Valium injection

Generic name:

Diazepam

Drug class:

Benzodiazepine (anxiolytic, anticonvulsant, muscle relaxant, sedative-hypnotic)

Dosage form:

Injection solution (2 mg/mL and 5 mg/mL)

Route of administration:

Intravenous, Intramuscular

Dose:

• Anxiety: 2–10 mg IM/IV every 6–8 hours as needed
• Preoperative sedation: 5–10 mg IV immediately before procedure
• Acute seizure control: 5–10 mg slow IV; may repeat every 10–15 minutes (max 30 mg)
• Status epilepticus: total 15–20 mg via repeated IV boluses or continuous infusion
• Alcohol withdrawal: 10 mg IV initially, then 5–10 mg every 3–6 hours
• Adjust dose for elderly and patients with hepatic impairment

Mechanism of action:

Enhances inhibitory neurotransmission by binding to the benzodiazepine site on GABAA receptors, increasing the frequency of chloride channel opening and causing neuronal hyperpolarization.

Drug usage cases:

• Generalized anxiety disorder
• Acute alcohol withdrawal
• Preoperative sedation and anxiolysis
• Muscle spasm
• Adjunctive therapy in convulsive disorders (including status epilepticus)
• Off-label: panic disorder, insomnia, procedural sedation, catatonia

Drug contra indications:

• Hypersensitivity to diazepam or other benzodiazepines
• Acute narrow-angle glaucoma
• Severe respiratory insufficiency
• Myasthenia gravis
• Severe hepatic impairment
• Sleep apnea syndrome
• Infants under 6 months of age

Side effects:

• Drowsiness, sedation
• Dizziness, ataxia, coordination disturbances
• Hypotension, bradycardia
• Respiratory depression
• Anterograde amnesia
• Confusion, cognitive impairment
• Paradoxical reactions (agitation, aggression)
• Nausea, dry mouth
• Injection site reactions (pain, thrombophlebitis)
• Tolerance, dependence, withdrawal symptoms

Warnings:

• Risk of abuse, dependence, and addiction; use lowest effective dose for shortest duration
• CNS depression; caution with other CNS depressants (e.g., opioids, alcohol)
• Respiratory depression risk; monitor breathing during IV administration
• Caution in elderly, debilitated, or patients with comorbidities; lower doses recommended
• Avoid abrupt discontinuation; taper gradually to minimize withdrawal
• Potential for paradoxical reactions
• Slow IV injection to reduce risk of hypotension and respiratory depression

Use during pregnancy or breastfeeding:

Diazepam crosses the placental barrier. Use during the first trimester may increase risk of congenital malformations (e.g., cleft palate). Late in pregnancy and during labor may cause neonatal sedation, respiratory depression, and floppy infant syndrome. Diazepam is excreted in breast milk and may accumulate in the infant, causing sedation and feeding difficulties. Use only if potential benefit justifies potential risk; monitor neonate for sedation and respiratory function; consider alternative therapies.