This information is a reference and it is not enough that the drug has been prescribed by a doctor ..
PHARMACHOLOGIC EFFECT
Tranquilizer, 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. May cause anticholinergic effect.
PHARMACOKINETICS
Suction fast. C max in plasma is observed after 90 minutes. 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; sleep disorders, motor excitation of various etiologies in neurology and psychiatry, withdrawal syndrome with chronic alcoholism; spastic conditions associated with the defeat of the brain or spinal cord, as well as myositis, bursitis, arthritis, accompanied by a strain of skeletal muscles; status epilepticus; premedication before anesthesia; as a component of combined anesthesia; relief of labor, premature birth, premature detachment of the placenta, tetanus.
DOSING MODE
Is taken orally, injected in / m, iv, rectally. The daily dose varies from 500 Ојg to 60 mg. Single dose, frequency and duration of application are set individually.
SIDE EFFECT
From the nervous system: drowsiness, dizziness, muscle weakness; rarely - confusion, depression, visual impairment, diplopia, dysarthria, headache, tremor, ataxia; in isolated cases, paradoxical reactions: excitement, anxiety, sleep disturbances, hallucinations. After iv introduction hiccups are sometimes observed. With prolonged use, it is possible to develop drug dependence, memory impairment.
From the digestive system: rarely - constipation, nausea, dry mouth, salivation; in isolated cases - increased activity of transaminases and alkaline phosphatase in the blood plasma, jaundice.
From the endocrine system: rarely - increased or decreased libido.
From the urinary system: rarely - urinary incontinence.
From the side of the cardiovascular system: with parenteral application, a slight decrease in blood pressure is possible.
On the part of the respiratory system: with parenteral use in isolated cases - breathing disorders.
Allergic reactions: rarely - skin rash.
CONTRAINDICATIONS
Severe myasthenia gravis, severe chronic hypercapnia. Instructions in the history of alcohol or drug dependence (except for acute withdrawal). Hypersensitivity to diazepam and other benzodiazepines.
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.
APPLICATION FOR 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 intravenous 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 ingestion.
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 INTERACTION
When used simultaneously with drugs that exert a depressing effect on the central nervous system (including neuroleptics, sedatives, hypnotics, opioid analgesics, anesthetics), the oppressive effect on the central nervous system, on the respiratory center, and severe 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.
In patients who have been receiving antihypertensive drugs for a long time, the beta-blockers, anticoagulants, cardiac glycosides, the 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 use of ethanol, ethanol containing drugs, the oppressive effect on the central nervous system (mainly the respiratory center) increases, and a pathological intoxication syndrome may also occur.
The information is provided for your information, do not self-medicate, it is dangerous for your health.
