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Instructions for use of diazepam solution. The use of Diazepam in neurology and psychiatry: instructions and reviews Diazepam dosage for children with seizures

Moist cough
15.07.2023

Diazepam is a tranquilizer (a group of benzodiazepines) widely used in medicine.

Pharmacological action of Diazepam

The active substance of the same name, Diazepam, being a benzodiazepine derivative with a wide spectrum of action, has a hypnosedative, anxiolytic (by reducing the stimulating effect of neurotransmitters - serotonin, norepinephrine), anticonvulsant and muscle relaxant (due to depression of the central nervous system) effect.

Composition, release form and analogues of Diazepam

Diazepam is produced in the form of film-coated tablets containing 2 mg and 5 mg of the active substance of the same name.

Analogues of Diazepam are the following medications: Seduxen, Apaurin, Sibazon, Relanium, Relium. Against the background of hypersensitivity to the active substance, the doctor may prescribe one of the analogues of Diazepam with a similar therapeutic effect: Alzolam, Gidazepam, Alprazolam, Neurol, Zolomax, Mezapam, Nozepam, Lorafen, Rudotel, Helex, Grandaxin, Elenium, Chlozepid, Tazepam.

Indications for use of Diazepam

Diazepam according to the instructions is prescribed for the treatment of:

  • Anxiety disorders;
  • Dysphoria (usually as part of combination therapy);
  • Insomnia and difficulty falling asleep;
  • Spastic conditions associated with damage to the brain or spinal cord - cerebral palsy, athetosis, tetanus;
  • Myositis, bursitis, arthritis, spondyloarthritis, rheumatoid arthritis;
  • Osteoarthritis, accompanied by skeletal muscle tension;
  • Vertebral syndrome;
  • Spasm of skeletal muscles due to local injury;
  • Angina pectoris;
  • Tension headache;
  • Alcohol withdrawal syndrome – anxiety, tension, agitation, tremor, transient reactive states;
  • Meniere's disease;
  • Convulsive syndrome due to drug poisoning.

Diazepam is used as a premedication before operations, endoscopic procedures, and general anesthesia. Also, the use of Diazepam is effective as part of complex treatment:

  • Peptic ulcer of the stomach and duodenum;
  • Arterial hypertension;
  • Psychosomatic disorders in obstetrics and gynecology, including gestosis, menopausal and menstrual disorders;
  • Eczema and other diseases accompanied by irritability and itching.

Contraindications

Diazepam is contraindicated for use against the background of:

  • Hypersensitivity;
  • Coma;
  • Shock;
  • Severe chronic obstructive pulmonary disease (due to the risk of progression of respiratory failure);
  • Acute alcohol intoxication with weakening of vital functions;
  • Acute intoxication with medications that have a depressing effect on the central nervous system, including hypnotics and narcotic analgesics;
  • Myasthenia;
  • Angle-closure glaucoma (against the background of an acute attack or the presence of a predisposition);
  • Acute respiratory failure.

Diazepam is contraindicated for pregnant and lactating women. The medication is not prescribed to children under three years of age.

How to use Diazepam

The treatment regimen for Diazepam according to the instructions is always determined by the doctor and depends on age, severity of symptoms and response to therapy (from several days to several weeks). On average, prescribed for treatment:

  • Anxiety disorders, dysphoria – 2-10 mg 2-3 times a day;
  • Insomnia – in the evening 4-10 mg;
  • Muscle spasms - three times a day, 2-10 mg;
  • Spastic conditions of central origin against the background of degenerative neurological diseases, convulsive syndrome, Meniere's disease - 2-3 times a day, 5-10 mg;
  • Diseases of the musculoskeletal system – 1-4 times a day, 5 mg;
  • Alcohol withdrawal syndrome - on the first day, 10 mg 3-4 times a day, after which the dosage is halved;
  • Angina pectoris and arterial hypertension, gastric and duodenal ulcers, eczema and other diseases that are accompanied by irritability and itching, as well as in obstetrics and gynecology - up to three times a day, 2-5 mg.

For premedication on the eve of surgery, 10-20 mg of Diazepam is prescribed. Weakened patients, elderly people and children over three years of age are usually prescribed 2 mg twice a day.

In case of overdose, Diazepam and analogues can lead to the development of drowsiness, dizziness, weakness, dysarthria, and respiratory failure. More severe cases are characterized by loss of consciousness, hyporeflexia or areflexia, and respiratory depression, especially when taken concomitantly with alcoholic beverages or other substances that depress the central nervous system.

Side effects

Side effects in the form of disturbances in the functioning of the nervous system during the use of Diazepam, according to reviews, can manifest themselves as:

  • Drowsiness, weakness, ataxia (often);
  • Insomnia, decreased activity, tremor, confusion, hallucinations, dysarthria, depression, decreased libido, incoherent speech, headache, dizziness, memory impairment, anxiety (uncommon);
  • Extrapyramidal reactions, euphoria, depression, depressed mood, tremor, catalepsy, hyporeflexia (rare);
  • Irritability, psychomotor agitation, aggressive outbursts, suicidal tendencies, fear, muscle spasms, acute agitation (in some cases).

Diazepam, according to reviews, causes disturbances in the hematopoietic system only in isolated cases. Most often they are expressed in the form of neutropenia, leukopenia, agranulocytosis, anemia and thrombocytopenia.

Violations from other body systems when using Diazepam, according to reviews, are observed infrequently:

  • Bradycardia, palpitations, cardiovascular collapse, fainting (cardiovascular system);
  • Diplopia, blurred vision, nystagmus (sensory organs);
  • Constipation, hiccups, nausea, vomiting, gastralgia, heartburn, loss of appetite (digestive system);
  • Skin rash, urticaria, itching (skin);
  • Muscle weakness (musculoskeletal system);
  • Urinary retention, urinary incontinence, renal dysfunction (urinary system);
  • Menstrual cycle disorders (reproductive system).

In some cases, Diazepam, according to the instructions, can cause the development of jaundice and liver dysfunction.

Long-term use of Diazepam may lead to a change in its tolerance, which manifests itself in the form of physical or mental dependence. However, the risk of developing these symptoms is higher when taking the medicine in high dosages.

Abrupt cessation of Diazepam therapy can cause withdrawal syndrome, manifested in most cases as vomiting, tremors, convulsions, sweating, muscle and abdominal cramps.

Storage conditions

Diazepam, according to the instructions, is one of the potent medications dispensed only as prescribed by a doctor. The shelf life of the tablets is 5 years. It is necessary to comply with the storage conditions recommended by the manufacturer (at a temperature not exceeding 25 ° C).

Name

Diazepam tablets

Release form

tablets 5mg

INN

Diazepam
Analogues

Sibazon, Relium, Relanium, Diazepex

ATX code: N05BA01.
Compound

Each tablet contains:

active substance:

diazepam - 5 mg.
Pharmacotherapeutic group

Anxiolytics (tranquilizers). Benzodiazepine drugs.
pharmachologic effect

It has a sedative-hypnotic, anticonvulsant and central muscle relaxant effect. Anxiolytic manifests itself in reducing emotional stress, easing anxiety, fear, and restlessness. The sedative effect is manifested by a decrease in symptoms of neurotic origin (anxiety, fear). Direct inhibition of motor nerves and muscle function is also possible. Having moderate sympatholytic activity, it can cause a decrease in blood pressure and dilation of coronary vessels. Increases the threshold of pain sensitivity. Reduces nighttime secretion of gastric juice. The effect of the drug appears on days 2-7 of treatment. The productive symptoms of psychotic origin (acute delusional, hallucinatory, affective disorders) are practically not affected; a decrease in affective tension and delusional disorders is rarely observed. With withdrawal syndrome in chronic alcoholism, it causes a weakening of agitation, tremor, negativism, as well as alcoholic delirium and hallucinations. The therapeutic effect in patients with cardialgia, arrhythmias and paresthesia is observed by the end of 1 week of treatment.

Indications for use

  • Anxiety disorders.
  • Dysphoria (as part of combination therapy as an additional drug).
  • Insomnia (difficulty falling asleep).
  • Spasm of skeletal muscles due to local injury;
  • spastic conditions associated with damage to the brain or spinal cord (cerebral palsy, athetosis, tetanus);
  • myositis,
  • bursitis,
  • arthritis,
  • rheumatic pelvispondyloarthritis,
  • progressive chronic polyarthritis;
  • arthrosis,
  • accompanied by skeletal muscle tension;
  • vertebral syndrome,
  • angina pectoris
  • tension headache.
  • Alcohol withdrawal syndrome (anxiety, tension, agitation, tremor, transient reactive states).

As part of complex therapy:

  • arterial hypertension,
  • peptic ulcer of the stomach and duodenum;
  • psychosomatic disorders in obstetrics and gynecology:
  • menopausal and menstrual disorders,
  • gestosis;
  • status epilepticus;
  • eczema and other diseases accompanied by itching and irritability.
  • Meniere's disease.
  • Drug poisoning.
  • Premedication before surgical interventions and endoscopic manipulations, general anesthesia y.

Directions for use and doses

The drug is taken orally. The dose is calculated individually depending on the patient’s condition, the clinical picture of the disease, and sensitivity to the drug.

As an anxiolytic drug, it is prescribed orally, 2.5-10 mg 2-4 times a day.

Psychiatry: for neuroses, hysterical or hypochondriacal reactions, states of dysphoria of various origins, phobias - 5-10 mg 2-3 times a day. If necessary, the dose can be increased to 60 mg/day.

For alcohol withdrawal syndrome - 10 mg 3-4 times a day in the first 24 hours, followed by a decrease to 5 mg 3-4 times a day.

Elderly, debilitated patients, as well as patients with atherosclerosis at the beginning of treatment - orally, 2 mg 2 times a day, if necessary, increase until the optimal effect is obtained. Working patients are recommended to take 2.5 mg 1-2 times a day or 5 mg (main dose) in the evening.

Neurology: spastic conditions of central origin in degenerative neurological diseases - orally, 5-10 mg 2-3 times a day.

Cardiology and rheumatology: angina pectoris - 2-5 mg 2-3 times a day; arterial hypertension - 2-5 mg 2-3 times a day, vertebral syndrome during bed rest - 10 mg 4 times a day; as an additional drug in physiotherapy for rheumatic pelvispondyloarthritis, progressive chronic polyarthritis, arthrosis - 5 mg 1-4 times a day.

As part of complex therapy for myocardial infarction: orally, 5-10 mg 1-3 times a day; vertebral syndrome - orally, 5 mg 1-4 times a day.

Obstetrics and gynecology: psychosomatic disorders, menopausal and menstrual disorders, gestosis - 2-5 mg 2-3 times a day. Preeclampsia - 5-10 mg orally 3 times a day.

Anesthesiology, surgery: premedication - on the eve of surgery, in the evening - 10-20 mg orally. Pediatrics: psychosomatic and reactive disorders, spastic conditions of central origin - prescribed with a gradual increase in dose (starting with low doses and slowly increasing them to the optimal dose, well tolerated by the patient), daily dose (can be divided into 2-3 doses, with the main one the highest dose, taken in the evening): children from 6 months and older - 1-2.5 mg (or 40-200 mcg/kg, or 1.17-6 mg/sq.m) 3-4 times a day; from 1 year to 3 years - 1 mg; from 3 to 7 years - 2 mg; from 7 years and older - 3-5 mg. Daily doses are 2, 6 and 8-10 mg, respectively.
special instructions

During treatment, patients are strictly prohibited from drinking ethanol. In case of renal/liver failure and long-term treatment, monitoring of the peripheral blood picture and liver enzymes is necessary. The risk of developing drug dependence increases when using large doses, a significant duration of treatment, and in patients who have previously abused ethanol or drugs. Should not be used for a long time without special instructions. Abrupt cessation of treatment is unacceptable due to the risk of withdrawal syndrome (headache, myalgia, anxiety, tension, confusion, irritability; in severe cases - derealization, depersonalization, hyperacusis, photophobia, tactile hypersensitivity, paresthesia in the limbs, hallucinations and epileptic seizures), however, due to the slow half-life of diazepam, its manifestation is much less pronounced than that of other benzodiazepines. If patients experience such unusual reactions as increased aggressiveness, acute states of agitation, anxiety, feelings of fear, thoughts of suicide, hallucinations, increased muscle cramps, difficulty falling asleep, shallow sleep, treatment should be discontinued.

Side effects

From the nervous system: at the beginning of treatment (especially in elderly patients) - drowsiness, dizziness, increased fatigue, decreased ability to concentrate, ataxia, disorientation, unsteady gait and poor coordination of movements, lethargy, dullness of emotions, slowed mental and motor reactions, anterograde amnesia (more more often than when taking other benzodiazepines); rarely - headache, euphoria, depression, tremor, depressed mood, catalepsy, confusion, dystonic extrapyramidal reactions (uncontrolled body movements, including the eyes), weakness, myasthenia gravis during the day, hyporeflexia, dysarthria; extremely rarely - paradoxical reactions (aggressive outbursts, psychomotor agitation, fear, suicidal tendencies, muscle spasms, confusion, hallucinations, acute agitation, irritability, anxiety, insomnia).

From the hematopoietic organs: leukopenia, neutropenia, agranulocytosis (chills, pyrexia, sore throat, excessive fatigue or weakness), anemia, thrombocytopenia.

From the digestive system: dry mouth or hypersalivation, heartburn, hiccups, gastralgia, nausea, vomiting, loss of appetite, constipation; liver dysfunction, increased activity of liver transaminases and alkaline phosphatase, jaundice.

From the cardiovascular system: palpitations, tachycardia, decreased blood pressure (with parenteral administration).

From the genitourinary system: urinary incontinence, urinary retention, renal dysfunction, increased or decreased libido, dysmenorrhea.

Allergic reactions: skin rash, itching.

Effect on the fetus: teratogenicity (especially the first trimester), central nervous system depression, respiratory failure and suppression of the sucking reflex in newborns whose mothers used the drug.

Local reactions: at the injection site - phlebitis or venous thrombosis (redness, swelling or pain at the injection site).

Others: addiction, drug dependence; rarely - depression of the respiratory center, dysfunction of external respiration, visual impairment (diplopia), bulimia, weight loss. With a sharp reduction in dose or discontinuation of use - withdrawal syndrome (irritability, headache, anxiety, excitement, agitation, fear, nervousness, sleep disturbances, dysphoria, spasm of smooth muscles of internal organs and skeletal muscles, depersonalization, increased sweating, depression, nausea, vomiting, tremor, perceptual disorders, including hyperacusis, paresthesia, photophobia, tachycardia, convulsions, hallucinations, rarely - acute psychosis). When used in obstetrics - in full-term and premature infants - muscle hypotension, hypothermia, dyspnea.

Contraindications

Hypersensitivity, coma, shock, acute alcohol intoxication with weakening of vital functions, acute intoxication with drugs that have a depressant effect on the central nervous system (including narcotic analgesics and hypnotics), myasthenia gravis, angle-closure glaucoma (acute attack or predisposition); severe COPD (risk of progression of respiratory failure), acute respiratory failure, pregnancy (especially the first trimester), lactation period, children under 6 months.

With caution: epilepsy or epileptic seizures in history (initiation of treatment with diazepam or its abrupt withdrawal may accelerate the development of seizures or status epilepticus), absence seizure or Lennox-Gastaut syndrome (with intravenous administration contributes to the occurrence of tonic status epilepticus), hepatic and/or renal insufficiency, cerebral and spinal ataxia, hyperkinesis, history of drug dependence, tendency to abuse psychoactive drugs, organic brain diseases, hypoproteinemia, sleep apnea (established or suspected), old age.
Precautionary measures

Initiation of treatment with diazepam or its abrupt withdrawal in patients with epilepsy or with a history of epileptic seizures may accelerate the development of seizures or status epilepticus. During pregnancy, they are used only in exceptional cases and only for “vital” indications. It has a toxic effect on the fetus and increases the risk of birth defects when used in the first trimester of pregnancy. Taking therapeutic doses later in pregnancy may cause depression of the newborn's central nervous system. Constant use during pregnancy can lead to physical dependence - possible withdrawal syndrome in the newborn. Children, especially young children, are very sensitive to the CNS depressant effects of benzodiazepines. It is not recommended for newborns to be prescribed drugs containing benzyl alcohol - the development of a fatal toxic syndrome, manifested by metabolic acidosis, central nervous system depression, difficulty breathing, renal failure, decreased blood pressure and possibly epileptic seizures, as well as intracranial hemorrhage, is possible.

During the treatment period, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions.
Interaction with other drugs

Strengthens the inhibitory effect on the central nervous system of ethanol, sedatives and antipsychotic drugs (neuroleptics), antidepressants, narcotic analgesics, drugs for general anesthesia, muscle relaxants. Inhibitors of microsomal oxidation (including cimetidine, oral contraceptives, erythromycin, disulfiram, fluoxetine, isoniazid, ketoconazole, metoprolol, propranolol, propoxyphene, valproic acid) prolong the half-life of diazepam and enhance the effect. Inducers of microsomal liver enzymes reduce effectiveness. Narcotic analgesics increase euphoria, leading to an increase in psychological dependence. Antihypertensive drugs can increase the severity of the decrease in blood pressure. Increased respiratory depression may occur during concomitant administration of clozapine. When used simultaneously with low-polarity cardiac glycosides, it is possible to increase the concentration of the latter in the blood serum and develop digitalis intoxication (as a result of competition for binding to plasma proteins). Reduces the effectiveness of levodopa in patients with parkinsonism. Omeprazole prolongs the elimination time of diazepam. MAO inhibitors, analeptics, psychostimulants - reduce activity. Premedication with diazepam can reduce the dose of fentanyl required for induction of general anesthesia and reduce the time required to “turn off” consciousness using induction doses.

May increase the toxicity of zidovudine. Rifampicin may increase the elimination of diazepam and reduce its plasma concentrations. Theophylline (used in low doses) may reduce or even reverse the sedative effect.
Overdose

Symptoms:

drowsiness, confusion, paradoxical arousal, decreased reflexes, areflexia, stunnedness, decreased response to painful stimuli, deep sleep, dysarthria, ataxia, visual impairment (nystagmus), tremor, bradycardia, shortness of breath or difficulty breathing, apnea, severe weakness, decreased blood pressure , collapse, depression of cardiac and respiratory activity, coma.

Treatment:

Drink plenty of fluids, gastric lavage, take activated charcoal and immediately consult a doctor.
Release form

Tablets of 5 mg in package No. 20 (No. 10x2 in blister packs).

Manufacturer

RUE "Belmedpreparaty"

Diazepam (tablets) (Diazepamum)

Compound

1 tablet of Diazepam 5 contains:
Diazepam – 5 mg;

1 tablet of Diazepam 10 contains:
Diazepam – 10 mg;
Additional ingredients including lactose monohydrate.

pharmachologic effect

Diazepam is an anxiolytic drug (tranquilizer) of the benzodiazepine series. Diazepam has a pronounced anxiolytic, hypnosedative, anticonvulsant and muscle relaxant effect. The effect of the drug is due to the ability of diazepam to potentiate the central action of gamma-aminobutyric acid, the main inhibitory transmitter of the central nervous system.
Like all benzodiazepine drugs, diazepam forms a component of a functional supramolecular unit - the benzodiazepine-gamma-aminobutyric acid-chlorionophore receptor complex, which is located on the membranes of neurons.
Diazepam selectively stimulates the action of gamma-aminobutyric acid on receptors in the reticular formation of the brain column, as a result of which there is a decrease in excitation of the cerebral cortex, as well as the thalamus, hypothalamus and limbic system.
The muscle relaxant effect of diazepam is realized due to the inhibitory effect on polysynaptic spinal reflexes.

Diazepam helps increase the stability of nerve tissue under hypoxic conditions, and also increases the pain threshold, inhibits sympathoadrenal and parasympathetic paroxysms.
Diazepam is characterized by a dose-dependent effect on the central nervous system: low doses of the drug (2-15 mg per day) have a stimulating effect, and high doses (more than 15 mg per day) have a sedative effect.
When taking diazepam, patients experience a decrease in emotional stress, fear, anxiety and restlessness. Diazepam has virtually no effect on productive symptoms of psychotic origin (including hallucinations and delusions). Rarely there is a decrease in affective tension.
In patients with alcohol withdrawal syndrome, diazepam leads to a decrease in the severity of tremor, acute agitation, negativism, acute alcoholic delirium and hallucinations.
The therapeutic effect of diazepam develops 2-7 days after the start of treatment.

After oral administration, about 75% of the dose is absorbed in the digestive tract. The peak plasma concentration of the active component is observed 60-90 minutes after oral administration, equilibrium concentrations are established within 1-2 weeks of continuous therapy. About 98% of diazepam is bound to plasma proteins. In the liver, almost 99% of diazepam is metabolized to form both active and inactive metabolites.
The active component and its metabolites penetrate the hematoplacental barrier and are detected in breast milk.
Diazepam is excreted primarily by the kidneys (up to 70% of the dose taken), less than 10% is excreted in the feces. Excretion occurs in two stages, the half-life of the first stage is 3 hours, the second - 48 hours.
In elderly patients, the half-life can increase to 100 hours, in patients with impaired renal and liver function - up to 4 days. It is also possible to increase the half-life of diazepam in newborns.
When diazepam is taken repeatedly, its accumulation in the body is noted.

Indications for use

Diazepam is used in monotherapy and complex treatment of patients with neurotic conditions (including in combination with anxiety syndrome, hysteria, hypochondria, neurasthenia and reactive depression), psychosis, dysphoria and organic diseases of the central nervous system.
Diazepam is prescribed for insomnia (mainly with difficulty falling asleep), as well as in combination with other drugs for patients with alcohol withdrawal syndrome (including those accompanied by anxiety, restlessness, nervous tension, transient reactive state and psychoneurosis).
Diazepam is used in the treatment of patients with skeletal muscle spasm due to local injuries, as well as patients with spastic conditions associated with damage to the spinal cord or brain.
Diazepam can be prescribed in the complex treatment of patients with myositis, arthritis, bursitis, arthrosis, rheumatic spondylitis and progressive chronic polyarthritis, which are accompanied by skeletal muscle tension.

As part of complex therapy, Diazepam is prescribed to patients with vertebral syndrome, angina pectoris, tension headaches, and arterial hypertension.
Diazepam can be recommended for psychosomatic disorders in obstetric and gynecological practice, for menopausal and menstrual disorders.
Diazepam is used to treat patients with status epilepticus, tetanus, and various diseases that are accompanied by itching and irritability (for example, eczema).
Diazepam may be recommended for patients with Meniere's disease.
Diazepam can be used as premedication before operations and endoscopic procedures.

Mode of application

Diazepam is for oral use. The tablets are taken regardless of meals, with plenty of drinking water. The duration of therapy and dose of diazepam is determined by the doctor individually for each patient.
As an anxiolytic agent, diazepam is usually prescribed in a dose of 2.5-10 mg 2 to 4 times a day.
In psychiatric practice, for neurotic disorders that are accompanied by hysteria or hypochondria, as well as for dysphoria and phobias, diazepam is usually prescribed at a dose of 5-10 mg twice or thrice a day. If necessary, the dose of diazepam is gradually increased to the maximum daily dose (60 mg of diazepam).
For alcohol withdrawal syndrome, as a rule, 10 mg of diazepam is prescribed three or four times a day on the first day of therapy, after which the dose is reduced to 5 mg of diazepam three times a day. Weakened patients, as well as patients with atherosclerosis, are recommended to take 2 mg of diazepam twice a day and, if necessary and well tolerated, gradually increase the dose until the optimal effect is obtained.

Working patients are generally recommended to take diazepam at a dose of 2.5 mg 1-2 times during the day and 5 mg in the evening.
In neurological practice, for spastic conditions of central origin, 5-10 mg of diazepam is usually prescribed twice or thrice a day.
In cardiology and rheumatology, diazepam is usually prescribed in combination with other drugs at a dose of 2-5 mg twice or three times a day. For patients with vertebral syndrome during bed rest, the dose may be increased to 10 mg of diazepam four times a day.
As part of the complex therapy of myocardial infarction, the use of diazepam, as a rule, begins with parenteral administration, after which they switch to oral administration of 5-10 mg of diazepam up to 3 times a day.
In gynecological and obstetric practice, as a rule, diazepam is prescribed at a dose of 2-5 mg twice or thrice a day.
The maximum daily dose of diazepam is 60 mg.

In pediatric practice, for reactive and psychosomatic disorders, as well as spastic conditions of central origin, as a rule, children under 3 years of age are prescribed parenteral administration with an individual dose calculation; children over 3 years of age are prescribed 2.5 mg of diazepam. If necessary, the dose is gradually increased, carefully monitoring the patient's condition.
For elderly patients, the recommended dose of diazepam is halved. If well tolerated, the dose of diazepam can be gradually increased in elderly patients.

Side effects

Diazepam is usually well tolerated by patients, however, during drug therapy, the possibility of developing the following undesirable effects caused by diazepam cannot be ruled out:
From the nervous system: muscle weakness, drowsiness, lethargy, emotional lability, ataxia, decreased concentration, visual impairment, confusion, depressive states. In addition, headache, tremor, dysarthria, acute agitation, dizziness, hallucinations, sleep and memory disturbances may develop. Diazepam can cause the development of drug dependence and withdrawal syndrome.
From the digestive and hepatobiliary system: stool disorders, hypersalivation, dry oral mucosa, nausea, jaundice, increased activity of alkaline phosphatase and liver transaminases.
Allergic reactions: skin rash, urticaria.
Others: decreased or increased libido, urinary incontinence.

When used in obstetric practice, full-term and premature infants may develop muscle weakness, decreased body temperature and breathing problems (dyspnea).
The risk of developing drug dependence is higher in patients with a history of alcohol dependence, as well as in patients who receive high doses of diazepam. If drug dependence develops and abrupt cessation of diazepam intake, withdrawal syndrome may develop, which is accompanied by headache and muscle pain, anxiety, irritability, confusion and emotional stress. In severe cases, withdrawal syndrome is accompanied by hyperacusis, depersonalization, photosensitivity, increased tactile sensitivity, epileptic seizures, hallucinations and paresthesia.

Contraindications

Diazepam is not used for the treatment of persons with individual intolerance to the active component of the tablets.
Diazepam is not prescribed to patients with suicidal tendencies, myasthenia gravis, alcohol dependence (except in cases of acute withdrawal), drug dependence, or epilepsy or a history of epileptic seizures.
Diazepam is contraindicated in patients with hypercapnia, angle-closure glaucoma and acute attack of glaucoma, spinal and cerebral ataxia, porphyria and hepatitis.
Diazepam should not be prescribed to patients with sleep apnea and severe respiratory or cardiac failure.
Caution should be exercised when prescribing Diazepam to patients with impaired renal and hepatic function.
Diazepam in pediatric practice should only be taken to treat children over 3 years of age.
Potentially unsafe activities that require increased alertness should be avoided while taking diazepam.

Pregnancy

The use of Diazepam in the first and third trimester of pregnancy is strictly prohibited. In the second trimester of pregnancy, Diazepam can only be prescribed under the constant supervision of a doctor. Women of reproductive age should choose a reliable contraceptive before starting diazepam.
During lactation, diazepam is prohibited. If it is impossible to avoid taking Diazepam, the issue of stopping breastfeeding should be decided before starting to take the drug.

Drug interactions

Drugs that inhibit microsomal oxidation (including oral contraceptives, cimetidine, fluoxetine, metoprolol, valproic acid, disulfiram, isoniazid, propranolol and ketoconazole) when used in combination increase the half-life of diazepam and enhance its effects.
Diazepam potentiates the effect of alcohol, antipsychotics, sedatives and antidepressants on the central nervous system.
The drug Diazepam enhances the effects of analgesics, muscle relaxants and anesthetics.
There is a decrease in the absorption of diazepam when used in combination with antacids.
With the simultaneous use of diazepam and antihypertensive drugs, a significant decrease in antithrombin is possible.

Clozapine may increase the risk of respiratory depression in patients receiving diazepam.
It is possible to increase plasma concentrations of non-polar cardiac glycosides and increase the risk of digitalis intoxication when taking these drugs simultaneously with diazepam.
Diazepam reduces the effectiveness of levodopa.
When taken concomitantly, omeprazole increases the half-life of diazepam.
Psychostimulants, analeptics and drugs that inhibit monoamine oxidase, when used in combination, reduce the effectiveness of diazepam.
Low doses of theophylline may reduce or alter the sedative effects of diazepam.

Overdose

When taking excessive doses of diazepam, patients experience the development of paradoxical excitation, depression of cardiac and respiratory activity, areflexia, as well as apnea and coma.
A specific antidote is a benzodiazepine antagonist - flumazenil. In case of overdose, gastric lavage is performed and enterosorbent agents are prescribed. In case of intoxication with diazepam, the functions of the circulatory and respiratory systems should be monitored. If necessary, perform artificial ventilation.
Hemodialysis in case of diazepam overdose is ineffective.

Release form

Diazepam tablets containing 5 or 10 mg of the active substance, in blister packs of 10 pieces, in a cardboard pack there are 2 blister packs.
Diazepam tablets containing 5 or 10 mg of the active substance, in blister packs of 24 pieces, 1 blister pack included in a cardboard pack. Attention!
Description of the drug " Diazepam (tablets)"on this page is a simplified and expanded version of the official instructions for use. Before purchasing or using the drug, you should consult your doctor and read the instructions approved by the manufacturer.
Information about the drug is provided for informational purposes only and should not be used as a guide to self-medication. Only a doctor can decide to prescribe the drug, as well as determine the dose and methods of its use.

Prohibited during pregnancy

Prohibited during breastfeeding

Prohibited for children

Has restrictions for older people

Has limitations for liver problems

Has limitations for kidney problems

Diazepam is a drug used in neurology, psychiatry, cardiology, surgery, anesthesiology, and dermatology. The medicine is used in many countries around the world under different trade names.

The pharmaceutical product can be used either alone or in combination with other medications to enhance their effect on the human body. It is important to consider that this is a rather potent substance, so you should read the instructions for use of Diazepam in detail before taking it.

General information about the medication

Diazepam belongs to the group of benzodiazepines. It has a whole range of pharmacological properties, due to which it has become widespread in many branches of medicine. Refers to List No. III of the List of Narcotic Drugs and Psychotropic Substances.

Pharmacological group, INN, scope of application

Diazepam belongs to the pharmacological group of anxiolytics. It is a benzodiazepine derivative, affects neuromuscular transmission and has an antiepileptic effect. It is used in neurological, surgical, psychiatric, dermatological, cardiological, anesthesiological practice.

INN of the drug is Diazepam.

Release forms and prices for Diazepam

The drug has two forms of release:

  • tablets for oral administration;
  • solution for injection in ampoules of 5 mg/ml.

The approximate price of Diazepam in Russian pharmacies is presented in the table.

Important! The table also shows prices for drugs containing diazepam as an active ingredient. Moreover, it is worth considering that the cost of medications is approximate. Diazepam medications are very difficult to find, not only in brick-and-mortar pharmacies, but also in online pharmacies.

Composition of the drug and pharmacological properties

The tablet form of Diazepam contains 5 or 10 mg of the active component of diazepam, the solution - 10 mg in 1 ampoule.

The drug Diazepam has a wide range of actions:

  • sleeping pills;
  • sedative;
  • antiepileptic;
  • central muscle relaxant.

It is due to these pharmacological properties that the drug has found its use in neurology, cardiology, psychiatry and even surgery.

When taken orally, diazepam is absorbed into the gastrointestinal tract quite quickly (1-1.5 hours). When a drug is administered intramuscularly, its absorption sometimes takes longer.

98% of the active component binds to plasma proteins. The substance penetrates the blood-brain barrier and also the placenta. It is known that a certain amount of diazepam passes into breast milk. Most of the substance, together with metabolites, is excreted primarily in urine.

Use and contraindications for Diazepam

Diazepam is prescribed for a large number of different diseases. Due to its widespread use, indications for its use must be considered based on medical direction.

Psychiatry and neurology

Diazepam is used in neurological and psychiatric practice to treat patients with:


The drug is also used for epilepsy and alcoholic delirium (as part of complex therapy).

Pediatrics

Diazepam is prescribed to children to eliminate neurotic and neurosis-like conditions, the accompanying symptoms of which are:

  • headache;
  • sleep disorders;
  • anxiety;
  • panic fear;
  • an unreasonable feeling of anxiety.

Important! The drug is prescribed to children only if there is no effect from the use of other drugs in this group. In this case, the duration of use of Diazepam in patients of this age category should be as short as possible.

Surgical, anesthesiological field

Diazepam is not prescribed as an independent agent in surgery and anesthesiology, since it is not a full-fledged anesthesia medication. However, it is well suited for premedication before short operations.

Cardiology practice

Diazepam is often prescribed in cardiology to treat diseases such as:

  • angina pectoris;
  • vascular ischemia;
  • arterial hypertension.

The drug is also used as part of complex treatment of myocardial infarction.

Dermatology

In dermatology, Diazepam is prescribed for the treatment of eczema, dermatitis, dermatoses, psoriasis and other skin diseases accompanied by itching and burning. In this case, the drug is used not only internally, but also externally, for lotions or compresses (solution).

Gynecology, obstetrics

Medicines are prescribed in obstetrics only for vital indications. Thus, the drug is prescribed to patients with eclampsia in the last stages of pregnancy, as well as to facilitate labor. Parenteral administration of Diazepam is indicated for women at risk of premature placental abruption.

In gynecology, tablets are prescribed to patients during menopause, as well as to women suffering from psychosomatic disorders during PMS.

Contraindications


It is not recommended to prescribe the drug in the 1st and 2nd trimesters of pregnancy, except in situations where it is vitally necessary. Breastfeeding and infancy up to a month are also contraindications for taking tablets or using the solution.

Instructions for use of the drug

Despite the recommended dosages prescribed in the instructions for Diazepam, the required daily number of tablets or volume of solution is determined individually for each patient. However, generally accepted guidelines for dose titration are appropriate for most patients. In some situations, the dose of the medicine has to be increased. The rules for using Diazepam are directly dependent on the form of its release.

Injection

Adults and adolescent children may be prescribed a dose of Diazepam ranging from 2 to 20 mg. The medicine is administered intramuscularly or intravenously. The exact dosage is calculated taking into account the specific diagnosis, the severity of the pathology, the weight and age of the patient.

Important! Some diseases, such as tetanus, may require higher doses of Diazepam. The medicine is administered exclusively in a hospital setting, under round-the-clock monitoring of the patient’s condition by medical staff.

Dose titration also depends on the purpose of using the injection solution:


Note. For elderly patients suffering from impaired renal function, the dosage of the drug should be reduced.

At the very beginning of the therapeutic process, it is necessary to carefully monitor the patient's condition. Monitoring should be carried out at regular intervals to avoid possible overdose.

Tablet form

Treatment with Diazepam tablets should be started with the minimum effective dose. Then, as necessary, it can be increased until the expected result from the therapy is achieved. The dosage is calculated as follows:


Diazepam in the form of microenemas

Microenemas with Diazepam for rectal use are a quick help for epileptic seizures in adults and children. You can also find the drug under the name Diazepam Desitin. The medicine is dispensed in special tubes that are equipped with a long “spout”. To carry out the treatment procedure, you need to press on the tube itself so that the medicine gets into the rectum. With a gentle, slow movement, the “nose” of the tube is removed from the anus.

It is important! If a microenema with diazepam is given to prevent the development of an epileptic seizure, then the anal area must be thoroughly cleaned before the procedure. But in emergency situations, you should not waste time on performing hygienic procedures.

Microenemas with diazepam are also given for convulsions that occur against the background of hyperthermia. A tube of 5 mg of diazepam is administered to infants from six months of age, as well as to children weighing less than 15 kg. Children weighing more than 15 kg are given 10 mg of diazepam gel for microenemas.

The effect appears within 4-5 minutes after administration of the drug. In view of this, this dosage form of Diazepam is suitable for emergency treatment of various types of seizures and muscle spasms (except tetanus!).

Rectal suppositories

Suppositories with diazepam, like microenemas, are used if it is necessary to urgently eliminate convulsive seizures in epilepsy, as well as seizures of other etiologies. Each suppository may contain 5 or 10 mg of the active ingredient.

Rectal administration of suppositories can be performed on infants from 1 month. The daily dose is 10 mg, single - from 200 to 500 mcg per 1 kg of weight. For children over 5 years old, suppositories are given at 150-500 mcg per 1 kg. The maximum permissible daily dosage is 20 mg.

Possible adverse reactions and overdose of Diazepam

Allergic reactions may occur as side effects when using Diazepam. They appear:

  • itching;
  • skin rashes;
  • redness of the epidermis and swelling;
  • Quincke's edema or angioedema (rare).

Since the medication has a direct effect on the cardiovascular system, taking it may cause:

  • decreased blood pressure;
  • bradycardia;
  • increased heart rate.

On the part of the central nervous system, adverse reactions associated with the use of Diazepam may occur:

  • drowsiness;
  • lethargy;
  • inhibition of reactions;
  • headaches;
  • dizziness;
  • double vision;
  • speech disorders;
  • trembling in the limbs;
  • nervousness;
  • increased excitability;
  • unreasonable fear.

Often, when taking Diazepam orally, digestive dysfunction occurs, accompanied by diarrhea, nausea, vomiting, hiccups, and dry mouth.

An overdose of Diazepam causes depression of the central nervous system. It can manifest itself as weakness, drowsiness, impaired consciousness, and muscle hypotonicity. Sometimes there is a decrease in blood pressure, ataxia, and depression of respiratory function. In severe cases, a coma occurs.

It is possible to eliminate the symptoms of an overdose - the only antidote for Diazepam poisoning is the drug Flumazenil. But it is administered only by a competent specialist, and exclusively in a hospital setting. However, for overly susceptible patients, Flumazenil is recommended to be used before taking Diazepam. In this case, the antidote can be used at home.

The release forms described in the table are extremely rare in Moscow pharmacies (less than 100 offers) or have already been withdrawn from sale.

Preparations containing Diazepam (Diazepam, ATC code N05BA01)
Name Release form Packaging, pcs. Manufacturer country Price in Moscow, r Offers in Moscow
Relanium 5 and 10 Poland, Polfa 191-198 2
Relanium tablets 5mg 20 Poland, Polfa 30-31 2
Relium injection solution 5mg/ml (0.5%) - 2ml 5 and 50 Poland, Polfa 101 1↗
Relium tablets 5mg 20 Poland, Polfa 30-31 2↗
Seduxen tablets 5mg 24 Poland, Polfa 24 1
Sibazon injection solution 5mg/ml (0.5%) - 2ml 10 Russia, different No No
Sibazon tablets 5mg 20 Russia, different 17-19 2↗
Preparations containing Chlordiazepoxide (ATC code N05BA02)
Elenium tablets 10mg 50 Poland, Polfa 454-482 3
Preparations containing Medazepam (Medazepam, ATX code N05BA03)
Mezapam tablets 10mg 50 Russia, Organic 183-371 2↗
Preparations containing Oxazepam (Oxazepam, ATX code N05BA04)
Nozepam tablets 10mg 50 Different 78-85 3↗
Tazepam tablets 10mg 50 Poland, Polfa 119-120 2
Preparations containing Lorazepam (Lorazepam, ATX code N05BA06)
Lorafen tablets 1 mg 25 Poland, Polfa 206 1
Lorafen tablets 2.5 mg 25 Poland, Polfa 300 1
Preparations containing Alprazolam (Alprazolam, ATC code N05BA12)
Name Release form Packaging, pcs. Manufacturer country Price in Moscow, r Offers in Moscow
Alprazolam tablets 0.25 and 1 mg 50 Russia, Organic 278-875 2↗

Relanium (Diazepam) - official instructions for use. The drug is a prescription, the information is intended only for healthcare professionals!

Clinical and pharmacological group:

Tranquilizer (anxiolytic)

pharmachologic effect

Anxiolytic drug (tranquilizer), benzodiazepine derivative.

Diazepam has a depressant effect on the central nervous system, occurring primarily in the thalamus, hypothalamus and limbic system. Enhances the inhibitory effect of gamma-aminobutyric acid (GABA), which is one of the main mediators of pre- and postsynaptic inhibition of the transmission of nerve impulses in the central nervous system. It has anxiolytic, sedative, hypnotic, muscle relaxant and anticonvulsant effects.

The mechanism of action of diazepam is determined by stimulation of benzodiazepine receptors of the supramolecular GABA-benzodiazepine-chlorionophore receptor complex, which leads to activation of the GABA receptor, causing a decrease in the excitability of subcortical brain structures and inhibition of polysynaptic spinal reflexes.

Indications for use of the drug RELANIUM®

  • treatment of neurotic and neurosis-like disorders with anxiety;
  • relief of psychomotor agitation associated with anxiety;
  • relief of epileptic seizures and convulsive conditions of various etiologies;
  • conditions accompanied by increased muscle tone (including tetanus, acute cerebrovascular accidents);
  • relief of withdrawal syndrome and delirium in alcoholism;
  • for premedication and ataralgesia in combination with analgesics and other neurotropic drugs in various diagnostic procedures, in surgical and obstetric practice;
  • in the clinic of internal diseases: in the complex therapy of arterial hypertension (accompanied by anxiety, increased excitability), hypertensive crisis, vascular spasms, menopausal and menstrual disorders.

Tablet dosage regimen

The dose of the drug is selected individually, and it is necessary to take into account both the patient’s condition and the response to treatment; The following are general guidelines only. At the beginning of therapy, it is recommended to use small doses of the drug with a gradual increase.

Divide the daily dose into 2-4 doses (individually). It is advisable to take 2/3 of the daily dose in the evening.

For adults

Neurological disorders, psychosomatic diseases, anxiety-phobic disorders: the usual single dose is 2.5-5 mg (1/2-1 tablet). The average daily dose for adults is 5-20 mg.

A single dose of Relanium should not exceed 10 mg!

Symptomatic treatment of convulsive syndrome: usually used 2.5-10 mg (1/2-2 tablets) 2-4 times a day.

In the complex treatment of mental disorders of organic origin: the initial dose is 20-40 mg per day (4-8 tablets), the maintenance daily dose is 15-20 mg per day (3-4 tablets).

Muscle contractures, spasticity, rigidity: 5-20 mg per day (1-4 tablets).

In elderly and cachetic patients, as well as with decreased liver function, the elimination of Relanium can be significantly prolonged. It is recommended to start treatment with a lower (approximately half) dose, which can be gradually increased, taking into account individual tolerability of the drug.

Children should always be assessed individually, taking into account age, level of physical development, general condition and response to treatment. The initial dose is 1.25-2.5 mg per day, divided into 4 doses. This dose can be reduced or increased, taking into account the individual response to the therapy.

The use of anxiolytic drugs from the benzodiazepine group is contraindicated in children under 6 months of age.

Dosage regimen for injection solution

In order to relieve psychomotor agitation associated with anxiety, 5-10 mg IV is prescribed slowly; if necessary, after 3-4 hours the drug is re-administered in the same dose.

For tetanus, 10 mg IV is prescribed slowly or deep IM, then 100 mg of diazepam is administered IV drip in 500 ml of 0.9% sodium chloride solution or 5% glucose solution at a rate of 5-15 mg/h.

For status epilepticus, 10-20 mg is prescribed IM or IV; if necessary, after 3-4 hours the drug is re-administered in the same dose.

To relieve spasms of skeletal muscles - 10 mg IM 1-2 hours before surgery.

In obstetrics, 10-20 mg is prescribed intramuscularly when the cervix is ​​dilated by 2-3 fingers.

Side effect

From the side of the central nervous system and peripheral nervous system: at the beginning of treatment (especially in elderly patients) - drowsiness, dizziness, increased fatigue, impaired concentration, ataxia, disorientation, dulling of emotions, slowing of mental and motor reactions, anterograde amnesia (develops more often, than with other benzodiazepines); rarely - headache, euphoria, depression, tremor, catalepsy, confusion, dystonic extrapyramidal reactions (uncontrolled movements), asthenia, muscle weakness, hyporeflexia, dysarthria; in some cases - paradoxical reactions (outbursts of aggression, psychomotor agitation, fear, suicidal tendencies, muscle spasms, confusion, hallucinations, anxiety, sleep disturbances).

From the hematopoietic system: leukopenia, neutropenia, agranulocytosis (chills, hyperthermia, sore throat, severe fatigue or weakness), anemia, thrombocytopenia.

From the digestive system: dry mouth or hypersalivation, heartburn, hiccups, gastralgia, nausea, vomiting, loss of appetite, constipation, liver dysfunction, increased activity of liver transaminases and alkaline phosphatase, jaundice.

From the cardiovascular system: arterial hypotension, tachycardia.

From the urinary system: urinary incontinence or retention, renal dysfunction.

From the reproductive system: increased or decreased libido, dysmenorrhea.

From the respiratory system: respiratory depression (if the drug is administered too quickly).

Allergic reactions: skin rash, itching.

Local reactions: phlebitis or venous thrombosis (redness, swelling, pain) at the injection site.

Other: addiction, drug dependence; rarely - depression of the respiratory center, visual impairment (diplopia), bulimia, weight loss.

With a sharp reduction in dose or discontinuation of use - withdrawal syndrome (increased irritability, headache, anxiety, fear, psychomotor agitation, sleep disturbances, dysphoria, spasm of smooth muscles of internal organs and skeletal muscles, depersonalization, increased sweating, depression, nausea, vomiting, tremor , perceptual disorders, including hyperacusis, paresthesia, photophobia, tachycardia, convulsions, hallucinations; rarely - psychotic disorders). When used in obstetrics in newborns - muscle hypotonia, hypothermia, dyspnea.

Contraindications to the use of the drug RELANIUM®

  • severe form of myasthenia;
  • coma;
  • angle-closure glaucoma;
  • indications in the anamnesis of symptoms of dependence on drugs, alcohol (with the exception of treatment of alcohol withdrawal syndrome and delirium);
  • sleep apnea syndrome;
  • state of alcoholic intoxication of varying severity;
  • acute intoxication with drugs that have a depressing effect on the central nervous system (narcotic, hypnotic and psychotropic drugs);
  • severe chronic obstructive pulmonary diseases (risk of progression of respiratory failure);
  • acute respiratory failure;
  • children up to 30 days inclusive;
  • pregnancy (especially the 1st and 3rd trimesters);
  • lactation period (breastfeeding);
  • hypersensitivity to benzodiazepines.

Prescribe with caution in absence seizures (petit mal) or Lennox-Gastaut syndrome (with intravenous administration it can provoke the development of tonic status epilepticus), epilepsy or a history of epileptic seizures (initiation of treatment with diazepam or its abrupt withdrawal may accelerate the development of seizures or status epilepticus) , liver and/or renal failure, cerebral and spinal ataxia, with hyperkinesis, a tendency to abuse psychotropic drugs, with depression, organic diseases of the brain (paradoxical reactions are possible), with hypoproteinemia, in elderly patients.

Use of the drug RELANIUM® during pregnancy and breastfeeding

The drug is contraindicated for use during pregnancy and lactation.

Relanium® has a toxic effect on the fetus and increases the risk of birth defects when used in the first trimester of pregnancy. Taking the drug in therapeutic doses later in pregnancy may cause depression of the fetal central nervous system. Chronic use during pregnancy can lead to physical dependence - possible withdrawal symptoms in the newborn.

When Relanium is used in doses of more than 30 mg within 15 hours before or during childbirth, it can cause respiratory depression in the newborn (up to apnea), decreased muscle tone, decreased blood pressure, hypothermia, and weak sucking (“floppy baby syndrome”).

Use for liver dysfunction

If it is necessary to use the drug in patients with liver diseases, the risk-benefit ratio of therapy should be assessed.

Use for renal impairment

If it is necessary to use the drug in patients with kidney disease, the risk-benefit ratio of therapy should be assessed.

Use in elderly patients

Prescribe with caution to elderly patients.

Use in children

Newborns after the 5th week of life (over 30 days) are prescribed IV slowly at 100-300 mcg/kg body weight up to a maximum dose of 5 mg; if necessary, the administration is repeated after 2-4 hours (depending on clinical symptoms).

For children aged 5 years and older, the drug is administered intravenously at a dose of 1 mg every 2-5 minutes up to a maximum dose of 10 mg; if necessary, administration can be repeated after 2-4 hours.

special instructions

Diazepam should be prescribed with extreme caution for severe depression, because the drug can be used to realize suicidal intentions.

Relanium IV solution should be injected slowly into a large vein, at least over 1 minute for every 5 mg (1 ml) of the drug. It is not recommended to carry out continuous intravenous infusions - sedimentation and adsorption of the drug by materials from PVC infusion bottles and tubes is possible.

In case of renal or liver failure and long-term use, it is necessary to monitor the peripheral blood picture and the activity of liver enzymes.

The risk of developing drug dependence increases when using Relanium in high doses, with a significant duration of treatment in patients who have previously abused alcohol or drugs. Unless absolutely necessary, the drug should not be used for a long time. Abrupt cessation of treatment is unacceptable due to the risk of withdrawal syndrome, however, due to the slow elimination of diazepam, the manifestation of this syndrome is much less pronounced than with other benzodiazepines.

If patients experience such unusual reactions as increased aggressiveness, psychomotor agitation, anxiety, fear, suicidal thoughts, hallucinations, increased muscle cramps, difficulty falling asleep, superficial sleep, treatment should be stopped.

Initiation of treatment with Relanium or its abrupt withdrawal in patients with epilepsy or a history of epileptic seizures may accelerate the development of seizures or status epilepticus.

If it is necessary to use the drug in patients with liver and kidney diseases, the risk-benefit ratio of therapy should be assessed.

Relanium® is not administered intra-arterially due to the risk of developing gangrene.

With prolonged use of the drug, addiction may develop.

During the treatment period, alcohol consumption is prohibited.

Impact on the ability to drive vehicles and operate machinery

Patients receiving the drug should refrain from engaging in potentially hazardous activities that require increased attention and speed of psychomotor reactions.

Overdose

Symptoms: drowsiness, depression of consciousness of varying severity, paradoxical excitation, decreased reflexes to areflexia, decreased response to painful stimuli, dysarthria, ataxia, visual impairment (nystagmus), tremor, bradycardia, decreased blood pressure, collapse, cardiac depression, respiratory depression, coma.

Treatment: gastric lavage, forced diuresis, activated charcoal; carrying out symptomatic therapy (maintaining breathing and blood pressure), mechanical ventilation.

Hemodialysis is ineffective.

A specific antidote is flumazenil, which should be used in a hospital setting. Flumazenil is not indicated for patients with epilepsy who have been treated with benzodiazepines. In such cases, the antagonistic effect towards benzodiazepines can provoke the development of epileptic seizures.

Drug interactions

MAO inhibitors, strychnine and corazole antagonize the effects of Relanium.

With the simultaneous use of Relanium with sleeping pills, sedatives, opioid analgesics, other tranquilizers, benzodiazepine derivatives, muscle relaxants, general anesthesia, antidepressants, antipsychotics, as well as with ethanol, a sharp increase in the inhibitory effect on the central nervous system is observed.

When used simultaneously with cimetidine, disulfiram, erythromycin, fluoxetine, as well as with oral contraceptives and estrogen-containing drugs that competitively inhibit metabolism in the liver (oxidation processes), it is possible to slow down the metabolism of diazepam and increase its concentration in the blood plasma.

Isoniazid, ketoconazole and metoprolol also slow down the metabolism of diazepam and increase its concentration in the blood plasma.

Propranolol and valproic acid increase the concentration of diazepam in the blood plasma.

Rifampin can induce the metabolism of diazepam, which leads to a decrease in its concentration in blood plasma.

Inducers of microsomal liver enzymes reduce the effectiveness of Relanium.

Opioid analgesics enhance the inhibitory effect of Relanium on the central nervous system.

When used simultaneously with antihypertensive drugs, the hypotensive effect may be enhanced.

Increased respiratory depression may occur when used concomitantly with clozapine.

With the simultaneous use of Relanium with cardiac glycosides, it is possible to increase the concentration of the latter in the blood serum and develop digitalis intoxication (as a result of competitive interaction with plasma proteins).

Relanium reduces the effectiveness of levodopa in patients with parkinsonism.

Omeprazole prolongs the elimination time of diazepam.

Respiratory analeptics and psychostimulants reduce the activity of Relanium.

When used simultaneously with Relanium, the toxicity of zidovudine may increase.

Theophylline (in low doses) may reduce the sedative effect of Relanium.

Premedication with Relanium allows you to reduce the dose of fentanyl required for induction of general anesthesia and shortens the time of onset of general anesthesia.

Pharmaceutical interactions

Relanium® is incompatible in the same syringe with other drugs.

Conditions for dispensing from pharmacies

The drug is available with a prescription.

Storage conditions and periods

Relanium® belongs to list No. 1 of potent substances of the Standing Committee for Drug Control of the Ministry of Health of the Russian Federation.

The drug should be stored out of the reach of children, protected from light at a temperature of 15° to 25°C. Shelf life - 5 years.