Seek emergency medical attention or call the Poison Help line at There are several uses for diazepam which have been approved by the U. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to the fetus. Withdrawal symptoms can occur even after short-term use of diazepam and can range from mild to major withdrawal symptoms. A List of Prescription Medications Muscle relaxers are drugs that can help relieve muscle cramps and spasticity.
There have been reports of neonatal flaccidity, respiratory and feeding difficulties, and hypothermia in children born to mothers who have been receiving benzodiazepines late in pregnancy. In addition, children born to mothers receiving benzodiazepines on a regular basis late in pregnancy may be at some risk of experiencing withdrawal symptoms during the postnatal period.
Cleft palate and encephalopathy are the most common and consistently reported malformations produced in these species by administration of high, maternally toxic doses of diazepam during organogenesis. Rodent studies have indicated that prenatal exposure to diazepam doses similar to those used clinically can produce long-term changes in cellular immune responses, brain neurochemistry, and behavior.
In general, the use of diazepam in women of childbearing potential, and more specifically during known pregnancy, should be considered only when the clinical situation warrants the risk to the fetus. The possibility that a woman of childbearing potential may be pregnant at the time of institution of therapy should be considered. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to the fetus.
Patients should also be advised that if they become pregnant during therapy or intend to become pregnant they should communicate with their physician about the desirability of discontinuing the drug. Special care must be taken when Valium is used during labor and delivery, as high single doses may produce irregularities in the fetal heart rate and hypotonia , poor sucking, hypothermia, and moderate respiratory depression in the neonates.
With newborn infants it must be remembered that the enzyme system involved in the breakdown of the drug is not yet fully developed especially in premature infants. Diazepam passes into breast milk. Breastfeeding is therefore not recommended in patients receiving Valium. The usual precautions are indicated for severely depressed patients or those in whom there is any evidence of latent depression or anxiety associated with depression, particularly the recognition that suicidal tendencies may be present and protective measures may be necessary.
Should this occur, use of the drug should be discontinued. These reactions are more likely to occur in children and the elderly. A lower dose is recommended for patients with chronic respiratory insufficiency , due to the risk of respiratory depression. Benzodiazepines should be used with extreme caution in patients with a history of alcohol or drug abuse see Drug Abuse And Dependence.
In debilitated patients, it is recommended that the dosage be limited to the smallest effective amount to preclude the development of ataxia or oversedation 2 mg to 2. Some loss of response to the effects of benzodiazepines may develop after repeated use of Valium for a prolonged time. The data currently available are inadequate to determine the mutagenic potential of diazepam. Safety and effectiveness in pediatric patients below the age of 6 months have not been established.
In elderly patients, it is recommended that the dosage be limited to the smallest effective amount to preclude the development of ataxia or oversedation 2 mg to 2. Extensive accumulation of diazepam and its major metabolite, desmethyldiazepam, has been noted following chronic administration of diazepam in healthy elderly male subjects. Metabolites of this drug are known to be substantially excreted by the kidney, and the risk of toxic reactions may be greater in patients with impaired renal function.
Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function. Decreases in clearance and protein binding, and increases in volume of distribution and half-life have been reported in patients with cirrhosis. In such patients, a 2- to 5- fold increase in mean half-life has been reported. Delayed elimination has also been reported for the active metabolite desmethyldiazepam. Benzodiazepines are commonly implicated in hepatic encephalopathy.
Pharmacokinetics in Special Populations: Overdose of benzodiazepines is usually manifested by central nervous system depression ranging from drowsiness to coma. In mild cases, symptoms include drowsiness, confusion, and lethargy. In more serious cases, symptoms may include ataxia , diminished reflexes, hypotonia , hypotension , respiratory depression, coma rarely , and death very rarely. Overdose of benzodiazepines in combination with other CNS depressants including alcohol may be fatal and should be closely monitored.
Following overdose with oral benzodiazepines, general supportive measures should be employed including the monitoring of respiration , pulse , and blood pressure. Vomiting should be induced within 1 hour if the patient is conscious. Gastric lavage should be undertaken with the airway protected if the patient is unconscious. Intravenous fluids should be administered. If there is no advantage in emptying the stomach, activated charcoal should be given to reduce absorption.
Special attention should be paid to respiratory and cardiac function in intensive care. General supportive measures should be employed, along with intravenous fluids, and an adequate airway maintained. Should hypotension develop, treatment may include intravenous fluid therapy, repositioning, judicious use of vasopressors appropriate to the clinical situation, if indicated, and other appropriate countermeasures. Dialysis is of limited value. As with the management of intentional overdosage with any drug, it should be considered that multiple agents may have been ingested.
Flumazenil, a specific benzodiazepine-receptor antagonist , is indicated for the complete or partial reversal of the sedative effects of benzodiazepines and may be used in situations when an overdose with a benzodiazepine is known or suspected. Prior to the administration of flumazenil, necessary measures should be instituted to secure airway, ventilation and intravenous access.
Flumazenil is intended as an adjunct to, not as a substitute for, proper management of benzodiazepine overdose. Patients treated with flumazenil should be monitored for resedation, respiratory depression and other residual benzodiazepine effects for an appropriate period after treatment. The prescriber should be aware of a risk of seizure in association with flumazenil treatment, particularly in long-term benzodiazepine users and in cyclic antidepressant overdose. Caution should be observed in the use of flumazenil in epileptic patients treated with benzodiazepines.
Withdrawal symptoms of the barbiturate type have occurred after the discontinuation of benzodiazepines see Drug Abuse And Dependence. Valium is contraindicated in patients with a known hypersensitivity to diazepam and, because of lack of sufficient clinical experience, in pediatric patients under 6 months of age. Valium is also contraindicated in patients with myasthenia gravis , severe respiratory insufficiency, severe hepatic insufficiency, and sleep apnea syndrome.
It may be used in patients with open-angle glaucoma who are receiving appropriate therapy, but is contraindicated in acute narrow-angle glaucoma. Diazepam is a benzodiazepine that exerts anxiolytic, sedative , musclerelaxant, anticonvulsant and amnestic effects. Most of these effects are thought to result from a facilitation of the action of gamma aminobutyric acid GABA , an inhibitory neurotransmitter in the central nervous system.
Absorption is delayed and decreased when administered with a moderate fat meal. In the presence of food mean lag times are approximately 45 minutes as compared with 15 minutes when fasting. There is also an increase in the average time to achieve peak concentrations to about 2. Diazepam and its metabolites cross the blood-brain and placental barriers and are also found in breast milk in concentrations approximately one tenth of those in maternal plasma days 3 to 9 post-partum.
In young healthy males, the volume of distribution at steady-state is 0. The decline in the plasma concentration-time profile after oral administration is biphasic. N-desmethyldiazepam and temazepam are both further metabolized to oxazepam. Temazepam and oxazepam are largely eliminated by glucuronidation. The initial distribution phase is followed by a prolonged terminal elimination phase half-life up to 48 hours.
The terminal elimination half-life of the active metabolite N-desmethyldiazepam is up to hours. Diazepam and its metabolites are excreted mainly in the urine, predominantly as their glucuronide conjugates. Diazepam accumulates upon multiple dosing and there is some evidence that the terminal elimination half-life is slightly prolonged. In full term infants, elimination half-lives around 30 hours have been reported, with a longer average half-life of 54 hours reported in premature infants of 28 - 34 weeks gestational age and 8 - 81 days post-partum.
In both premature and full term infants the active metabolite desmethyldiazepam shows evidence of continued accumulation compared to children. Longer half-lives in infants may be due to incomplete maturation of metabolic pathways. Elimination half-life increases by approximately 1 hour for each year of age beginning with a half-life of 20 hours at 20 years of age.
This appears to be due to an increase in volume of distribution with age and a decrease in clearance. Consequently, the elderly may have lower peak concentrations, and on multiple dosing higher trough concentrations. It will also take longer to reach steady-state. Conflicting information has been published on changes of plasma protein binding in the elderly. Reported changes in free drug may be due to significant decreases in plasma proteins due to causes other than simply aging.
Do you yourself have a potential problem with Valium? Or learn more about next steps for prescription pill addicts here. Hello, My Mom is taking valium 10mg 3x a day for the past several years. She is also taking Prozac 20mg 3x a day. Thank you for your reply. HI there, I am just wondering what the effects are of diazepam when mixed with heroin? I have heard that it is very dangerous and can be fatal.
Would this occur with even a small dose of diazepam? Thank you for any insight you can give. Both heroin and diazepam are central nervous system depressants. When taken together, heroin and Valium have an additive effect on one another and your heart can slow down, as well a breathing. When combined, this can lead to overdose or death! In fact, using pills and heroin within 12 hours of each other is the single largest cause of fatal overdose in the U. More on overdose interventions here: For break through pain, doctors usually prescribe hydrocodone or oxycodone the main ingredient in Percocet.
Hi , in currently in the process of trying to get a diagnosis of hyperparathyroidism. I possibly have underlying thyroid issues as well. Since the horrible symptoms started almost 18 months ago I started taking 5 mg of Valium since may not every day but when I was feeling really anxious or teary and and emotional due to whatever hormonal issue I have.
I take 5 mg every two or 3 days … For muscle pain as well from parathyroid disease. Is that considered addiction? You are in quite a specific situation. I believe your question will be better answered by a doctor or pharmacist. You should also check to find out if the thyroid medications interact with diazepam, in which case, you may need to wait to get your system cleaned from it, and start using the new meds afterwards.
My husband who is doctor has. Have you spoken with him about your concern? Stick to the facts, including data on becoming dependent on Valium http: If he is not addicted, he will be able to stop using Valium with the help of his prescribing doctor and an individualized tapering plan. I wish you my best! When i left i was prescribed 50 pills and to take 3 per day only have had for 3 days and lost the rest i am worried if i should see my doctor because im worried about seisures because of not finishing script.
Valium is used to treat anxiety disorders, alcohol withdrawal symptoms, or muscle spasms. Sometimes, it is used with other medications to treat seizures. Anyway dentist perscribed me Valium 5mg and wants me to take it an hour before my next appointment…. Is it going to help with the pain of the shot and if not do I really need it.
I lost my husband end of Jan. I was trying to find something that I could take maybe once a week so I can sleep through the night. I found pills my dr. I flushed in toilet. Is there anything that would keep me sleep for 8 hours without morning grogginess. My friend takes valium but I think should not be taken every night. She also looks at the computer. Any suggestions for me?