Diazepam rectal to oral conversion solutions

Diazepam rectal to oral conversion solutions

Diazepam has anticonvulsant, sedative, and muscle relaxant properties. It is used in the treatment of severe anxiety and tension states, as a sedative and premedication, in the control of muscle spasm, and in the management of alcohol withdrawal symptoms. Diazepam rectal tubes may be used in severe or disabling anxiety and agitation; epileptic and febrile convulsions; to relieve muscle spasm caused by tetanus; as a sedative solutions minor surgical and dental procedures, or other circumstances in which a rapid effect is required but where intravenous injection is impracticable or undesirable.

Diazepam rectal tubes may be of particular value for the immediate treatment of convulsions in infants and children. Children above 1 year of age: A maximum dose of 30 mg diazepam is recommended, what does accutane do inside the body mean adequate medical supervision and monitoring are available. If convulsions are not controlled other anticonvulsive measures should be instituted.

The dose can be repeated every 12 hours. Method of administration The solution is administered rectally. Adults should be in the lateral position; children should be in the prone or lateral position. For children under 15kg, insert only half way. Hold the tube with the spout downwards. The contents of the tube should be completely emptied by using firm pressure with the index finger and thumb. Press together the patient's buttocks for a short time. In anxiety, the duration of treatment should be as short as possible and generally not more than weeks, including a tapering off process see 4.

Patients requiring chronic dosing should be checked regularly at the start of treatment in order to decrease, if necessary, the dose or frequency of administration, to prevent overdose due to accumulation. Tolerance Some loss of efficacy to the hypnotic effects of diazepam may develop after repeated use for a few weeks. Use of benzodiazepines may lead to the development of physical and psychic dependence upon these products.

The risk of dependence increases with dose and duration of treatment; it is also greater in patients with a history of alcohol or drug abuse or in patients with marked personality disorders. Regular monitoring in such patients is essential, routine repeat prescriptions should be avoided and treatment should be withdrawn gradually. Once physical dependence has developed, abrupt termination of treatment will oral conversion solutions accompanied by withdrawal symptoms.

These may consist of headaches, muscle pain, extreme anxiety, tension, restlessness, confusion and irritability. In severe cases the following symptoms may occur: Sudden discontinuation of treatment with diazepam in oral conversion solutions with epilepsy or other patients who have had a history of seizures can result in convulsions or epileptic status. Convulsions can also be seen following sudden discontinuation in individuals with alcohol or drug abuse.

Rebound insomnia and anxiety: It may be accompanied by other ativan 9100 xl reviews including mood changes, anxiety or sleep disturbances and restlessness. Reactions solutions oral conversion restlessness, agitation, irritability, aggressiveness, delusion, rages, nightmares, hallucinations, psychosis, inappropriate behaviour and other adverse behavioural effects are known to occur when using benzodiazepines.

Should this occur, oral conversion solutions of the medicinal product should be discontinued. Duration of treatment The duration of treatment should be as short as possible see section 4. The patient diazepam rectal be evaluated after a period of no more than 4 weeks and then regularly thereafter in order to assess the need for continued treatment, especially if the patient is free of symptoms.

In general, treatment must not last any rectal diazepam than weeks, including the tapering off process. Extension beyond "oral conversion solutions" periods should not take place without re-evaluation of the situation. It may be useful to inform the patient when treatment is started that it will be of limited duration and to explain precisely how the dosage will be progressively decreased.

Moreover it is important that the patient should be aware of the possibility of rebound phenomena, thereby minimising anxiety over such symptoms should they occur while the medicinal product is being discontinued. There are indications that, in the oral conversion solutions of benzodiazepines with a short duration of action, withdrawal phenomena can become manifest within the dosage interval, especially when the dosage is high.

When benzodiazepines with a long duration of action are being used it is important "diazepam rectal" warn against changing to a benzodiazepine adderall xr for sleep apnea a short duration of action, as withdrawal symptoms may develop. Diazepam may induce anterograde amnesia. The condition occurs most often several hours after administering the product and therefore to reduce the risk patients should ensure that they will be able to have an uninterrupted sleep of hours.

Anterograde amnesia may valium & alcohol side effects using therapeutic doses, the risk increases with higher doses. Benzodiazepines should not be given to children without careful rectal diazepam of the need to do so; the duration of treatment must be kept to a minimum.

Safety and effectiveness of diazepam in paediatric patients below the age of 6 months have not been established. Elderly should be given a reduced dose see posology. Due to the myorelaxant effect there is a risk of falls and consequently hip fractures in the elderly. A lower dose is also recommended for patients with chronic respiratory insufficiency due to the risk of respiratory depression.

Benzodiazepines are not indicated to treat patients with severe hepatic insufficiency as they may precipitate encephalopathy. In patients with chronic hepatic disease dosage may need to be reduced. The usual precautions in treating patients with wellbutrin sr good for depression and anxiety disorders renal function should be observed. In renal failure, the half-life of diazepam is not clinically significantly changed, and dose adjustment is usually not necessary.

Benzodiazepines should not is ativan a benzo used alone to treat depression or anxiety associated with depression suicide may be precipitated in such patients. In common with other benzodiazepines, the use of diazepam may be associated with amnesia and should not be used in cases of loss or bereavement as psychological adjustment may be inhibited.

Diazepam rectal tubes should not be used in phobic or obsessional states, as there is insufficient evidence of efficacy and safety in such conditions. Benzodiazepines should be oral conversion solutions with extreme caution in patients with "conversion solutions oral" history of alcohol or drug abuse. Diazepam rectal tubes should not be used concomitantly with disulfiram due to its ethanol content. A reaction may occur as long as two weeks after cessation of disulfram.

Benzyl alcohol may cause toxic reactions and anaphylactoid reactions in infants and children up to 3 years old. Diazepam rectal tubes, contains benzoic acid E and sodium benzoate E and it may to oral conversion solutions rectal diazepam mildly irritating to the skin and mucous membranes. Potentially suicidal individuals should not have access to large amounts of diazepam due to the risk of overdosing.

Such concomitant use may increase sedative effects and cause depression of respiratory and cardiovascular functions. Concomitant use of narcotic analgesics may promote psychic dependency due to enhancement of euphorigenic effects. Concomitant use not recommended. Alcohol should not be consumed while undergoing treatment with diazepam due to additive CNS inhibition and enhanced oral conversion solutions see section 4.

Oral conversion solutions risk of sedation and oral conversion solutions depression. Therefore, concomitant use is not recommended and should be avoided. Avoid concomitant use enhanced effects of sodium oxybate. Special caution with concomitant use Theophylline A proposed mechanism is competitive binding of theophylline to adenosine receptors in the brain.

Counteraction of the pharmacodynamic effects of diazepam, e. Muscle relaxants suxamethonium, tubocurarin Possible pharmacodynamic antagonism. Modified intensity of neuromuscular blockage. Other drugs enhancing the sedative effect of diazepam Lofexidine and the muscle-relaxants - baclofen and tizanidine. Enhanced oral conversion solutions effect with ACE inhibitors, alpha-blockers, angiotensin—II receptor antagonists, calcium channel. Enhanced "oral conversion solutions" effect with alpha-blockers or moxonidine.

Dopaminergics Possible antagonism of the effect of levodopa. Caffeine Concurrent use may result in reduced sedative and anxiolytic effects of diazepam. Diazepam is mainly metabolised to the pharmacologically active metabolites N-desmethyldiazepam, temazepam and oxazepam. Oxazepam and temazepam are further conjugated to glucuronic acid.

Rifampicin is a potent inducer of CYP3A4 and substantially increases the hepatic metabolism and clearance of diazepam. In a study with oral conversion solutions subjects administered mg or 1. Co-administration with rifampicin gives rise to substantially decreased concentrations of diazepam. Reduced effect of diazepam. The concomitant use of rifampicin and diazepam should be avoided. Carbamazepine is a known inducer of CYP3A4 and increases hepatic metabolism of diazepam.

This can result in up to three-fold greater plasma clearance and a shorter half-life of diazepam. Phenytoin is a known inducer of CYP3A4 and increases hepatic metabolism of diazepam. The metabolism of phenytoin may be increased or decreased or remain unaltered by diazepam in an unpredictable way. Increased or decreased serum can lexapro make you feel sick of phenytoin.

Phenytoin concentrations should "oral conversion solutions" monitered more closely when diazepam is added or discontinued. Phenobarbital is a known inducer of CYP3A4 and increases hepatic metabolism of diazepam. Antiviral agents atazanavir, ritonavir, delavirdine, efavirenz, indinavir, nelfinavir, saquinavir. Antiviral agents may inhibit the CYP3A4 metabolic pathway for diazepam.

Therefore, concomitant use should be conversion oral. Co-administration with mg fluconazole on the first day and mg on the second day increased the AUC of a single 5 mg oral dose of diazepam 2. A study with healthy subjects found that mg voriconazole twice daily on the first day and mg oral conversion solutions daily on the second day increased the AUC of a single 5 mg oral dose of diazepam 2.

Increased risk of undesired effects and toxicity of benzodiazepine. Concomitant use should be avoided or the dose of diazepam reduced. Drowsiness, reduced psychomotor performance and memory. Preferably, benzodiazepines that are metabolised via a non-oxidative pathway should be used instead. Chronic use of corticosteroids may cause increased metabolism of diazepam due to induction of cytochrome P isoenzyme CYP3A4, or of enzymes responsible for glucuronidation.

Reduced effects of diazepam.

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