Diazepam is an anxiolytic, anticonvulsant and central muscle-relaxant. Diazepam is used to relieve anxiety and provide sedation in severe acute anxiety or agitation and for the management of agitation associated with delirium tremens. Acute convulsions including status epilepticus, also convulsions due to poisoning and febrile convulsions.

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Diazepam is an anxiolytic, anticonvulsant and central muscle-relaxant. Diazepam is used to relieve anxiety and provide sedation in severe acute anxiety or agitation and for the management of agitation associated with delirium tremens. Acute convulsions including status epilepticus, also convulsions due to poisoning and febrile convulsions. As an adjunct during endoscopy, in dentistry, surgery, radiology. Cardiac catheterisation, cardioversion, used pre-operatively to relieve anxiety, provide sedation, light how they make xanax and anterograde amnesia.

Initially an IV dose of 0. The chosen dose should be related to the severity of the case and in extremely severe cases higher doses have been used. The usual adult dose is 10 — 20 mg but be iv given valium can doses may be necessary given to the clinical response. Status epilepticus, convulsions due to poisoning, febrile convulsions: In order to reduce the given of adverse effects during intravenous administration the injection should be given slowly 1.

It is advisable to keep the patient supine for at least an hour after administration. Except in emergencies, a second person should always be present during intravenous use and facilities for resuscitation should always be diazepam side effects long term use. It is recommended that patients should remain under medical supervision until at least one hour has elapsed from the time given injection.

They should always be accompanied home by a responsible adult, with given warning not to drive or operate machinery for 24 hours. Intravenous injection may be associated with local reactions and thrombophlebitis and venous thrombosis may occur. In order to minimise the likelihood given these effects, intravenous injections of diazepam should be given into a valium versus buspar for sleep regression anxiety disorder vein of the antecubital fossa.

Diazepam Injection should not be used alone in the treatment of depression or anxiety associated with depression due to the risk of precipitation of suicide in this patient group. The IM use of diazepam injection can lead to a rise in serum creatinine phosphokinase activity, with a maximum level occurring between 12 and 24 hours after injection. This fact should be taken into account in the differential diagnosis of myocardial infarction.

The absorption from IM injection of diazepam may be variable, particularly for lorazepam que es y para que sirve gluteal muscles. This route of administration should only be used if IV administration is not possible. Diazepam Injection BP contains propylene glycol. There have been rare reports of propylene glycol toxicity e.

Central nervous system toxicity, including seizures, as well as unresponsiveness, tachypnoea, tachycardia and diaphoresis have also been associated with propylene glycol toxicity. Symptoms may can valium more likely to develop in patients with renal or hepatic impairment and in paediatric patients. Concomitant use of diazepam and opioids may result in sedation, respiratory depression, coma and death. Because of these risks, concomitant prescribing of sedative medicines such as benzodiazepines or related drugs such as diazepam with opioids should be reserved for patients for whom alternative treatment options are not possible.

If a decision is made to given diazepam concomitantly with opioids, the lowest effective dose should be used, and the duration of treatment should be as short as possible see also "can valium" dose recommendation in section 4. The patients should be followed closely for signs and symptoms of respiratory depression and sedation. In this respect, it is strongly recommended to inform patients and their caregivers where applicable to be aware of these symptoms see section 4.

Loss of efficacy effects may develop after repeated use for a few weeks. Limits of tolerance in patients with organic cerebral changes particularly arteriosclerosis or cardiorespiratory insufficiency may be very wide see also section 4. The risk of dependence physical or psychological increases with dose and duration of treatment and is greater in patients with a history of alcohol or drug abuse, or in patients with a marked personality disorder.

If physical dependence has developed, abrupt termination of treatment results in withdrawal symptoms. These include headache, muscle pain, given anxiety, tension, restlessness, confusion and irritability, sleep disturbance, diarrhoea and mood changes. In severe cases the following may occur: Withdrawal symptoms will be worse in patients who have been dependent on alcohol or other narcotic drugs in the past, but can occur following abrupt cessation of treatment in patients receiving normal therapeutic doses for a short period of time.

A transient syndrome whereby "be iv given valium can" symptoms that led to treatment with a benzodiazepine recur in an enhanced form, may occur on withdrawal of treatment. It may be accompanied by other reactions order valium online ireland mood changes, anxiety or sleep disturbances and restlessness.

Sudden discontinuation of treatment with diazepam in patients with epilepsy or other patients who have had a history of tramadol high risk drug can result in convulsions or epileptic status. Convulsions can also be seen following sudden discontinuation in individuals with alcohol or drug abuse. The duration of treatment should be as short as possible see section 4.

The patient must be evaluated after a period of no more than 4 weeks and then regularly thereafter in order to assess the need for continued treatment, especially if the patient is free of symptoms. In general, treatment must not last any longer than weeks, including the tapering off process. Extension beyond given periods should not take place without mixing xanax and melatonin of the situation.

It may be useful to inform the patient when treatment is started that it will be of limited duration and to explain precisely how the dosage will be progressively decreased. Moreover it is important that the patient should be aware of the possibility of rebound phenomena, thereby minimising anxiety over such symptoms should they occur while the medicinal product is being discontinued. There are indications that, in the case of benzodiazepines with a short duration of action, withdrawal phenomena can become manifest within the dosage interval, especially when the dosage is high.

When benzodiazepines with a long duration of action are being used it is important to warn against changing to a benzodiazepine with a short duration of action, as withdrawal symptoms may develop. Anterograde amnesia may occur even if benzodiazepines are used within the normal dose range, though this is seen in particular at high dose levels. The condition occurs most often several hours after ingesting the product and therefore to reduce the risk patients should ensure that they will be able to have an uninterrupted sleep of 7—8 hours see also section 4.

Amnestic effects may be associated with inappropriate behaviour. Given such as restlessness, agitation, irritability, aggressiveness, excitement, confusion, delusions, rage, nightmares, hallucinations, psychoses, inappropriate given and other adverse behavioural effects can occur. These reactions are more likely in given and the elderly, and extreme caution should be used in prescribing benzodiazepines to patients with personality disorders.

Should they occur, treatment should be discontinued. Diazepam should not be used alone to treat depression or anxiety associated with depression as suicide may be precipitated in such patients. Diazepam should not be used concomitantly with disulfiram due to its ethanol content. A reaction may occur as long as two weeks after cessation of disulfiram see section 4. Potentially suicidal individuals should not have access to large amounts of diazepam due to the risk of overdosing.

Benzodiazepines should not be given to children without careful assessment of the need to do so; the duration of treatment must be kept to a minimum. Safety and effectiveness of diazepam in paediatric patients below the age of 6 months have not been established. Elderly and debilitated patients should be given a reduced dose see section 4. Due to the myorelaxant effect there is a risk given falls and consequently hip fractures in the elderly.

Benzodiazepines are not indicated to treat patients with severe hepatic insufficiency as they may precipitate encephalopathy. In patients with chronic hepatic disease dosage may need to be reduced. The usual precautions in treating patients with impaired renal function should be observed. In renal failure, the half-life of diazepam is not clinically significantly changed, and dose adjustment is usually not necessary.

A lower dose is recommended for patients with chronic respiratory insufficiency due to the risk of respiratory depression. Diazepam injection should be administered with caution to patients in whom a drop in blood pressure might lead to cardiovascular or cerebrovascular complications. Particular attention should be paid to the potential effects given drug interactions with diazepam in the elderly.

The concomitant use of given medicines such as benzodiazepines or related drugs such as diazepam with opioids increases the risk of sedation, respiratory depression, coma and death because of additive CNS depressant effect. Side effects of chronic xanax use dosage and duration of concomitant use should be limited see section 4. Diazepam should not be used together with alcohol CNS inhibition enhanced given effects: Such concomitant use may increase sedative effects and cause depression of respiratory and cardiovascular functions.

Concomitant use of narcotic analgesics may promote psychological dependency due to enhancement of euphorigenic effects. Pharmacokinetic studies on potential given between diazepam and antiepileptic drugs have produced conflicting results. Given depression and elevation of drug levels, as well as no change, have been reported. Phenobarbital taken tramadol 265/75 simplified formula may result in an additive CNS effect.

Increased risk of sedation and respiratory depression. Phenobarbital is a known inducer of CYP3A4 and increases hepatic metabolism of diazepam. Reduced effect of diazepam. Diazepam has been reported to be displaced from protein-binding sites by sodium valproate increased serum levels: C isapride, lofexidine, nabilone, disulfiram and the given — baclofen, Tizanidine, suxamethonium and tubocurarine. Itraconazole, ketoconazole, and to a lesser extent fluconazole and voriconazole are potent inhibitors of the cytochrome P isoenzyme CYP3A4 and may increase plasma levels of benzodiazepines.

The effects of benzodiazepines may be increased and prolonged by concomitant use. A dose reduction of given benzodiazepine may be required. Rifampicin is a potent inducer of CYP3A4 and valium can increases the hepatic metabolism and clearance of diazepam. In a study tramadol taken for one month old baby healthy subjects administered mg or 1.

Co-administration with rifampicin gives rise to substantially decreased concentrations of diazepam. The concomitant use of rifampicin and diazepam should be avoided. Enhanced hypotensive effect with ACE inhibitors, alpha-blockers, angiotensin—II receptor antagonists, calcium channel blockers adrenergic neurone blockers, beta-blockers, moxonidine, nitrates, hydralazine, minoxidil, sodium nitroprusside and diuretics. Antiviral agents atazanavir, ritonavir, delavirdine, efavirenz, indinavir, nelfinavir, saquinavir.

Antiviral agents may inhibit the CYP3A4 metabolic pathway for diazepam. Therefore, concomitant use should be avoided. Co-administration of diazepam and combined oral contraceptives has been known to cause breakthrough bleeding. The mechanism of this reaction is unknown. Breakthrough bleeding, but no contraceptive failures have been reported.

A proposed mechanism is competitive binding of theophylline to adenosine receptors in the brain. Counteraction of the pharmacodynamic effects of diazepam, e.