DIAZEPAM 5MG AND 10MG TABLETS

Read this entire leaflet carefully before you start taking this medicine.

Keep this leaflet. You may need to read it again.
If you have any further questions, ask your doctor or pharmacist.
This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours.
If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.
In this leaflet:

What Diazepam tablets are and what they are used for
2. Before you take
3. How to take
4. Possible side effects
5. How to store
6. Further information
1. What Diazepam tablets are and what they are used for
Diazepam belongs to a group of medicines called benzodiazepines. Diazepam helps in the treatment of anxiety, muscle spasms and convulsions (fits).

Diazepam tablets are used to treat a number of conditions, including:

In adults

short term relief (2-4 weeks only) of severe anxiety, which is an emotional state where you may sweat, tremble, feel anxious and have a fast heart beat and may occur alone or with insomnia (trouble sleeping) or mental health problems
helping muscles relax and for muscle spasm and cerebral palsy (a condition affecting the brain which causes movement problems and rigidity or stiffness)
epilepsy (when taken with other medicines)
patients with the symptoms of alcohol withdrawal
helping to relax nervous dental patients.
In children

helping to treat tension and irritability caused by cerebral spasticity (a condition associated with a disease or trauma affecting the brain or spinal cord which causes weakness, un-coordinated movements, rigidity and stiffness)
helping to treat muscle spasm caused by tetanus (when taken with other medicines).
Both adults and children can take Diazepam tablets before an operation to help with relaxation and to cause sleepiness.

2. Before you take
Do not take Diazepam tablets and tell your doctor if you

are allergic (hypersensitive) to diazepam or to other benzodiazepine medicines or to any of the other ingredients in your tablets (see section 6)
breathing problems, which may be severe, including slow and/or shallow breathing
suffer from depression (with or without anxiety) or hyperactivity
have a phobia (a fear of a particular object or situation) or other mental illness
have myasthenia gravis (a condition which causes muscles to weaken and tire easily)
suffer from sleep apnoea (a sleep disorder where you have abnormal pauses in breathing during sleep)
have severe liver disorders
have porphyria (an inherited condition causing skin blisters, abdominal pain and brain or nervous system disorders)
planning a pregnancy or are pregnant (see below Pregnancy and breast-feeding).
Check with your doctor or pharmacist before taking Diazepam tablets if you

have a history of alcoholism or drug abuse
have problems with your heart and lungs or have severe kidney failure
have someone close to you that has recently died
have low blood levels of a protein called albumin
have a personality disorder
have a poor blood supply to the brain (arteriosclerosis)
are elderly Diazepam tablets can cause confusion and have effects on muscles causing falls and injuries.
have breathing difficulties
smoke
suffer from depression
have suicidal thoughts
have epilepsy or a history of seizures
Other considerations

Mental side effects – contact your doctor if you experience side effects such as agitation, hyperactivity, restlessness, aggressiveness, nightmares or hallucinations. These side effects are more likely to occur in children or the elderly.
Amnesia (total or partial memory loss) – you could experience amnesia when taking this medicine. Amnesia is more likely to occur when taking high doses of diazepam.
Dependence – when taking this medicine there is a risk of dependence, which increases with the dose and duration of treatment and also in patients with a history of alcoholism and drug abuse. Therefore, you should take Diazepam tablets for a short a period of time as possible.
Tolerance – if after a few weeks you notice that the tablets are not working as well as they did when first starting treatment, you should speak to your doctor.
Withdrawal – treatment should be gradually withdrawn. Withdrawal symptoms occur with Diazepam tablets even when normal doses are given for short periods of time. See Section 3, ‘If you stop taking Diazepam tablets.’
Taking other medicines

Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription. Especially:

antidepressants (e.g. fluvoxamine, fluoxetine)
antipsychotics such as clozapine (to treat mental problems)
antihistamines (to treat allergies)
general anaesthetics
sedatives (used to give calming effects)
hypnotics (to help you sleep)
erythromycin (an antibiotic)
muscle relaxants (e.g.suxamethonium, tubocurarin)
some strong pain killers such as morphine (opioids) may give you a heightened sense of well being when taken with diazepam, which can increase your desire to continue taking these medicines (dependency) or can make you very sleepy.
barbiturates such as phenobarbital (to treat epilepsy and mental disorders)
medicines to lower high blood pressure, diuretics (water tablets), nitrates (for heart conditions) as these could lower your blood pressure too much.
antacids (reduces stomach acid) may slow down absorption of diazepam in the body.
Taking these medicines with diazepam could affect your mental status, make you very sleepy and suppress your breathing and blood pressure.

disulfiram (to treat alcohol addiction). Taking this medicine with diazepam could make you very sleepy and can cause diazepam to be removed from the body more slowly than usual.
medicines for epilepsye.g. phenobarbital, phenytoin and carbamazepine, sodium valproate, (diazepam can affect the blood levels of these medicines). Diazepam can furthermore affect how phenytoin works.
theophylline (to treat asthma and other breathing disorders), as it can weaken the effect of diazepam. As this can cause diazepam to be removed from the body more quickly than usual.
cimetidine, omeprazole or esomeprazole (stomach acid reducing medicines), as these can cause diazepam to be removed from the body more slowly than usual.
rifampicin, to treat infections (an antibiotic) as this can cause diazepam to be removed from the body more quickly than usual. The effect of diazepam can be weakened.
amrenavir, atazanavir, ritonavir, delavirdine, efavirenz, indinavir, nelfinavir or saquinavir (antivirals), fluconazole, itraconazole, ketoconazole or voriconazole (anti-fungal medicines) as these can cause diazepam to be removed from the body more slowly than usual and therefore increase the risk of side effects. As these can make you feel sleepy for longer or cause difficulty breathing.
isoniazid (used to treat tuberculosis), as it can cause diazepam to be removed from the body more slowly than usual.
oral contraceptives, as they can slow down the removal of diazepam from the body and increase its effect. Breakthrough bleeding can occur when taking diazepam and oral contraceptives together, but the contraceptive protection is not reduced.
cisapride (used to treat stomach problems), as it can cause diazepam to be removed from the body more slowly than usual.
corticosteroids (medicines used to treat inflammation in the body) as they can weaken the effect of diazepam.
levodopa (used to treat Parkinson’s disease). Diazepam can reduct the effect of levodopa.
valproic acid (used to treat epilepsy and mental disorders) as it can slow down the removal of diazepam from the body and increase its effect.
ketamine (an anaesthetic) as diazepam increases the effect of ketamine.
lofexidine (to help relieve symptoms when you stop taking opioids)
nabilone (to treat nausea and vomiting)
alpha blockers or moxonidine (to lower high blood pressure)
Taking Diazepam tablets with food and drink