Class: Benzodiazepine. C-IV
Dosage Forms. Tablet: 2 mg, 5 mg, 10 mg; Solution: 1 mg/mL, 5 mg/mL; Rectal Gel: 20 mg/5 mL
Common FDA Label Indication, Dosing, and Titration.
1. Alcohol withdrawal syndrome: 10 mg po tid-qid in first 24 h, then 5 mg po tid-qid prn
2. Anxiety: Adults, 2-10 mg po bid-qid; Children, 1-2.5 mg po tid-qid
3. Seizure, adjunct: Adults, 2-10 mg po bid-qid; Children, 1-2.5 mg po tid-qid
1. Benzodiazepine withdrawal syndrome: 10 mg po tid-qid in first 24 h, then 5 mg po tid-qid prn
MOA. Enhanced postsynaptic effect of the inhibitory neurotransmitter, gamma-aminobutyric acid (GABA)
Drug Characteristics: Diazepam
Medication Safety Issues: Diazepam
Drug Interactions: Diazepam
Adverse Reactions: Diazepam
Efficacy Monitoring Parameters. Reduction of anxiety symptoms, alcohol withdrawal symptoms, or seizures.
Toxicity Monitoring Parameters. Severe drowsiness, thoughts of suicide, yellowing of eyes, seizures.
Key Patient Counseling Points. May cause drowsiness; avoid driving or other tasks requiring motor coordination. Avoid alcohol.
Clinical Pearls. Use caution in elderly, appear more sensitive to the effects; dose reductions of 50% have been recommended. Use CNS depressants concurrently with caution, may have additive effects. Avoid abrupt discontinuation after chronic use, may cause seizures. Long-acting benzodiazepines have increased risk of physical and psychological dependence when compared to short acting.