Brand name
- Valium®
Drug Class
- Benzodiazepines
Preparations
- Tablets 2, 5, 10 mg
- Injection: 10 mg
Indications
- Anxiolytic agent
- Sedative
- Anticonvulsant
Dosing
Anticonvulsant:
- 2 mg to 10 mg, 2 to 4 times daily
Anxiety:
- Depending upon severity of symptoms-2 mg to 10 mg, 2 to 4 times daily
Insomnia:
- a single daily dose of 2 to 4 mg may be given, usually at bedtime.
For elderly or debilitated patients:
- 2 mg to 2.5 mg, 1 or 2 times daily initially; increase gradually as needed and tolerated
Alcohol withdrawal symptoms:
- 10 mg, 3 or 4 times during the first 24 hours, reducing to 5 mg, 3 or 4 times daily as needed
Skeletal muscle spasm:
- 2 mg to 10 mg, 3 or 4 times daily
Drug Interactions
The effect of valium can be potentiated with
- Phenothiazines
- Antipsychotics
- Anxiolytics
- Sedatives hypnotics
- Anticonvulsants
- narcotic analgesics
- Anesthetics
- Sedative antihistamines
- Barbiturates
- MAO inhibitors
- Antidepressants
Alcohol
- Concomitant use with alcohol is not recommended due to enhancement of the sedative effect.
Hepatic Cytochrome P450 3A and 2C19 inhibitors:
- May lead to increased and prolonged sedation.
- Is known to occur with cimetidine, ketoconazole, fluvoxamine, fluoxetine, and omeprazole.
Phenytoin
- metabolic elimination of phenytoin is decreased by diazepam
Adverse Effects
General:
- paradoxical reaction (excitatory)
- may worsen depression or psychosis
- Fatigue
- Diplopia
- Blurred vision
- Hypersensitivity reactions,
- Anaphylactic reactions
Respiratory:
- Respiratory depression and partial airway obstruction, especially when combined with narcotics
- laryngospasm
Cardiovascular:
- Hypotension
CNS:
- Confusion
- Amnesia
- Stimulation
- Restlessness
- Aacute hyperexcited states
- anxiety
- Agitation
- Aggressiveness
- Irritability
- Rage
- Hallucinations
- Psychoses
- Delusions
- increased muscle spasticity
- insomnia
- sleep disturbances
- Nightmare
Urogenital:
- incontinence
- changes in libido
- urinary retention
Skin:
- Allergy
Blood:
- thrombophlebitis
Pregnancy and Breastfeeding
- Not recommended
Warning
Sign and symptoms of toxicity:
- Drowsiness
- Confusion
- Lethargy
- Ataxia
- Diminished reflexes
- Hypotonia
- Hypotension
- Respiratory depression
- Coma
Management:
- Gastric lavage
- Activated charcoal may limit drug absorption
- Dialysis has limited value
- Flumazeil