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valium [xpsychology.png] [orderMeds.PNG] Depression | Schizophrenia | Anxiety | Mental Disorders | Xanax | Valium | Ativan Home pagevaliumbuy valiumxanax valiumbuy valium onlinevalium onlinedrug valiumorder valiumcheap valiumorder valium onlinevalium diazepamgeneric valiumvalium on linevalium side effectspurchase valiumonline pharmacy valiumvalium without prescriptionvalium pictureprescription valiumdj valiumvalium pillvalium effectsvalium pharmacyvalium dosagepurchase valium onlinevalium informationvalium drug testvalium overdosebbs inurl net site valium3.75 discount valiumvalium withdrawalhow long does valium stay in your system10mg.notlong.com valiumbuy valium without prescription10mg 3.54 valiumvalium addictiondiscount valium3.53 buy valiumlink valiumvalium for dogbuy cheap valiumarchive cn inurl site valiumroche valiumvalium salevalium 10mg3.75 order valiumsymptom valium withdrawal3.61 buy valium4.01 line valiumvalium use3.33 drug valiumtea valerian valium3.89 diazepam generic online valiumcat valiumchicago drug valiumonline prescription valiumvalium vicodinvalium vs xanaxblue valiumbuy valium online no prescriptionvalium half lifesnorting valiumvalium teabuy generic valiumvalium pregnancybuy cheap online valium valiumbuy line valiummexican valiumbuying valiumvalium buying onlinedosages valiumvalerian valiumbuy overnight valium10mg href m7gq valium xrl.usvalium abusewhat does valium look likevalium dosevalium 5mggeneric valium picturevalium and alcohol10mg 10mg.notlong.com href valium valiumvalium overnight deliveryvalium infobetween interaction stjohns valium wortvalium tabletbuy online.somee.com site valium2006 guest valiumbbs inurl jp site valiumbuy valium diazepambuyxanaxonline.web.fc2.com link valiumdiazepam and valium and genericbuy online.surf.to site valiumvalium overnightget valium onlinebuy online.connect.to site valiumdescription valiumvalium 10discount.html link read southrap.ru valiumbuy doctor.com link online.talented valiumcheap online valiummylan 477 pill valium [index.html] | PSYweb PRO Disorders Med Info Diagnosis DSM (TM) ICD-10 Glossary Studies Treatments Resources The Brain Assessment Fast Facts Order Meds Testing PetRX Help the Mentally Ill Diazepam ( Valium ) Valium ( Diazepam, T-Quil, Valrelease ) Valium (diazepam) is an anti-anxiety agent (benzodiazepine) used primarily for short-term relief of mild to moderate anxiety and the associated nervousness and tension. It may also be used to treat symptoms of acute alcohol withdrawal, to help control epilepsy or to relieve muscle spasms. Valium (diazepam) affects chemicals in the brain that may become unbalanced and cause anxiety, seizures and muscle spasms. Valium (diazepam) may also be used for other purposes. CLASS: Benzodiazepines. Generic name: Diazepam. Type: Anti anxiety. Strengths: Oral Solution: 5mg / 5ml, 5 mg/ml. Tablets: 2mg, 5mg, 10mg. Caps: Time-r el 15mg. Injection: IM/IV inj 5 mg/ml. Normal dosage: If under 18 years of age: Safety and effectiveness not established. Valium should not be given to children under 6 months of age. * Children over months of age, 1mg to 2.5mg 3 to 4 times daily. * 18 to 60 years of age, 2mg to 10mg 2 to 4 times daily. * Over 60 years of age, 2mg to 2.5mg 1 to 2 times daily (increase as needed). * Dosages: Actual dosage must be determined by a physician. Dosage Depends on Disorder: * Anxiety disorders and the short-term relief of the symptoms of anxiety, 18 to 60 years of age,2mg to 10mg 2 to 4 times daily or time-r el 15-30mg. * Acute alcohol withdrawal, 18 to 60 years of age, 10mg 3 to 4 times during the first 24 hours the 5mg 3 or 4 times daily. * Relief of muscle spasm, 18 to 60 years of age, 2mg to 10mg 3 to 4 times daily. * Convulsive disorders, 18 to 60 years of age, 2mg to 10mg 2 to 4 times daily. * Status epilepticus: + 18 to 60 years of age, IV 5-10mg at 2-5mg/min, up to a maximum dose of 30mg. May repeat in 2-4 hours. + Children over 5 years of age, IV 1mg/min q3-5min, up to a maximum dose of 10mg. May repeat in 2-4 hours. + Children 1 month to 5 years of age, 0.2-0.5mg/min slowly q2-5min, up to a maximum dose of 5mg. Problems with: Liver Function: Use cautiously. Kidney Function: Use cautiously. Testing: Before taking: N/A. While taking: N/A. Take: With or without food. Take each dose with a full glass of water. Full Benefits In: Up to a week Missed Dose(s): If within one hour take. If over an hour skip and then continue on your normal schedule. Never Take a Double Dose! If Stop Taking: Do not stop without consulting your physician. Overdose symptoms include: Confusion,loss of consciousness,or sleepiness. Take Valium (diazepam) exactly as directed by your doctor. Take each oral dose with a full glass of water. To ensure the correct dose, measure the liquid forms of Valium (diazepam) with a dose-measuring spoon or cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one. Do not take diazepam more often or in larger doses than is prescribed. Valium (diazepam) is habit forming. You can become physically and psychologically dependent on the medication. Withdrawal effects may occur if diazepam is stopped suddenly after several weeks of continuous use. Your doctor may recommend a gradual reduction in dose. Take a missed dose as soon as you remember. However, if it is almost time for the next dose, skip the dose you missed and take only the next regularly scheduled dose. Do not take a double dose of this medication; could be dangerous. Store at room temperature away from moisture and heat. Keep this and all medications out of the reach of children. Note: You can become physically and psychologically dependent on the medication. Warnings Narcotics may increase the sedative effects of this drug. Do not take other sedative, benzodiazepines, or sleeping pills with this drug. The combinations could be fatal. Do not drink alcohol when taking benzodiazepines. Alcohol can lower blood pressure and decrease your breathing rate to the point of unconsciousness. Use caution when driving, operating machinery, or performing other hazardous diazepam. Alcohol may increase drowsiness and dizziness caused by diazepam. Alcohol may also increase the risk of having a seizure if diazepam is being taken for a seizure condition. The habit-forming potential of diazepam is high. It is possible to become dependent in only two weeks. This drugs should not be taken for more than four weeks ( Yudofsky, Hales and Ferguson . ) Do not stop taking this drug abruptly; this could cause psychological and physical withdrawal symptoms. Do not take this drug if you are pregnant. Some studies have found that taking this drug may lead to serious birth defects. If this drug is used in late pregnancy it may cause " floppy infant" syndrome. Do not take this drug if planning to become pregnant. Do not take if you are breast-feeding. Do not give this drug to anyone under six mounts old and never use on hyperactive or psychotic children. If over 60, only use drug in small doses with close monitoring. Do not use if: You had negative reactions to other benzodiazepines, if you have a history of drug dependence, if you have had a stroke, if you have multiple sclerosis, if you have Alzheimer's disease, if you are seriously depressed or if you have other brain disorders. Symptoms or Effects Do not take Valium (diazepam) if you have narrow-angle glaucoma. Valium (diazepam) may worsen this condition. Before taking this medication, tell your doctor if you have kidney or liver disease, have asthma, bronchitis, emphysema or another respiratory disease or if you are depressed or have suicidal thoughts. Do not take this medication without first talking to your doctor if you are pregnant or breast feeding a baby. If you are over 65 years of age, you may be more likely to experience side effects from Valium (diazepam). You may require a lower dose of this medication. Drug Interactions: Valium (diazepam) may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medications, seizure medications, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any medicine without first talking to your doctor. Antacids may decrease the effects of Valium (diazepam); separate doses of an antacid and Valium (diazepam) by several hours whenever possible. Drugs other than those listed here may also interact with Valium (diazepam). Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines. If Valium (diazepam) is taken with certain other drugs, the effects of either could be increased, decreased, or altered. These drugs included: * antiseizure drugs. * antidepressants drugs. * antipsychotic drugs. * barbiturates. * cimetidine (tagamet). * digoxin (lanoxin). * disulfiram (Antabuse). * isoniazid (rifamate). * levodopa (larodopa, sinemet). * MAO inhibitors. * narcotics. * omerprazole (prilosec). * oral contraceptives. * propoxyphene (Darvon). * ranitidine (zantac). * rifampin (rifadin). Common: Clumsiness / Sleepiness. Rare: Abdominal cramps, blurred vision, dry mouth, racing heartbeat / palpitations, shaking / slurred speech, urination problems, convulsions, hallucinations, memory loss, trouble breathing, staggering / trembling, headache or confusion. See physician if severe: Clumsiness/Sleepiness See physician always: Abdominal cramps, blurred vision, dry mouth, racing heartbeat / palpitations, shaking / slurred speech, urination problems, headache. See physician NOW: Confusion. Stop taking and see physician NOW: Convulsions, hallucinations, memory loss, trouble breathing or staggering / trembling. Stop taking diazepam and seek emergency medical attention or contact your doctor immediately if you experience any of the following: an allergic reaction (difficulty breathing, closing of your throat, swelling of your lips, face, or tongue or hives); sores in the mouth or throat, yellowing of the skin or eyes; a rash, hallucinations or severe confusion or changes in your vision. [1] [2] Next Page Valium English | German | Spanish | French | Italian | Japanese | Korean | Dutch | Portuguese | Russian | Swedish | Chinese Go back | HOME | Top | Search | Disclaimer | References | Help the Mentally Ill Valium diazepam affects chemicals in the brain and is used to relieve tension, nervousness, and anxiety. Valium Prescription Drug Information for Consumers & Professionals Home New Drugs Latest News Drug Interactions Pill Identification Images Forum Drugs.com - prescription drug and medicine information available on over 24,000 approved- medications and pharmaceuticals, including side effects and drug interactions. Log-in Register Advertisement Buy a Link Now Special Offers From our sponsors Categories Allergies & Hayfever Diabetes Gastro Center Weight Loss AIDS/HIV Cancer & Oncology Mental Health & Depression Cholesterol Hair Loss Muscular Injuries & Arthritis Pain Relief Sexual Health Recent Drug Searches Clarinex-D 24 hour Meclizine Clonidine Raptiva Baclofen Clonazepam Valium Xanax Avastin Eligard Search Drugs.com ____________________________________________________________ Advanced Search Drug Search Internet Search Or click the first letter of a drug name: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z Valium diazepam Brand Names: Diastat, Valium What is the most important information I should know about Valium (diazepam)? o Use caution when driving, operating machinery, or performing other hazardous activities. Valium (diazepam) will cause drowsiness and may cause dizziness. If you experience drowsiness or dizziness, avoid these activities. o Avoid alcohol while taking Valium (diazepam). Alcohol may increase drowsiness and dizziness caused by Valium (diazepam). Alcohol may also increase the risk of having a seizure if Valium (diazepam) is being taken for a seizure condition. o Valium (diazepam) is habit forming. You can become physically and psychologically dependent on the medication. Do not take more than the prescribed amount of medication or take it for longer than is directed by your doctor. Withdrawal effects may occur if Valium (diazepam) is stopped suddenly after several weeks of continuous use. Your doctor may recommend a gradual reduction in dose. What is Valium (diazepam)? o Valium (diazepam) is in a class of drugs called benzodiazepines. Valium (diazepam) affects chemicals in the brain that may become unbalanced and cause anxiety, seizures, and muscle spasms. o Valium (diazepam) is used to relieve anxiety, nervousness, and tension associated with anxiety disorders. It is also used to treat certain types of seizure disorders and muscle spasms. o Valium (diazepam) may also be used for purposes other than those listed in this medication guide. What should I discuss with my healthcare provider before taking Valium (diazepam)? o Do not take Valium (diazepam) if you have narrow-angle glaucoma. Valium (diazepam) may worsen this condition. o Before taking this medication, tell your doctor if you · have kidney disease; · have liver disease; · have asthma, bronchitis, emphysema, or another respiratory disease; or · are depressed or have suicidal thoughts. o You may not be able to take Valium (diazepam), or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above. o Valium (diazepam) is in the FDA pregnancy category D. This means that Valium (diazepam) is known to harm an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant. o Valium (diazepam) passes into breast milk. Do not take Valium (diazepam) without first talking to your doctor if you are breast-feeding a baby. o If you are over 65 years of age, you may be more likely to experience side effects from Valium (diazepam). You may require a lower dose of this medication. How should I take Valium (diazepam)? o Take Valium (diazepam) exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you. o Take each oral dose with a full glass of water. o To ensure the correct dose, measure the liquid forms of Valium (diazepam) with a dose-measuring spoon or cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one. o Your doctor or nurse will give you detailed instructions for administration of the Diastat rectal gel. In general, application of the rectal gel is as follows: · Remove the protective cover from the medication syringe and lubricate the rectal tip with lubricating jelly. · Turn the person on their side facing you. Bend the upper leg forward and separate the buttocks to expose the rectum. · Gently insert the syringe tip into the rectum. The rim should be snug against the rectal opening. Slowly count out loud to three while gently pushing the plunger in until it stops. Slowly count to three before removing the syringe. Slowly count to three and hold the buttocks together to prevent leakage. · Keep the person on their side facing you, note the time the medication was given, and observe the person for signs of seizure, skin color, breathing, or any unusual reaction. o Do not take Valium (diazepam) more often or in larger doses than is prescribed. o Valium (diazepam) is habit forming. You can become physically and psychologically dependent on the medication. Do not take more than the prescribed amount of medication or take it for longer than is directed by your doctor. Withdrawal effects may occur if Valium (diazepam) is stopped suddenly after several weeks of continuous use. Your doctor may recommend a gradual reduction in dose. o Store Valium (diazepam) at room temperature away from moisture and heat. What happens if I miss a dose? o Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the dose you missed and take only the next regularly scheduled dose. Do not take a double dose of this medication. A double dose could be dangerous. What happens if I overdose? o Seek emergency medical attention. o Symptoms of a Valium (diazepam) overdose include sleepiness, dizziness, confusion, a slow heart beat, difficulty breathing, difficulty walking and talking, an appearance of being drunk, and unconsciousness. What should I avoid while taking Valium (diazepam)? o Use caution when driving, operating machinery, or performing other hazardous activities. Valium (diazepam) will cause drowsiness and may cause dizziness. If you experience drowsiness or dizziness, avoid these activities. o Avoid alcohol while taking Valium (diazepam). Alcohol may increase drowsiness and dizziness caused by Valium (diazepam). Alcohol may also increase the risk of having a seizure if Valium (diazepam) is being taken for a seizure condition. o Valium (diazepam) may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, seizure medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any medicine without first talking to your doctor. What are the possible side effects of Valium (diazepam)? o If you experience any of the following serious side effects, stop taking Valium (diazepam) and seek emergency medical attention or contact your doctor immediately: · an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, face, or tongue; or hives); · sores in the mouth or throat; · yellowing of the skin or eyes; · a rash; · hallucinations or severe confusion; or · changes in your vision. o Other, less serious side effects may be more likely to occur. Continue to take Valium (diazepam) and talk to your doctor if you experience · drowsiness, dizziness, or clumsiness; · depression; · nausea, vomiting, diarrhea, or constipation; · difficulty urinating; · vivid dreams; · headache; · dry mouth; · decreased sex drive; or · changes in behavior. o Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. What other drugs will affect Valium (diazepam)? o Valium (diazepam) may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, seizure medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any medicine without first talking to your doctor. o Antacids may decrease the effects of Valium (diazepam). Separate doses of an antacid and Valium (diazepam) by several hours whenever possible. o Drugs other than those listed here may also interact with Valium (diazepam). Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines. Where can I get more information? o Your pharmacist has additional information about Valium (diazepam) written for health professionals that you may read. _________________________________________________________________ o Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed. o Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist. Copyright 1996-2003 Cerner Multum, Inc. Version: 4.03. Revision date: 7/18/03. 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Diazepam From Wikipedia, the free encyclopedia (Redirected from Valium) Jump to: navigation, search Diazepam chemical structure Diazepam Systematic (IUPAC) name 7-chloro-1-methyl- 5-phenyl-1,3-dihydro-2H- 1,4-benzodiazepin-2-one Identifiers CAS number 439-14-5 ATC code N05BA01 N05BA17 PubChem 3016 DrugBank APRD00642 Chemical data Formula C[16]H[13]ClN[2]O Mol. weight 284.7 Pharmacokinetic data Bioavailability 93% Metabolism Hepatic Half life 36-100 hours Excretion Renal Therapeutic considerations Pregnancy cat. D (USA) C (Aus) Legal status Schedule IV (International) Routes Oral, IM, IV, suppository Diazepam (pronounced daI|ęzIpęm, marketed under brand names Valium, Stesolid, Seduxen ''Bosaurin' and Apozepam)[1] is a drug which is a benzodiazepine derivative. It possesses anxiolytic, anticonvulsant, sedative, skeletal muscle relaxant and amnestic properties. This makes it a useful drug for treating anxiety, insomnia, seizures, alcohol withdrawal, and muscle spasms. It is also used before certain medical procedures (such as endoscopies) to reduce tension and anxiety, and in some surgical procedures to induce amnesia.[2][3] Diazepam is a core medicine in the World Health Organization's "Essential Drugs List", which is a list of minimum medical needs for a basic health care system.[4] Diazepam is used to treat a wide range of conditions and is one of the most frequently prescribed benzodiazepines. Contents * 1 Benzodiazapine * 2 History * 3 Pharmacokinetics * 4 Indications + 4.1 Veterinary uses * 5 Dosage + 5.1 Adult dosage recommendations + 5.2 Pediatric dosage recommendations + 5.3 Availability * 6 Side effects * 7 Interactions * 8 Contraindications + 8.1 Special caution needed + 8.2 Patients at a high risk for abuse and dependence * 9 Withdrawal * 10 Overdose * 11 Recreational use * 12 Legal status * 13 Physical properties * 14 Trivia * 15 External links * 16 References * 17 Footnotes [edit] Benzodiazapine Diazepam is a benzodiazepine that binds to a specific subunit on the GABA[A] receptor at a site that is distinct from the endogenous GABA molecule.[5][6]The GABA[A] receptor is an inhibitory channel which, when activated, decreases neuologic activity. Due to the role of diazepam as a positive allosteric modulator of GABA, when it binds to benzodiazepine receptors it causes inhibitory effects. This arises from the hyperpolarization of the postsynaptic membrane, due to the control exerted over negative chloride ions by GABA[A] receptors.[5][7] Diazepam appears to act on areas of the limbic system, thalamus and hypothalamus, inducing anxiolytic effects. Its actions are due to the enhancement of GABA activity.[2][5] [edit] History Diazepam was the second benzodiazepine to be invented by Leo Sternbach of Hoffmann-La Roche, and was approved for use in 1963. It is five times more potent than its predecessor, chlordiazepoxide, which it quickly surpassed in terms of sales. After this initial success, other pharmaceutical companies began to introduce other benzodiazepine derivatives.[8] The benzodiazepines gained popularity among medical professionals as an improvement upon barbiturates, which have a comparatively narrow therapeutic index, and are far more sedating at therapeutic doses. The benzodiazepines are also far less dangerous; death rarely results from diazepam overdose, except in cases where it is consumed with large amounts of other depressants (such as alcohol or other sedatives).[9] Diazepam was the top-selling pharmaceutical in the United States from 1969 to 1982, with peak sales in 1978 of 2.3 billion pills.[8] Over the years, physicians, psychiatrists and neurologists have discovered many new off-label uses for diazepam, such as treatment of spastic paresis and palliative treatment of stiff-person syndrome.[10] [edit] Pharmacokinetics Diazepam can be administered orally, intravenously, intramuscularly, or as a suppository.[11] When diazepam is administered orally, it is rapidly absorbed and has a fast onset of action. The onset of action is 1-5 minutes for IV administration and 15-30 minutes for IM administration. The duration of the diazepam's main pharmacological effects is 15 minutes to 1 hour for both routes of administration.[12] Peak plasma levels are achieved 30 minutes to 2 hours after oral administration. When diazepam is administered as an intramuscular injection, absorption is slow, erratic and incomplete.[1][13] Diazepam is highly lipid-soluble, and is widely distributed throughout the body after administration. It easily crosses both the blood-brain barrier and the placenta, and is excreted into breast milk. After absorption, diazepam is redistributed into muscle and adipose tissue. Continual daily doses of diazepam will quickly build up to a high concentration in the body (mainly in adipose tissue), which will be far in excess of the actual dose for any given day.[11][13] Diazepam is metabolised in the liver via the cytochrome P450 enzyme system. It has a biphasic half-life of 1-2 and 2-5 days, and has several pharmacologically active metabolites. The main active metabolite of diazepam is desmethyldiazepam (also known as nordazepam or nordiazepam). Diazepam's other active metabolites include temazepam and oxazepam. These metabolites are conjugated with glucuronide, and are excreted primarily in the urine. Because of these active metabolites, the serum values of diazepam alone are not useful in predicting the effects of the drug.[1][13] Diazepam has a half-life (t1/2a) of 20-50 hours, and desmethyldiazepam has a half-life of 30-200 hours.[13] Most of the drug is metabolised; very little diazepam is excreted unchanged.[11] In humans, the protein binding of diazepam is around 98.5%.[1] [edit] Indications Diazepam is mainly used to treat anxiety, insomnia, and symptoms of acute alcohol or opiate withdrawal. It is also used as a premedication for inducing sedation, anxiolysis or amnesia prior to certain medical procedures (e.g. endoscopy).[1] Diazepam is rarely used as a primary drug for the long-term treatment of epilepsy. This is due to the fact that tolerance to the anticonvulsant effects of diazepam usually develops within 6 to 12 months of treatment, effectively rendering it useless for this purpose.[11] Diazepam has a broad spectrum of indications (most of which are off-label), including: * Treatment of anxiety, panic attacks, and states of agitation[1] * Treatment of status epilepticus, adjunctive treatment of other forms of epilepsy[1] * Treatment of the symptoms of alcohol and opiate withdrawal[1] * Short-term treatment of insomnia^[1] * Treatment of tetanus, together with other measures of intensive-treatment[14] * Initial management of mania, together with firstline drugs like lithium, valproate or other antipsychotics[citation needed] * Adjunctive treatment (with antidepressants) of depression with symptoms of anxiety[citation needed] * Adjunctive treatment (with antipsychotics), in patients who develop early extrapyramidal side-effects[citation needed] * Adjunctive treatment of painful muscle conditions[10] * Adjunctive treatment of spastic muscular paresis (para-/tetraplegia) caused by cerebral or spinal cord conditions such as stroke, multiple sclerosis, spinal cord injury (long-term treatment is coupled with other rehabilitative measures)[10] * Palliative treatment of stiff person syndrome^[7] * Pre-/postoperative sedation, anxiolysis and/or amnesia (e.g. before endoscopic or surgical procedures)[10] * Treatment of overdosage with hallucinogens or CNS stimulants[11] * Adjunctive treatment of drug-induced seizures, resulting from exposure to sarin, VX, soman (or other organophosphate poisons), lindane, chloroquine, physostigmine, or pyrethroids[11] * Emergency treatment of eclampsia, along with IV magnesium sulfate * Prophylactic treatment of oxygen toxicity during hyperbaric oxygen therapy.[15] [edit] Veterinary uses Diazepam is very useful as short term sedative and anxiolytic for cats and dogs. It can also be used for preoperative sedation of cats and dogs and as an anticonvulsive suitable for short-term and long-term treatment, if sedation is tolerated. The anticonvulsant dosage is typically 0.25 milligram/pound administered intervenously or, for emergency treatment, rectally in suppository form.[16] [edit] Dosage Dosages should be determined on an individual basis, depending upon the condition to be treated, the severity of symptoms, the body weight of the patient, and any comorbid conditions the patient may have.[11] Elderly patients and those with liver disorders experience decreased metabolism of diazepam; therefore the dosage for these patients should be reduced. General guidelines for this group of patients: initial doses of 2mg to 2.5mg, 1 or 2 times daily; increase gradually as required/tolerated.[7] [edit] Adult dosage recommendations * Insomnia - Up to 30mg orally, as a single dose, at bedtime.[11] * Anxiety/panic attacks - Dosage differs depending upon severity of symptoms. For panic attacks, diazepam is taken "as needed". + Oral - 2mg to 10mg oral, 2 to 4 times daily.[7] + IV/IM - 2mg to 10mg. Repeat in 3 to 4 hours, if necessary.[10] * Pre-/postoperative sedation - If other premedications are used, they must be administered separately.[10] + Oral - Up to 20mg as a single dose.[11] + IV/IM - 2mg to 10mg, repeated at intervals of at least 5 to 10 minutes, until adequate sedation and/or anxiolysis is achieved.[11] * Status epilepticus + Oral - 2mg to 10mg, 2 to 4 times daily.[7] + IV/IM - 5mg to 10mg. May be repeated every 5 to 10 minutes until termination of seizures. Maximum dose of 40mg to 60mg can be used; if this dose is ineffective, other anticonvulsant drug therapy should be instituted.[11] + Rectal solution - 10mg as a single dose. May be repeated after 5 minutes, if necessary. The oral solution can also be administered rectally.[11] * Painful muscle conditions or muscle spasms + Oral - Up to 15mg daily, in divided doses. In severe spasticity associated with cerebral palsy, doses may be increased gradually up to 60mg daily.[11] + IV/IM - 5mg to 10mg initially, then 5mg to 10mg in 3 to 4 hours, if necessary.[10] * Tetanus - 100 to 300µg/kg intravenously, repeated every 1 to 4 hours.[11] * Spastic paresis - Usually starting with 3 times daily 2mg, increasing to up to 3 times 20mg in slow increments, taking care to avoid ataxia.[citation needed] * Alcohol/opioid withdrawal - For symptomatic relief of agitation, tremor, delirium tremens and hallucinosis. + Oral - 10mg, 3 or 4 times during the first 24 hours. Reduce to 5mg, 3 or 4 times a day, or as needed.[7] + IV/IM - 10mg initially, 5mg to 10mg in 3 to 4 hours, if necessary.[10] * Initial treatment of mania - 30 to 40mg daily oral or rectal, rarely more.[citation needed] * Overdosage with hallucinogens/CNS stimulants - Normally a single intravenous dose of 10 to 20mg is sufficient.[citation needed] * Adjunctive treatment of depression - Usually 10 to 30mg daily oral, the greater part of the dose given at bedtime. The doses should be decreased and the medication stopped as soon as the clinical situation allows.[citation needed] * Adjunctive treatment of extrapyramidal side-effects - Depends on the individual. Effective dose(s) unknown. Do not administer for more than 4 weeks.[citation needed] * Cardioversion - To relieve anxiety/tension and to reduce recall of procedure. 5mg to 15mg IV, 5 to 10 minutes prior to the procedure.[10] * Prophylactic treatment of oxygen toxicity during hyperbaric therapy - 5mg to 10mg.[15] [edit] Pediatric dosage recommendations * Patients over 6 months of age: + Initiate therapy with the lowest effective dose.[7] + Oral: Initial dose of 40 to 200µg/kg of bodyweight. Can be repeated as tolerated, up to 4 times daily.[11] + Rectal suppository: 40 to 200µg/kg of bodyweight, which can be repeated as tolerated up to 4 times daily.[11] o Sedation or muscle relaxation[11] # IV/IM - 200µg/kg of bodyweight. o Status epilepticus[11] # IV/IM - 200 to 300µg/kg of bodyweight. May be repeated after 5 to 10 minutes, if required. # Rectal solution - 5mg (for patients 1 to 3 years of age); repeat after 5 to 10 minutes, if necessary. o Tetanus[10] # Patients 30 days to 5 years of age - 1mg to 2mg IV/IM, slowly; repeat every 3 to 4 hours, as necessary. # Patients 5 years of age or older - 5mg to 10mg IV/IM, slowly; repeat every 3 to 4 hours, as necessary. o Convulsive disorders[10] # Patients 30 days to 5 years of age - 0.2mg to 0.5mg IV/IM, slowly, every 2 to 5 minutes. Maximum dose of 5mg. # Patients 5 years of age or older - 1mg IV/IM, slowly, every 2 to 5 minutes. Maximum of dose of 10mg. Repeat in 2 to 4 hours, if necessary. + Patients under 6 months of age: o Diazepam should not be given to children under 6 months of age.[7] [edit] Availability Diazepam is supplied in the following forms: * For oral administration: + Tablets - 2mg, 5mg, 10mg[7]. Generic versions available. + Capsules, time-release - 15mg (marketed by Roche as Valrelease®)[13] + Liquid solution - 1mg/ml in 500ml containers and unit-dose (5mg & 10mg); 5mg/ml in 30 ml dropper bottle (marketed by Roxane as Diazepam Intensol®)[13] * For parenteral administration: + Solution for IV/IM injection - 5mg/ml. 2ml ampoules and syringes; 1ml, 2ml, 10ml vials; 2 ml Tel-E-Ject; also contains 40% propylene glycol, 10% ethyl alcohol, 5% sodium benzoate and benzoic acid as buffers, and 1.5% benzyl alcohol as a preservative.[17][13] * For rectal administration: + Solution[11] + Suppositories - 5mg and 10mg[18][11] [edit] Side effects Diazepam has a range of side effects which are common to most benzodiazepines. Most common side effects include: * Somnolence * Suppression of REM sleep or dreaming * Impaired motor function + Impaired coordination + Impaired balance + Dizziness * Depression * Anterograde amnesia (especially pronounced in higher doses) * Reflex tachycardia^[12] Rare paradoxical side effects can include: nervousness, irritability, insomnia, muscle cramps, and in extreme cases, rage and violence.[citation needed] If these side effects are present, diazepam treatment should be immediately terminated. Up to 30% of individuals treated on a long-term basis develop a form of dependence known as "low-dose-dependence". These patients do not develop a tolerance, and do not need increasingly large doses to experience the euphoric side effects of the drug.[citation needed] Diazepam may impair the ability to drive vehicles or operate machinery. The impairment is worsened by consumption of alcohol, because both act as central nervous system depressants.[7] During the course of therapy, tolerance to the sedative effects usually develops.[citation needed] Patients with severe attacks of apnea during sleep may suffer respiratory depression (hypoventilation) leading to respiratory arrest and death. Organic changes such as leukopenia and liver-damage of the cholostatic type with or without jaundice (icterus) have been observed in a few cases.[citation needed] [edit] Interactions If diazepam is to be administered concomitantly with other drugs, attention should be paid to the possible pharmacological interactions. Particular care should be taken with drugs that enhance the effects of diazepam, such as barbiturates, phenothiazines, narcotics and antidepressants.[7] Diazepam does not increase or decrease hepatic enzyme activity, and does not alter the metabolism of other compounds. There is no evidence which would suggest that diazepam alters its own metabolism with chronic administration.[11] Agents which have an effect on hepatic cytochrome P450 pathways or conjugation can alter the rate of diazepam metabolism. These interactions would be expected to be most significant with long-term diazepam therapy, and their clinical significance is variable.[11] * Diazepam increases the central depressive effects of alcohol, other hypnotics/sedatives (e.g. barbiturates), narcotics, and other muscle relaxants. The euphoriant effects of opioids may be increased, leading to increased risk of psychological dependence.[19][20] * Cimetidine, omeprazole, ketoconazole, itraconazole, disulfiram, fluvoxamine, isoniazid, erythromycin, probenicid, propranolol, imipramine, ciprofloxacin, fluoxetine and valproic acid prolong the action of diazepam by inhibiting its elimination.[11][13] * Oral contraceptives ("the pill") significantly decrease the elimination of desmethyldiazepam, a major metabolite of diazepam.[20] * Rifampin, phenytoin, carbamazepine and phenobarbital increase the metabolism of diazepam, thus decreasing drug levels and effects.[11] * Nefazodone can cause increased blood levels of benzodiazepines.[20] * Cisapride may enhance the absorption, and therefore the sedative activity, of diazepam.[21] * Small doses of theophylline may inhibit the action of diazepam.[citation needed] * Diazepam may block the action of levodopa (used in the treatment of Parkinson's Disease).[19] * Diazepam may alter digoxin serum concentrations.[11] * Other drugs that may have interactions with diazepam include: Antipsychotics (e.g. chlorpromazine), MAO inhibitors, ranitidine.[20] * Smoking tobacco can enhance the elimination of diazepam and decrease its action.[19] * Foods that acidify the urine can lead to faster absorption and elimination of diazepam, reducing drug levels and activity.[19] * Foods that alkalinize the urine can lead to slower absorption and elimination of diazepam, increasing drug levels and activity.[11] * There are conflicting reports as to whether food in general has any effects on the absorption and activity of orally administered diazepam.[19] [edit] Contraindications Use of diazepam should be avoided, when possible, in individuals with the following conditions: * Ataxia * Severe hypoventilation * Acute narrow-angle glaucoma * Severe hepatic deficiencies (hepatitis and liver cirrhosis decrease elimination by a factor of 2) * Severe renal deficiencies (e.g. patients on dialysis) * Severe sleep apnea * Severe depression, particularly when accompanied by suicidal tendencies * Acute intoxication with alcohol, narcotics, or other psychoactive substances * Myasthenia gravis * Hypersensitivity or allergy to any drug in the benzodiazepine class [edit] Special caution needed * Pediatric patients + Less than 18 years of age - Treatment usually not indicated, except treatment of epilepsy, and pre-/postoperative treatment. The smallest possible effective dose should be used for this group of patients.[20] + Under 6 months of age - Safety and effectiveness have not been established; diazepam should not be given to individuals in this age group.[7][20] * Elderly and very ill patients - Possibility that apnea and/or cardiac arrest may occur. Concomitant use of other central nervous system depressants increases this risk. The smallest possible effective dose should be used for this group of patients..[7][20][22] * I.V. or I.M. injections in hypotensive individuals or those in shock should be administered carefully and vital signs should be monitored.[22] [edit] Patients at a high risk for abuse and dependence Diazepam can lead to physiological tolerance, and psychological and/or physical dependence. At a particularly high risk for diazepam misuse, abuse, and dependence are: * Patients with a history of alcohol or drug abuse or dependence^[7][23] * Emotionally unstable patients[citation needed] * Patients with severe personality disorders, such as Borderline Personality Disorder[citation needed] * Patients with chronic pain or other physical disorders[citation needed] Patients from the aforementioned groups should be monitored very closely during therapy for signs of abuse and development of dependence. Discontinue therapy if any of these signs are noted. Long-term therapy in these patients is not recommended.[7][23] The American Society of Addiction Medicine has policy indicating that patients with addictive disease should not be presecribed benzodiazepines such as diazepam. [edit] Withdrawal Administration of therapeutic doses of diazepam for 6 weeks or longer can result in physical dependence, characterized by a withdrawal syndrome when the drug is discontinued. With larger doses, physical dependence develops more rapidly.[11] After continued therapy in excess of a few weeks, diazepam should never be stopped abruptly. The dose should instead be lowered gradually, over a period of 2 to 4 weeks, in order to minimize withdrawal symptoms.[11][23] Withdrawal symptoms are initially minimal, and increase in severity over the first 5 to 9 days after ingestion of the drug is stopped. Diazepam's long half-life and active metabolites delay the onset of such symptoms.[11] The withdrawal symptoms for diazepam are similar to those of other CNS depressants (e.g. alcohol, barbiturates), and can include^[11]: * Anxiety * Dysphoria * Irritability * Insomnia * REM Rebound * Confusion * Tremors * Muscle spasms * Abdominal and muscle cramps * Anorexia (i.e. lack of appetite) * Nausea/vomiting * Hyperthermia/sweating * Hypotension In severe cases of diazepam withdrawal, symptoms can include: * Convulsions (i.e. seizures) * Death The more severe side effects usually only develop for patients who were treated with excessive doses for extended periods of time. Usually only the milder symptoms develop in patients terminating therapeutic-level treatment after several months.[7] [edit] Overdose An individual who has consumed too much diazepam will display one or more of the following symptoms[7][24]: * Somnolence/difficulty staying awake * Mental confusion * Hypotension * Impaired motor functions + Impaired reflexes + Impaired coordination + Impaired balance + Dizziness * Coma Although not usually fatal when taken alone, a diazepam overdose is considered a medical emergency and generally requires the immediate attention of medical personnel. The antidote for an overdose of diazepam (or any other benzodiazepine) is flumazenil (Anexate®). This drug is only used in cases with severe respiratory depression or cardiovascular complications. Because flumazenil is a short-acting drug and the effects of diazepam can last for days, several doses of flumazenil may be necessary. Artificial respiration and stabilization of cardiovascular functions may also be necessary. Although not routinely indicated, activated charcoal can be used for decontamination of the stomach following a diazepam overdose. Emesis is contraindicated. Dialysis is minimally effective. Hypotension may be treated with levarterenol or metaraminol.[11][9][7][24] The oral LD[50] (lethal dose in 50% of the population) of diazepam is 720mg/kg in mice and 1240mg/kg in rats.[7] A case where a patient took 300mg resulted only in prolonged sleep and consecutive drowsiness for the next days without serious impairment of cardiac or respiratory functions.[citation needed] Overdoses of diazepam with alcohol and/or other depressants may be fatal.[9] [edit] Recreational use Generally, diazepam is not used as a recreational drug as frequently as alprazolam or flunitrazepam. Diazepam is often found as an adulterant in heroin.[citation needed] This may be because diazepam greatly amplifies the effects of opioids. Sometimes diazepam is used by stimulant abusers to 'come down' and sleep and also by users of LSD and other hallucinogens to help ease their trip without unpleasant after-effects.[citation needed] [edit] Legal status Internationally, diazepam is a Schedule IV drug under the Convention on Psychotropic Substances.[25] [edit] Physical properties Diazepam occurs as solid white or yellow crystals and has a melting point of 131.5 to 134.5°C. It is odorless, and has a slightly bitter taste. The British Pharmacopoeia lists diazepam as being very slightly soluble in water, soluble in alcohol and freely soluble in chloroform. The United States Pharmacopoeia lists diazepam as soluble 1 in 16 of ethyl alcohol, 1 in 2 of chloroform, 1 in 39 of ether, and practically insoluble in water. The pH of diazepam is neutral (i.e. 7). Diazepam has a shelf-life of 5 years for oral tablets and 3 years for IV/IM solution.[11] Diazepam should be stored at room temperature (15°-30°C). The solution for parenteral injection should be protected from light and kept from freezing. The oral forms should be stored in air-tight containers and protected from light.[13] Diazepam can absorb into plastic, and therefore diazepam solution is not stored in plastic bottles or syringes. It can absorb into plastic bags and tubing used for intervenous infusions. Absorption appears to be dependent on several factors such as temperature, concentration, flow rates and tube length. Diazepam should not be administered if a precipitate has formed and will not dissolve.[13] [edit] Trivia * Several plants, such as potato and wheat, contain trace amounts of naturally occurring diazepam and other benzodiazepines.[26] * In April 1975, a young New Jersey woman named Karen Ann Quinlan allegedly took a small dose of Valium along with alcohol, became unconscious and stopped breathing. She became comatose and was declared to be in a persistent vegetative state. Her right to die case ended up in the US Supreme Court. The life support system was not unplugged, however, and she was weaned from her respirator by doctors in 1976. She never woke up and died 9 years later.[citation needed] * Diazepam has had many high-profile users, including Andy Warhol and Elvis Presley.[8] * Valium is the subject of "Mother's Little Helper" by The Rolling Stones, "Rowche Rumble" by The Fall and is mentioned in "Don't Push" by Sublime and Walk on the Wild Side by Lou Reed. [edit] External links * Roche Pharmaceuticals (US) - Valium Product Information [edit] References * Fachinformationen (German) for Valium, provided by Roche Pharmaceuticals * Bandelow, Borwin et al. Handbuch der Arzneimitteltherapie, Bd.1, Psychopharmaka, 2nd edition. Enke, 2004. ISBN 3131130415. * Benkert, Otto et al. Kompendium der Psychiatrischen Pharmakotherapie, 5th edition. Springer, 2003. ISBN 3540218939. [edit] Footnotes 1. ^ a b c d e f g h i Wishart, David (2006). Diazepam. DrugBank. Retrieved on 2006-03-10. 2. ^ a b Diazepam. PubChem. National Institute of Health: National Library of Medicine: (2006). Retrieved on 2006-03-11. 3. ^ Diazepam. Medical Subject Headings (MeSH). National Library of Medicine: (2006). Retrieved on 2006-03-10. 4. ^ WHO Model List of Essential Medicines. (PDF) World Health Organization: (March 2005). Retrieved on 2006-03-12. 5. ^ a b c 6. ^ Sieghart, W. (January 1994). "Pharmacology of benzodiazepine receptors: an update". Journal of Psychiatry and Neuroscience 19 (1): 24-29. PubMed. Retrieved on 2006-03-10. 7. ^ a b c d e f g h i j k l m n o p q r s Thomson Healthcare (Micromedex) (March 2000). Diazepam. Prescription Drug Information. Drugs.com. Retrieved on 2006-03-11. 8. ^ a b c Sample, Ian. "Leo Sternbach's Obituary", The Guardian (Guardian Unlimited), Monday October 3, 2005. Retrieved on 2006-03-10. 9. ^ a b c Barondes, Samuel H. (2003). Better Than Prozac. New York: Oxford University Press. ISBN 0195151305, 47-59. 10. ^ a b c d e f g h i j k Diazepam: indications. Rxlist.com. RxList Inc.: (January 24, 2005). Retrieved on 2006-03-11. 11. ^ a b c d e f g h i j k l m n o p q r s t u v w x y z aa ab ac ad ae af 12. ^ a b Langsam, Yedidyah. DIAZEPAM (VALIUM AND OTHERS). Brooklyn College (Eilat.sci.Brooklyn.CUNY.edu). Retrieved on 2006-03-23. 13. ^ a b c d e f g h i j 14. ^ Okoromah, C. N., F. E. Lesi (2004). "Diazepam for treating tetanus". Cochrane database of systematic reviews (Online) (1). PubMed. 15. ^ a b (1999) Hyperbaric Medicine Practice, Second Edition. Best Publishing Company. ISBN 0941332780. 16. ^ Hines, Ron DVM PhD (January 14, 2006). Epilepsy In Your Dog Or Cat. 2nd Chance Sanctuary Pet Health Center. Retrieved on May 18, 2006. 17. ^ Diazepam: description. Rxlist.com. RxList Inc.: (January 24, 2005). Retrieved on 2006-03-10. 18. ^ Kaewnopparat, N., Kaewnopparat, S., Rojanarat, W., Ingkatawornwong, S. (July/August 2004). "Enhanced Release of Diazepam From Hollow-Type Suppositories". International Journal of Pharmaceutical Compounding. Retrieved on 2006-03-10. 19. ^ a b c d e Holt, Gary A. (1998). Food and Drug Interactions: A Guide for Consumers. Chicago: Precept Press. ISBN 0944496598, 90-91. 20. ^ a b c d e f g Diazepam. PDRHealth.com. PDRHealth.com: (2006). Retrieved on 2006-03-10. 21. ^ Bateman, D.N. (1986). "The action of cisapride on gastric emptying and the pharmacodynamics and pharmacokinetics of oral diazepam.". Eur J Clin Pharmacol. 30 (2): 205-8. PMID 3709647. 22. ^ a b Diazepam: precautions. Rxlist.com. RxList Inc.: (January 24, 2005). Retrieved on 2006-03-10. 23. ^ a b c Diazepam: abuse and dependence. Rxlist.com. RxList Inc.: (January 24, 2005). Retrieved on 2006-03-10. 24. ^ a b Diazepam: overdose. Rxlist.com. RxList Inc.: (January 24, 2005). Retrieved on 2006-03-10. 25. ^ International Narcotics Control Board (2003). List of psychotropic substances under international control. Green list. Retrieved on 2006-03-11. 26. ^ Wildmann J, Vetter W, Ranalder UB, Schmidt K, Maurer R, Mohler H (1988). "Occurrence of pharmacologically active benzodiazepines in trace amounts in wheat and potato". Biochem Pharmacol 37 (19): 3549-59. PubMed. Retrieved on 2006-04-12. Benzodiazepines edit N03AE - antiepileptics: (01:Clonazepam) N05BA - anxiolytics: (01:Diazepam) (02:Chlordiazepoxide) (03:Medazepam) (04:Oxazepam) (05:Clorazepate) (06:Lorazepam) (07:Adinazolam) (08:Bromazepam) (09:Clobazam) (10:Ketazolam) (11:Prazepam) (12:Alprazolam) (13:Halazepam) (14:Pinazepam) (15:Camazepam) (16:Nordazepam) (17:Fludiazepam) (18:Ethyl loflazepate) (19:Etizolam) (21:Clotiazepam) (22:Cloxazolam) (23:Tofisopam) N05CD - hypnotics and sedatives: (01:Flurazepam) (02:Nitrazepam) (03:Flunitrazepam) (04:Estazolam) (05:Triazolam) (06:Lormetazepam) (07:Temazepam) (08:Midazolam) (09:Brotizolam) (10:Quazepam) (11:Loprazolam) (12:Doxefazepam) (13:Cinolazepam) No ATC code: (Gidazepam) (Nimetazepam) Anticonvulsants (N03) edit N03AA - Barbiturates: {Phenobarbital} {Methylphenobarbital} {Metharbital} {Barbexaclone} -- Pyrimidinediones: {Primidone} N03AB - Hydantoins: {Ethotoin} {Phenytoin} {Mephenytoin} {Fosphenytoin} N03AC - Oxazolidinediones: {Trimethadione} {Paramethadione} {Ethadione} N03AD - Succinimides: {Ethosuximide} {Phensuximide} {Mesuximide} N03AE - Benzodiazepines: {Clobazam} {Clonazepam} {Clorazepate} {Diazepam} {Midazolam} {Lorazepam} {Nitrazepam} N03AF - Carboxamides: {Carbamazepine} {Oxcarbazepine} {Rufinamide} N03AG - Fatty acid derivatives: Valproylamides: {Valpromide} {Valnoctamide} -- Carboxylic acids: {Valproic acid} {Sodium valproate} {Valproate semisodium} {Tiagabine} -- GABA analogs: {Gabapentin} {Vigabatrin} {Progabide} {Pregabalin} N03AX and others -- Monosaccharides: {Topiramate} -- Aromatic allylic alcohols: {Stiripentol} -- Ureas: {Phenacemide} {Pheneturide} -- Carbamates: {Felbamate} {Meprobamate} {Emylcamate} -- Pyrrolidines: {Levetiracetam} {Nefiracetam} {Brivaracetam} {Seletracetam} -- Sulfonamides: {Sultiame} {Zonisamide} {Acetazolamide} {Methazolamide} {Ethoxzolamide} -- Propionates: {Beclamide} -- Aldehydes: {Paraldehyde} -- Bromides: {Potassium bromide} Retrieved from "http://en.wikipedia.org/wiki/Diazepam" Categories: Articles with unsourced statements | Benzodiazepines | Hoffmann-La Roche | Sedatives | Hypnotics | Anticonvulsants | Muscle relaxants | Anxiolytics | Schedule IV controlled substances | Military drugs Views * Article * Discussion * Edit this page * History Personal tools * Sign in / create account Navigation * Main Page * Community Portal * Featured articles * Current events * Recent changes * Random article * Help * Contact Wikipedia * Donations Search ____________________ Go Search Toolbox * What links here * Related changes * Upload file * Special pages * Printable version * Permanent link * Cite this article In other languages * Deutsch * Espańol * E+B+R+J+T+ * Nederlands * „¬ * Norsk (bokmål) * Polski * Portuguźs * Russkij * Suomi * Svenska * MediaWiki Wikimedia Foundation * This page was last modified 02:06, 14 July 2006. * All text is available under the terms of the GNU Free Documentation License. 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