Indications & Dose:
Muscle spasm of varied aetiology
Adult: 2–15 mg daily in divided doses, then increased if necessary to 60 mg daily, adjusted according to response, dose only increased in spastic conditions
Acute muscle spasm
Adult: 10 mg, then 10 mg after 4 hours if required, intravenous injection to be administered into a large vein at a rate of no more than 5 mg/minute
Tetanus
Child: 100–300 micrograms/kg every 1–4 hours
Adult: 100–300 micrograms/kg every 1–4 hours
Child: 3–10 mg/kg, adjusted according to response, to be given over 24 hours
Adult: 3–10 mg/kg, adjusted according to response, to be given over 24 hours
Muscle spasm in cerebral spasticity or in postoperative skeletal muscle spasm
Child 1–11 months: Initially 250 micrograms/kg twice daily
Child 1–4 years: Initially 2.5 mg twice daily
Child 5–11 years: Initially 5 mg twice daily
Child 12–17 years: Initially 10 mg twice daily; maximum 40 mg per day
Anxiety
Adult: 2 mg 3 times a day, then increased if necessary to 15–30 mg daily in divided doses, for debilitated patients, use elderly dose Elderly: 1 mg 3 times a day, then increased if necessary to 7.5–15 mg daily in divided doses Insomnia associated with anxiety
Adult: 5–15 mg daily, to be taken at bedtime
Severe acute anxiety
Control of acute panic attacks
Acute alcohol withdrawal
Adult: 10 mg, then 10 mg after at least 4 hours if required, intravenous injection to be administered into a large vein, at a rate of not more than 5 mg/ minute Acute drug-induced dystonic reactions
Adult: 5–10 mg, then 5–10 mg after at least 10 minutes as required, to be administered into a large vein, at a rate of not more than 5 mg/minute
Acute anxiety and agitation
Adult: 500 micrograms/kg, then 500 micrograms/ kg after 12 hours as required Elderly: 250 micrograms/kg, then 250 micrograms/ kg after 12 hours as required
Premedication
Adult: 5–10 mg, to be given 1–2 hours before procedure, for debilitated patients, use elderly dose
Elderly: 2.5–5 mg, to be given 1–2 hours before procedure
Sedative cover for minor surgical and medical procedures
Adult: 10–20 mg, to be administered into a large vein over 2–4 minutes, immediately before procedure
Status epilepticus
Febrile convulsions
Convulsions due to poisoning
BY INTRAVENOUS INJECTION
Neonate: 300–400 micrograms/kg, then 300–400 micrograms/kg after 10 minutes if required, to be given over 3–5 minutes.
Child 1 month–11 years: 300–400 micrograms/kg (max. per dose 10 mg), then 300–400 micrograms/ kg after 10 minutes if required, to be given over 3– 5 minutes
Child 12–17 years: 10 mg, then 10 mg after 10 minutes if required, to be given over 3–5 minutes
Adult: 10 mg, then 10 mg after 10 minutes if required, administered at a rate of 1mL (5 mg) per minute
Neonate: 1.25–2.5 mg, then 1.25–2.5 mg after 10 minutes if required.
Child 1 month–1 year: 5 mg, then 5 mg after 10 minutes if required
Child 2–11 years: 5–10 mg, then 5–10 mg after 10 minutes if required
Child 12–17 years: 10–20 mg, then 10–20 mg after 10 minutes if required
Adult: 10–20 mg, then 10–20 mg after 10–15 minutes if required
Elderly: 10 mg, then 10 mg after 10–15 minutes if required
Life-threatening acute drug-induced dystonic reactions
Child 1 month–11 years: 100 micrograms/kg, repeated if necessary, to be given over 3–5 minutes
Child 12–17 years: 5–10 mg, repeated if necessary, to be given over 3–5 minutes
Dyspnoea associated with anxiety in palliative care
Adult: 5–10 mg daily
Pain of muscle spasm in palliative care
Adult: 5–10 mg daily
NOTE: Only use intramuscular route when oral and intravenous routes not possible.
Contraindications:
Side Effects:
Cautions:
Precautions:
Elderly, debilitated, hepatic disease, renal disease, children, low serum albumin
PREGNANCY AND LACTATION:
Drug and metabolite enter breast milk; lethargy and loss of weight in nursing infant have been reported
Interaction:
Drugs
Carbamazepine: Markedly reduces effect of oral diazepam; parenteral diazepam less affected
Cimetidine: Inhibits hepatic metabolism of diazepam
Ciprofloxacin: Inhibits hepatic metabolism of diazepam; may also competitively inhibit gamma amino butyric acid receptors
Clarithromycin: Inhibits hepatic metabolism of diazepam
Clozapine: Additive respiratory and cardiovascular depression
Delavirdine: Inhibits hepatic metabolism of diazepam
Disulfiram: Inhibits hepatic metabolism of diazepam
Erythromycin: Inhibits hepatic metabolism of diazepam
Ethanol: Additive CNS effects
Fluconazole: Inhibits hepatic metabolism of diazepam
Fluoxetine: Inhibits hepatic metabolism of diazepam
Fluvoxamine: Inhibits hepatic metabolism of diazepam
Isoniazid: Inhibits hepatic metabolism of diazepam
Itraconazole: Inhibits hepatic metabolism of diazepam
Ketoconazole: Inhibits hepatic metabolism of diazepam
Levodopa: May reduce anti-Parkinsonian effect
Metoprolol: Inhibits hepatic metabolism of diazepam
Omeprazole: Inhibits hepatic metabolism of diazepam
Phenytoin: Markedly reduces effect of oral diazepam; parenteral diazepam less affected
Quinolones: Inhibits hepatic metabolism of diazepam; may also competitively inhibit gamma amino butyric acid receptors
Rifampin: Markedly reduces effect of diazepam
Troleandomycin: Inhibits hepatic metabolism of diazepam
Warnings:
Adverse Effects:
Lactations:
Special Precautions:
Counselling:
Side Effects Or Adverse Reactions:
CNS: Anxiety, confusion, depression, dizziness, drowsiness, fatigue; hallucinations, headache, insomnia, stimulation, tremors, withdrawal syndrome
CV: ECG changes, hypotension; orthostatIc hypotension, tachycardia, venous thrombosis, phlebitis, local irritation, swelling, and vascular impairment following IV inj into small veins on hand
EENT: Blurred vision, mydriasis, tinnitus
GI: Anorexia, constipation, diarrhea, dry mouth, increased ALT/ AST, nausea, vomiting
RESP: Respiratory depression
SKIN: Dermatitis, itching, rash
Patient And Carer Advice:
© Pakistan Drug Directory. All Rights Reserved.
Designed By: Pakistan Drug Directory Team