Short-term (2-4 weeks) treatment of anxiety, which may also be associated with insomnia. As a tranquilizer and premedication agent. Treatment of symptoms of sudden alcohol withdrawal. Helpful in the treatment of some types of epilepsy, e.g. clonic muscular convulsions. Treatment of increased muscle tone.
Composition:
5 ml of suspension contains 2 mg of diazepam.
Action:
Anxiolytic drug, a benzodiazepine derivative. It has an inhibitory effect on the limbic system and hypothalamus. The mechanism of action of diazepam is to connect with a specific receptor associated with the receptor complex activating the chloride channel. Diazepam increases the inflow of chloride ions to the inside of the neuron, which leads to hyperpolarization of the membranes and, as a result, to the inhibition of neuronal function. It is characterized by a strong anticonvulsant, anti-anxiety and sedative action. It also shows hypnotic effects and relaxes skeletal muscles. It reduces tension, anxiety, irritability, excitability and aggressiveness. Following oral administration, diazepam is rapidly and almost completely absorbed from the gastrointestinal tract. It is 97% bound to plasma proteins. It is rapidly metabolised in the liver to active metabolites: demethyldiazepam (nordiazepam), oxazepam and temazepam. It is mainly excreted in the urine. It penetrates into the cerebrospinal fluid, across the placenta barrier and into breast milk. T0,5 diazepam is 1-2 days, the main metabolite - demethyldiazepam - 2-5 days. The half-life is longer in newborns, people with liver or kidney failure and in the elderly, whereas in patients with epilepsy may be shortened.
Contraindications:
Hypersensitivity to diazepam, benzodiazepines or other components of the preparation. Pregnancy and breastfeeding. acute intoxication with alcohol, opioids, hypnotics, neuroleptics and lithium salts. Disturbances of consciousness. Shock. Breathing disorders, acute respiratory failure, sleep apnea syndrome. Severe hepatic failure.Myasthenia gravis. Do not use in children until 1 year of age.
Precautions:
It should not be used as a monotherapy in the treatment of depression or anxiety associated with depression. Diazepam should not be used to treat chronic psychoses or phobias and obsessions. Avoid use (or reduce the duration of use) in people with history of alcoholism and drug addiction. Use with caution in patients with personality disorders, narrow-angle glaucoma, myasthenia gravis, chronic bronchospasm, weakened patients, in hepatic and / or renal failure, in cardiac insufficiency and in patients with hypotension. Because of the risk of chronic obstruction, caution should be used in elderly patients. Post-mortem obliteration may occur after the use of therapeutic doses, the risk increases with increasing dose; to reduce the risk of chronic obstruction, the patient should be given an uninterrupted sleep for 7-8 hours. The preparation may have an allergenic effect due to the presence of excipients: asthma attack in patients with asthma, urticaria (sodium benzoate, propyl hydroxybenzoate, methyl hydroxybenzoate) and adverse reactions in patients with diabetes, patients with glucose-galactose malabsorption, fructose intolerance or in patients with sucrose-isomaltase deficiency.
Pregnancy and lactation:
Use of the drug in pregnancy is only allowed if its use in the mother is absolutely necessary, and the use of a safer alternative medicine is impossible or contraindicated. Taking diazepam in the first trimester of pregnancy increases the risk of birth defects. In newborns who had been given diazepam only once before delivery, hypotonia, hypothermia, no sucking reflex, decreased activity and respiratory failure were observed. In children of mothers who took long-term diazepam during pregnancy, symptoms of withdrawal syndrome were observed. Diazepam passes into breast milk - it should not be used during breastfeeding.
Side effects:
Common (≥1 / 100, <1/10): pain and dizziness, decreased intellectual performance, dysarthria, fatigue, drowsiness, lack of mobility, increased muscle tone, muscle weakness, tremors, confusion. Rare (≥1 / 10,000, <1/1000): tachycardia, leukopenia, agranulocytosis, anemia, thrombocytopenia, lymphocytosis with eosinophilia, hyperactivity, anxiety, aggression, sleep disorders (including insomnia), sensory disturbances, memory disorders (amnesia ), visual disturbances, breathing disorders, nausea, vomiting, constipation, diarrhea, dry mouth, hematuria, facial flushing, skin rash, pruritus, incontinence, hypotension, menstrual disorders, euphoria, depression, psychosis, feeling dizzy libido disorders, increased or decreased appetite, jaundice, increase or decrease in transaminase and alkaline phosphatase activity. Paradoxical reactions are sometimes observed, especially in children and elderly patients, including restlessness, agitation, irritability, aggression, delusions, nightmares, hallucinations, psychoses. Diazepam can cause mental and physical dependence. Abrupt discontinuation of treatment may result in withdrawal symptoms (including headache, muscle pain, anxiety, tension, agitation, confusion, irritability).
Dosage:
Orally. Children over 1 year of age, usually: in anxiety states, states of increased muscle tone or as an anticonvulsant - 1-2.5 mg 3-4 times a day or 0.04-0.2 mg / kg. 3-4 times a day; the dose can be gradually increased depending on the effectiveness and severity of side effects. Adults: anxiety - 2-10 mg 2-4 times a day; insomnia associated with anxiety - 5-15 mg a day before falling asleep; treatment of symptoms of sudden alcohol withdrawal - 10 mg 3-4 times in the first 24 hours, then the dose can be reduced to 5 mg 3-4 times a day; as a premedicate - 5-15 mg before surgery; states of increased muscle tone - 2-15 mg per day in divided doses; as an anticonvulsant - 2-10 mg 2-4 times a day. In elderly and debilitated patients: initially 2 mg 1-2 times daily, then the dose can be gradually increased depending on the patient's response and tolerability. Lower doses should be used in people with hepatic impairment. Diazepam treatment should not last longer than 4 weeks.
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