as opioid pain or cough relievers such as codeine, hydrocodone , alcohol, marijuana , other drugs for sleep or anxiety such as alprazolam , lorazepam , zolpidem , muscle relaxants such as carisoprodol , cyclobenzaprine , or antihistamines such as cetirizine , diphenhydramine.

Check the labels on all your medicines such as allergy or cough -and-cold products because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely. Does Diazepam Syringe interact with other medications? Should I avoid certain foods while taking Diazepam Syringe? If someone has overdosed and has serious symptoms such as passing out or trouble breathing , call Otherwise, call a poison control center right away. US residents can call their local poison control center at Canada residents can call a provincial poison control center.

Symptoms of overdose may include: Do not share this medication with others. It is against the law. This medication is not usually given on a regular schedule. Store at room temperature away from light and moisture. Do not refrigerate or freeze. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company. Information last revised September Copyright c First Databank, Inc. To be taken into consideration by patients on a controlled sodium diet. This medicinal product contains Harmful for those suffering from alcoholism.

To be taken into account in pregnant or breast-feeding women, children and high-risk groups such as patients with liver disease or epilepsy. Enhanced sedation or respiratory or CNS depression with concomitant administration of diazepam. Concomitant use should be avoided. General anaesthetics and narcotic analgesics: Enhanced sedation or respiratory and cardiovascular depression.

If such centrally acting depressant drugs are given parenterally in conjunction with intravenous diazepam, severe respiratory and cardiovascular depression may occur; careful monitoring is required. When intravenous diazepam is to be administered concurrently with a narcotic analgesic agent e. Premedication with diazepam may decrease the dose of fentanyl derivatives required for induction of anaesthesia.

Agents that interfere with metabolism by hepatic enzymes isoniazid and to a lesser extent erythromycin may reduce the clearance of diazepam and potentiate its action. Known inducers of hepatic enzymes, for example, rifampicin, may increase the clearance of benzodiazepines diazepam. Enhanced sedation or respiratory or CNS depression with concomitant administration of mirtazapine or tricyclic antidepressants.

Diazepam plasma levels increased by concomitant fluvoxamine or fluoxetine. Enhanced sedaion or respiratory and cardiovascular depression. Known inducers of hepatic enzymes, for example, carbamazepine, phenobarbital and phenytoin, may increase the clearance of benzodiazepines, however, despite enzyme stimulation, the net effect of adding these antiepileptics can be augmentation of benzodiazepine-induced sedation.

Serum phenytoin levels may rise, fall or remain unaltered. In addition, phenytoin may cause diazepam serum levels to fall. Concomitant sodium valproate may increase serum levels of diazepam, with associated drowsiness. Enhanced sedation or respiratory and cardiovascular depression with sedative antihistamines. Enhanced hypotensive effect with concomitant administration of ACE inhibitors or beta-blockers or calcium-channel blockers or hydralazine.

Enhanced sedative effect with alpha blockers and possibly moxonidine. Increased plasma concentrations of zotepine. Severe hypotension, collapse, respiratory depression, potentially fatal respiratory arrest and unconsciousness have been reported in a few patients on benzodiazepines and clozapine. Caution is advised when initiating clozapine therapy in patients taking benzodiazepines.

Increased risk of hypotension, bradycardia and respiratory depression with concomitant administration of parenteral benzodiazepines with intramuscular olanzapine. Enhanced sedation or respiratory and cardiovascular depression with other anxiolytics. Reduced clearance of digoxin. Enhanced hypotensive effect when benzodiazepines and diuretics are used concomitantly. Increased CNS depressant effects with baclofen and tizanidine.

Diazepam metabolism is accelerated by smoking. Enhanced hypotensive effect when benzodiazepines and nitrates are used concomitantly. May reduce the clearance of diazepam and may potentiate its actions. Enhanced CNS depressant effects of sodium oxybate with concomitant benzodiazepines. Cimetidine, omeprazole and esomeprazole have been shown to reduce the clearance of diazepam and may potentiate its actions. Diazepam metabolism is accelerated by theophylline.

Sedative effects of diazepam reduced by caffeine. Sedative effects of diazepam reversed with concomitant administration of aminophylline 4. It should not be used, especially in the first and third trimesters, unless the benefit is considered to outweigh the risk. If the product is prescribed to a woman of childbearing potential she should be warned to contact her physician regarding the discontinuance of the product if she intends to become or suspects that she is pregnant.

There may be a small increase in the risk of congenital malformation, particularly oral cleft, with the use of benzodiazepines in the first trimester. In labour, high single doses or repeated low doses have been reported to produce effects on the neonate, such as hyperbilirubinaemia, hypothermia, hypotonia, respiratory depression and poor suckling floppy infant syndrome in the neonate and irregularities in the foetal heart.

Infants born to mothers who take benzodiazepines chronically during the latter stages of pregnancy may develop physical dependence and may be at some risk for developing withdrawal symptoms in the postnatal period. A small number of children exposed in utero to benzodiazepines have shown slow development in the early years but by four years of age had developed normally.

Since benzodiazepines are found in the breast milk, benzodiazepines should not be given to breast feeding mothers. This medicine can impair cognitive function and can affect a patient's ability to drive safely. This class of medicine is in the list of drugs included in regulations under 5a of the Road of Traffic Act When prescribing this medicine, patients should be told: Blood and lymphatic system disorders: Blood dyscrasias including thrombocytopenia and agranulocytosis have been reported with diazepam.

Hypersensitivity reactions, including anaphylaxis, are rare. In susceptible patients, an unnoticed depression may become evident. Paradoxical reactions including aggression, rage, hostility, hallucinations, nightmares, disinhibition, euphoria, excitation, irritability, restlessness, increased anxiety, agitation, inappropriate behaviour and insomnia are known to occur with benzodiazepines and may be quite severe with diazepam.

They are more likely to occur in children and the elderly. Elderly or debilitated patients are particularly susceptible to the CNS effects of benzodiazepines. It is recommended that dosage be limited to the smallest effective dose and increased gradually, if necessary, to decrease the possibility of development of ataxia, dizziness, and oversedation, which may lead to falls and other accidents see 4. Long term use of benzodiazepines in the elderly may be associated with an increased risk of dementia.

Headaches, confusion, slurred speech, tremor, reduced alertness and drowsiness. Anterograde amnesia may occur using therapeutic doses, the risk increasing at higher doses see 4. Amnestic effects may be associated with inappropriate behaviour. Extrapyramidal effects and convulsions have occurred rarely with diazepam. Ear and labyrinth disorders: Rarely, vertigo Cardiac disorders: Hypotension, particularly with high dosage, bradycardia, chest pain. Cardiac arrest may occur with diazepam injection.

Diazepam injection may be associated with thrombophlebitis and venous thrombosis. Respiratory, thoracic and mediastinal disorders: Rarely, respiratory depression and apnoea, particularly with high dosage. Rarely, salivation changes, including dry mouth or excessive salivation and gastrointestinal disturbances including nausea. Raised liver enzymes, jaundice and cholestasis. Skin and subcutaneous tissue disorders: Skin reactions such as Steven-Johnson syndrome, urticaria, rash.

Musculoskeletal and connective tissue disorders: Renal and urinary disorders: Reproductive system and breast disorders: Inhibition of female orgasm, changes in libido, gynaecomastia and rarely, increased prolactin levels and galactorrhoea. Plasma testosterone concentrations may be increased in men taking diazepam.

General disorders and administration site conditions: Fatigue and a hangover effect. Diazepam injection may be associated with pain. Inadvertent intra-arterial administration of diazepam has resulted in ischaemia and tissue necrosis. Development of dependence is common after regular use, even in therapeutic doses for short periods, particularly in patients with a history of drug or alcohol abuse or marked personality disorders. Discontinuation may be associated with withdrawal symptoms or rebound phenomena see 4.

Rare and more serious withdrawal symptoms include muscle twitching, confusional or paranoid psychosis, convulsions, hallucinations, and a state resembling delirium tremens. Broken sleep with vivid dreams and increased REM sleep may persist for some weeks after withdrawal of benzodiazepines. Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme www.

Cardiac rate and rhythm remain normal in the absence of anoxia or severe hypotension. In severe overdose, deep coma, or other manifestations of severe depression of brainstem vital functions, particularly the respiratory centre, may occur. Coma usually lasts for only a few hours but in elderly people it may be more protracted and cyclical. Benzodiazepine respiratory depressant effects are more serious in patients with severe chronic respiratory disease. As drug levels fall, severe agitation, insomnia and, possibly, major convulsions may develop.

Benzodiazepines potentiate the effects of other central nervous system depressants, including alcohol. Respiration, heart rate, blood pressure and body temperature should be monitored and supportive measures taken to maintain cardiovascular and respiratory function. Flumazenil is indicated to counteract the central depressive effect of benzodiazepines but expert advice is essential since adverse effects may occur e. Flumazenil should not be used in mixed overdoses or as a diagnostic test.

Flumazenil is contraindicated in the presence of drugs that reduce seizure threshold e. In addition, diazepam demonstrates muscle relaxant and anticonvulsive properties. It is used in the short-term treatment of anxiety and tension states, as a sedative and premedicant, in the control of muscle spasm and in the management of alcohol withdrawal symptoms. Diazepam binds to specific receptors in the central nervous system and particular peripheral organs. After binding to the benzodiazepine receptor, diazepam augments the inhibitory effect of GABA-ergic transmission.

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