Health Guide
Drug Guide

Benzodiazepine (Oral route, parenteral route, rectal route)

Brand Names:

Dosage Forms:

Uses of This Medicine:

Benzodiazepines belong to the group of medicines called central nervous system (CNS) depressants (medicines that slow down the nervous system).

Some benzodiazepines are used to relieve anxiety. However, benzodiazepines should not be used to relieve nervousness or tension caused by the stress of everyday life.

Some benzodiazepines are used to treat insomnia (trouble in sleeping). However, if used regularly (for example, every day) for insomnia, they usually are not effective for more than a few weeks.

Many of the benzodiazepines are used in the treatment of other conditions, also. Diazepam is used to help relax muscles or relieve muscle spasm. Diazepam injection is used before some medical procedures to relieve anxiety and to reduce memory of the procedure. Chlordiazepoxide, clorazepate, diazepam, and oxazepam are used to treat the symptoms of alcohol withdrawal. Alprazolam and clonazepam are used in the treatment of panic disorder. Clobazam, clonazepam, clorazepate, diazepam, and lorazepam are used in the treatment of certain convulsive (seizure) disorders, such as epilepsy. The benzodiazepines may also be used for other conditions as determined by your doctor.

Benzodiazepines may be habit-forming (causing mental or physical dependence), especially when taken for a long time or in high doses.

These medicines are available only with your doctor's prescription.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, some of the benzodiazepines are used in certain patients with the following medical conditions:

Before Using This Medicine:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to medicines in this group or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children

Most of the side effects of these medicines are more likely to occur in children, especially the very young. These patients are usually more sensitive than adults to the effects of benzodiazepines.

It is possible that using clonazepam for long periods of time may cause unwanted effects on physical and mental growth in children. If such effects do occur, they may not be noticed until many years later. Before this medicine is given to children for long periods of time, you should discuss its use with your child's doctor.

Older adults

Most of the side effects of these medicines are more likely to occur in the elderly, who are usually more sensitive to the effects of benzodiazepines.

Taking benzodiazepines for trouble in sleeping may cause more daytime drowsiness in elderly patients than in younger adults. In addition, falls and related injuries are more likely to occur in elderly patients taking benzodiazepines.

Pregnancy

Chlordiazepoxide and diazepam have been reported to increase the chance of birth defects when used during the first 3 months of pregnancy. Although similar problems have not been reported with the other benzodiazepines, the chance always exists since all of the benzodiazepines are related.

Studies in animals have shown that clonazepam, lorazepam, and temazepam cause birth defects or other problems, including death of the animal fetus.

Too much use of a benzodiazepine during pregnancy may cause the baby to become dependent on the medicine. This may lead to withdrawal side effects after birth. Also, use of benzodiazepines during pregnancy, especially during the last weeks, may cause body temperature problems, breathing problems, difficulty in feeding, drowsiness, or muscle weakness in the newborn infant.

Benzodiazepines given just before or during labor may cause weakness in the newborn infant. When diazepam is given in high doses (especially by injection) within 15 hours before delivery, it may cause breathing problems, muscle weakness, difficulty in feeding, and body temperature problems in the newborn infant.

Breast-feeding

Benzodiazepines may pass into the breast milk and cause drowsiness, difficulty in feeding, and weight loss in nursing babies of mothers taking these medicines.

Other medicines

Using medicines in this class with any of the following medicines is not recommended. Your doctor may decide not to treat you with a medication in this class or change some of the other medicines you take.

Using medicines in this class with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Other interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Other medical problems

The presence of other medical problems may affect the use of medicines in this class. Make sure you tell your doctor if you have any other medical problems, especially:

Proper Use of This Medicine:

For caregivers administering diazepam rectal gel:

For patients taking clorazepate extended-release tablets :

For patients taking alprazolam, diazepam, or lorazepam concentrated oral solution:

For patients taking lorazepam sublingual tablets:

For patients taking alprazolam oral disintegrating tablets:

Take this medicine only as directed by your doctor . Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. If too much is taken, it may become habit-forming (causing mental or physical dependence).

If you think this medicine is not working properly after you have taken it for a few weeks, do not increase the dose. Instead, check with your doctor.

For patients taking this medicine on a regular schedule for epilepsy or other seizure disorder:

For patients taking this medicine for insomnia:

For patients taking flurazepam:

Dosing

The dose medicines in this class will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of these medicines. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

Missed dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

If you are taking this medicine regularly (for example, every day as for epilepsy) and you miss a dose, take it right away if you remember within an hour or so of the missed dose. However, if you do not remember until later, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Keep out of the reach of children.

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Do not keep outdated medicine or medicine no longer needed.

Keep the oral disintegrating tablet form of this medicine in a tightly sealed bottle and discard any cotton that was included in the bottle

Precautions While Using This Medicine:

If you will be taking a benzodiazepine regularly for a long time:

If you are taking a benzodiazepine for epilepsy or another seizure disorder:

If you are taking a benzodiazepine for insomnia (trouble in sleeping):

Benzodiazepines may be habit-forming (causing mental or physical dependence), especially when taken for a long time or in high doses. Some signs of dependence on benzodiazepines are:

If you think you may have become mentally or physically dependent on this medicine, check with your doctor. Do not stop taking it suddenly.

If you have been taking this medicine in large doses or for a long time, do not stop taking it without first checking with your doctor. Your doctor may want you to reduce gradually the amount you are taking before stopping completely. Stopping this medicine suddenly may cause withdrawal side effects, including seizures. Stopping this medicine suddenly is most likely to cause seizures if you have been taking it for epilepsy or another seizure disorder.

This medicine will add to the effects of alcohol and other central nervous system (CNS) depressants (medicines that slow down the nervous system, possibly causing drowsiness). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates; medicine for seizures; muscle relaxants; or anesthetics, including some dental anesthetics. This effect may last for a few days after you stop taking this medicine. Check with your doctor before taking any of the above while you are taking this medicine.

If you think you or someone else may have taken an overdose of this medicine, get emergency help at once. Taking an overdose of a benzodiazepine or taking alcohol or other CNS depressants with the benzodiazepine may lead to unconsciousness and possibly death. Some signs of an overdose are continuing slurred speech or confusion, severe drowsiness, severe weakness, and staggering.

Before you have any medical tests, tell the medical doctor in charge that you are taking this medicine. The results of the metyrapone test may be affected by chlordiazepoxide.

If you develop any unusual and strange thoughts or behavior while you are taking this medicine, be sure to discuss it with your doctor. Some changes that have occurred in people taking this medicine are like those seen in people who drink alcohol and then act in a manner that is not normal. Other changes may be more unusual and extreme, such as confusion, agitation, and hallucinations (seeing, hearing, or feeling things that are not there).

This medicine may cause some people, especially older persons, to become drowsy, dizzy, lightheaded, clumsy or unsteady, or less alert than they are normally. Even if taken at bedtime, it may cause some people to feel drowsy or less alert on arising. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

Less common
Anxiety
confusion (may be more common in the elderly)
fast, pounding, or irregular heartbeat
lack of memory of events taking place after benzodiazepine is taken (may be more common with triazolam
mental depression
Rare
Abnormal thinking, including disorientation, delusions (holding false beliefs that cannot be changed by facts), or loss of sense of reality
agitation
behavior changes, including aggressive behavior, bizarre behavior, decreased inhibition, or outbursts of anger
convulsions (seizures)
hallucinations (seeing, hearing, or feeling things that are not there)
hypotension (low blood pressure)
muscle weakness
skin rash or itching
sore throat, fever, and chills
trouble in sleeping
ulcers or sores in mouth or throat (continuing)
uncontrolled movements of body, including the eyes
unusual bleeding or bruising
unusual excitement, nervousness, or irritability
unusual tiredness or weakness (severe)
yellow eyes or skin
Symptoms of overdose
Confusion (continuing)
convulsions (seizures)
drowsiness (severe) or coma
shakiness
slow heartbeat
slow reflexes
slurred speech (continuing)
staggering
troubled breathing
weakness (severe)

For patients having chlordiazepoxide, diazepam, or lorazepam injected: Check with your doctor if there is redness, swelling, or pain at the place of injection.

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
Clumsiness or unsteadiness
dizziness or lightheadedness
drowsiness
slurred speech
Less common or rare
Abdominal or stomach cramps or pain
blurred vision or other changes in vision
changes in sexual desire or ability
constipation
diarrhea
dryness of mouth or increased thirst
false sense of well-being
headache
increased bronchial secretions or watering of mouth
muscle spasm
nausea or vomiting
problems with urination
trembling or shaking
unusual tiredness or weakness

Not all of the side effects listed above have been reported for each of these medicines, but they have been reported for at least one of them. All of the benzodiazepines are similar, so any of the above side effects may occur with any of these medicines.

After you stop using this medicine, your body may need time to adjust. During this time, check with your doctor if you notice any of the following side effects:

More common
Irritability
nervousness
trouble in sleeping
Less common
Abdominal or stomach cramps
confusion
fast or pounding heartbeat
increased sense of hearing
increased sensitivity to touch and pain
increased sweating
loss of sense of reality
mental depression
muscle cramps
nausea or vomiting
sensitivity of eyes to light
tingling, burning, or prickly sensations
trembling or shaking
Rare
Confusion as to time, place, or person
convulsions (seizures)
feelings of suspicion or distrust
hallucinations (seeing, hearing, or feeling things that are not there)

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.


Last Updated: 6/12/2013

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