User:Mr. Ibrahem/Diazepam
From Wikipedia, the free encyclopedia
Diazepam, first marketed as Valium, is a medicine of the benzodiazepine family that typically produces a calming effect.[9] It is commonly used to treat a range of conditions, including anxiety, seizures, alcohol withdrawal syndrome, benzodiazepine withdrawal syndrome, muscle spasms, trouble sleeping, and restless legs syndrome.[9] It may also be used to cause memory loss during certain medical procedures.[10][11] It can be taken by mouth, inserted into the rectum, injected into muscle, injected into a vein or used as a nasal spray.[5][11] When given into a vein, effects begin in one to five minutes and last up to an hour.[11] By mouth, effects begin after 15 to 60 minutes.[12]
Clinical data | |
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Pronunciation | /daɪˈæzɪpæm/ |
Trade names | Valium, Vazepam, Valtoco, others[1] |
AHFS/Drugs.com | Monograph |
MedlinePlus | a682047 |
License data | |
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Dependence liability | High[2] |
Addiction liability | Moderate[3][4] |
Routes of administration | By mouth, IM, IV, rectal, nasal spray[5] |
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Pharmacokinetic data | |
Bioavailability | 76% (64–97%) by mouth, 81% (62–98%) rectal[7] |
Metabolism | Liver—CYP2B6 (minor route) to desmethyldiazepam, CYP2C19 (major route) to inactive metabolites, CYP3A4 (major route) to desmethyldiazepam |
Elimination half-life | (50 hours); 20–100 hours (36–200 hours for main active metabolite desmethyldiazepam)[8][6] |
Excretion | Kidney |
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Chemical and physical data | |
Formula | C16H13ClN2O |
Molar mass | 284.74 g·mol−1 |
3D model (JSmol) | |
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Common side effects include sleepiness and trouble with coordination.[11][8] Serious side effects are rare.[9] They include suicide, decreased breathing, and an increased risk of seizures if used too frequently in those with epilepsy.[9][11][13] Occasionally, excitement or agitation may occur.[14][15] Long term use can result in tolerance, dependence, and withdrawal symptoms on dose reduction.[9] Abrupt stopping after long-term use can be potentially dangerous.[9] After stopping, cognitive problems may persist for six months or longer.[14] It is not recommended during pregnancy or breastfeeding.[11] Its mechanism of action is by increasing the effect of the neurotransmitter gamma-aminobutyric acid (GABA).[14]
Diazepam was patented in 1959 by Hoffmann-La Roche.[9][16][17] It has been one of the most frequently prescribed medications in the world since its launch in 1963.[9] In the United States it was the highest selling medication between 1968 and 1982, selling more than two billion tablets in 1978 alone.[9] In 2017, it was the 135th most commonly prescribed medication in the United States, with more than five million prescriptions.[18][19] In 1985 the patent ended, and there are now more than 500 brands available on the market.[9] It is on the World Health Organization's List of Essential Medicines as an alternative to lorazepam.[20] The wholesale cost in the developing world is about US$0.01 per dose as of 2015[update].[21] In the United States, it is about US$0.40 per dose.[11]