 Valium |  |
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- BRAND NAMES:
Alboral; Aliseum; Alupram; Amiprol; Anlin; Ansiolin;
Antenex; Anxicalm; Anxionil; Apo-diazepam; Apozepam; Armonil; Arzepam;
Assival; Atensine; Azedipamin; Baogin; Benzopin; Best; Betapam; Britazepam;
Calmpose; Calmod; Caudel; Centrazepam; Chuansuan; Consilium; D-Val; Desconet;
Desloneg; Di-Tran; Diaceplex; Dialag; Dialar; Diapam; Diapax; Diapine;
Diaquel; Diatran; Diazemuls; Diazepam; Diazepan; Diazepin; Dipaz; Dipezona;
Disopam; Dizam; Doval; D-Pam; Drenian; Ducene; Dupin; Eridan; Elcion CR;
Euphorin; Euphorin P; Evacalm; Gewacalm; Gradual; Gubex; Horizon; Jinpanfan;
Kratium; Kratium 2 ; Lamra; Lembrol; Lovium; Mandro; Mandro-Zep; Melode;
Mentalium; Meval; Mylan; Nellium; Nerozen; Neurosedin; Nivalen; Nixtensyn;
Noan; Notense; Novazam; Novodipam; Ortopsique; Paceum; Pacitran; Paralium;
Parzam; Pax; Paxate; Paxum; Pharmadine; Placidox 2; Placidox 5; Placidox 10;
Plidan; Pomin; Propam; Prozepam; Psychopax; Q-Pam; Radizepam; Relanium;
Reliver; Rival; Ro-Azepam; Saromet; Scriptopam; Seduxen; Servizepam;
Simasedan; Sipam; Solis; Sonacon; Stesolid; T-Quil; Tensium; Tranquil;
Tranquirit; Trazepam; Valaxona; Valinter; Valitran; Valium; Valrelease;
Valuzepam; Vanconin; Vatran; Vazen; Vivol; Winii; X-O'Spaz; Zepaxid; Zetran
Pharmacology:
Anxiolytic - Sedative - Muscle Relaxant
Diazepam is a benzodiazepine with CNS depressant properties and a somewhat
flatter dose-response slope than the sedative-hypnotic drugs. In laboratory
animals, it produces, in varying doses, taming, disinhibitory, sedative,
anticonvulsant, muscle relaxant, ataxic and hypnotic effects.
Diazepam is relatively devoid of autonomic effects and does not
significantly reduce locomotor activity at low doses, or depress
amphetamine-induced excitation. In high doses, it activates the drug
metabolizing enzymes in the liver. Diazepam also possesses dependence
liability and may produce withdrawal symptoms, but has a wide margin of
safety against poisoning.
Metabolism studies in animals and man have indicated that oral diazepam is
rapidly absorbed from the gastrointestinal tract. Peak blood levels are
reached within 1-2 hours after administration. The acute half-life is 6-8
hours with a slower decline thereafter, possibly due to tissue storage.
In humans, comparable blood levels of diazepam were obtained in maternal and
cord blood indicating placental transfer of the drug. Diazepam may appear in
human breast milk.
With the parenteral form, peak blood levels are reached within 15 minutes
after i.v. administration and are of the same magnitude as after oral
administration. The respective half-life is approximately 2-3 hours.
The distribution and fate of tritium-labeled diazepam in man has indicated
that the drug has a rapid and extensive uptake by tissues. Although the
radioactivity in the blood appears to represent mainly the intact drug,
diazepam was shown to be excreted exclusively in the form of its
metabolites. The two major metabolites are oxazepam glucuronide and N-desmethylated
diazepam.
Indications:
The short-term symptomatic management of mild to
moderate degrees of anxiety in conditions dominated by tension, excitation,
agitation, fear or aggressiveness, such as may occur in psychoneurosis,
anxiety reactions due to stress conditions and anxiety states with somatic
expression.
In acute alcoholic withdrawal, diazepam may be useful in the symptomatic
relief of acute agitation, tremor and impending acute delirium tremens.
As an adjunct for the relief of skeletal muscle spasm due to reflex spasm to
local pathology, such as inflammation of the muscle and joints or secondary
to trauma; spasticity caused by upper motor neuron disorders, such as
cerebral palsy and paraplegia; athetosis and the rare stiff man syndrome.
Contraindications:
Myasthenia gravis, known hypersensitivity to
benzodiazepines. Not recommended for children under 6 months of age.
Warnings
Pregnancy:
Several studies have suggested an increased risk of congenital malformations
associated with the use of diazepam, chlordiazepoxide and meprobamate during
the first trimester of pregnancy. Therefore, the administration of diazepam
is rarely justified in women of childbearing potential. If the drug is
prescribed for a woman of childbearing potential, she should be warned to
contact her physician regarding discontinuation of the drug if she intends
to become or suspects that she is pregnant.
Precautions
- Geriatrics:
- Elderly and debilitated patients or those
with organic brain disorders have been found to be prone to CNS
depression following even low doses. For these patients it is recommended
that the dosage be limited to the smallest effective amount to preclude
development of ataxia, oversedation or other possible adverse effects.
Use in emotional disorders:
Diazepam is not recommended in the treatment of psychotic or severely
depressed patients. Precautions are indicated for severely depressed
patients or those who show evidence of impending depression, particularly
the recognition that suicidal tendencies may be present and protective
measures may be necessary. Since excitement and other paradoxical
reactions may result from the use of the drug in psychotic patients,
it should not be used in ambulatory patients suspected of having
psychotic tendencies.
Use in epileptic patients:
Since diazepam may exacerbate grand mal seizures in some patients,
caution is required when it is used in epileptic patients. An adjustment
may be necessary in their anticonvulsive medication. Abrupt withdrawal
of diazepam in these patients should also be avoided.
Potentiation of drug effects:
Patients should be advised to abstain from alcohol and other CNS
depressant drugs during treatment with diazepam. Phenothiazines,
barbiturates, MAO inhibitors and other psychoactive drugs may potentiate
the action of the drug and should not usually be given concurrently.
Drug dependence:
Abrupt cessation of large doses of diazepam after prolonged periods
may precipitate acute withdrawal symptoms and, in these cases, the
drug should be discontinued gradually. Caution should be exercised
when it is considered necessary to administer diazepam to addiction
prone individuals.
Occupational Hazards:
Patients receiving diazepam should be advised to proceed cautiously
whenever mental alertness and physical coordination are required.
The usual precautions in treating patients with impaired renal and
hepatic functions should be observed. If diazepam is administered
for protracted periods, periodic blood counts and liver function
tests would be highly advisable.
Adverse Effects:
The most common adverse effects reported are drowsiness and ataxia.
Other reactions noted less frequently are fatigue, dizziness, nausea,
blurred vision, diplopia, vertigo, headache, slurred speech, tremors,
hypoactivity, dysarthria, euphoria, impairment of memory, confusion,
depression, incontinence or urinary retention, constipation, skin
rash, generalized exfoliative dermatitis, hypotension, changes in
libido.
The more serious adverse reactions occasionally reported are leukopenia,
jaundice, hypersensitivity and paradoxical reactions.
Paradoxical reactions such as hyperexcited states, anxiety, excitement,
hallucinations, increased muscle spasticity, insomnia, rage, as
well as sleep disturbances and stimulation, have been reported;
should these occur, the drug should be discontinued.
Minor changes in EEG patterns have been observed in patients on
diazepam therapy. These changes consist of low to moderate voltage
fast activity, 20 to 30 cycles/second and are of no known significance.
Overdose
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Symptoms:
Drowsiness, oversedation and ataxia. When the effects of drug overdosage
begin to wear off, the patient exhibits some jitteriness and overstimulation.
The cardinal manifestations of overdosage are drowsiness and confusion,
reduced reflexes and coma. There are minimum effects on respiration,
pulse and blood pressure unless the overdosage is extreme.
Treatment:
Gastric lavage may be beneficial if performed soon after oral ingestion
of diazepam. If necessary, a CNS stimulant such as caffeine or methylphenidate
may be administered with caution. Supportive measures should be
instituted as indicated, such as, maintenance of an adequate airway,
levarterenol for hypotension. Dialysis appears to be of little value.
Dosage
Must be individualized according to diagnosis, severity of symptoms
and degree of response. While the usual daily dosages given below
will meet the needs of most patients, there will be some who may
require higher doses. In the first few days of administration a
cumulative effect of the drug may occur, and therefore the dosage
should be increased only after stabilization is evident.
Adults:
Symptomatic relief of anxiety and tension in psychoneurosis and
anxiety reactions: 2 to 10 mg, 2 to 4 times daily depending upon
severity of symptoms.
Symptomatic relief in acute alcohol withdrawal: 10 mg, 3 or 4 times
during the first 24 hours, reducing to 5 mg, 3 or 4 times daily
as needed.
Adjunctively for relief of skeletal muscle spasms: 2 to 10 mg, 3
to 4 times daily.
Elderly and debilitated patients, or in the presence of debilitating
disease:
2 mg, 1 or 2 times daily initially; increase gradually as needed
and tolerated.
Children (Because of varied responses, initiate therapy with lowest
dose and increase as required. Not for use in children under 6 months):
1 to 2.5 mg, 3 or 4 times daily initially; increase gradually as
needed and tolerated.
Do not prescribe or administer diazepam for periods in excess of
6 weeks, unless a definite need for utilizing this medication has
been established by a followup medical examination.
Below an example of prices from a US licensed pharmacy that is
currently processing orders for US board licensed physicians listed
in our members area. Your meds will be shipped directly to your
home:
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MEDICATION
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120 Tablets
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| Valium 10mg (Diazepam 10mg) |
$$47.61
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| Valium 5mg (Diazepam 5mg) |
$25.75
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Prices were verified
and are subject to change
without notice. In case of any changes we will post to our website
asap.
VIew sample
prices for all medications
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*Shipping cost and cost of phone consultations are not included.
Because discounts have been offered to subscribers you can receive
a phone consultation starting at $40. This is the same type of
consultation that normally costs $110-$130. When approved you
will receive a legit prescription for 1 initial fill with 2 or
3 refills. Our membership fee starts at $24.95 and can save you
lots of money and time!
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