Valpam® [diazepam] – Tranquilizer & Anxiolytic

Composition

Ampoule: Each ampoule (2mL) contains diazepam 10 mg.
Syrup: Each teaspoonful (5mL) contains diazepam 2 mg.
Tablets: Each tablet contains diazepam 2 mg or 5mg.

Properties

Diazepam (Valpam®) is a benzodiazepine with anticonvulsant anxiolytic, sedative, muscle relaxant, and amnestic properties.

Diazepam is extensively metabolized in the liver into active metabolites such as desmethyldiazepam (nordazepam), oxazepam, and temazepam.

Diazepam is excreted in the urine, mainly in the form of its metabolites, either free or in conjugated form.

The peak serum concentrations are attained after 25 minutes and 0.5 – 1.5 hours following I.V. and I.M. injections respectively.

Diazepam, unlike major tranquilizers, has no demonstrable peripheral autonomic blocking action, nor does it produce extrapyramidal side effects.

Diazepam crosses the blood brain barrier and is highly lipid soluble, these properties qualify it for intravenous use in short-term anesthetic procedures, since it acts promptly on the brain, and its initial effects decrease rapidly as it is redistributed into fat depots and tissues.

Indications

As an anxiolytic

Short – term relief of anxiety symptoms.
Tension and agitations.
Cardiac disorders and myocardial infarction.

As a premedication

Anesthetic procedure.
Minor gynecological and surgical operations.
All sorts of endoscopy.Cardiac catheterization.
Cardioversion.

As a short – term anesthetic

Extraction of impacted wisdom tooth.
Closed reduction of fractures.

As an anticonvulsant and muscle relaxant

Eclampsia and pre – eclampsia.
Febrile seizure prophylaxis.
Status epilepticus and severe recurrent convulsive seizures.
Muscle spasticity associated with cerebral palsy, athetosis, or tetanus.

In acute alcohol or drug withdrawal.

Contraindications

Hypersensitivity to the drug.

Precautions

Should be better avoided in patients with glaucoma except those under treatment, and also during early pregnancy.

The dose must be reduced in the elderly or debilitating patients or those with chronic pulmonary or cardiac diseases.

Side Effects

Like all other benzodiazepines, diazepam may cause drowsiness, fatigue, headache, blurring of vision, or skin rash.

If injected rapidly, pain, venous thrombosis, or phlebitis may occur at the site of injection.

Valpam Ampoules Dosage

Infants over 30 days of age till 5 years:

Status epilepticus: 0.2-0.5 mg slowly every 2-5 minutes up to a maximum dose of 5 mg.
Muscle spasm and tetanus: 1-2 mg, slowly, repeated every 3-4 hours if necessary.

Children over 5 years:

Status epilepticus: 1 mg every 2-5 minutes up to a maximum dose of 10 mg.
Muscle spasm and tetanus: 5-10 mg, repeated every 3-4 hours.

Older children and adults:

The usual recommended dose ranges from 2 to 20 mg by slow I.M. or I.V. injection, depending on the indication and its severity.
For endoscopic and anesthetic procedures or status epilepticus: 10 mg by slow I.M. or I.V. injection, up to 30 mg.

N.B.

Diazepam should be injected slowly taking at least one minute for each 5 mg given to reduce the possibility of venous thrombosis, phlebitis, local irritation and swelling.

Diazepam is not injected in the small veins such as those on the dorsum of the hand or wrist.

Diazepam should not be mixed with other drugs in syringe or infusion flask.

Valpam Syrup Dosage