Diazepam

Diazepam is a benzodiazepine anxiolytic and anticonvulsant medicine available in Bangladesh under many brand names. Below are its uses, dosage, side effects and precautions — and all brands with their current prices.

• Short-term relief of severe anxiety or anxiety associated with distressing symptoms.
• Management of acute alcohol withdrawal symptoms such as agitation and tremor.
• Relief of skeletal muscle spasm and spasticity when a benzodiazepine is appropriate.
• Adjunctive treatment of certain seizures, including acute convulsive episodes or status epilepticus under medical supervision.
• Premedication or sedation before selected medical procedures.

Diazepam dose and route depend on the condition being treated, age, weight, response, and other medical problems. Adults are usually treated with the lowest effective dose for the shortest possible time; tablets may be taken as prescribed in divided doses, while injection should be given only by trained healthcare professionals. Suppository or rectal use for seizures should follow the exact emergency plan given by the doctor. Do not increase the dose, use it more often, or stop long-term treatment suddenly without medical advice.

• Common: drowsiness, tiredness, dizziness, muscle weakness, impaired coordination, unsteadiness, confusion, and slowed reaction time.
• May cause memory problems, blurred vision, headache, nausea, constipation, or changes in mood.
• Serious: severe sedation, slow or difficult breathing, fainting, allergic reaction, worsening depression, suicidal thoughts, paradoxical agitation or aggression, dependence, withdrawal symptoms, and seizures if stopped suddenly after prolonged use.

Use extra caution in older adults, frail patients, people with liver disease, kidney disease, breathing problems, sleep apnoea, myasthenia gravis, depression, suicidal thoughts, history of alcohol or drug dependence, or those taking other sedating medicines. Avoid driving, operating machinery, or risky work until the effect is known. Diazepam can cause tolerance, dependence, and withdrawal; it should generally be used short term and tapered only as advised. Use Diazepam under the guidance of a registered doctor or pharmacist.

• Alcohol greatly increases sedation and breathing risk and should be avoided.
• Opioid pain medicines, sleeping pills, antipsychotics, antidepressants, antihistamines, anaesthetics, and other CNS depressants can cause dangerous drowsiness, coma, or respiratory depression.
• Medicines that may increase diazepam levels include azole antifungals, some macrolide antibiotics, cimetidine, omeprazole, fluvoxamine, fluoxetine, and some HIV medicines.
• Medicines that may reduce effect include rifampicin, carbamazepine, phenytoin, phenobarbital, and St John’s wort.
• Grapefruit juice may increase sedation in some patients and should be discussed with a healthcare professional.

• Known allergy or hypersensitivity to diazepam, other benzodiazepines, or any ingredient of the product.
• Severe respiratory insufficiency or acute severe breathing difficulty unless specifically managed by specialists.
• Sleep apnoea syndrome.
• Severe liver insufficiency.
• Myasthenia gravis.
• Acute narrow-angle glaucoma.

Diazepam should be used during pregnancy only if clearly needed and prescribed by a doctor, as benzodiazepines may affect the baby and use near delivery can cause newborn sedation, breathing difficulty, low muscle tone, or withdrawal symptoms. Diazepam passes into breast milk and may cause infant drowsiness, poor feeding, and weight-gain problems; breastfeeding mothers should use it only with medical advice and infant monitoring, or consider alternatives.

Store at room temperature away from excess heat, moisture, and direct light. Keep all tablets, suppositories, and injections out of the reach of children and away from misuse. Do not use expired medicine or damaged injection ampoules; dispose of unused or expired diazepam safely according to a pharmacist’s advice.