What is diazepam?

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Generic Name: Diazepam Brand Name(s): Generics only. No brands available.

Know the basics

What is diazepam used for?

Diazepam is used to treat anxiety, acute alcohol withdrawal, and seizures. It is also used to relieve muscle spasms and to provide sedation before medical procedures. Diazepam belongs to a class of drugs called benzodiazepines which act on the brain and nerves (central nervous system) to produce a calming effect. Diazepam works by enhancing the effects of a certain natural chemical in the body (GABA).

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by yourhealth care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

Diazepam may also be used to prevent extremely bad nightmares (night terrors).

How should I take diazepam?

Take diazepam by mouth as directed by your doctor. The dosage is based on your medical condition, age, and response to therapy. If you are taking a liquid form of this medication, use a medication measuring device to carefully measure out the prescribed dose. Do not use a household spoon because you may not get the correct dose. If you are using the oral concentrate solution, use the dropper provided to carefully measure out the dose and mix it in liquid or soft food (e.g., applesauce, pudding) just before taking.

Use diazepam exactly as prescribed. Do not increase your dose, take it more frequently or use it for a longer period of time than prescribed because diazepam can be habit-forming. Also, if used for an extended period of time or for seizure control, do not suddenly stop using this drug without your doctor’s approval. Some conditions may become worse when the drug is abruptly stopped. Your dose may need to be gradually decreased.

When used for an extended period, this medication may not work as well and may require different dosing. Talk with your doctor if this medication stops working well.

Avoid eating grapefruit or drinking grapefruit juice while being treated with this medication unless your doctor instructs you otherwise. Grapefruit juice can increase the amount of certain medications in your bloodstream. Consult your doctor or pharmacist for more details.

Inform your doctor if your condition persists or worsens.

How do I store diazepam?

Diazepam is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store diazepam in the bathroom or the freezer. There may be different brands of diazepam that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush diazepam down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Know the precautions & warnings

What should I know before using diazepam?

Before taking diazepam,

  • tell your doctor and pharmacist if you are allergic to diazepam, alprazolam (Xanax), chlordiazepoxide (Librium, Librax), clonazepam (Klonopin), clorazepate (Tranxene), estazolam (ProSom), flurazepam (Dalmane), lorazepam (Ativan), oxazepam (Serax), prazepam (Centrax), temazepam (Restoril), triazolam (Halcion), or any other drugs.
  • tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially antihistamines; cimetidine (Tagamet); digoxin (Lanoxin); disulfiram (Antabuse); fluoxetine (Prozac); isoniazid (INH, Laniazid, Nydrazid); ketoconazole (Nizoral); levodopa (Larodopa, Sinemet); medications for depression, seizures, pain, Parkinson’s disease, asthma, colds, or allergies; metoprolol (Lopressor, Toprol XL); muscle relaxants; oral contraceptives; probenecid (Benemid); propoxyphene (Darvon); propranolol (Inderal); ranitidine (Zantac); rifampin (Rifadin); sedatives; sleeping pills; theophylline (Theo-Dur); tranquilizers; valproic acid (Depakene); and vitamins. These medications may add to the drowsiness caused by diazepam.
  • if you use antacids, take diazepam first, then wait 1 hour before taking the antacid.
  • tell your doctor if you have or have ever had glaucoma; seizures; or lung, heart, or liver disease.
  • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking diazepam, call your doctor immediately.

Talk to your doctor about the risks and benefits of taking diazepam if you are 65 years of age or older. Older adults should not usually take diazepam because it is not as safe as other medications that can be used to treat the same conditions.

  • if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking diazepam.
  • you should know that this drug may make you drowsy. Do not drive a car or operate machinery until you know how this drug affects you.
  • remember that alcohol can add to the drowsiness caused by this drug.
  • tell your doctor if you use tobacco products. Cigarette smoking may decrease the effectiveness of this drug.

Is it safe to take diazepam during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this medication during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking this medication. This medication is pregnancy risk category D according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown.

Know the side effects

What are the side effects of diazepam?

Common side effects of Valium include drowsiness, fatigue, constipation, and ataxia (loss of balance).

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • confusion, hallucinations, unusual thoughts or behavior;
  • unusual risk-taking behavior, decreased inhibitions, no fear of danger;
  • depressed mood, thoughts of suicide or hurting yourself;
  • hyperactivity, agitation, aggression, hostility;
  • new or worsening seizures;
  • weak or shallow breathing;
  • a feeling like you might pass out;
  • muscle twitching, tremor;
  • loss of bladder control;
  • little or no urinating.

Common side effects may include:

  • memory problems;
  • drowsiness, tired feeling;
  • dizziness, spinning sensation;
  • feeling restless or irritable;
  • muscle weakness;
  • nausea, constipation;
  • drooling or dry mouth, slurred speech;
  • blurred vision, double vision;
  • mild skin rash, itching;
  • loss of interest in sex.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Know the interactions

What drugs may interact with diazepam?

Diazepam may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Alfentanil, Amobarbital, Anileridine, Aprobarbital, Buprenorphine, Butabarbital, Butalbital, Carbinoxamine, Carisoprodol, Chloral Hydrate, Chlorzoxazone, Cobicistat, Codeine, Dantrolene, Eslicarbazepine Acetate, Ethchlorvynol, Etravirine, Fentanyl, Fosphenytoin, Fospropofol, Hydrocodone, Hydromorphone, Itraconazole, Ketorolac, Levorphanol, Meclizine, Meperidine, Mephenesin, Mephobarbital, Meprobamate, Metaxalone, Methadone, Methocarbamol, Methohexital, Mirtazapine, Morphine, Morphine Sulfate Liposome, Orlistat, Oxycodone, Oxymorphone, Pentobarbital, Phenobarbital, Phenytoin, Primidone, Propoxyphene, Remifentanil, Secobarbital, Sodium Oxybate, Sufentanil, Suvorexant, Tapentadol, Thiopental, Zolpidem.

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Amitriptyline, Amprenavir, Clarithromycin, Dalfopristin, Disulfiram, Erythromycin, Fluvoxamine, Ginkgo, Isoniazid, Perampanel, Quinupristin, Rifapentine, Roxithromycin, St John’s Wort, Theophylline, Troleandomycin.

Does food or alcohol interact with diazepam?

Diazepam may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

  • Grapefruit Juice.

What health conditions may interact with diazepam?

Diazepam may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have, especially:

  • Alcohol abuse, or history of,
  • Drug abuse or dependence, or history of—Dependence on diazepam may develop.
  • Breathing problems or lung disease, severe;
  • Glaucoma, narrow-angle;
  • Liver disease, severe;
  • Myasthenia gravis;
  • Sleep apnea (temporary stopping of breathing during sleep)—Should not be used in patients with these conditions.
  • Depression, or history of—Use with caution. May make this condition worse.
  • Kidney disease;
  • Liver disease, mild or moderate—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Understand the Dosage

The information provided is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist before using this medication.

What is the dose of Diazepam for an adult?

Usual Adult Dose for Anxiety

2 to 10 mg orally 2 to 4 times a day.
Intramuscular and Intravenous: 2 to 5 mg (moderate anxiety) or 5 to 10 mg (severe anxiety) for one dose. May repeat in 3 to 4 hours, if necessary.

Usual Adult Dose for Alcohol Withdrawal

10 mg orally 3 to 4 times during the first 24 hours, then 5 mg 3 to 4 times a day as needed.
Intramuscular and Intravenous: 5 to 10 mg one time. May repeat in 3 to 4 hours, if necessary.

Usual Adult Dose for ICU Agitation

Initial dose: 0.02 to 0.08 mg/kg Intravenous over 2 to 5 minutes every 0.5 to 2 hours to control acute agitation.
Maintenance dose: 0.4 to 0.2 mg/kg/hr by continuous Intravenous infusion.

Usual Adult Dose for Muscle Spasm

2 to 10 mg orally 3 to 4 times a day.
Intramuscular and Intravenous: 5 to 10 mg initially, then 5 to 10 mg in 3 to 4 hours, if necessary. For tetanus, larger doses may be required.

Usual Adult Dose for Seizures

2 to 10 mg orally 2 to 4 times a day.
Rectal gel: 0.2 mg/kg, rounded up to the nearest available unit dose. A supplemental dose of 2.5 mg may be added for more precise titration or if a portion of the first dose is expelled. May repeat in 4 to 12 hours. Maximum of 1 episode every 5 days, or 5 episodes per month.

Usual Adult Dose for Endoscopy or Radiology Premedication

Intravenous: 10 mg or less is usually adequate; however up to 20 mg may be necessary to produce the desired sedation in some patients.
Intramuscular: If Intravenous cannot be used, 5 to 10 mg 30 minutes prior to the procedure.
Dosage of narcotics should be reduced by at least a third and in some cases may be omitted.

Usual Adult Dose for Status Epilepticus

Intramuscular and Intravenous: 5 to 10 mg initially (Intravenous preferred).
May be repeated at 10 to 15 minute intervals up to a maximum dose of 30 mg.
If necessary, may be repeated again in 2 to 4 hours.

Usual Adult Dose for Light Anesthesia

Premedication for Anesthesia:
10 mg, Intramuscular (preferred route), 1 to 2 hours before surgery.

What is the dose of Diazepam for a child?

Usual Pediatric Dose for Seizures

Rectal gel: Infants less than 6 months old: Not recommended; product contains benzoic acid, benzyl alcohol, ethanol 10%, propylene glycol, and sodium benzoate. Prolonged CNS depression has been reported in neonates receiving diazepam.
Infants and Children 6 months to 2 years: Dose not established
2 to 5 years: 0.5 mg/kg, rounded up to the nearest available unit dose.
6 to 11 years: 0.3 mg/kg, rounded up to the nearest available unit dose.
12 years or greater: 0.2 mg/kg, rounded up to the nearest available unit dose.
A supplemental dose of 2.5 mg may be added in 10 minutes for more precise titration or if a portion of the first dose is expelled. May repeat in 4 to 12 hours. Maximum of 1 episode every 5 days, or 5 episodes per month.

Usual Pediatric Dose for Status Epilepticus

Neonates: Intravenous: (This is not recommended as a first line agent because the injection contains benzoic acid, benzyl alcohol, and sodium benzoate): 0.1 to 0.3 mg/kg/dose given over 3 to 5 minutes, every 15 to 30 minutes to a maximum total dose of 2 mg.

Infants greater than 30 days old and Children: Intravenous: 0.1 to 0.3 mg/kg dose given over 3 to 5 minutes, every 5 to 10 minutes (maximum of 10 mg/dose).

Manufacturer recommendation:

Infants greater than 30 days old and Children less than 5 years: Intravenous: 0.2 to 0.5 mg slow Intravenous every 2 to 5 minutes up to a maximum total dose of 5 mg. Repeat in 2 to 4 hours if needed.

Children greater than or equal to 5 years: Intravenous: 1 mg slow Intravenous every 2 to 5 minutes up to a maximum of 10 mg. Repeat in 2 to 4 hours if needed.

Usual Pediatric Dose for Anxiety

1 to 12 years:
0.12 to 0.8 mg/kg/day orally in divided doses every 6 to 8 hours as needed.

Intramuscular: 0.04 to 0.3 mg/kg every 2 to 4 hours as needed, up to a maximum of 0.6 mg/kg in 8 hours.

Febrile seizure prophylaxis in children: Oral: 1 mg/kg/day orally in divided doses every 8 hours. Initiate therapy at first sign of fever and continue for 24 hours after fever resolves.

Usual Pediatric Dose for Muscle Spasm

1 to 12 years:
0.12 to 0.8 mg/kg/day orally in divided doses every 6 to 8 hours as needed.

Intramuscular: 0.04 to 0.3 mg/kg every 2 to 4 hours as needed, up to a maximum of 0.6 mg/kg in 8 hours.

Febrile seizure prophylaxis in children: Oral: 1 mg/kg/day orally in divided doses every 8 hours. Initiate therapy at first sign of fever and continue for 24 hours after fever resolves.

Usual Pediatric Dose for Seizure Prophylaxis

1 to 12 years:
0.12 to 0.8 mg/kg/day orally in divided doses every 6 to 8 hours as needed.

Intramuscular: 0.04 to 0.3 mg/kg every 2 to 4 hours as needed, up to a maximum of 0.6 mg/kg in 8 hours.

Febrile seizure prophylaxis in children: 1 mg/kg/day orally in divided doses every 8 hours. Initiate therapy at first sign of fever and continue for 24 hours after fever resolves.

Usual Pediatric Dose for Light Sedation

Conscious sedation for procedures:
1 to 12 years: 0.2 to 0.3 mg/kg orally 45 to 60 minutes before procedure, up to a maximum of 10 mg
13 to 18 years: 5 mg orally 45 to 60 minutes before procedure, may repeat with 2.5 mg dose.

Sedation:
1 to 12 years:
0.02 to 0.3 mg/kg orally every 6 to 8 hours as needed.
Intramuscular: 0.04 to 0.3 mg/kg Intramuscular every 2 to 4 hours as needed, up to a maximum of 0.6 mg/kg in 8 hours.

13 to 18 years:
2 to 10 mg orally 2 to 4 times a day as needed.
Intramuscular and Intravenous: 2 to 10 mg 2 to 4 times a day as needed.

Usual Pediatric Dose for Tetanus

Less than 1 month: 0.83 to 1.67 mg/kg/hour by continuous intravenous infusion, or 1.67 to 3.33 mg/kg intravenous, slowly, every 2 hours (20 to 40 mg/kg/day). Diazepam injection is not recommended as the drug of choice for neonates due to its benzyl alcohol and propylene glycol content.

1 month to 5 years: 1 to 2 mg Intramuscular and Intravenous, slowly, repeated every 3 to 4 hours as necessary, or 15 mg/kg/day in divided doses every 2 hours.

Greater than 5 years: 5 to 10 mg IM or IV, slowly, repeated every 3 to 4 hours as necessary.

How is diazepam available?

Diazepam is available in the following dosage forms and strengths:

Tablet, oral: 2 mg5 mg10 mg

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of diazepam, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: May 30, 2016 | Last Modified: January 4, 2017

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