Diazepam
Diazepam is in a class of medications called benzodiazepines which are used along with other medications to control seizures.
What is Diazepam used for?
- Seizures.
- Status epilepticus.
- Alcohol withdrawal syndrome.
- Procedural anxiety/ sedation
- Muscle spasm, spasticity, and/or rigidity.
How is Diazepam available?
- Tablet.
- Syrup/ oral liquid.
- Intra nasal.
- Rectal gel
- Injection.
How does Diazepam act (mechanism of action)?
This medication is a long-acting Diazepam. It works by attaching specific receptors in the brain and nervous system, especially in areas that control emotions and alertness. This helps enhance the calming effects of a chemical in the brain called GABA. By doing this, it makes nerve cells less excitable and more stable, which helps reduce anxiety, relax muscles, and promote sleep.
How much time does Diazepam take to act?
Sedation (to help calm or relax a child): When given through an IV, it starts working in about 4 to 5 minutes.
Seizures (status epilepticus):
When given through an IV, it starts working in 1 to 3 minutes.
When given as a rectal dose, it starts working in 2 to 10 minutes.
It can take longer for some people to experience the full benefits. The exact time frame can vary
depending on the individual.
Why is Diazepam important for you/your child’s treatment?
It is important that your child takes Diazepam regularly so that you/your child doesn’t suffer from Seizures or have fewer seizures episodes and other diseases.
Diazepam controls seizures but doesn’t cure epilepsy and works only while you keep taking it. So do not stop giving Diazepam suddenly, as it may result in having more seizures.
What is the ideal time to take diazepam?
Usually after breakfast and then after dinner, you can adjust the time slot according to your schedule.
However, there are some exceptions when your doctor may advise to give it three or four times a day. Please follow your doctor’s instructions in such case.
It should ideally be given at the same time every day to establish a routine as it minimizes the chances of missing a dose.
When should diazepam be taken?
Diazepam can be taken either before or after food. It doesn’t make a big difference in how it works. However, taking it after food may help reduce any stomach upset if that’s a concern. Just follow the instructions from your doctor or pharmacist on how to take it.
Always follow your doctor’s instructions about the timing and dosage and never take more than prescribed.
How should I give the medicine?
Tablets: A whole tablet must be swallowed with a glass of water, juice or milk. You may give it by crushing and mixing it in water/ juice or small serving of yogurt / Curd.
Liquid or syrup: Use an oral syringe or a medicine spoon to measure the adequate amount. You can easily get these from any pharmacy nearby.
Do not use a kitchen teaspoon as it will not give the accurate amount of the drug.
IV (intravenous): should only be administered in a hospital or healthcare setting by a trained professional.
What if I miss a dose?
If you miss a dose, take it within 6 hours of remembering. Do not take the missed dose if it is close to the next one; just take the next dose as normal. If you miss two or more doses, discuss it with your doctor.
NEVER GIVE A DOUBLE DOSE OF DIAZEPAM
If your child vomits out the content within 30 minutes of taking the medicine dosage then you can give the dose again; but if your child vomits after 30 minutes of taking the dose, then just leave it be and do not give it again.
Could this medication have any side effects on my child?
Every medication has both positive and potential negative effects. Fortunately, adverse effects are not common for everyone, but it’s essential to be aware of them. Understanding possible side effects allows us to act quickly and effectively if they occur, ensuring that we can address any concerns promptly while continuing to benefit from the intended effects of medications.
Even though it may be rare, few people sometimes may have serious side effects when taking a drug. Consult your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect.
Side Effects of Diazepam
- Drowsiness (feeling very sleepy).
- Heart and circulation: Low blood pressure, flushing (redness or warmth in the skin), Slow heart rate, fainting, shock.
- Skin: Rash, Sweating, itching, hives.
- Digestive system: Stomach pain, diarrhea, changes in taste, hiccups, Loss of appetite, vomiting.
- Nervous system: Feeling restless or nervous, weakness, trouble with coordination, confusion, dizziness, slurred speech, mood swings, euphoria (feeling overly happy), headache, speech problems, spinning sensation (vertigo).
- Breathing: Asthma, nosebleeds, stuffy or uncomfortable nose.
- Urinary system: Bladder infections.
- Blood: Anemia or other blood issues.
- Infections: Increased risk of infection.
- Muscles: Uncontrolled muscle movements.
- Eyes: Enlarged pupils, unusual eye movements.
Always tell your doctor if you notice any side effects, especially ones that bother you or don’t go away.
Does diazepam cause weight gain?
Diazepam does not usually cause weight gain as a common side effect. However, some people might notice changes in appetite or weight while taking it. If you are concerned about weight changes, talk to your doctor.
Can other common medicines be taken during the course of diazepam?
When taking Diazepam, some common medications can be taken with caution, while others should generally be avoided due to the risk of dangerous interactions. Medications like Acetaminophen, Ibuprofen, and Cetirizine are typically safe to use with diazepam, but it is important to consult your doctor before combining them. On the other hand, opioids (e.g., morphine, oxycodone), other sedatives, alcohol, antidepressants, and antihistamines (like Benadryl) should generally be avoided, as they can increase drowsiness, slow your breathing, or cause other serious side effects when taken with Diazepam. Always check with your doctor before using any new medication alongside Diazepam.What food to avoid while taking diazepam?
While taking diazepam, it’s important to avoid certain foods and drinks that can interact with the medication, as they may increase the risk of side effects or reduce the drug’s effectiveness:- Grapefruit and grapefruit juice: It can interfere with the metabolism of diazepam, potentially increasing its effects and side effects.
- Alcohol: Combining diazepam with alcohol can amplify sedative effects, leading to dangerous drowsiness, dizziness, and impaired coordination.
- High-fat meals: These can delay the absorption of diazepam and affect how your body processes it.
PREGNANCY AND LACTATION:
Diazepam is not recommended during pregnancy and breastfeeding.Pregnancy: It should be avoided, especially in the early stages. Always consult your doctor for the best advice regarding medication during pregnancy and breastfeeding.
Breastfeeding: It is generally not recommended while breastfeeding. Speak with your doctor about alternatives.
Is there any risk if I conceive while taking diazepam?
Yes, there may be risks if you conceive while taking Diazepam, especially during the first few months of pregnancy
If you think you might be pregnant or are planning to get pregnant, talk to your doctor right away. They can help you decide on the best and safest options for you and your baby.
Can I stop taking diazepam?
It is important not to stop taking diazepam suddenly without consulting your doctor. Stopping it abruptly can lead to withdrawal symptoms, such as anxiety, tremors, seizures, and irritability, especially if you’ve been taking it for a long period.Contraindications of Diazepam:
- Allergy to benzodiazepines
- Severe respiratory issues
- Severe liver disease
- Acute narrow-angle glaucoma
- Myasthenia gravis
- Pregnancy (especially in the first trimester)
- Breastfeeding
Where should you store Diazepam?
- Store diazepam in a cool, dry place at room temperature, away from heat, moisture, and direct sunlight.
- Keep it out of reach of children and pets.
- Always keep it in its original packaging until it’s time to use it.
Monitoring parameters of Diazepam:
- Heart rate, respiratory rate, blood pressure
- Liver enzyme levels
- Serum creatinine and Urea levels
- Complete blood counts with long term therapy
Always let your doctor know if you feel unwell or notice unusual symptoms.
How to handle side effects?
Try these tips:
- Drowsiness or dizziness: Avoid activities that require full concentration, like driving, until you know how diazepam affects you.
Rest in a quiet, safe place if you feel too sleepy or dizzy.
- Headaches: Drink plenty of water and try relaxation techniques.
Take over-the-counter pain relief (if your doctor approves).
- Stomach issues (like diarrhea or upset stomach): Eat smaller, lighter meals.
Avoid spicy or greasy foods.
- Feeling emotional or confused: Let your doctor know if mood changes or confusion occur. They may adjust your dose.
Talk to a trusted person if you’re feeling upset.
Summary
Diazepam is used for treating anxiety, muscle spasms, seizures, and for sedation before medical procedures. It calms the brain and nervous system. Common side effects include drowsiness, dizziness, muscle weakness, confusion, and dry mouth. Avoid alcohol while taking diazepam due to increased sedative effects. Not recommended during pregnancy or breastfeeding. Follow your doctor’s instructions and consult them for persistent or severe side effects.Let us know if you find this useful!
Author:
1. Dr. Ramya. R, Pharm D, Clinical pharmacologist, Aster Hospitals, Bengaluru
2. Dr Praveen Kumar, B. Pharm, Pharm D(PB), Head Clinical Pharmacologist, Aster Hospitals, Bengaluru
3. Dr C P Ravi Kumar, Consultant Paediatric Neurologist, Aster CMI Hospital.