Diazepam - Revision history

MDElliottMD: parser-claude: Diazepam MedTemplate refill, Top 300 stub upgrade

2026-05-23T07:15:53Z

parser-claude: Diazepam MedTemplate refill, Top 300 stub upgrade

← Older revision		Revision as of 07:15, 23 May 2026
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	{{MedTemplate		{{MedTemplate
	\| generic = Diazepam		\| generic = Diazepam
	\| brand = Valium		\| brand = Valium (oral, IV/IM, rectal), Diastat (rectal gel for breakthrough seizures), Valtoco (nasal spray for breakthrough seizures), Libervant (buccal film)
	\| structure =		\| structure =
	\| classes = Benzodiazepine, Anxiolytic		\| classes = [[:Category:Benzodiazepines\|Benzodiazepine (long-acting)]], [[:Category:Anxiolytics\|Anxiolytic]], [[:Category:Anticonvulsants\|Anticonvulsant]], [[:Category:Skeletal muscle relaxants\|Skeletal muscle relaxant]], [[:Category:Schedule IV controlled substances\|Schedule IV controlled substance]]
	\| ~~mechanism = GABAA positive allosteric modulator~~		\| uses = <vote slug="anxiety-disorders-broad-use">Anxiety disorders (FDA)</vote>, <vote slug="alcohol-withdrawal-use">Alcohol withdrawal (FDA; the classic indication for long-acting benzodiazepines)</vote>, <vote slug="preoperative-sedation-use">Preoperative sedation (FDA)</vote>, <vote slug="status-epilepticus-use">Status epilepticus (FDA, IV)</vote>, <vote slug="breakthrough-seizures-use">Breakthrough seizures (FDA, Diastat rectal gel; Valtoco intranasal)</vote>, <vote slug="acute-muscle-spasm-use">Acute muscle spasm (FDA, IV/IM)</vote>, <vote slug="cerebral-palsy-spasticity-use">Cerebral palsy spasticity (FDA)</vote>
	\| uses =		\| starting_dose = Anxiety: 2-10 mg PO 2-4 times daily. Alcohol withdrawal: 10-20 mg PO/IV every 4-6 hours, symptom-triggered. Status epilepticus: 5-10 mg IV. Breakthrough seizures: Diastat rectal 0.2-0.5 mg/kg or Valtoco intranasal 5-20 mg
	\| starting_dose =		\| preparations = Tablets 2, 5, 10 mg; oral solution 1, 5 mg/mL; injection 5 mg/mL; Diastat rectal gel 2.5, 5, 10, 20 mg; Valtoco nasal spray 5, 7.5, 10 mg/dose; Libervant buccal film
	\| preparations =		\| fda_max = 40 mg/day (oral, anxiety)
	\| fda_max =		\| pill_id =
	\| routes =		\| routes = Oral, IV, IM, rectal, intranasal, buccal
	\| onset =		\| onset = 15-60 minutes (oral); 1-5 minutes (IV); 4-10 minutes (rectal or intranasal)
	\| duration =		\| duration = 6-24 hours (parent); much longer when accounting for the long-lived active metabolites
	\| halflife =		\| halflife = Diazepam 20-50 hours; '''N-desmethyldiazepam (nordazepam) 30-200 hours''' is the major active metabolite and accumulates substantially with chronic dosing<ref name="valium-label">FDA Prescribing Information, Valium (diazepam), Roche/Bausch, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/013263s094lbl.pdf</ref>
	~~\| bioavailability =~~		\| bioavailability = ~93% (oral); ~90% (rectal)<ref name="valium-label" />
	~~\| pregnancy~~ =		\| pregnancy = Some signal for cleft palate with first-trimester exposure (debated); neonatal sedation and withdrawal with third-trimester exposure.{{citation needed}}
	~~\| legal~~ =		\| legal = [[USLegal:Schedule IV\|Schedule IV controlled substance]] in US. Carries the benzodiazepine class '''Boxed Warning''' for risk of fatal respiratory depression, coma, and death when combined with opioids<ref name="valium-label" />
	\| ~~intro =~~		\| mechanism = <vote slug="diazepam-mech-claim">Classic positive allosteric modulator of the GABA-A receptor at the benzodiazepine binding site (α-γ subunit interface), enhancing chloride ion conductance and producing the full benzodiazepine effect spectrum: anxiolysis, anticonvulsant activity, skeletal muscle relaxation, and sedation. The very long elimination half-life combined with the even-longer-lived active metabolite nordazepam is the clinical signature, producing stable plasma levels with infrequent dosing.</vote> The pharmacokinetic profile produces '''self-tapering withdrawal''' as plasma levels gradually decline, the basis of diazepam's preference in alcohol withdrawal protocols. CYP3A4 and CYP2C19 substrate; CYP3A4 inhibitors substantially raise exposure<ref name="valium-label" />.
	~~\| pharmacokinetics~~ =
	~~\| pharmacodynamics~~ =
	\| ~~indications~~ =
	\| ~~dosing~~ =
	\| ~~effects =~~
	~~\| interactions~~ = ~~<pharmaInteractions~~/>
	\| ~~pregnancy_details =~~
	~~\| monitoring~~ =
	~~\| counseling~~ =
	~~\| anecdotes =~~
	~~\| seealso =~~
	~~\| references~~ =
	}}		}}

			== References ==
			<references />

	[[Category:Benzodiazepines]]		[[Category:Benzodiazepines]]
	[[Category:Anxiolytics]]		[[Category:Anxiolytics]]
	[[Category:~~GABAA Positive Allosteric Modulators (General)~~]]		[[Category:Anticonvulsants]]
	[[Category:~~GABAergics~~]]		[[Category:Skeletal muscle relaxants]]
	[[Category:~~Antiepileptics]]~~		[[Category:Schedule IV controlled substances]]
	~~[[Category:Muscle relaxants~~]]

MDElliottMD: Category taxonomy ship: retag Anticonvulsants -> Antiepileptics

2026-05-22T00:36:19Z

Category taxonomy ship: retag Anticonvulsants -> Antiepileptics

← Older revision		Revision as of 00:36, 22 May 2026
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	[[Category:GABAA Positive Allosteric Modulators (General)]]		[[Category:GABAA Positive Allosteric Modulators (General)]]
	[[Category:GABAergics]]		[[Category:GABAergics]]
	[[Category:~~Anticonvulsants~~]]		[[Category:Antiepileptics]]
	[[Category:Muscle relaxants]]		[[Category:Muscle relaxants]]

MDElliottMD: Tier 2 taxonomy consolidation: remove retired Category:Anxiolytics & Sedative-Hypnotics

2026-05-21T17:44:46Z

Tier 2 taxonomy consolidation: remove retired Category:Anxiolytics & Sedative-Hypnotics

← Older revision		Revision as of 17:44, 21 May 2026
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	}}		}}

	~~[[Category:Anxiolytics & Sedative-Hypnotics]]~~
	[[Category:Benzodiazepines]]		[[Category:Benzodiazepines]]
	[[Category:Anxiolytics]]		[[Category:Anxiolytics]]

MDElliottMD: Dedupe migration per interface-claude 2026-05-20: Muscle Relaxants (CNS-acting) merged into canonical Muscle relaxants. Member retagged.

2026-05-19T18:00:19Z

Dedupe migration per interface-claude 2026-05-20: Muscle Relaxants (CNS-acting) merged into canonical Muscle relaxants. Member retagged.

← Older revision		Revision as of 18:00, 19 May 2026
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	[[Category:GABAergics]]		[[Category:GABAergics]]
	[[Category:Anticonvulsants]]		[[Category:Anticonvulsants]]
	[[Category:Muscle ~~Relaxants (CNS-acting)~~]]		[[Category:Muscle relaxants]]

MDElliottMD: Dedupe migration per interface-claude 2026-05-20: Anticonvulsants / Antiepileptics merged into canonical Anticonvulsants. Member retagged.

2026-05-19T18:00:13Z

Dedupe migration per interface-claude 2026-05-20: Anticonvulsants / Antiepileptics merged into canonical Anticonvulsants. Member retagged.

← Older revision		Revision as of 18:00, 19 May 2026
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	\| references =		\| references =
	}}		}}


	[[Category:Anxiolytics & Sedative-Hypnotics]]		[[Category:Anxiolytics & Sedative-Hypnotics]]
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	[[Category:GABAA Positive Allosteric Modulators (General)]]		[[Category:GABAA Positive Allosteric Modulators (General)]]
	[[Category:GABAergics]]		[[Category:GABAergics]]
	[[Category:Anticonvulsants ~~/ Antiepileptics~~]]		[[Category:Anticonvulsants]]
	[[Category:Muscle Relaxants (CNS-acting)]]		[[Category:Muscle Relaxants (CNS-acting)]]

MDElliottMD: Comprehensive categorization: +GABAA Positive Allosteric Modulators (General), GABAergics, Anticonvulsants / Antiepileptics, Muscle Relaxants (CNS-acting)

2026-05-15T18:42:10Z

Comprehensive categorization: +GABAA Positive Allosteric Modulators (General), GABAergics, Anticonvulsants / Antiepileptics, Muscle Relaxants (CNS-acting)

← Older revision		Revision as of 18:42, 15 May 2026
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	[[Category:Benzodiazepines]]		[[Category:Benzodiazepines]]
	[[Category:Anxiolytics]]		[[Category:Anxiolytics]]
			[[Category:GABAA Positive Allosteric Modulators (General)]]
			[[Category:GABAergics]]
			[[Category:Anticonvulsants / Antiepileptics]]
			[[Category:Muscle Relaxants (CNS-acting)]]

MediaWiki default: Assign pharmacological categories from List_of_CNS-active_medicines

2026-05-14T15:06:52Z

Assign pharmacological categories from List_of_CNS-active_medicines

← Older revision		Revision as of 15:06, 14 May 2026
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	}}		}}


			[[Category:Anxiolytics & Sedative-Hypnotics]]
			[[Category:Benzodiazepines]]
	[[Category:Anxiolytics]]		[[Category:Anxiolytics]]

MDElliottMD: Pharmacopedia: add

2026-05-14T03:30:49Z

Pharmacopedia: add <pharmaInteractions/>

← Older revision		Revision as of 03:30, 14 May 2026
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	\| dosing =		\| dosing =
	\| effects =		\| effects =
	\| interactions =		\| interactions = <pharmaInteractions/>
	\| pregnancy_details =		\| pregnancy_details =
	\| monitoring =		\| monitoring =

MDElliottMD: Pharmacopedia: remove contraindications parameter

2026-05-14T02:40:31Z

Pharmacopedia: remove contraindications parameter

← Older revision		Revision as of 02:40, 14 May 2026
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	\| dosing =		\| dosing =
	\| effects =		\| effects =
	~~\| contraindications =~~
	\| interactions =		\| interactions =
	\| pregnancy_details =		\| pregnancy_details =

MDElliottMD: Added empty fda_max parameter to MedTemplate call

2026-05-13T02:32:41Z

Added empty fda_max parameter to MedTemplate call

← Older revision		Revision as of 02:32, 13 May 2026
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	\| starting_dose =		\| starting_dose =
	\| preparations =		\| preparations =
			\| fda_max =
	\| routes =		\| routes =
	\| onset =		\| onset =
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	[[Category:Anxiolytics]]		[[Category:Anxiolytics]]