Diazepam (injection)

Overview

Patients who experience certain kinds of seizures, are nervous and anxious prior to a medical procedure or surgery, or have muscle aches and spasms have found relief through doctor-administered diazepam injections. This drug is commonly used in patients who are undergoing alcohol withdrawal and the feelings of anxiety and nervousness that it can cause.

The drug, a benzodiazepine, works to depress the central nervous system (CNS) which in turn helps the patient to relax. Patients should not drink alcohol, also a CNS depressant, while they are being treated with diazepam. It is important to inform your doctor of all medications you are taking including prescription and non-prescription drugs, herbal remedies and any vitamin or mineral supplements.

There are other medications that depress the CNS and should be avoided, such as any over the counter or prescription cold or allergy medication or antihistamine, painkillers, barbiturates, muscle relaxers, and sleeping aids. If you are unsure about the safety of any medication while you are taking diazepam be sure to consult with your physician or pharmacist for guidance.

Diazepam has been known to cause overdose, and patients should be aware of the symptoms of such an occurrence. If you experience any of the side effects that are related to overdose, it is imperative that you contact 911 or seek immediate emergency care. Inform your doctor of any side effects that you experience that become worse over time or do not dissipate after a few days.

Do not use diazepam if you are pregnant or nursing, and be sure to use effective birth control while taking this drug. If you become pregnant while taking diazepam, it is imperative that you notify your doctor right away.

Follow all of the dosage requirements set forth by your physician because if you stop taking diazepam abruptly, you may experience withdrawal symptoms and the stress on your body may worsen the underlying condition for which you are taking the drug.

Conditions Treated

  • Seizure disorders
  • Alcohol withdrawal
  • Muscle relaxation
  • Muscle spasm
  • Reduction of stress or anxiety associated with a medical procedure or surgery

Type Of Medicine Benzodiazepine

Side Effects

The use of diazepam may cause certain side effects that warrant medical care; if you experience any of the following symptoms, it is advisable that you contact your physician as soon as possible:

More Likely:

  • Unsteadiness, trembling, or other
  • Shakiness and unsteady walk
  • Veins that appear overly prominent in the area of the injection
  • Skin discoloration
  • Difficulty with coordination or muscle control
  • Tenderness, pain, swelling, or warmth at the site of injection

Less Likely:

  • Abdominal or stomach pain
  • Unusual tiredness or weakness
  • Blurred vision
  • Unusual bleeding or bruising
  • Chest pain or discomfort
  • Unable to sleep
  • Cold, clammy, or pale skin
  • Trouble sleeping
  • Cough
  • Trembling or shaking of hands or feet
  • Decrease in frequency of urination
  • Sore throat
  • Difficulty in passing urine (dribbling)
  • Slow heart rate
  • Fear or nervousness
  • Shortness of breath
  • Hallucinations
  • Rash
  • Irregular heartbeats
  • Outbursts of anger
  • Loss of appetite
  • Nausea
  • Shakiness in the legs, arms, hands, or feet
  • Muscle spasm
  • Lower back or side pain
  • Nightmares
  • Loss of bladder control
  • Painful or difficult urination
  • Pale skin
  • Itching
  • Headache
  • Sleeplessness
  • Fever
  • Slow or irregular heartbeat
  • Slurred speech
  • Dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
  • Sweating
  • Decrease in urine volume
  • Trouble speaking
  • Dark urine
  • Ulcers, sores, or white spots in the mouth
  • Confusion
  • Unpleasant breath odor
  • Chills
  • Unusual excitement, nervousness, restlessness, or irritability
  • Changes in patterns and rhythms of speech
  • Vomiting of blood
  • Black, tarry stools
  • Yellow eyes or skin

Unknown Incidence:

  • Deep or fast breathing with dizziness
  • Pale or blue lips, fingernails, or skin
  • Wheezing
  • Irregular, fast or slow, or shallow breathing
  • Tightness in the chest
  • Numbness of the feet, hands, and around the mouth
  • Difficult or troubled breathing

Because it is possible for an overdose to occur when taking diazepam injections, it is important that patients and their caregivers familiarize themselves with the signs of possible overdose and seek immediate emergency care if any of the following occur:

Seek Emergency Care if You Experience:

  • Sleepiness or unusual drowsiness
  • Loss of consciousness
  • Lack of coordination
  • Change in consciousness

While all of the side effects and symptoms that are listed require medical care and attention, or even emergency services, there are other side effects possible with diazepam that will likely go away on their own after a few days. If you experience any of this group of symptoms and they become worse or last for longer than just a few days, it is advisable that you consult with your doctor to determine if further medical attention is necessary.

Less Likely:

  • Constipation
  • Sensation of spinning
  • Difficulty in swallowing
  • Redness of skin
  • Double vision
  • Loss of sexual ability, desire, drive, or performance
  • Feeling of constant movement of self or surroundings
  • Increased watering of the mouth
  • Hiccups
  • Increase in sexual ability, desire, drive, or performance
  • Increased interest in sexual intercourse
  • Hives or welts
  • Itching
  • Lack of appetite
  • Feeling sad or empty
  • Loss of interest or pleasure
  • Dry mouth
  • Seeing double
  • Inability to have or keep an erection
  • Discouragement
  • Trouble concentrating
  • Decreased interest in sexual intercourse
  • Uncontrolled eye movements

While the information above is comprehensive, it is possible that you may experience side effects or symptoms that are not included in this section. Any experience that you have while taking diazepam that you find worrisome or a bother should be reported to your doctor.

Dosage

This drug is administered by your doctor, nurse, or another healthcare professional, and should never be self-administered. They will inject the drug through an IV into your vein, or as a shot (injection) into your muscle tissue.

Typically, diazepam is given in injectable form on a temporary basis, after which the patient will transition to an oral delivery method. If you are concerned about how long you are taking the drug, or how the drug is administered into your system, speak with your doctor to alleviate any worry that you may have.

Major Drug Interactions:

If you are currently taking flumazenil, you should not be given diazepam injections. Be sure to inform your doctor right away if you are taking flumazenil or if you have done so in the recent past.

There are a number of drugs that may cause issues when used concurrently with a diazepam injection. It is important that you inform your doctor of all medications that you are taking and notify them if there are any changes in the dosage or the frequency with which you take any of these. Your doctor may alter the dosage or frequency with which you take one or both of these medications, or they will prescribe an alternative.

  • Alfentanil
  • Thiopental
  • Anileridine
  • Sufentanil
  • Bromopride
  • Secobarbital
  • Butabarbital
  • Propoxyphene
  • Butorphanol
  • Primidone
  • Carbinoxamine
  • Phenobarbital
  • Chloral Hydrate
  • Pentobarbital
  • Cobicistat
  • Oxymorphone
  • Conivaptan
  • Orlistat
  • Dihydrocodeine
  • Morphine
  • Eslicarbazepine Acetate
  • Methohexital
  • Etravirine
  • Methadone
  • Flibanserin
  • Meprobamate
  • Fospropofol
  • Mephenesin
  • Hydromorphone
  • Meperidine
  • Levorphanol
  • Mephobarbital
  • Hydrocodone
  • Metaxalone
  • Fosphenytoin
  • Methocarbamol
  • Fentanyl
  • Mirtazapine
  • Ethchlorvynol
  • Meclizine
  • Morphine Sulfate Liposome
  • Doxylamine
  • Oxycodone
  • Dantrolene
  • Pentazocine
  • Codeine
  • Periciazine
  • Chlorzoxazone
  • Phenytoin
  • Carisoprodol
  • Propofol
  • Calcifediol
  • Remifentanil
  • Butalbital
  • Sodium Oxybate
  • Buprenorphine
  • Tapentadol
  • Bromazepam
  • Tramadol
  • Amobarbital
  • Zolpidem

The drugs listed below may increase your chance of experiencing unwanted side effects but do not typically cause serious health problems when used together; your doctor may opt to change one or both of your medications or they may just alter the dosage amount or the frequency with which you take them.

  • Amitriptyline
  • St. John's Wort
  • Clarithromycin
  • Rifapentine
  • Disulfiram
  • Isoniazid
  • Fluvoxamine
  • Quinupristin
  • Erythromycin
  • Roxithromycin
  • Ginkgo
  • Dalfopristin
  • Theophylline
  • Amprenavir
  • Troleandomycin

Additional Medical Issues and Conditions:

There are certain conditions that may be negatively affected when you take diazepam injections, and it is important that you notify your healthcare team if you suffer from any of the following:

  • Alcohol abuse
  • Kidney disease
  • Alcohol intoxication
  • Hypotension (low blood pressure)
  • Physical shock
  • Liver disease
  • Heart or blood vessel disease
  • Respiratory problems or lung disease
  • Muscle weakness
  • Glaucoma
  • Drug abuse or dependence

Warnings

While you are being administered diazepam injections it is important that you keep any and all appointments that your doctor schedules. They may order blood work or other diagnostic tests to ensure that the drug is working as necessary and that no unwanted side effects are occurring. If you are directed by your physician to receive blood work or another test, it is important that you keep the appointment.

Diazepam is not safe for use by pregnant or nursing women. If you are currently pregnant be sure to advise your doctor prior to receiving any injections. While you are being treated with diazepam injections be sure to utilize an effective form of contraception and advise your physician right away if you become pregnant.

This medication may cause side effects that will make it dangerous for you to drive a car, operate machinery, or perform any other task that requires clear vision and full mental alertness. Prior to engaging in any of these activities, be sure that you understand how the diazepam injections affect your vision and alertness.

Many patients report that they experience double and blurred vision for a period of time following their injections. The drug can also cause lightheadedness and dizziness. While these symptoms are more likely to affect older patients, they can occur in patients of any age; be sure you know how your body reacts to the injections prior to driving or operating machinery.

Because this medication slows down the central nervous system (CNS) it is not advised that patients consume any alcohol, also a depressant of the CNS, while being treated with diazepam. There are also many over the counter and non-prescription medications that can depress the CNS and should be avoided by anyone taking diazepam. Such medications include common cold and allergy medications and pain relievers. Prescription drugs such as tranquilizers, muscle relaxers, or sleeping medications should also be avoided. If you are taking any barbituates for treatment of seizures, be sure to inform your doctor prior to beginning a course of treatment that includes diazepam. It is important to allow a few days to elapse between taking any CNS depressant and beginning diazepam.

If you stop taking diazepam in an abrupt manner if may cause withdrawal symptoms. You will want to follow the instructions provided by your physician and wean yourself off of the diazepam in a structured fashion. If you stop taking it too quickly it can worsen the condition for which you are taking the drug and also cause unwanted and potentially dangerous side effects such as tremors, hallucinations, convulsions, or stomach cramps. Be sure to discuss any desired alterations to your course of treatment with your doctor prior to making any changes.

Storage

This drug is administered by your doctor, surgeon, or another healthcare professional which eliminates the need for the patient to store or properly dispose of the drug. Diazepam should not be self-administered or taken without medical advice and supervision.

Summary

Diazepam is an effective drug for the treatment of alcohol withdrawal, anxiety prior to surgery, muscle aches and spasms, and certain seizure disorders. This injection is administered by a healthcare professional and should never be self-administered. If you are taking this drug it is imperative that you follow all dosage instructions provided by your doctor because you may experience withdrawal symptoms if you stop taking diazepam in an abrupt manner.

It is possible to overdose on diazepam and patients need to familiarize themselves with the signs of such an occurrence. If you experience any of the side effects that are related to overdose call 911 immediately or seek emergency medical assistance. This drug should not be used with another central nervous system (CNS) depressants and it is imperative that you inform your doctor of all of the drugs and medications that you are currently taking.

Your doctor may order blood tests or other diagnostic tests while you are taking diazepam to ensure that it is working effectively and is not causing any unwanted side effects. Be sure to keep all appointments and follow all of the instructions provided by your medical team while taking this drug.