Diazepam: Brands, Price & Uses in Bangladesh

Diazepam is a long-acting benzodiazepine indicated for several distinct clinical uses, which vary in the strength of supporting evidence.

Established / FDA-approved uses

• Anxiety disorders — short-term relief of symptoms of anxiety, or anxiety associated with depressive symptoms.
• Acute alcohol withdrawal — symptomatic relief of acute agitation, tremor, impending or acute delirium tremens, and hallucinosis.
• Skeletal muscle spasm — adjunct for relief of spasm due to local pathology (e.g. inflammation, trauma) or spasticity from upper motor neuron disorders (cerebral palsy, paraplegia), athetosis, and stiff-man syndrome.
• Seizure disorders — adjunct therapy (not sole treatment) in convulsive disorders; intravenous Diazepam is used for status epilepticus and severe recurrent convulsive seizures.
• Preoperative/procedural sedation — relief of anxiety and tension before surgery, endoscopic procedures, or cardioversion, and to reduce recall of the event.

Adjunct / combination-therapy uses

• Diazepam is used together with specific antihypertensive therapy in some cardiac arrhythmia and hypertension settings requiring sedation, but only as an adjunct, never as primary treatment.

Other formulation-specific approved use

• Rectal gel formulations of Diazepam are approved for management of selected, refractory patients with epilepsy who require intermittent use to control bouts of increased seizure activity (acute repetitive seizures), as an add-on to a stable regimen of antiepileptic drugs.

Diazepam is not approved for long-term, first-line treatment of chronic anxiety or as monotherapy for epilepsy, and should be reserved for short-term or adjunctive use given the risks of dependence.

Dosage of Diazepam must be individualized for maximum therapeutic benefit, using the lowest effective dose for the shortest duration appropriate to the indication.

Renal/hepatic adjustment

Use with caution and at reduced doses in renal impairment. Diazepam is contraindicated in severe hepatic insufficiency, and doses should be reduced and closely monitored in mild-to-moderate hepatic impairment due to reduced clearance and metabolite accumulation.

Administration

Diazepam tablets/oral solution may be taken with or without food. Injectable Diazepam should be administered slowly by trained personnel with resuscitation equipment available, due to the risk of respiratory depression. Rectal gel is administered per the specific applicator instructions provided with the product. Do not stop Diazepam abruptly after regular use for more than a few weeks — dose must be tapered gradually under medical supervision to reduce the risk of withdrawal symptoms, including withdrawal seizures.

Common

• Drowsiness, sedation, and fatigue
• Ataxia and muscle weakness
• Dizziness and light-headedness
• Confusion, especially in elderly patients
• Dry mouth, blurred vision

Serious (see Precautions and Warnings for full detail)

• Respiratory depression, particularly when combined with opioids or other CNS depressants
• Physical dependence, misuse, and withdrawal reactions with prolonged use
• Paradoxical reactions (agitation, aggression, disinhibition), more common in children and the elderly
• Cognitive impairment and increased fall risk in elderly patients