Diazepam

What it is used for

• Urine marking and anxiety
• Spraying
• Fast-acting anxiolytic
• Treatment of seizure disorders
• Halt an ongoing seizure
• Maintenance therapy for seizures
• Functional urethral obstruction/urethral sphincter hypertonus
• Functional urethral obstruction/urethral sphincter hypertonus
• Short-term emergency control of severe epileptic seizures
• Appetite stimulant
• Tranquilization
• Tranquilization
• Sedation prior to pentobarbital anesthesia
• Treatment of CNS hyperactivity and seizures
• Premedication/sedation
• Sedation anesthesia
• Tranquilizer
• Field anesthesia
• Seizures (Foals)
• Seizures (Adults)
• Treatment of seizures secondary to intra-arterial injection of xylazine or similar agents
• Appetite stimulant
• Adjunctive therapy of pain control (with analgesics)
• Sedation/induction
• Pre-anesthetic (Rabbits)
• Sedation (Rabbits)
• Anesthesia (Rabbits)
• Long anesthesia (Rabbits)
• Sedation/Anesthesia (Hamsters, Gerbils, Mice, Rats)
• Sedation/Anesthesia (Guinea pigs)
• Sedative in calves
• Tranquilizer
• Treatment of CNS hyperactivity and seizures
• Bermuda grass induced toxicosis and tremors
• To stimulate appetite
• Cluster seizures or status epilepticus (client treatment at home)
• Cluster seizures (client treatment at home)
• Refractory status epilepticus
• Status or cluster seizure treatment at home
• Status epilepticus
• Status epilepticus
• Functional urethral obstruction/urethral sphincter hypertonus
• Functional urethral obstruction/urethral sphincter hypertonus
• Functional urethral obstruction/urethral sphincter hypertonus
• Psychotherapeutic agent (situational anxiety)
• Psychotherapeutic agent (storms)
• Fast-acting anxiolytic
• Adjunctive treatment of metronidazole toxicity (CNS)
• Short-term emergency control of severe epileptic seizures and status epilepticus
• Anxiolytic / Behavioural medicine (panic/fear)

How it is given

Possible side effects

• Sedation and ataxia (most common)
• Dogs: Paradoxical CNS excitement/agitation (especially at doses >0.8 mg/kg)
• Dogs: Increased appetite
• Cats: Idiosyncratic hepatic failure (with oral use)
• Cats: Behavior changes (irritability, depression, aberrant demeanor)
• Horses: Muscle fasciculations, weakness, ataxia, recumbency (at doses >0.2 mg/kg)
• Hypotension and phlebitis (with rapid IV injection)
• Sedation
• Muscle weakness
• Ataxia
• Paradoxical excitation and aggression (especially with rapid IV injection or oral overdose in dogs)
• Pain and erratic absorption (IM injection)
• Fulminant hepatic necrosis (cats, repeated oral dosing)
• Thrombophlebitis (associated with propylene glycol injectable formulations)

Cautions & contraindications

• Known hypersensitivity to benzodiazepines
• Cats exposed to chlorpyrifos (potentiates organophosphate toxicity)
• Significant liver disease (especially in cats)
• Intra-carotid artery injections (must be strictly avoided)
• CNS depression
• Respiratory depression
• Severe muscle weakness
• Hepatic impairment (may worsen hepatic encephalopathy)
• Long-term treatment of behavioural disorders (due to risks of disinhibition and interference with memory/learning)
• > **Intravenous Administration:** Inject IV slowly (over 1-3 minutes). Rapid injection, especially in small animals or neonates, may cause hypotension or cardiotoxicity secondary to the propylene glycol vehicle. Flush the IV catheter with fluids after administration to help prevent thrombophlebitis. > **Feline Hepatotoxicity:** Use in cats is controversial due to reports of serious, potentially fatal idiosyncratic hepatotoxicity associated with oral administration. Baseline and follow-up liver function tests are strongly recommended if used. * **Patient Selection:** Use cautiously in patients with hepatic or renal disease, debilitated or geriatric patients, and those in coma, shock, or with significant respiratory depression. * **Behavioral Disinhibition:** Use very cautiously in aggressive patients, as it may disinhibit anxiety that normally suppresses aggressive behavior. * **Working Animals:** May impair the abilities of working animals. * **Toxicity Treatment:** Do not use to treat paradoxical CNS stimulation caused by human sleep aids (zolpidem, eszopiclone); use phenothiazines or phenobarbital instead. * **Pregnancy:** May be teratogenic (FDA Category D). Use during the first trimester only if benefits clearly outweigh risks.

Drug interactions

• Amitriptyline: May increase diazepam levels
• Antacids: May decrease oral diazepam absorption
• Azole Antifungals (itraconazole, ketoconazole): May increase diazepam levels by inhibiting metabolism
• Cimetidine: May decrease metabolism of benzodiazepines
• CNS Depressants (barbiturates, narcotics, anesthetics): Additive CNS depression effects may occur
• Dexamethasone: May decrease diazepam levels
• Digoxin: Diazepam may increase digoxin levels
• Erythromycin: May decrease the metabolism of benzodiazepines
• Mineral Oil: May decrease oral diazepam absorption
• Omeprazole: May inhibit the metabolism of diazepam and increase levels
• Phenobarbital: May decrease diazepam concentrations
• Phenytoin: May decrease diazepam concentrations
• Quinidine: May increase diazepam levels
• Rifampin: May induce hepatic microsomal enzymes and decrease the pharmacologic effects of benzodiazepines
• Antihistamines: Enhanced sedative effect
• Opioid analgesics: Enhanced sedative effect
• Anaesthetic agents: Diazepam reduces the dose requirement of other anaesthetic agents
• Tricyclic antidepressants: Can be used in combination for management of severe behavioural responses
• Flumazenil: Reverses the effects of diazepam (benzodiazepine antagonist)

Perguntas frequentes