Diazepam (injection route)


    Brand Name

    US Brand Name

    Valium


    Description

    Diazepam injection is used to relieve symptoms of anxiety and alcohol withdrawal. It is also used to relieve anxiety before surgery or certain procedures. When diazepam is used before surgery, the patient will not remember some of the details about the procedure.

    Diazepam injection is also used to treat seizures, including status epilepticus. It may also be used to help relax muscle or relieve muscle spasms.

    Diazepam injection is a benzodiazepine. Benzodiazepines belong to the group of medicines called central nervous system (CNS) depressants, which are medicines that slow down the nervous system.

    This medicine is given only by or under the direct supervision of your doctor.

    This product is available in the following dosage forms:

    • Solution

    Before Using

    In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

    Allergies

    Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

    Pediatric

    Appropriate studies have not been performed on the relationship of age to the effects of diazepam injection in newborn babies (30 days of age and younger). Safety and efficacy have not been established.

    Geriatric

    Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of diazepam injection in the elderly. However, elderly patients are more likely to have trouble breathing, heart attack, or age-related liver, kidney, heart, or lung problems, which may require caution and an adjustment in the dose for patients receiving this medicine.

    Breastfeeding

    There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

    Drug Interactions

    Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

    Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

    • Flumazenil

    Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Abametapir
    • Acepromazine
    • Alfentanil
    • Alprazolam
    • Amobarbital
    • Anileridine
    • Aprepitant
    • Aripiprazole
    • Aripiprazole Lauroxil
    • Asenapine
    • Avacopan
    • Baclofen
    • Benperidol
    • Benzhydrocodone
    • Bromazepam
    • Bromopride
    • Buprenorphine
    • Buspirone
    • Butabarbital
    • Butalbital
    • Butorphanol
    • Calcifediol
    • Calcium Oxybate
    • Cannabidiol
    • Cannabis
    • Carbamazepine
    • Carbinoxamine
    • Carisoprodol
    • Carphenazine
    • Cetirizine
    • Chloral Hydrate
    • Chlordiazepoxide
    • Chlorpromazine
    • Chlorzoxazone
    • Clarithromycin
    • Clobazam
    • Clonazepam
    • Clorazepate
    • Clozapine
    • Cobicistat

    Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Amitriptyline
    • Amprenavir
    • Dalfopristin
    • Desogestrel
    • Dienogest
    • Disulfiram
    • Drospirenone
    • Erythromycin
    • Estradiol
    • Ethinyl Estradiol
    • Ethynodiol
    • Fluoxetine
    • Gestodene
    • Ginkgo
    • Levonorgestrel
    • Mestranol
    • Nomegestrol
    • Norethindrone
    • Norgestimate
    • Norgestrel
    • Quinupristin
    • Rifapentine
    • Roxithromycin
    • St John's Wort
    • Theophylline
    • Troleandomycin

    Other Interactions

    Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

    Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

    • Ethanol

    Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

    • Grapefruit Juice

    Other Medical Problems

    The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

    • Alcohol intoxication or
    • Glaucoma, acute narrow-angle or
    • Loss of consciousness (coma) or
    • Shock—Should not be used in patients with these conditions.
    • Alcohol or drug abuse or dependence, or history of—Dependence on diazepam injection may develop.
    • Breathing problems or lung disease or
    • Heart or blood vessel disease or
    • Hypotension (low blood pressure) or
    • Muscle weakness—Use with caution. May make these conditions worse.
    • Kidney disease or
    • Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

    Proper Use

    A nurse or other trained health professional will give you this medicine. This medicine is given through a needle placed in one of your veins or as a shot into one of your muscles.

    After you receive a shot of this medicine, your doctor will watch you closely to make sure it is working properly and to check for unwanted effects.


    Precautions

    It is very important that your doctor check the progress of you or your child at regular visits to see if the medicine is working properly. Blood tests may be needed to check for any unwanted effects.

    Tell your doctor if you are pregnant or planning to become pregnant. Using this medicine during the later pregnancy may cause problems in your newborn baby (eg, sedation or withdrawal symptoms). Tell your doctor right away if your baby has an abnormal sleep pattern, diarrhea, feeding problems, a high-pitched cry, irritability, low muscle tone, restlessness, shakiness or tremors, sluggishness, trouble breathing, weight loss, vomiting, or fails to gain weight. If you think you have become pregnant while using the medicine, tell your doctor right away.

    This medicine may cause dizziness or drowsiness, or trouble with thinking.Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

    This medicine will add to the effects of alcohol and other central nervous system (CNS) depressants. CNS depressants are medicines that slow down the nervous system, which may cause drowsiness or make you less alert. Some examples of CNS depressants are antihistamines or medicine for hay fever, allergies, or colds, sedatives, tranquilizers, or sleeping medicine, prescription pain medicine or narcotics, barbiturates (used for seizures), muscle relaxants, or anesthetics (numbing medicines), including some dental anesthetics. This effect may last for a few days after you or your child stop taking this medicine. Check with your doctor before taking any of the above while you or your child are using this medicine.

    Symptoms of an overdose include: change or loss of consciousness, confusion, dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position, irregular, fast or slow, or shallow breathing, lack of coordination, loss of strength or energy, muscle pain or weakness, pale or blue lips, fingernails, or skin, shakiness and unsteady walk, unsteadiness, trembling, or other problems with muscle control or coordination, sweating, trouble breathing, unusual drowsiness, dullness, tiredness, weakness or feeling of sluggishness, or unusual weak feeling. Call your doctor right away if you notice these symptoms.

    This medicine may cause respiratory depression (serious breathing problem that can be life-threatening), especially when used with narcotic pain medicines. Tell your doctor if you are using any narcotic medicine.

    Do not stop taking it without checking with your doctor first. Your doctor may want you or your child to gradually reduce the amount you are using before stopping it completely. This may help prevent a worsening of your condition and reduce the possibility of withdrawal symptoms, including hallucinations, seizures, stomach or muscle cramps, tremors, or unusual behavior.

    Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.


    Side Effects

    Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

    Check with your doctor immediately if any of the following side effects occur:

    More common

    • Shakiness and unsteady walk
    • tenderness, pain, swelling, warmth, skin discoloration, and prominent superficial veins over affected area
    • unsteadiness, trembling, or other problems with muscle control or coordination

    Less common

    • Black, tarry stools
    • blurred vision
    • changes in patterns and rhythms of speech
    • chest pain or discomfort
    • chills
    • cold, clammy, or pale skin
    • confusion
    • cough
    • dark urine
    • decrease in frequency of urination
    • decrease in urine volume
    • difficulty in passing urine (dribbling)
    • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
    • fear or nervousness
    • fever
    • hallucinations
    • headache
    • irregular heartbeats
    • itching
    • loss of appetite
    • loss of bladder control
    • lower back or side pain
    • muscle spasm
    • nausea
    • nightmares
    • outbursts of anger
    • painful or difficult urination
    • pale skin
    • rash
    • shakiness in the legs, arms, hands, or feet
    • slow or irregular heartbeat
    • slurred speech
    • sore throat
    • stomach pain
    • sweating
    • trembling or shaking of hands or feet
    • trouble in speaking
    • trouble sleeping
    • ulcers, sores, or white spots in the mouth
    • unpleasant breath odor
    • unusual bleeding or bruising
    • unusual excitement, nervousness, restlessness, or irritability
    • unusual tiredness or weakness
    • vomiting of blood
    • yellow eyes or skin

    Incidence not known

    • Chest tightness
    • deep or fast breathing with dizziness
    • difficult or trouble breathing
    • irregular, fast or slow, or shallow breathing
    • numbness of the feet, hands, and around the mouth
    • pale or blue lips, fingernails, or skin

    Get emergency help immediately if any of the following symptoms of overdose occur:

    Symptoms of overdose

    • Agitation
    • change in consciousness
    • changes in patterns and rhythms of speech
    • confusion
    • excitement
    • irritability
    • lack of coordination
    • loss of consciousness
    • loss of strength or energy
    • muscle pain or weakness
    • restlessness
    • shakiness and unsteady walk
    • sleepiness
    • slurred speech
    • talkativeness
    • trouble in speaking
    • unsteadiness, trembling, or other problems with muscle control or coordination
    • unusual drowsiness, dullness, tiredness, weakness or feeling of sluggishness
    • unusual weak feeling

    Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

    Less common

    • Constipation
    • decreased interest in sexual intercourse
    • difficulty in swallowing
    • discouragement
    • double vision
    • dry mouth
    • feeling of constant movement of self or surroundings
    • feeling sad or empty
    • hiccups
    • hives or welts, itching
    • inability to have or keep an erection
    • increase in sexual ability, desire, drive, or performance
    • increased interest in sexual intercourse
    • increased watering of the mouth
    • lack of appetite
    • loss in sexual ability, desire, drive, or performance
    • loss of interest or pleasure
    • redness of skin
    • seeing double
    • sensation of spinning
    • trouble concentrating
    • uncontrolled eye movements

    Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

    Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.






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