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DIAZEPAM

pronounced as(dye az' e pam)
Why is this medication prescribed?
Diazepam is used to relieve anxiety, muscle spasms, and seizures and
to control agitation caused by alcohol withdrawal.
How should this medicine be used?
Diazepam comes as a tablet, extended-release (long-acting) capsule,
and concentrate (liquid) to take by mouth. Do not open, chew, or crush
the extended-release capsules; swallow them whole. It is usually taken
1-4 times a day and may be taken with or without food. Follow the
directions on your prescription label carefully, and ask your doctor
or pharmacist to explain any part you do not understand. Take diazepam
exactly as directed.
Diazepam concentrate (liquid) comes with a specially marked dropper
for measuring the dose. Ask your pharmacist to show you how to use the
dropper. Dilute the concentrate in water, juice, or carbonated
beverages just before taking it. It also may be mixed with applesauce
or pudding just before taking the dose.
Diazepam can be habit-forming. Do not take a larger dose, take it more
often, or for a longer time than your doctor tells you to. Tolerance
may develop with long-term or excessive use, making the drug less
effective. This medication must be taken regularly to be effective. Do
not skip doses even if you feel that you do not need them. Do not take
diazepam for more than 4 months or stop taking this medication without
talking to your doctor. Stopping the drug suddenly can worsen your
condition and cause withdrawal symptoms (anxiousness, sleeplessness,
and irritability). Your doctor probably will decrease your dose
gradually.
Diazepam is also used to treat irritable bowel syndrome and panic
attacks. Talk to your doctor about the possible risks of using this
drug for your condition.

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This medication is sometimes prescribed for other uses; ask your
doctor or pharmacist for more information.
What special precautions should I follow?
Return to top
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.

What should I do if I forget a dose?
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If you take several doses per day and miss a dose, skip the missed
dose and continue your regular dosing schedule. Do not take a double
dose to make up for a missed one.
What side effects can this medication cause?
Return to top
Side effects from diazepam are common and include the following:

    * drowsiness
    * dizziness
    * tiredness
    * weakness
    * dry mouth
    * diarrhea
    * nausea
    * changes in appetite

Tell your doctor if any of these symptoms are severe or do not go
away:

    * restlessness or excitement
    * constipation
    * difficulty urinating
    * frequent urination
    * blurred vision
    * changes in sex drive or ability

If you experience any of the following symptoms, call your doctor
immediately:

    * seizures
    * shuffling walk
    * persistent, fine tremor or inability to sit still
    * fever
    * difficulty breathing or swallowing
    * severe skin rash
    * yellowing of the skin or eyes
    * irregular heartbeat

If you experience a serious side effect, you or your doctor may send a
report to the Food and Drug Administration's (FDA) MedWatch Adverse
Event Reporting program online [at http://www.fda.gov/Safety/MedWatch]
or by phone [1-800-332-1088].
What storage conditions are needed for this medicine?
Return to top

Keep this medication in the container it came in, tightly closed, and
out of reach of children. Store it at room temperature and away from
excess heat and moisture (not in the bathroom). Throw away any
medication that is outdated or no longer needed. Talk to your
pharmacist about the proper disposal of your medication.
In case of emergency/overdose
Return to top

In case of overdose, call your local poison control center at
1-800-222-1222. If the victim has collapsed or is not breathing, call
local emergency services at 911.
What other information should I know?
Return to top

Keep all appointments with your doctor and the laboratory. Your doctor
will order certain lab tests to check your response to diazepam.

Diazepam can cause false results in urine tests for sugar using
Clinistix and Diastix. Diabetic patients should use TesTape to test
their urine for sugar.

If you are taking diazepam to control seizures and have an increase in
their frequency or severity, call your doctor. Your dose may need to
be adjusted. If you use diazepam for seizures, carry identification
(Medic Alert) stating that you have epilepsy and that you are taking
diazepam.

Do not let anyone else take your medication. Ask your pharmacist any
questions you have about refilling your prescription.

It is important for you to keep a written list of all of the
prescription and nonprescription (over-the-counter) medicines you are
taking, as well as any products such as vitamins, minerals, or other
dietary supplements. You should bring this list with you each time you
visit a doctor or if you are admitted to a hospital. It is also
important information to carry with you in case of emergenci

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Side-effects

Adverse effects of benzodiazepines such as diazepam include
anterograde amnesia and confusion (especially pronounced in higher
doses) and sedation. The elderly are more prone to adverse effects of
diazepam such as confusion, amnesia, ataxia and hangover effects as
well as falls. Long-term use of benzodiazepines such as diazepam is
associated with tolerance, benzodiazepine dependence as well as a
benzodiazepine withdrawal syndrome.Like other benzodiazepines,
diazepam can impair short-term memory and learning of new information.
While benzodiazepine drugs such as diazepam can cause anterograde
amnesia, they do not cause retrograde amnesia; information learned
before benzodiazepines is not impaired. Tolerance to the cognitive
impairing effects of benzodiazepines does not tend to develop with
long-term use. The elderly are more sensitive to the cognitive
impairing effects of benzodiazepines. Additionally after cessation of
benzodiazepines cognitive deficits may persist for at least six
months; it is unclear whether these impairments take longer than six
months to abate or if they are permanent. Benzodiazepines may also
cause or worsen depression. Infusions or repeated intravenous
injections of diazepam when managing seizures for example may lead to
drug toxicity including respiratory depression, sedation as well as
hypotension. Tolerance may also develop to infusions of diazepam if it
is given for longer than 24 hours. Adverse effects such as sedation,
benzodiazepine dependence and abuse potential limit the use of
benzodiazepines.

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