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Last updated: February 2024
- 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
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– Below 25 °C