DIAZEPAM oral

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    Last updated: February 2024

     

    Prescription under medical supervision

     

     
     
    Do not exceed the recommended duration of treatment (risk of dependence and tolerance).

     

    Therapeutic action

    • Anxiolytic, sedative, antiseizure (anticonvulsant), muscle relaxant

    Indications

    • Severe anxiety, insomnia, and agitation

    Forms and strengths

    • 2 mg and 5 mg tablets

    Dosage and duration

    Anxiety

    • Adult: 2.5 to 5 mg 2 times daily for 2 to 3 weeks max. reducing the dose by half the last days before stopping treatment

     

    Insomnia

    • Adult: 2 to 5 mg once daily at bedtime for 7 days max.

     

    Agitation

    • Adult: 10 mg single dose

    Contra-indications, adverse effects, precautions

    • Do not administer to patients with severe respiratory insufficiency, severe hepatic impairment or acute alcohol intoxication.
    • Administer with caution:
      • to older patients and patients with renal or hepatic impairment (reduce the dose by half);
      • to patients with history of drug/substance abuse or mental health disorders.
    • May cause:
      • hypotension, muscle weakness, ataxia, hypotonia, drowsiness (caution when driving/operating machinery), lethargy, confusion, impaired concentration, memory loss, hyperactive or aggressive behaviour;
      • withdrawal syndrome or rebound effect if prolonged treatment is discontinued abruptly;
      • respiratory depression and coma in the event of overdose.
    • Avoid or monitor in combination with:
      • drugs containing alcohol, opioid analgesics, antipsychotics, first-generation antihistamines (hydroxyzine, promethazine), antidepressants, other antiseizure medications, etc. (increased sedation);
      • enzyme inducers such as rifampicin, rifabutin, nevirapine, phenobarbital, phenytoin, carbamazepine, etc. (reduced effect of diazepam);
      • omeprazole, macrolides, ritonavir, isoniazid, fluconazole, itraconazole, etc. (increased diazepam toxicity);
      • phenytoin (increased phenytoin toxicity).
    • Avoid alcohol during treatment (increased risk of adverse effects).
    • Pregnancy and breast-feeding: avoid (passage through the placenta and breast milk)

    Remarks

    • Diazepam is subject to international controls: follow national regulations.
    • Diazepam is also used in the treatment of pre-delirium tremens (alcohol withdrawal) in adults: 10 mg every 6 hours for 1 to 3 days, then reduce and stop over 7 days.

    Storage

     
    –  
     
    –  Below 25 °C