SUMMARY:

Diazepam is also known as Valium and Diastat. It comes as a tablet, solution, nasal liquid, rectal gel, and concentrated solution. There are a wide variety of uses for diazepam such as for the treatment of anxiety, pre-op sedation, procedural sedation, alcohol withdrawal, muscle spasms, and seizures. A common dosing range when treating anxiety is 2-10 mg PO bid-qid. There are also approved uses in pediatrics such as for anxiety, muscle spasms, and status epilepticus. The benefits from diazepam are often linked to the enhancement of the GABA-A, not the GABA-B, receptors. The most common side effects are drowsiness, confusion, libido changes, and irritability. There are several Black Box Warnings to be aware of such as concomitant opioid use, the risk of abuse/misuse/addiction, and the risk of dependence/withdrawal reactions. Make sure to monitor the patients’ LFTs if prolonged usage as well as their blood pressure and mental status.