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Diazepam

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diazepam
Type benzodiazepine
Group benzodiazepine
links
ATC-code N05BA01
CAS-number 439-14-5
Medscape 342902
PubChem 3016
PubMed diazepam
Drugs.com diazepam
Kompas (nl) diazepam
bcfi (nl) FAAI
Wikipedia diazepam
more info
DDD 10mg
Dmax 60mg [1]
Cth 250-750μg/L [2][3]
Ctox 1500-3000μg/L [4] [5]
EQ-dosage 1[6] diazepam
T1/2 48h [1]
Teff 118h [7]
metabolites 10[1]
bioavailability 93%[1]
administration oral, rectal, IM, IV
tablets 2,5,10 mg [8]
Price/day 0 [9]

diazepam is a benzodiazepine in the group benzodiazepine.


Caution area Value Ref Description
Lactation 8 [1][10][11][12] Unsafe and possibly harming
Pregnancy 8 [1][13][12][11] unsafe - D - suspected to cause malfunctions or irreversible damage (teratogenic)
Diabetes mellitus 2 [14] very weak influence on diabetes - probably safe, consider monitoring
Hepatic insufficiency 8 [1][10] Unsafe with mild hepatic impairment (Child-Pugh classification A - monitoring required)
Children 1 [15][10] fully applicable - registered for pediatric use and well studied
Elderly 6 [10][16] average safety - adapt dosage
Dementia 8 [13] strong influence on cognition
Chronic Obstructive Pulmonary Disease 8 [13][17][18][19] unsafe - adapt dosage or substitute drug
Hypertension 3 [14] rare (between 1 in 1,000 and 1 in 10,000 patients: 0,01% - 0,1%)
Hypotension 3 [13] rare (between 1 in 1,000 and 1 in 10,000 patients: 0,01% - 0,1%)
Heart failure 2 [14] weak influence on HF - rather safe, monitoring recommended
Long QT-syndrome 2 [20] QTc-prolongation reported - safe - Arizona Scale - not listed
Seizures 1 [1] safe - occurrence extremely rare (case-report)
Cerebrovascular accidents 2 [14] weak influence on CVA - safe, monitoring recommended
Renal insufficiency 2 [1] generally safe - unsafe when MDRD < 10 (end stage renal disease (ESRD))
Dyskinesia 1 [21][22] occurrence extremely rare (case-report)
Movement disorders 3 [13] rare (between 1 in 1,000 and 1 in 10,000 patients: 0,01% - 0,1%)
Haematology 3 [23][13] rare (between 1 in 1,000 and 1 in 10,000 patients: 0,01% - 0,1%)
Anticholinergic effects 3 [13] rare (between 1 in 1,000 and 1 in 10,000 patients: 0,01% - 0,1%)
Male sexual dysfunction 1 [23] occurrence extremely rare (case-report)
Female sexual dysfunction 1 [23] occurrence extremely rare (case-report)
Traffic 10 [1][24] severe influence (category III) >0,8 g/l (>0,8‰)
Weight 6 [10] uncommon (between 1 in 100 and 1 in 1,000 patients: 0,1% - 1%)
Weight gain 0 unknown/unverified
Weight loss 0 unknown/unverified
Photosensitivity 0 unknown/unverified
Sedation 10 [18][25] very common (over 1 in 10 patients: > 10%)
Poor CYP2D6 metabolizer 0 unknown/unverified
Ultra rapid CYP2D6 metabolizer 0 unknown/unverified
Poor CYPC19 metabolizer 0 unknown/unverified
Ultra rapid CYP2C19 metabolizer 0 unknown/unverified


  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 KNMP; Informatorium Medicamentorum 2009; Monografie "diazepam" (Dutch)
  2. Universitair Medisch Centrum Groningen, Referentiewaarden klinisch farmacologisch bepalingen
  3. VU Medisch Centrum, Referentiewaarden klinisch farmacologisch bepalingen
  4. NVZA; Toxicology.org; Monografie ID=29 (dutch)
  5. MICROMEDEX; POISINDEX Benzodiazepines; Section 7.5.2 Toxic Concentrations
  6. KNMP; Informatorium Medicamentorum 2009; Inleidende tekst "Benzodiazepineagonisten" (Dutch)
  7. Ashton, H. BENZODIAZEPINE EQUIVALENCY TABLE. April 2007
  8. Symfora groep, ArtaLievegoedgroep, de Voorde Formularium 2010 versie 1.1
  9. oraal 1.18/maand/DDD cf FTK: results in €0.04
  10. 10.0 10.1 10.2 10.3 10.4 Drugs.com diazepam
  11. 11.0 11.1 Iqbal MM, Sobhan T, Aftab SR, Mahmud SZ. Diazepam use during pregnancy: a review of the literature. Del Med J. 2002 Mar;74(3):127-35  (pubmed-id 11963349)
  12. 12.0 12.1 McElhatton PR. The effects of benzodiazepine use during pregnancy and lactation. Reprod Toxicol. 1994 Nov-Dec;8(6):461-75  (pubmed-id 7881198)
  13. 13.0 13.1 13.2 13.3 13.4 13.5 13.6 13.7 Actavis UK Ltd; SPC DIAZEPAM TABLETS BP 10mg
  14. 14.0 14.1 14.2 14.3 Bazire S. Psychotropic drug directory 2007. Trowbridge: Cromwell Press; 2007
  15. NKFK Kinderformularium ID=286 (dutch)
  16. Swift CG, Ewen JM, Clarke P, Stevenson IH. Responsiveness to oral diazepam in the elderly: relationship to total and free plasma concentrations. Br J Clin Pharmacol. 1985 Aug;20(2):111-8  (pubmed-id 3929807)
  17. Woodcock AA, Gross ER, Geddes DM. Drug treatment of breathlessness: contrasting effects of diazepam and promethazine in pink puffers. Br Med J (Clin Res Ed). 1981 Aug 1;283(6287):343-6  (pubmed-id 6788319)
  18. 18.0 18.1 Committee on the Review of Medicines. Systematic review of the benzodiazepines. Guidelines for data sheets on diazepam, chlordiazepoxide, medazepam, clorazepate, lorazepam, oxazepam, temazepam, triazolam, nitrazepam, and flurazepam. Br Med J. 1980 Mar 29;280(6218):910-2  (pubmed-id 7388368)
  19. Catchlove RF, Kafer ER. The effects of diazepam on respiration in patients with obstructive pulmonary disease. Anesthesiology. 1971 Jan;34(1):14-8  (pubmed-id 5540362)
  20. The Netherlands Pharmacovigiliance Centre LAREB; Knowledge; Overview Signals
  21. Singh MM, Becker RE, Pitman RK, Nasrallah HA, Lal H, Dufresne RL, Weber SS, McCalley-Whitters M. Diazepam-induced changes in tardive dyskinesia: suggestions for a new conceptual model. Biol Psychiatry. 1982 Jun;17(6):729-42  (pubmed-id 6125219)
  22. Singh MM. Diazepam in the treatment of tardive dyskinesia. Preliminary observations. Int Pharmacopsychiatry. 1976;11(4):232-4  (pubmed-id 1010710)
  23. 23.0 23.1 23.2 MICROMEDEX; Monograph Diazepam; Section 3.3 Adverse Reactions
  24. The International Council on Alcohol, Drugs and Traffic Safety (ICADTS). ICADTS drug list - July 2007 (Internet)
  25. Davison K, Farquharson RG, Khan MC, Majid A. A double-blind comparison of alprazolam, diazepam and placebo in the treatment of anxious out-patients. Br J Clin Pharmacol. 1985;19 Suppl 1:37S-43S  (pubmed-id 2859877)