DIAZEPAM emulsion

Therapeutic action

• Anxiolytic, sedative, anticonvulsant, muscle relaxant

Indications

• Muscle spasms due to tetanus in neonates

Forms and strengths, route of administration

• 10 mg ampoule (5 mg/ml, 2 ml) emulsion for slow IV injection (3 to 5 minutes) or infusion in 10% glucose (if not available, 5%).
  DO NOT ADMINISTER BY IM OR RECTAL ROUTE.

Dosage and duration

The dosage range is variable, depending on the severity of symptoms and clinical response. For information:

• 0.1 to 0.3 mg/kg by slow IV injection every 1 to 4 hours

or

• 0.1 to 0.5 mg/kg/hour by continuous perfusion, preferably via an electric syringe

Dilute one ampoule of diazepam emulsion (10 mg) in a syringe of 50 ml of 10% glucose to obtain a solution containing 0.2 mg of diazepam per ml.
Every 6 hours, discharge the content remaining in the electric syringe and prepare a new syringe for 6 hours.

Contra-indications, adverse effects, precautions

• Do not administer to patients with severe respiratory insufficiency or severe hepatic impairment.
• Reduce the dose by one half in patients with renal or hepatic impairment.
• May cause:
  • hypotension, respiratory depression, if injected too rapidly by IV route and if large doses are administered;
  • drowsiness, muscle weakness;
  • in the event of overdose: hypotonia, lethargy, respiratory distress, coma.
• Avoid and monitor in combination with:
  • drugs containing alcohol, opioid analgesics, other anticonvulsants, etc. (increased sedation);
  • enzyme inducers such as nevirapine, ritonavir, phenobarbital, phenytoin, etc. (efficacy of diazepam reduced);
  • omeprazole, macrolides, ritonavir, fluconazole, etc. (effects of diazepam increased);
  • phenytoin (phenytoin plasmatic concentrations modified).

Remarks

• Diazepam is subject to international controls: follow national regulations.
• Do not mix with other drugs in the same syringe or infusion.

Storage