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Administration

Diazepam is available in multiple formulations, including oral tablets, intramuscular injections (IM), intravenous injection (IV), or rectal gel. Oral tablets have a more reliable absorption and controlled release when compared to IM. When administered intravenously, diazepam has an onset of action within 1 to 3 minutes, while oral dosing onset ranges between 15 to 60 minutes. Diazepam is long-lasting with a duration of action of more than 12 hours. Buy Diazepam Valium 5mg online Australia

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• Treatment of acute ethanol withdrawal: Initial dosing should be 10 mg IM or IV. If needed, a follow-up dose of 5 to 10 mg is permissible 3 to 4 hours later. If using the oral tablet, dosing is 10 mg every 6 to 8 hours within the first 24 hours, then 5mg every 6 to 8 hours thereafter as needed.[4]
• Treatment of anxiety: 2 to 10 mg can be given orally 2 to 4 times daily. If given parentally, dosing can be 2 to 10 mg and repeated in 3 to 4 hours, if needed.[9]
• Treatment of muscle spasm: 2 to 10 mg can be given orally 3 to 4 times daily. If given parentally, an initial dose of 5 to 10 mg can be followed by another 5-10mg dose in 3 to 4 hours, if necessary.[10]
• Treatment of preoperative anxiety: Dosing is 10 mg IM before surgery.[11]
• For sedation in the ICU: Loading dose of 5 to 10 mg for initial administration, followed by a maintenance dose of 0.03 to 0.10 mg/kg every 0.5 to 6 hours. (Barr 2013)
• Treatment of seizures: 2 to 10 mg orally dosed 2 to 4 times daily as adjunctive maintenance therapy. For intermittent management of seizures, rectal gel 0.2mg/kg is an option. It may be repeated in 4 to 12 hours if needed. Do not exceed five uses per month or more than one dose every five days.
• Skeletal muscle relaxant: 2 to 10 mg, dosed 3 to 4 times daily as an adjunct therapy.
• Treatment of status epilepticus: 0.15 to 0.20 mg/kg IV per dose and may be repeated once needed. Do not exceed 10 mg per single dose. Rectal administration of 0.2 to 0.5 mg/kg administered one time. Do not exceed 20 mg per dose.

Contraindications

Contraindications to diazepam include patients with a known hypersensitivity to diazepam. Diazepam is also contraindicated in patients under 6 months of age. Other contraindications to diazepam include patients with severe respiratory insufficiency, myasthenia gravis, sleep apnea syndrome, and severe hepatic insufficiency. It is permissible in patients with open-angle glaucoma receiving appropriate therapy but is contraindicated in acute narrow-angle glaucoma.[17][18] Buy Diazepam Valium 5mg online Australia

Toxicity

Diazepam Overdose

The toxic-to-therapeutic ratio of benzodiazepines is very high, making them relatively safe medications. However, the potential of overdose from diverted diazepam always exists when combined with opioids, alcohol, or other centrally acting agents. Overdose in adults frequently involves the co-ingestion of other CNS depressants, which work synergistically to increase toxicity. In the case of single-agent diazepam overdose, symptoms manifest as CNS depression and are very rarely fatal. In mild cases, lethargy, drowsiness, and confusion are common symptoms. In cases of severe overdose, symptoms manifest as ataxia, diminished reflexes, hypotonia, hypotension, respiratory depression, coma (rarely), and death (very rarely).[19] Buy Diazepam Valium 5mg online Australia

Treatment of benzodiazepine overdose involves protecting the airway, fluid resuscitation, and the use of flumazenil if indicated. Flumazenil works via competitive antagonism at the benzodiazepine receptor and can rapidly reverse coma. However, in patients with benzodiazepine tolerance, the use of flumazenil can precipitate acute withdrawal symptoms, autonomic instability, and seizures.[3] Buy Diazepam Valium 5mg online Australia