Diazepam - instructions for use, reviews, analogs and formulations (tablets or pills 2 mg, 5 mg and 10 mg, injections in injections) of a drug for the treatment of epilepsy, neuroses, fear in adults, children and pregnancy

In this article, you can read the instructions for using the drug Diazepam. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Diazepam in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Diazepam in the presence of existing structural analogues.Use for the treatment of epilepsy, neuroses, fear in adults, children, as well as during pregnancy and lactation.

Diazepam - a tranquilizer, a benzodiazepine derivative. Has anxiolytic, sedative, anticonvulsant, central muscle relaxant effect. The mechanism of action is associated with increased inhibitory effect of GABA in the central nervous system. The miorelaksiruyuschee effect is due also to the inhibition of spinal reflexes. Can cause an anticholinergic effect.

Composition

Diazepam + excipients.

Pharmacokinetics

Suction fast. Binding to plasma proteins is 98%. It penetrates through the placental barrier, into the cerebrospinal fluid, and is excreted in breast milk. Metabolised in the liver. It is excreted by the kidneys - 70%.

Indications

• neuroses;
• borderline states with the phenomena of tension, anxiety, anxiety, fear;
• schizophrenia;
• sleep disorders (insomnia);
• motor excitation of various etiologies in neurology and psychiatry;
• abstinence syndrome in chronic alcoholism;
• spastic conditions associated with damage to the brain or spinal cord;
• myositis, bursitis, arthritis accompanied by a tension of skeletal muscles;
• status epilepticus;
• premedication before anesthesia;
• as a component of combined anesthesia;
• facilitating labor activity;
• premature delivery;
• premature placental abruption;
• tetanus.

Forms of release

Dragee 2 mg and 5 mg.

Tablets 2 mg, 5 mg and 10 mg.

Solution for intravenous and intramuscular injection (injections in ampoules for injection).

Instructions for use and dosage

Inside, adults - 4-15 mg per day in 2 divided doses (maximum daily dose - 60 mg, in a hospital). Breast children older than 6 months - 0.1-0.8 mg / kg per day in 3-4 divided doses.

Intravenously, intramuscularly - 10-20 mg with a multiplicity in accordance with the indication.

Side effect

• drowsiness;
• dizziness;
• muscle weakness;
• confusion of consciousness;
• depression;
• visual impairment;
• headache;
• tremor;
• excitation;
• sense of anxiety;
• sleep disorders;
• hallucinations;
• hiccough;
• development of drug dependence;
• memory impairment;
• constipation;
• nausea;
• dry mouth;
• salivation;
• increased or decreased libido;
• urinary incontinence;
• lowering blood pressure;
• skin rash.

Contraindications

• severe myasthenia gravis;
• severe chronic hypercapnia;
• indication in the history of alcohol or drug dependence (except acute withdrawal);
• increased sensitivity to diazepam and other benzodiazepines.

Application in pregnancy and lactation

Do not use diazepam in the first trimester of pregnancy, except in cases of extreme necessity. It should be borne in mind that with the use of diazepam in pregnancy, a significant change in the fetal heart rate is possible.

When used in obstetrics in doses recommended for the relief of labor, in newborns, more often in premature babies, temporary hypotension, hypothermia, and respiratory failure are possible.

With regular admission during lactation, breastfeeding should be discontinued.

Use in children

Diazepam in newborns should be avoided, since the enzyme system involved in the metabolism of diazepam has not yet fully formed.

special instructions

With extreme caution apply in patients with cardiac and respiratory insufficiency, organic changes in the brain (in such cases, it is recommended to avoid parenteral diazepam administration), with angle-closure glaucoma and predisposition to it, with myasthenia gravis.

Special care is required with the use of diazepam, especially at the beginning of treatment, in patients who have been receiving antihypertensive drugs for a long time, central action, beta-blockers, anticoagulants, cardiac glycosides.

If you cancel therapy, the dose should be reduced gradually. With sudden withdrawal of diazepam after prolonged use, anxiety, agitation, tremors, convulsions are possible.

Diazepam should be abolished with the development of paradoxical reactions (acute arousal, anxiety, sleep disturbances and hallucinations).

After intramuscular injection of diazepam, an increase in the activity of CK in the blood plasma is possible (which should be taken into account in the differential diagnosis of myocardial infarction).

Avoid intraarterial administration.

During the treatment period, do not drink alcohol.

Impact on the ability to drive vehicles and manage mechanisms

Diazepam may cause a slowdown in the rate of psychomotor reactions, which should be taken into account for patients involved in potentially hazardous activities.

Drug Interactions

When used simultaneously with drugs that exert a depressant effect on the central nervous system (incl.with neuroleptics, sedatives, hypnotics, opioid analgesics, means for anesthesia), the oppressive effect on the central nervous system, on the respiratory center, expressed arterial hypotension increases.

With simultaneous use with tricyclic antidepressants (including with amitriptyline), it is possible to increase the oppressive effect on the central nervous system, increase the concentration of antidepressants, and increase cholinergic action.

Patients who received long-term antihypertensive drugs of central action, beta-blockers, anticoagulants, cardiac glycosides, degree and mechanisms of drug interaction are unpredictable.

With simultaneous use with muscle relaxants, the effect of muscle relaxants is increased, the risk of apnea increases.

When used simultaneously with oral contraceptives, it is possible to enhance the effects of diazepam. Increased risk of development of breakthrough bleeding.

With simultaneous use with bupivacaine may increase the concentration of bupivacaine in blood plasma; with Diclofenac - may increase dizziness; with Isoniazid - a reduction in the excretion of diazepam from the body.

Drugs that induce induction of liver enzymes, incl.antiepileptic drugs (carbamazepine, phenytoin), can accelerate the excretion of diazepam.

With simultaneous use with caffeine, the sedative and, perhaps, the anxiolytic effect of diazepam decreases.

With simultaneous application with clozapine, arterial hypotension, respiratory depression, loss of consciousness are possible; with levodopa - suppression of antiparkinsonian action is possible; with lithium carbonate - a case of development of a coma is described; with Metoprolol - reduction of visual acuity, deterioration of psychomotor reactions are possible.

With simultaneous application with paracetamol, a decrease in the excretion of diazepam and its metabolite (desmethyldiazepam) is possible; with Risperidone - cases of ZNS development are described.

With simultaneous use with rifampicin, the excretion of diazepam increases due to a significant increase in its metabolism under the influence of rifampicin.

Theophylline in low doses, distorts the sedative effect of diazepam.

With the simultaneous use in rare cases, diazepam inhibits metabolism and enhances the effect of phenytoin. Phenobarbital and phenytoin can accelerate the metabolism of diazepam.

With simultaneous application of fluvoxamine increases the concentration in the blood plasma and side effects of diazepam.

With simultaneous use with cimetidine, omeprazole, disulfiram, an increase in the intensity and duration of action of diazepam is possible.

With the simultaneous intake of ethanol (alcohol), ethanol-containing drugs, the oppressive effect on the central nervous system (mainly the respiratory center) increases, and a syndrome of pathological intoxication may also occur.

Analogues of the drug Diazepam

Structural analogs for the active substance:

• Apaurin;
• Valium Rosh;
• Diazepabene;
• Diazepec;
• Diapam;
• Relanium;
• Relium;
• Seduxen;
• Sibazon.

Analogues on the curative effect (remedies for the treatment of epilepsy):

• Benzon;
• Berlidorm 5;
• Wimpat;
• Gopantam;
• Depakin;
• Depakin chrono;
• Diakarb;
• Zagreton;
• Carbamazepine;
• Carbasan retard;
• Keppra;
• Clonazepam;
• Clonotril;
• Convalis;
• Convulex;
• Convulsant;
• Lamolope;
• Mazepine;
• Napoton;
• He did not;
• Nitrazepam;
• Nitram;
• Nozepam;
• Pantogam is an asset;
• Pantogam;
• Pantokaltsin;
• Piracetam;
• Rivotril;
• Sabril;
• Sibazon;
• Stasepine;
• Storilate;
• Topamax;
• Topsaver;
• Fesipam;
• Phenazepam;
• Finlepsin;
• Finlepsin retard;
• Elzepam;
• Enchorat is chrono;
• Epial;
• Epitera.

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