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Valium (Diazepam) belongs to the group of benzodiazepine tranquilizers, which exerts anxiolytic, sedative, muscle relaxant and anticonvulsant effects. This is known to be the result of facilitating the action of y-aminobutyric acid (GABA), the most important inhibitory neurotransmitter in the brain.
Diazepam is rapidly and completely absorbed from the digestive tract, peak plasma concentrations appearing 30-90 minutes after oral intake. On IM injection, absorption is also complete.
Known histories of hypersensitivity to benzodiazepines, severe respiratory and hepatic insufficiency, sleep apnea syndrome, myasthenia gravis are some of Diazepam’s contraindications. Dependence on other substances including alcohol is another. An exception to the latter is the management of acute withdrawal reactions.
Benzodiazepines are not advised for the primary treatment of psychotic illness. Benzodiazepines should not be used alone to treat depression or anxiety associated with depression as suicide may occur in such patients.
If Valium is to be combined with other centrally-acting drugs such as antipsycholics, anxiolytics/sedatives, antidepressants, hypnotics, anticonvulsants, narcotic analgesics, anesthetics and sedative antihistamines, it should be borne in mind that their effects may potentiate or be potentiated by the action of Valium.
Concomitant use with alcohol is not suggested due to enhancement of the sedative effect.
There is a potentially relevant interaction between diazepam and compounds which inhibit certain hepatic enzymes (particularly cytochrome P-450 IIIA). Data showed that these compounds influence the pharmacokinetics of diazepam and may lead to increased and prolonged sedation. At present, this reaction is known to occur with cimetidine, ketoconazole, fluvoxamine, fluoxetine and omeprazole.
There have also been reports that the metabolic elimination of phenytoin is affected by Valium. On the other hand, there is no known interference with commonly used antidiabetics, anticoagulant or diuretic substances. Cisapride may lead to a temporary increase in the sedative effects or orally administered benzodiazepines due to faster absorption.
