Relanium, 5 mg/ml, solution for intravenous and intramuscular administration, 2 ml, 5 pcs.

Indications for use

Cupping:

• epileptic seizures and convulsive states of various etiologies;
• psychomotor agitation associated with anxiety;
• withdrawal syndrome and delirium in alcoholism.

Treatment:

• conditions in which increased muscle tone is noted (including acute cerebrovascular accidents and tetanus);
• neurotic and neurosis-like disorders with manifestations of anxiety;
• arterial hypertension (accompanied by anxiety and increased excitability), hypertensive crisis, vascular spasms, menstrual and menopausal disorders (as part of complex therapy).

In addition, Relanium is used for premedication and ataralgesia during diagnostic procedures, in surgical and obstetric practice (in combination with analgesics and other neurotropic drugs).

How does addiction to Elenium occur?

Practice shows that the effectiveness of a tranquilizer decreases with prolonged use. This causes the formation of tolerance to the drug, followed by abrupt withdrawal syndrome. This is how addiction is formed - substance abuse. There is a biological mechanism for the development of addiction, where the mechanism is implemented in vital processes occurring inside the body - at the cellular level, biomembrane, tissue, and so on.

It is called physical addiction. It develops due to the fact that the patient’s body, as it were, “tunes” itself to take psychotropic drugs, including them in its processes. The principle of action here is a simple drug (each in its own way), when it gets inside, it begins to perform the functions that were previously performed by substances produced by the body.

The body, saving its resources, significantly reduces their production or stops producing and selling them altogether. As a result, drugs upset the balance of vital substances: acetylcholine, neurotransmitters, dopamine, serotonin, which are considered the building blocks of DNA. They change the degree of wall permeability at the cellular level. When the process of physiological “reconfiguration” goes too far, then with their shortage or complete absence, withdrawal syndrome begins to sharply form, or, more simply, withdrawal.

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Contraindications

• state of alcoholic intoxication;
• history of drug and alcohol addiction (exceptions are delirium delirium and withdrawal syndrome);
• sleep apnea syndrome;
• angle-closure glaucoma;
• myasthenia gravis;
• acute respiratory failure;
• severe chronic obstructive pulmonary diseases;
• acute intoxication with drugs that have a depressing effect on the central nervous system (narcotic, hypnotic or psychotropic drugs);
• shock;
• coma;
• pregnancy (especially the first and third trimesters) and lactation;
• early childhood up to 30 days inclusive;
• hypersensitivity to the components of Relanium or other benzodiazepines.

Carefully:

• absence seizures (petit mal);
• Lennox-Gastaut syndrome;
• history of epilepsy or epileptic seizures;
• cerebral and spinal ataxia;
• renal and/or liver failure;
• hyperkinesis;
• organic brain diseases;
• depression;
• tendency to abuse psychotropic drugs;
• hypoproteinemia;
• elderly age.

Effect

Due to its therapeutic effect, Relanium is often used by drug addicts as an independent drug or to enhance the effect of other drugs.

After using Relanium, drug addicts experience the following sensation:

• Carefree;
• Emotional uplift;
• A warm wave spreading over the body;
• Floating and lightness;
• Muffled color and sound perception;
• Weakness of motor coordination.

Such sensations are similar to drug euphoria, although they cannot be compared with the pleasure from opiates or various types of stimulants. However, Relanium brings relief and prevents the onset of drug withdrawal, which is especially important for experienced drug addicts. Some drug addicts even take the drug intravenously in the hope of getting rid of drug addiction, however, in reality they fall under an even stronger relanium addiction.

Directions for use and dosage

Relanium is administered intramuscularly (IV) or intravenously (IV).

Recommended dosage regimens for adults:

• status epilepticus: 10-20 mg IV or IM, if necessary, another dose is administered after 3-4 hours;
• tetanus: 10 mg slowly intravenously or deep intramuscularly, after which 100 mg of diazepam is administered intravenously at a rate of 5-15 mg/hour in 500 ml of a 5% glucose solution or 0.9% sodium chloride solution;
• relief of psychomotor agitation associated with anxiety: 5-10 mg slowly intravenously, if necessary, a repeat dose is administered at intervals of 3-4 hours;
• skeletal muscle spasm: 10 mg IM 1-2 hours before the upcoming surgery;
• in obstetrics: 10-20 mg intramuscularly when the cervix is ​​dilated by 2-3 fingers.

Recommended doses for children:

• infants over 30 days and children under 5 years of age - slowly IV 0.1-0.3 mg/kg up to a maximum dose of 5 mg, if necessary (depending on the severity of clinical symptoms) the administration is repeated after 2-4 hours;
• children over 5 years old - slowly IV 1 mg every 2-5 minutes up to a maximum dose of 10 mg, if necessary, the drug is re-administered after 2-4 hours.

Intravenous Relanium should be injected slowly into a large vein - at a rate of at least 1 minute for every 1 ml of solution (5 mg). Continuous intravenous infusions are not recommended because a precipitate may form in the solution, and absorption of the drug by polyvinyl chloride materials of infusion tubes and balloons is also possible.

Reviews from people

Oksana Stupchenko

:

When the doctor prescribed this medicine for me, she didn’t even write it down on my card, but wrote it down for my aunt so that no one would know that I was taking it; most likely, it would not be advisable for people to know what the medicine is; a young girl was drinking at that time. This was about 9 years ago. You need to drink it a little at a time, a quarter, but it didn’t help me with my problem. I even took a whole tablet and it didn’t affect my consciousness in any way. With alcohol it’s the same garbage, after half an hour I’m sober. The doctor herself, this one said that she drank it for a whole year, only then it helped her. Her son died, and she took it hard. But to be honest, the medicine is not very good, I know, if you take a small dose it can make you feel uneasy, it causes hallucinations. I myself have neurosis and phobia, because of this I drank it. So I’ve had a phobia for 11 years, but then I took Relanium for less than a month and quit. It has a bad effect on internal organs. By the way, neuroses occur due to problems with the thyroid gland and gastrointestinal tract, so check the thyroid gland and stomach, if there is duodenitis, then it can cause neurosis. I also have duodenitis and problems with the thyroid gland, the bouquet is shorter :). But medicines and herbs (for duodenitis) have not helped yet, and it has not become any easier.

Valery Dyachenko

:

With alcohol withdrawal syndrome, the best thing is that I drink for several days, I don’t crave alcohol at all (I used to drink like a horse), my sleep has returned to normal. I can’t stand phenazepam at all; I start vomiting after one tablet. And I can take 4 tablets of Relium at a time, well, I’m a little slow, but I feel great, really, to each his own! Katya tell me why do you need it? Is it something you’re used to or is it vital?

Side effects

• from the central and peripheral nervous system: at the beginning of treatment (especially in older people) - dizziness, slowed mental and motor reactions, impaired concentration, increased fatigue, ataxia, dizziness, disorientation, drowsiness, dulling of emotions, anterograde amnesia; rarely - dysarthria, catalepsy, depression, euphoria, confusion, headache, dystonic extrapyramidal reactions (uncontrolled movements), tremor, conditions characterized by decreased reflexes, muscle weakness, asthenia; in some cases - paradoxical reactions (fear, anxiety, confusion, psychomotor agitation, sleep disturbances, hallucinations, outbursts of aggression, muscle spasms, suicidal tendencies);
• from the urinary system: impaired renal function, urinary retention or incontinence;
• from the cardiovascular system: increased heart rate, arterial hypotension;
• from the respiratory system: if the drug is administered too quickly - respiratory depression;
• from the digestive system: increased secretion of the salivary glands or dry mouth; nausea, loss of appetite, hiccups, heartburn, vomiting, gastralgia, constipation, jaundice, increased activity of liver transaminases and alkaline phosphatase, liver dysfunction;
• from the hematopoietic system: agranulocytosis (hyperthermia, chills, sore throat, severe fatigue/weakness), neutropenia, thrombocytopenia, anemia, leukopenia;
• from the reproductive system: painful menstruation, decreased or increased libido;
• allergic skin reactions: rash, itching;
• local reactions: venous thrombosis or phlebitis at the injection site (pain, swelling, redness);
• others: drug dependence, addiction; rarely - weight loss, bulimia, depression of the respiratory center, diplopia;
• when used in obstetrics in newborns: shortness of breath, hypothermia, muscle hypotonia, weak sucking.

With a sharp reduction in the dose of Relanium or cessation of treatment, withdrawal syndrome may develop: sleep disturbances, anxiety, increased irritability, psychomotor agitation, headache, increased sweating, spasm of smooth muscles of internal organs and skeletal muscles, dysphoria, nausea, depression, depersonalization, fear, tremor , vomiting, perception disorders, incl. paresthesia, hyperacusia, photophobia, hallucinations, tachycardia, convulsions; in rare cases - psychotic disorders.

Consequences

When regularly taking large doses of the drug, the body is exposed to severe disorders such as:

• Pronounced apathy;
• Dysarthria and speech slowness;
• Depression;
• Hand tremors;
• Emotionality;
• Amnestic memory disorders;
• Disorders of cardiovascular and genitourinary activity.

Abuse of the drug leads to the development of persistent sleep disorders; the patient can fall asleep only after a large dose of the drug. If there is no next dose, the patient will not be able to feel fully. Only treatment and rehabilitation will help improve the situation.

special instructions

Patients with severe depression should be under especially careful medical supervision, because they can use the drug to realize suicidal intentions.

When using Relanium in high doses during long-term treatment of patients who have previously abused drugs or alcohol, the risk of developing drug dependence increases. The drug should not be used for a long time unless absolutely necessary.

Due to the risk of withdrawal syndrome, treatment should not be abruptly stopped. Although, it is worth noting that diazepam is excreted slowly, so the manifestations of this syndrome are much less pronounced than with the use of other drugs from the benzodiazepine group.

With long-term treatment, renal and liver failure, it is necessary to monitor the activity of liver enzymes and the picture of peripheral blood.

Therapy should be discontinued if atypical reactions occur: suicidal thoughts, shallow sleep, difficulty falling asleep, feelings of fear, psychomotor agitation, anxiety, increased aggressiveness, increased muscle cramps, hallucinations.

At the beginning of treatment and with its abrupt cessation in patients with epilepsy or a history of epileptic seizures, the development of seizures or status epilepticus may be accelerated.

Due to the likelihood of developing gangrene, Relanium should not be administered intra-arterially.

During treatment, it is prohibited to drink alcohol; it is recommended to refrain from driving a car and performing other potentially dangerous activities.

Children, especially young children, are very sensitive to the depressant effects of benzodiazepines on the central nervous system (CNS).

It is not recommended to prescribe medications containing benzyl alcohol to newborns, because there is a risk of developing toxic syndrome, its manifestations: metabolic acidosis, difficulty breathing, central nervous system depression, arterial hypotension, renal failure, intracranial hemorrhage and, possibly, epileptic seizures.

Overdose

If you exceed the dose recommended by your doctor, you will have to face serious consequences. An overdose of Relanium solution and tablets is manifested by the following symptoms:

• Decreased reflexes.
• Drowsiness.
• Stunned.
• Apnea.
• Deep dream.
• Dyspnea.
• Confusion.
• Paradoxical excitement.
• Areflexia.
• Worsening of the reaction to painful stimuli.
• Impaired visual perception.
• Marked weakness.
• Nystagmus.
• Bradycardia.
• Tremor.
• Collapse.
• Drop in blood pressure.
• Depression of cardiac and respiratory activity.

In the worst case, coma occurs. To prevent the consequences of an overdose, you need to do gastric lavage and forced diuresis. Enterosorbents and mechanical ventilation are also prescribed. All actions during the rehabilitation period are aimed at maintaining body functions.

By the way, the active substance has a specific antagonist - flumazenil, which is used only in hospital settings. It is not prescribed to people with epilepsy who use benzodiazepines. This can trigger an epileptic seizure. Hemodialysis is also ineffective.

Drug interactions

• other tranquilizers, benzodiazepine derivatives, muscle relaxants, opioid analgesics, antidepressants, general anesthesia, antipsychotics, sedatives and hypnotics, ethanol: a sharp increase in the inhibitory effect on the central nervous system;
• zidovudine: its toxicity increases;
• cardiac glycosides: their concentration in the blood serum increases, as a result of which digitalis intoxication may develop;
• rifampicin: the metabolism of diazepam increases and, as a result, its concentration in the blood plasma decreases;
• levodopa: its effectiveness decreases;
• ketoconazole, metoprolol, isoniazid: the metabolism of diazepam slows down, which increases its concentration in the blood plasma;
• antihypertensive drugs: the hypotensive effect is enhanced;
• monoamine oxidase inhibitors, corazol, strychnine: antagonism appears against the effects of diazepam;
• psychostimulants, respiratory analeptics: the effect of Relanium decreases;
• clozapine: there is a risk of increased respiratory depression;
• propranolol, valproic acid: the concentration of diazepam in the blood plasma increases;
• estrogen-containing drugs that competitively inhibit metabolism in the liver, oral contraceptives, erythromycin, disulfiram, fluoxetine, cimetidine: the metabolism of diazepam slows down and its concentration in the blood plasma increases;
• omeprazole: the elimination period of diazepam increases;
• inducers of microsomal liver enzymes: the effect of Relanium is reduced;
• theophylline (in low doses): the sedative effect of diazepam is reduced.

Diazepam should not be mixed with any other drugs in the same syringe.

Premedication with Relanium allows you to reduce the dose of fentanyl required for general induction of anesthesia, and also reduces the time of onset of anesthesia.

Analogs

There are many drugs that are identical in their composition and effect. The following medications are analogues of Relanium:

• "Aparium". The active ingredient is also diazepam. The indications are absolutely similar. The drug is offered in two forms, differing in dosage - there are tablets of 2 and 5 mg, respectively.
• Valium Roche. It is available in the form of injections (1 ml contains 5 mg of diazepam), as well as in tablet form - each piece contains 5 or 10 mg of the active substance.
• "Diazepabene". Also diazepam, available in various forms. There are dragees, solutions for intramuscular, intravenous and injection administration, tablets.
• "Diazepam." A powerful tranquilizer, offered in the form of tablets (2 and 5 mg of active substance) and ampoule solution (2 ml - 10 mg).
• "Diazepex." Anxiolytic, sold in tablet form (2 or 5 mg). Each blister (there are two of these in a box) contains 10 pieces.

In addition to these drugs, alternatives are drugs known under the names “Diapam”, “Relium”, “Sibazona”, “Seduxen” and “Sibazon”.

Instructions:

Clinical and pharmacological group

02.008 (Tranquilizer (anxiolytic))

Release form, composition and packaging

The solution for intravenous and intramuscular administration is transparent, colorless or yellow-green.

Excipients: propylene glycol, ethanol 96%, benzyl alcohol, sodium benzoate, glacial acetic acid, acetic acid 10% (up to pH 6.3-6.4), water for injection.

2 ml - ampoules (5) - plastic holders (1) - cardboard packs. 2 ml - ampoules (5) - plastic holders (2) - cardboard packs. 2 ml - ampoules (5) - plastic holders (10) - cardboard packs .

pharmachologic effect

Anxiolytic drug (tranquilizer), benzodiazepine derivative.

Diazepam has a depressant effect on the central nervous system, occurring primarily in the thalamus, hypothalamus and limbic system. Enhances the inhibitory effect of gamma-aminobutyric acid (GABA), which is one of the main mediators of pre- and postsynaptic inhibition of the transmission of nerve impulses in the central nervous system. It has anxiolytic, sedative, hypnotic, muscle relaxant and anticonvulsant effects.

The mechanism of action of diazepam is determined by stimulation of benzodiazepine receptors of the supramolecular GABA-benzodiazepine-chlorionophore receptor complex, which leads to activation of the GABA receptor, causing a decrease in the excitability of subcortical brain structures and inhibition of polysynaptic spinal reflexes.

Pharmacokinetics

Suction

After intramuscular administration, diazepam is absorbed slowly and unevenly, depending on the site of administration; when administered into the deltoid muscle, absorption is rapid and complete. Bioavailability is 90%. Cmax with intramuscular administration is achieved within 0.5-1.5 hours, with intravenous administration within 0.25 hours.

Distribution

With constant use, Css are achieved within 1-2 weeks.

Plasma protein binding is 98%.

Diazepam and its metabolites penetrate the BBB and placental barrier and are excreted in breast milk in concentrations corresponding to 1/10 of the concentration in blood plasma.

With repeated use of the drug, a pronounced accumulation of diazepam and its active metabolites is observed.

Metabolism

Metabolized in the liver with the participation of isoenzymes CYP2C19, CYP3A4, CYP3A5 and CYP3A7 by 98-99% with the formation of a very active metabolite of desmethyldiazepam and less active ones - temazepam and oxazepam.

Removal

T1/2 of desmethyldiazepam is 30-100 hours, temazepam - 9.5-12.4 hours and oxazepam - 5-15 hours.

Excreted by the kidneys - 70% (in the form of glucuronides), unchanged - 1-2%, and less than 10% - with feces.

Refers to benzodiazepines with a long T1/2. After cessation of treatment, metabolites remain in the blood for several days or even weeks.

Pharmacokinetics in special clinical situations

T1/2 can increase in newborns - up to 30 hours, in elderly patients - up to 100 hours, in patients with liver and kidney failure - up to 4 days.

Dosage

In order to relieve psychomotor agitation associated with anxiety, 5-10 mg IV is prescribed slowly; if necessary, after 3-4 hours the drug is re-administered in the same dose.

For tetanus, 10 mg IV is prescribed slowly or deep IM, then 100 mg of diazepam is administered IV drip in 500 ml of 0.9% sodium chloride solution or 5% glucose solution at a rate of 5-15 mg/h.

For status epilepticus, 10-20 mg is prescribed IM or IV; if necessary, after 3-4 hours the drug is re-administered in the same dose.

To relieve spasms of skeletal muscles - 10 mg IM 1-2 hours before surgery.

In obstetrics, 10-20 mg is prescribed intramuscularly when the cervix is ​​dilated by 2-3 fingers.

Newborns after the 5th week of life (over 30 days) are prescribed IV slowly at 100-300 mcg/kg body weight up to a maximum dose of 5 mg; if necessary, the administration is repeated after 2-4 hours (depending on clinical symptoms).

For children aged 5 years and older, the drug is administered intravenously at a dose of 1 mg every 2-5 minutes up to a maximum dose of 10 mg; if necessary, administration can be repeated after 2-4 hours.

Overdose

Symptoms: drowsiness, depression of consciousness of varying severity, paradoxical excitation, decreased reflexes to areflexia, decreased response to painful stimuli, dysarthria, ataxia, visual impairment (nystagmus), tremor, bradycardia, decreased blood pressure, collapse, cardiac depression, respiratory depression, coma.

Treatment: gastric lavage, forced diuresis, activated charcoal; carrying out symptomatic therapy (maintaining breathing and blood pressure), artificial ventilation.

Hemodialysis is ineffective.

A specific antidote is flumazenil, which should be used in a hospital setting. Flumazenil is not indicated for patients with epilepsy who have been treated with benzodiazepines. In such cases, the antagonistic effect towards benzodiazepines can provoke the development of epileptic seizures.

Drug interactions

MAO inhibitors, strychnine and corazole antagonize the effects of Relanium.

With the simultaneous use of Relanium with sleeping pills, sedatives, opioid analgesics, other tranquilizers, benzodiazepine derivatives, muscle relaxants, general anesthesia, antidepressants, antipsychotics, as well as with ethanol, a sharp increase in the inhibitory effect on the central nervous system is observed.

When used simultaneously with cimetidine, disulfiram, erythromycin, fluoxetine, as well as with oral contraceptives and estrogen-containing drugs that competitively inhibit metabolism in the liver (oxidation processes), it is possible to slow down the metabolism of diazepam and increase its concentration in the blood plasma.

Isoniazid, ketoconazole and metoprolol also slow down the metabolism of diazepam and increase its concentration in the blood plasma.

Propranolol and valproic acid increase the concentration of diazepam in the blood plasma.

Rifampin can induce the metabolism of diazepam, which leads to a decrease in its concentration in blood plasma.

Inducers of microsomal liver enzymes reduce the effectiveness of Relanium.

Opioid analgesics enhance the inhibitory effect of Relanium on the central nervous system.

When used simultaneously with antihypertensive drugs, the hypotensive effect may be enhanced.

Increased respiratory depression may occur when used concomitantly with clozapine.

With the simultaneous use of Relanium with cardiac glycosides, it is possible to increase the concentration of the latter in the blood serum and develop digitalis intoxication (as a result of competitive interaction with plasma proteins).

Relanium reduces the effectiveness of levodopa in patients with parkinsonism.

Omeprazole prolongs the elimination time of diazepam.

Respiratory analeptics and psychostimulants reduce the activity of Relanium.

When used simultaneously with Relanium, the toxicity of zidovudine may increase.

Theophylline (in low doses) may reduce the sedative effect of Relanium.

Premedication with Relanium allows you to reduce the dose of fentanyl required for induction of general anesthesia and shortens the time of onset of general anesthesia.

Pharmaceutical interactions

Relanium® is incompatible in the same syringe with other drugs.

Use during pregnancy and lactation

The drug is contraindicated for use during pregnancy and lactation.

Relanium® has a toxic effect on the fetus and increases the risk of birth defects when used in the first trimester of pregnancy. Taking the drug in therapeutic doses later in pregnancy may cause depression of the fetal central nervous system. Chronic use during pregnancy can lead to physical dependence - possible withdrawal symptoms in the newborn.

When Relanium is used in doses of more than 30 mg within 15 hours before or during childbirth, it can cause respiratory depression in the newborn (up to apnea), decreased muscle tone, decreased blood pressure, hypothermia, and weak sucking (“floppy baby syndrome”).

Side effects

From the side of the central nervous system and peripheral nervous system: at the beginning of treatment (especially in elderly patients) - drowsiness, dizziness, increased fatigue, impaired concentration, ataxia, disorientation, dulling of emotions, slowing of mental and motor reactions, anterograde amnesia (develops more often, than with other benzodiazepines); rarely - headache, euphoria, depression, tremor, catalepsy, confusion, dystonic extrapyramidal reactions (uncontrolled movements), asthenia, muscle weakness, hyporeflexia, dysarthria; in some cases - paradoxical reactions (outbursts of aggression, psychomotor agitation, fear, suicidal tendencies, muscle spasms, confusion, hallucinations, anxiety, sleep disturbances).

From the hematopoietic system: leukopenia, neutropenia, agranulocytosis (chills, hyperthermia, sore throat, severe fatigue or weakness), anemia, thrombocytopenia.

From the digestive system: dry mouth or hypersalivation, heartburn, hiccups, gastralgia, nausea, vomiting, loss of appetite, constipation, liver dysfunction, increased activity of liver transaminases and alkaline phosphatase, jaundice.

From the cardiovascular system: arterial hypotension, tachycardia.

From the urinary system: urinary incontinence or retention, renal dysfunction.

From the reproductive system: increased or decreased libido, dysmenorrhea.

From the respiratory system: respiratory depression (if the drug is administered too quickly).

Allergic reactions: skin rash, itching.

Local reactions: phlebitis or venous thrombosis (redness, swelling, pain) at the injection site.

Other: addiction, drug dependence; rarely - depression of the respiratory center, visual impairment (diplopia), bulimia, weight loss.

With a sharp reduction in dose or discontinuation of use - withdrawal syndrome (increased irritability, headache, anxiety, fear, psychomotor agitation, sleep disturbances, dysphoria, spasm of smooth muscles of internal organs and skeletal muscles, depersonalization, increased sweating, depression, nausea, vomiting, tremor , perceptual disorders, including hyperacusis, paresthesia, photophobia, tachycardia, convulsions, hallucinations; rarely - psychotic disorders). When used in obstetrics in newborns - muscle hypotonia, hypothermia, dyspnea.

Storage conditions and periods

Relanium® belongs to list No. 1 of potent substances of the Standing Committee for Drug Control of the Ministry of Health of the Russian Federation.

The drug should be stored out of the reach of children, protected from light at a temperature of 15° to 25°C. Shelf life: 5 years.

Indications

- treatment of neurotic and neurosis-like disorders with anxiety;

- relief of psychomotor agitation associated with anxiety;

— relief of epileptic seizures and convulsive states of various etiologies;

- conditions accompanied by increased muscle tone (including tetanus, acute cerebrovascular accidents);

— relief of withdrawal syndrome and delirium in alcoholism;

— for premedication and ataralgesia in combination with analgesics and other neurotropic drugs during various diagnostic procedures, in surgical and obstetric practice;

— in the clinic of internal diseases: in the complex therapy of arterial hypertension (accompanied by anxiety, increased excitability), hypertensive crisis, vascular spasms, menopausal and menstrual disorders.

Contraindications

- severe form of myasthenia;

- coma;

- shock;

- angle-closure glaucoma;

- indications in the anamnesis of symptoms of dependence on drugs, alcohol (with the exception of treatment of alcohol withdrawal syndrome and delirium);

— sleep apnea syndrome;

— state of alcoholic intoxication of varying degrees of severity;

- acute intoxication with drugs that have a depressing effect on the central nervous system (narcotic, hypnotic and psychotropic drugs);

- severe chronic obstructive pulmonary diseases (risk of progression of respiratory failure);

- acute respiratory failure;

- children up to 30 days inclusive;

— pregnancy (especially the 1st and 3rd trimesters);

- lactation period (breastfeeding);

- hypersensitivity to benzodiazepines.

Prescribe with caution in absence seizures (petit mal) or Lennox-Gastaut syndrome (with intravenous administration it can provoke the development of tonic status epilepticus), epilepsy or a history of epileptic seizures (initiation of treatment with diazepam or its abrupt withdrawal may accelerate the development of seizures or status epilepticus) , liver and/or renal failure, cerebral and spinal ataxia, with hyperkinesis, a tendency to abuse psychotropic drugs, with depression, organic diseases of the brain (paradoxical reactions are possible), with hypoproteinemia, in elderly patients.

special instructions

Diazepam should be prescribed with extreme caution for severe depression, because the drug can be used to realize suicidal intentions.

Relanium IV solution should be injected slowly into a large vein, at least over 1 minute for every 5 mg (1 ml) of the drug. It is not recommended to carry out continuous IV infusions - sedimentation and adsorption of the drug by materials from PVC infusion balloons and tubes is possible.

In case of renal or liver failure and long-term use, it is necessary to monitor the peripheral blood picture and the activity of liver enzymes.

The risk of developing drug dependence increases when using Relanium in high doses, with a significant duration of treatment in patients who have previously abused alcohol or drugs. Unless absolutely necessary, the drug should not be used for a long time. Abrupt cessation of treatment is unacceptable due to the risk of withdrawal syndrome, however, due to the slow elimination of diazepam, the manifestation of this syndrome is much less pronounced than with other benzodiazepines.

If patients experience such unusual reactions as increased aggressiveness, psychomotor agitation, anxiety, fear, suicidal thoughts, hallucinations, increased muscle cramps, difficulty falling asleep, superficial sleep, treatment should be stopped.

Initiation of treatment with Relanium or its abrupt withdrawal in patients with epilepsy or a history of epileptic seizures may accelerate the development of seizures or status epilepticus.

Relanium® should be used with extreme caution and without exceeding recommended doses in elderly patients.

If it is necessary to use the drug in patients with liver and kidney diseases, the risk-benefit ratio of therapy should be assessed.

Relanium® is not administered intra-arterially due to the risk of gangrene.

With prolonged use of the drug, addiction may develop.

During the treatment period, alcohol consumption is prohibited.

Use in pediatrics

Children, especially young children, are very sensitive to the depressant effects of benzodiazepines on the central nervous system.

It is not recommended for newborns to be prescribed medications containing benzyl alcohol, because the development of a toxic syndrome, manifested by metabolic acidosis, central nervous system depression, difficulty breathing, renal failure, arterial hypotension and possibly epileptic seizures, as well as intracranial hemorrhage, is possible.

Impact on the ability to drive vehicles and operate machinery

Patients receiving the drug should refrain from engaging in potentially hazardous activities that require increased attention and speed of psychomotor reactions.

Use for renal impairment

If it is necessary to use the drug in patients with kidney disease, the risk-benefit ratio of therapy should be assessed.

Use for liver dysfunction

If it is necessary to use the drug in patients with liver diseases, the risk-benefit ratio of therapy should be assessed.

Conditions for dispensing from pharmacies

The drug is available with a prescription.

Signs of use

Regardless of what drugs the resident takes, they primarily suffer from:

• nervous system;
• immune;
• liver;
• cardiovascular;
• the heart itself;
• lungs.

Signs characteristic of using tranquilizers:

• incoherent speech;
• drowsiness;
• movement coordination is impaired;
• tremor - trembling of the limbs of the hands at rest, as a result of the destruction of cells in the brain;
• speech disorder;
• tremor in muscle tissue;
• inadequate assessment of everything that is happening;
• nystagmus – chaotic eye movement;
• Abrupt withdrawal may result in respiratory arrest.

Relanium

Active substance:

Diazepam*

Pharmgroup:

Anxiolytics