Inside, in / m, in / in, rectally. The dose is calculated individually depending on the patient's condition, clinical picture of the disease, sensitivity to the drug.
As an anxiolytic drug, it is prescribed orally, 2.5-10 mg 2-4 times a day.
Psychiatry: with neurosis, hysterical or hypochondriacal reactions, dysphoria of various origins, phobias - 5-10 mg 2-3 times a day. If necessary, the dose can be increased to 60 mg / day. With alcohol withdrawal syndrome - 10 mg 3-4 times a day for the first 24 hours, followed by a decrease to 5 mg 3-4 times a day. Elderly, debilitated patients, as well as patients with atherosclerosis at the beginning of treatment - orally, 2 mg 2 times a day, if necessary, increase until the optimal effect is obtained. Working patients are recommended to take 2.5 mg 1-2 times a day or 5 mg (basic dose) in the evening.
Neurology: spastic conditions of central origin in degenerative neurological diseases - orally, 5-10 mg 2-3 times a day.
Cardiology and rheumatology: angina pectoris - 2-5 mg 2-3 times a day; arterial hypertension- 2-5 mg 2-3 times a day, vertebral syndrome in bed rest - 10 mg 4 times a day; as an additional drug in physiotherapy for rheumatic pelvis spondyloarthritis, progressive chronic polyarthritis, arthrosis - 5 mg 1-4 times a day. As part of complex therapy myocardial infarction: initial dose - 10 mg / m, then inside, 5-10 mg 1-3 times a day; premedication in case of defibrillation - 10-30 mg IV slowly (in separate doses); spastic conditions of rheumatic origin, vertebral syndrome - the initial dose of 10 mg / m, then inside, 5 mg 1-4 times a day.
Obstetrics and gynecology: psychosomatic disorders, menopausal and menstrual disorders, preeclampsia - 2-5 mg 2-3 times a day. Preeclampsia - initial dose - 10-20 mg IV, then 5-10 mg orally 3 times a day; eclampsia - during a crisis - in / in 10-20 mg, then, if necessary, in / in a stream or drip, not more than 100 mg / day. In order to facilitate labor activity when opening the cervix by 2-3 fingers - IM 20 mg; in case of premature birth and premature detachment of the placenta - intramuscularly at an initial dose of 20 mg, after 1 hour the administration of the same dose is repeated; maintenance doses - from 10 mg 4 times to 20 mg 3 times a day. With premature detachment of the placenta, treatment is carried out without interruption - until the fetus ripens.
Anesthesiology, surgery: premedication - on the eve of surgery, in the evening - 10-20 mg orally; preparation for surgery - 1 hour before the start of anesthesia in / m for adults - 10-20 mg, for children - 2.5-10 mg; introduction to anesthesia - in / in 0.2-0.5 mg / kg; for short-term narcotic sleep during complex diagnostic and therapeutic interventions in therapy and surgery - in / in adults - 10-30 mg, children - 0.1-0.2 mg / kg.
Pediatrics: psychosomatic and reactive disorders, spastic states of central origin - are prescribed with a gradual increase in dose (starting with low doses and slowly increasing them to the optimal dose well tolerated by the patient), daily dose (can be divided into 2-3 doses, with the main dose the largest dose, taken in the evening): inside, it is not recommended to use up to 6 months, from 6 months and older - 1-2.5 mg, or 40-200 mcg / kg, or 1.17-6 mg / sq.m, 3- 4 times a day.
Inside, from 1 year to 3 years - 1 mg, from 3 to 7 years - 2 mg, from 7 years and older - 3-5 mg. Daily doses - 2, 6 and 8-10 mg, respectively.
Parenterally, status epilepticus and severe recurrent epileptic seizures: children from 30 days to 5 years - IV (slowly) 0.2-0.5 mg every 2-5 minutes up to a maximum dose of 5 mg, from 5 years and older - 1 mg every 2- 5 min to a maximum dose of 10 mg; if necessary, treatment can be repeated after 2-4 hours. Muscle relaxation, tetanus: children from 30 days to 5 years - IM or IV 1-2 mg, from 5 years and older - 5-10 mg, if necessary, a dose can be repeated every 3-4 hours.
For elderly and senile patients, treatment should begin with half the usual adult dose, gradually increasing it, depending on the effect achieved and tolerability. Parenterally, in case of anxiety, it is administered intravenously at an initial dose of 0.1-0.2 mg / kg, injections are repeated every 8 hours until the symptoms disappear, then they switch to oral administration.
With motor excitation, it is administered intramuscularly or intravenously at a dose of 10-20 mg 3 times a day. With traumatic lesions of the spinal cord, accompanied by paraplegia or hemiplegia, chorea - in / m for adults at an initial dose of 10-20 mg, for children - 2-10 mg.
With epileptic status - in / in the initial dose of 10-20 mg, subsequently, if necessary - 20 mg / m or / in drip. If necessary, intravenous drip (no more than 4 ml) is diluted in 5-10% dextrose solution or 0.9% NaCl solution. In order to avoid precipitation of the drug, at least 250 ml of infusion solution should be used, the resulting solution should be mixed quickly and thoroughly.
For the relief of severe muscle spasm - in / in once, or twice 10 mg. Tetanus: initial dose - 0.1-0.3 mg / kg IV at intervals of 1-4 hours or as an IV infusion of 4-10 mg / kg / day
Relanium instructions for use of the drug
Trade name: Relanium
International non-proprietary name: Diazepam
Dosage form: Solution for intramuscular and intravenous injections 5 mg/ml.
Relanium instructions for use (in ampoules)
Diazepam ( Diazepam) - has a sedative, hypnotic, anti-anxiety, anticonvulsant, muscle relaxant and amnestic action.
Enhances the effect of sleeping pills, narcotic, neuroleptic, analgesic drugs, alcohol.
Taking diazepam for a long time can lead to dependence on the drug.
Diazepam is on the WHO list of essential medicines.
Wikipedia
Composition and properties of Relanium (in ampoules)
1 ml of solution contains:
- active substance: diazepam 5.0 mg;
- excipients: propylene glycol, ethanol 96%, benzyl alcohol, sodium benzoate, glacial acetic acid, 10% acetic acid solution, water for injection.
Description: Colorless or yellow-green transparent solution.
Pharmacotherapeutic group: Psychotropic drugs. Anxiolytics. benzodiazepine derivatives. Diazepam
ATC code: N05BA01
Pharmacological properties
Pharmacokinetics
Diazepam has a high lipid solubility and crosses the blood-brain barrier, these properties must be taken into account when it is used intravenously for short-term analgesic procedures.
Effective plasma concentrations of diazepam after administration of an adequate intravenous dose are usually reached within 5 minutes (about 150 - 400 ng / ml).
After intramuscular administration, plasma absorption of diazepam is unstable and the peak of the lowest plasma concentration may even be lower than after oral administration of the drug.
Diazepam and its metabolites are highly bound to plasma proteins (98% diazepam).
Diazepam and its metabolites cross the placenta and are found in human milk.
Diazepam is metabolized primarily by the liver to pharmacologically active metabolites such as nordiazepam, temazepam and oxazepam, which appear in the urine as glucuronides, also pharmacologically active substances.
Only 20% of these metabolites are found in the urine during the first 72 hours.
Diazepam has a biphasic half-life with an initial rapid distribution phase followed by a long terminal elimination phase of 1 to 2 days.
For active metabolites (nordiazepam, temazepam and oxazepam), the half-life is 30-100 hours, 10-20 hours and 5-15 hours, respectively.
The drug is excreted mainly by the kidneys, partly with bile, which depends on age, as well as the function of the liver and kidneys.
Diazepam and its metabolites are excreted mainly in the urine, primarily in bound form.
Diazepam clearance is 20-30 ml/min.
Multiple doses lead to accumulation of diazepam and its metabolites.
A state of dynamic balance of metabolites is achieved even after two weeks, metabolites can reach a higher concentration than the primary drug.
The half-life in the elimination phase may be prolonged in neonates, elderly patients and patients with liver disease.
In patients with renal insufficiency, the half-life of diazepam does not change.
Intramuscular administration of the drug can lead to an increase in serum creatine phosphatase activity, with a maximum concentration achieved between 12 and 24 hours after injection.
This should be taken into account in the differential diagnosis of myocardial infarction.
Absorption after intramuscular injection of the drug can be variable, especially after injections into the gluteal muscles.
This route of administration should only be used when oral or intravenous administration is not possible or recommended.
Pharmacodynamics
Diazepam is a psychotropic substance from the 1,4-benzodiazepine class and has anxiolytic, sedative and hypnotic effects.
In addition, diazepam has muscle relaxant and anticonvulsant properties.
It is used for the short-term treatment of anxiety conditions, as a sedative premedication for the control of muscle spasm, and for the treatment of withdrawal symptoms in alcoholism.
Diazepam binds to specific receptors in the central nervous system and peripheral organs in particular.
Benzodiazepine receptors in the CNS have a close functional relationship with the receptors of the GABA-ergic system.
After binding to the benzodiazepine receptor, diazepam enhances the inhibitory effect of GABA-ergic transmission.
Indications for use Relanium
- acute anxiety or agitation, delirium tremen s;
- acute spastic conditions of muscles, tetanus;
- acute convulsive conditions, including epileptic ones, convulsions in case of poisoning, convulsions in alcoholic delirium on the background of somatic disorders;
- preoperative premedication or premedication before diagnostic procedures (dental, surgical, radiological, endoscopic procedures, cardiac catheterization, cardioversion).
Application of Relanium (method, dosage)
To achieve the optimal effect of the drug, the individual dosage for each patient should be carefully determined.
Relanium is intended for intravenous or intramuscular injection.
Adults:
Acute anxiety or agitation on the background of somatic disorders:
Delirium tremens: 10 - 20 mg intravenously or intramuscularly.
Depending on the intensity of the symptoms, it may be necessary to administer large doses.
Spastic conditions of the muscles: 10 mg intravenously or intramuscularly, the injection can be repeated no earlier than four hours later.
Tetanus: the initial intravenous dose is 0.1 mg/kg to 0.3 mg/kg body weight, repeated every 1 to 4 hours.
It can also be administered by continuous intravenous infusion at a dose of 3 mg/kg to 10 mg/kg of body weight every 24 hours, the same doses can be administered through a nasogastric tube.
Epileptic seizure, convulsions in case of poisoning: 0.15 - 0.25 mg / kg intravenously (usually 10 - 20 mg); the dose can be repeated after 30 to 60 minutes.
For the prevention of seizures, a slow intravenous infusion can be carried out (maximum dose of 3 mg / kg body weight for 24 hours).
0.2 mg/kg.
The usual dose in adults is 10 to 20 mg, but depending on the clinical response, it may be necessary to increase the dose.
Elderly or debilitated patients
The doses taken should not be more than half of the usually recommended doses.
Patients in this group require regular monitoring at the start of treatment to minimize doses taken and/or frequency of use to avoid overdose due to drug accumulation.
Children
Epileptic seizure, convulsions in case of poisoning, convulsions in case of hyperthermia: 0.2 - 0.3 mg / kg body weight (or 1 mg per year) intravenously.
The dose can be repeated if necessary after 30 - 60 minutes.
Tetanus: dosage as for adults.
Preoperative premedication or premedication before diagnostic procedures: 0.2 mg/kg body weight can be administered parenterally.
Treatment should be reduced to the necessary minimum, the drug should be administered only under the supervision of a physician.
Data regarding the efficacy and safety of the use of benzodiazepines in long-term therapy are limited.
Important: to reduce the likelihood of adverse events with the intravenous route of administration, the drug should be administered slowly (1.0 ml of solution for 1 minute).
The patient should be in the supine position for an hour after the administration of the drug.
In case of emergency situations associated with intravenous administration of the drug, there should always be a second person and a set for resuscitation.
The patient must be accompanied home by an adult responsible for the patient; the patient should be informed about the prohibition of driving a car and servicing machines within 24 hours from the moment of taking the medicine.
Do not dilute the Relanium solution.
An exception is the slow intravenous infusion of a large volume of 0.9% NaCl solution or glucose in the treatment of tetanus and epileptic seizures.
Do not dilute more than 40 mg diazepam (8 ml solution) in 500 ml infusion solution.
The solution should be prepared immediately before administration and used within 6 hours.
The drug should not be mixed with other drugs in an infusion solution or in the same syringe, since the stability of the drug cannot be guaranteed if this recommendation is not followed.
Side effects Relanium
After intravenous administration, local reactions may occur, as well as thrombosis and inflammation of the veins (phlebothrombosis).
After rapid intravenous administration, you may experience:
- respiratory depression, arterial hypotension, bradycardia.
After intramuscular injection, there may be:
- pain and redness;
- erythema (redness) at the injection site;
- relatively often - soreness at the injection site.
Often:
- fatigue;
- drowsiness;
- muscle weakness.
Rarely:
- changes in the composition of the blood, including thrombocytopenia, agranulocytosis;
- skin reactions;
- paradoxical reactions such as restlessness, agitation, irritability, aggressiveness, delirium, temper tantrums, nightmares, hallucinations (some of the sexual type), psychosis, personality disorder, and other behavioral disturbances.
Pre-existing depression may appear while taking medications from the benzodiazepine group; - confusion, weakening of emotional reactions, anterograde amnesia, ataxia, trembling, headache, dizziness, speech disturbances or unclear speech, drowsiness (appears most often at the beginning of treatment and usually disappears during further therapy).
Elderly patients are particularly sensitive to the effects of CNS depressant drugs and may become confused, especially in patients with organic brain changes. The dose of the drug in this group should not exceed half the dose prescribed for other adult patients; - visual disturbances, including double vision, blurred vision;
- arterial hypotension, bradycardia;
- respiratory distress, apnea, respiratory depression (after rapid intravenous injection of the drug, as well as when prescribing large doses). The frequency of occurrence of such complications can be reduced due to the exact observance of the recommended rate of administration of the drug. During the entire time, the patient should lie on his back.
- digestive disorders, nausea, dry mucous membranes oral cavity or excessive salivation, increased thirst, constipation;
- incontinence or stasis of urine;
- increase or decrease in sexual desire;
- fatigue (appears most often at the beginning of treatment and usually disappears during further therapy);
- pain, and in some cases redness after intramuscular injection of the drug.
Very rarely
- hypersensitivity reactions, including anaphylaxis;
- cases of cardiac arrest. Vascular depression may appear (after a rapid intravenous injection of the drug). Thrombophlebitis and vascular thrombosis may occur after intravenous injection of the drug. To reduce the chance of these symptoms occurring, the injection should be given into a large vein in the crook of the elbow.
Do not inject medicine into small veins. Intra-arterial administration and extravasation of the drug should be absolutely avoided. - increased activity of transaminases and basic phosphatase, jaundice.
Frequency unknown
- weakened muscle tone - usually depends on the prescribed dose (appears most often at the beginning of treatment and usually disappears during further therapy).
Elderly people and patients with impaired liver function are especially susceptible to the above undesirable effects.
Abuse of drugs from the group of benzodiazepines has been observed.
The use of the drug Relanium (even in therapeutic doses) can lead to the development of physical and mental dependence.
Contraindications Relanium
- Hypersensitivity to benzodiazepines or any excipient;
- Myasthenia gravis ( Myasthenia gravis);
- Severe or acute respiratory failure, respiratory depression, hypercapnia;
- sleep apnea syndrome;
- severe liver failure;
- severe heart failure;
- Phobias or obsessions;
- Do not prescribe as monotherapy in the treatment of depression or agitation associated with depression due to the risk of suicide characteristic of this category of patients;
- Chronic psychoses;
- Cerebral and spinal ataxia;
- Epilepsy and epileptic seizures;
- Hepatitis;
- Porphyria, myasthenia gravis;
- Alcohol dependence (except for acute withdrawal);
- Acute attack of glaucoma, angle-closure glaucoma;
- Pregnancy and lactation;
- Children's age up to 3 years.
Drug Interactions
If Relanium is used simultaneously with other drugs that act on the central nervous system (CNS), such as antipsychotics, anxiolytics, sedatives, antidepressants, hypnotics, antiepileptics, opiate painkillers, drugs for general anesthesia and antihistamines with a sedative effect, an increase in sedative action.
In the case of opiate pain medications, the euphoric effect may increase, which may lead to an increase in psychic dependence.
In addition, when drugs that suppress the central nervous system are taken parenterally in combination with intravenous injections of diazepam, severe mental depression and vascular depression may occur.
Elderly patients require special supervision.
When intravenous administration of the drug Relanium simultaneously with opiate painkillers, for example, in dentistry, it is recommended to give diazepam after taking the painkiller, and carefully choose the dose depending on the individual needs of the patient.
The results of pharmacokinetic studies regarding the potential interaction of diazepam with anticonvulsants (including valproic acid) are conflicting.
Both decrease and increase were observed, as well as no change in drug concentration.
In the case of simultaneous administration of Relanium with anticonvulsants, an increase in undesirable effects and toxicity may occur, especially in the case of drugs from the group of hydantoin derivatives or barbiturates, as well as complex preparations containing these substances.
Therefore, special care is required when determining the dosage in the initial period of treatment.
Isoniazid, erythromycin, disulfiram, fluvoxamine, fluoxytin, oral contraceptives inhibit the biotransformation of diazepam (reduce the clearance of diazepam), which can potentiate pharmachologic effect drug.
Drugs known to induce liver enzymes, such as rifampicin, may increase the clearance of benzodiazepines.
There are data on the effect of diazepam on elimination.
special instructions
Pregnancy and lactation
You should not take the medicine during pregnancy, especially in the first and last trimester, unless circumstances require it.
It was found that taking large doses or long-term use of small doses of benzodiazepine in the last trimester of pregnancy or during childbirth caused fetal heart rhythm disturbances, arterial hypotension, sucking disorders, decreased body temperature and mild mental depression in newborns.
It should be remembered that in newborns, especially premature ones, the enzyme system involved in drug metabolism is not fully developed.
In addition, newborn children of mothers who have taken benzodiazepines for a long time in the last period of pregnancy may show physical dependence, they may have a withdrawal syndrome after birth.
Diazepam passes into breast milk, so diazepam should not be taken during breastfeeding.
There are no reports confirming the safety of the drug in pregnant women.
Animal studies have not provided evidence of the safety of this treatment.
In the event that the drug is prescribed to women of reproductive age, the patient should be informed of the need to consult a doctor in order to interrupt treatment in cases where the patient is planning a pregnancy or suspects that she is pregnant.
Special warnings and precautions for the use of the drug
Usually, the drug should not be used parenterally in patients with organic brain changes (especially with atherosclerosis) or chronic pulmonary insufficiency.
However, in emergencies or when patients are being treated in a hospital setting, the drug can be administered parenterally at a lower dose.
In the case of intravenous injection, the drug should be administered slowly.
In patients with chronic pulmonary insufficiency and patients with chronic diseases liver may need to reduce doses.
In renal insufficiency, the half-life of diazepam is unchanged, so there is no need to reduce doses for patients with impaired renal function.
Diazepam should not be used as monotherapy in patients with depression or phobias during depression, as suicidal tendencies may occur.
A few hours after taking the medicine, amnesia may appear.
To reduce the risk of its occurrence, patients need to provide conditions for uninterrupted sleep for 7 to 8 hours.
When severe stress(loss of loved ones and mourning), due to the use of benzodiazepines, psychological adaptation can be inhibited.
With the use of benzodiazepines, especially in children and elderly patients, paradoxical reactions have been described, such as motor restlessness, agitation, irritability, aggressiveness, delirium, fits of anger, nightmares, hallucinations, psychosis, abnormal behavior and other behavioral disorders.
If such symptoms appear, the medication should be discontinued.
When treated with drugs from the benzodiazepine group, dependence may occur.
The risk of dependence is greater in patients undergoing a long course of treatment and / or using high doses, especially in predisposed patients who abuse alcohol or have a history of drug abuse in the patient.
After the onset of physical dependence on benzodiazepines, discontinuation of treatment may lead to withdrawal symptoms.
These include headache, muscle pain, feelings of panic, tension, restlessness, confusion, and irritability.
In severe cases, symptoms such as loss of sense of reality or one's own reality, goosebumps and numbness of the extremities, hypersensitivity to sound, light and touch, hallucinations or convulsions may appear.
After prolonged intravenous injections, abrupt withdrawal of the drug may be accompanied by withdrawal symptoms, so a gradual reduction in doses is recommended.
Special care should be taken when using diazepam in injections (especially intravenous) in elderly patients, in severe condition, as well as in patients with limited pulmonary reserve, since apnea and / or cardiac arrest may develop.
Concomitant use of diazepam and barbiturates, alcohol, or other central nervous system depressants increases the risk of circulatory or respiratory depression and increases the risk of sleep apnea.
Access to resuscitation equipment, including equipment to support mechanical ventilation, should be provided.
Benzyl alcohol, which is an excipient of the drug, is contraindicated in premature infants and newborns.
One ampoule contains 30 mg of benzyl alcohol, which can cause poisoning and pseudo-anaphylactic reactions in infants and children under 3 years of age.
The drug contains 100 mg of ethanol per 1 ml - this should be taken into account when prescribing it to pregnant women or women who are breastfeeding, children and patients from the group high risk, for example, with liver disease, epilepsy and in patients with alcohol dependence.
Special care should be taken when using benzodiazepines in patients with a history of alcohol or drug abuse.
Features of the influence of the drug on the ability to drive a vehicle or potentially dangerous mechanisms
Patients should be advised that, as with all drugs in this group, taking diazepam may impair the patient's ability to perform complex activities.
Calmness, impaired memory and concentration, and muscle function can adversely affect the ability to drive or operate machinery.
With insufficient sleep, the likelihood of violations of vigilance may increase.
Relanium overdose
Symptoms
Drowsiness, depression of consciousness of varying severity, paradoxical arousal, decreased reflexes to areflexia, reduced response to painful stimuli, slurred speech.
In severe poisoning, ataxia, hypotension, muscle weakness, respiratory failure, coma, and even death can develop.
Life-threatening poisoning can be caused by the simultaneous use of diazepam and alcohol or other drugs that have a depressant effect on the central nervous system.
Treatment
First of all, symptomatic, it consists in monitoring and maintaining the basic vital functions of the body (respiration, pulse, blood pressure) in the intensive care unit.
To reduce the absorption of diazepam, you can apply.
The specific antidote is flumazenil (a competitive inhibitor of the benzodiazepine receptor).
The significance of dialysis has not yet been established.
Flumazenil is a specific antidote administered intravenously in an emergency.
Patients requiring such care should be subject to continuous monitoring in a hospital setting.
Caution should be exercised when administering flumazenil to patients with epilepsy receiving drugs from the benzodiazepine group.
If arousal occurs, barbiturates should not be used.
Packaging, storage and manufacturer
| Release form and packaging | 2 ml ampoule of colorless or orange glass. Above the break point of the ampoule is a white or red dot and a ring-shaped strip of red color. 5 ampoules are put into a pallet made of PVC film. 1, 2 or 10 pallets along with approved instructions for medical use placed in a cardboard box. |
| Storage conditions | Store at a temperature not exceeding 25°C, protected from light. Do not freeze! Keep out of the reach of children! |
| Shelf life | 5 years. The term of use after dilution is 6 hours. Do not use after the expiration date. |
| Terms of dispensing from pharmacies | On prescription |
| Manufacturer | JSC Warsaw Pharmaceutical Plant Polfa, Poland |
Instructions Relanium solution in ampoules (scan version)
Download scanned version official instructions on the medical use of the drug Relanium, manufacturer JSC "Warsaw Pharmaceutical Plant Polfa". 
Relanium instructions for use
Recipe (international)
Rp.: Sol. Relanii 0.5% - 2 ml
D.t.d. No. 5
S. 2 ml intramuscularly
Rp: Relanii 5 mg
D.t.d. No. 20 in tabl.
S.: 1 tablet at night
Recipe (Russia)
Rep: Tab. Diazepami 0.005
D.t.d. No. 20 in tab.
S: 1 tab. 2 times a day inside.
Prescription form 148-1/u-88
Active substance
Diazepam ()
pharmachologic effect
Anticonvulsant, muscle relaxant, tranquilizer, hypnotic, sedative.
It has a depressing effect on the central nervous system, which is realized mainly in the thalamus, hypothalamus and limbic system. Enhances the inhibitory effect of GABA, which is one of the main mediators of pre- and postsynaptic inhibition of the transmission of nerve impulses in the central nervous system.
Stimulates the benzodiazepine receptors of the supramolecular GABA-benzodiazepine-chlorionophoric receptor complex, causes a decrease in the excitability of the subcortical structures of the brain, and inhibition of polysynaptic spinal reflexes.
Mode of application
For adults: 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 administered again at the same dose.
When tetanus is prescribed, 10 mg intravenously slowly or deeply intramuscularly, then 100 mg of diazepam in 500 ml of 0.9% sodium chloride solution or 5% glucose solution are injected intravenously at a rate of 5-15 mg / h.
In case of status epilepticus, 10-20 mg intramuscularly or intravenously are prescribed, if necessary, after 3-4 hours, the drug is administered again at the same dose.
To relieve spasm of skeletal muscles - 10 mg intramuscularly 1-2 hours before the start of the operation.
In obstetrics, IM is prescribed at a dose of 10-20 mg with the opening of the cervix by 2-3 fingers.
Newborns after the 5th week of life (older than 30 days) are prescribed intravenously at a dose of 100-300 mcg / kg of 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 slowly in / in 1 mg every 2-5 minutes to a maximum dose of 10 mg; if necessary, the introduction can be repeated after 2-4 hours.
Indications
— treatment of neurotic and neurosis-like disorders with manifestation of anxiety;
- relief of psychomotor agitation associated with anxiety;
- relief of epileptic seizures and convulsive conditions of various etiologies;
- conditions accompanied by an increase in muscle tone (including tetanus, acute disorders of cerebral circulation);
- relief of withdrawal symptoms and delirium in alcoholism;
- for premedication and ataralgesia in combination with analgesics and other neurotropic drugs in 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, vasospasm, menopausal and menstrual disorders.
Contraindications
- severe form of myasthenia gravis;
- angle-closure glaucoma;
- indications in the anamnesis of the phenomena of dependence on drugs, alcohol (with the exception of the treatment of alcohol withdrawal syndrome and delirium);
- sleep apnea syndrome;
- a state of alcoholic intoxication of varying severity;
- acute intoxication with drugs that have a depressing effect on the central nervous system (narcotic, hypnotic and psychotropic drugs);
- severe chronic obstructive pulmonary disease (danger of progression of respiratory failure);
- acute respiratory failure;
— childhood up to 30 days inclusive;
- pregnancy (especially I and III trimesters);
- lactation period breast-feeding);
- hypersensitivity to benzodiazepines.
Prescribe with caution in absences (petit mal) or Lennox-Gastaut syndrome (when administered intravenously, it can provoke the development of tonic status epilepticus), epilepsy or a history of epileptic seizures (initiation of treatment with diazepam or its abrupt cancellation may accelerate the development of seizures or status epilepticus) , liver and / or kidney failure, cerebral and spinal ataxia, with hyperkinesis, a tendency to abuse psychotropic drugs, with depression, organic brain diseases (paradoxical reactions are possible), with hypoproteinemia, in elderly patients.
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, fatigue, impaired concentration, ataxia, disorientation, dulling of emotions, slowing down 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 spasm, 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, abnormal liver function, increased activity of hepatic transaminases and alkaline phosphatase, jaundice.
- From the side of the cardiovascular system: arterial hypotension, tachycardia.
- From the urinary system: incontinence or urinary retention, impaired renal function.
- From the reproductive system: increased or decreased libido, dysmenorrhea.
—From the side respiratory system: respiratory depression (with too rapid administration of the drug).
— allergic reactions: skin rash, itching.
- Local reactions: phlebitis or venous thrombosis (redness, swelling, pain) at the injection site.
- Other: addictive, drug addiction; rarely - depression of the respiratory center, visual impairment (diplopia), bulimia, weight loss.
- With a sharp decrease in dose or discontinuation - withdrawal syndrome (increased irritability, headache, anxiety, fear, psychomotor agitation, sleep disturbances, dysphoria, spasm of smooth muscles internal organs and skeletal muscles, depersonalization, increased sweating, depression, nausea, vomiting, tremor, perception disorders, incl. hyperacusis, paresthesia, photophobia, tachycardia, convulsions, hallucinations; rarely - psychotic disorders).
- When used in obstetrics in newborns - muscle hypotension, hypothermia, dyspnea.
Release form
Solution d / in / in and / m injections of 10 mg / 2 ml: amp. 5, 10 or 50 pcs.
Release form, composition and packaging
The solution for intravenous and intramuscular administration is clear, colorless or yellow-green in color.
1 ml 1 amp.
diazepam 5 mg 10 mg
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.
ATTENTION!
The information on the page you are viewing was created for informational purposes only and does not promote self-treatment in any way. The resource is intended to familiarize healthcare professionals with additional information about certain medicines, thereby increasing their level of professionalism. The use of the drug "" without fail provides for a consultation with a specialist, as well as his recommendations on the method of application and dosage of the medicine you have chosen.
One of the most famous drugs widely used in the field of neurology and psychiatry is Relanium. His analogues are selected by the doctor, since medications in this category belong to strong tranquilizers. This medicine is used to treat many diseases and is dispensed from pharmacies strictly on prescription.
Composition and form of release
The medicine "Relanium" (its analogues are sold in a pharmacy and at any time can replace this drug if it does not fit) is considered a benzodiazepine tranquilizer (anxiolytic). Contains the active substance diazepam.
Auxiliary elements in its composition are: glacial acetic acid, propylene glycol, sodium benzoate, acetic acid 10%, ethanol 96%, and water for injection.
The drug "Relanium" may have the following form of release:
- tablets (instructions are attached to them) of 2, 5 and 10 mg;
- ampoules for injections of 2 ml.
Tablets in the amount of 10 pieces are enclosed in an aluminum blister and packed in a cardboard box of three blisters. Glass ampoules are packaged in plastic holders of 5 pieces. A carton can contain from one to ten plastic containers.
The drug "Relanium" belongs to potent narcotic drugs and is assigned to the list No. 1, which is controlled by the Permanent Committee for Drug Control of the Russian Federation.
The drug is stored at a temperature of 15-25 ° C, in a cool, protected from sunlight and out of the reach of children. The shelf life of the medicinal product from the date of its production is five years.
pharmachologic effect
Refers to the anxiolytic drugs of the benzodiazepine series, the drug "Relanium" instructions for use. Analogues this medicine are characterized by a similar effect on the body and are indicated in the treatment of the same diseases. The drug has a sedative-hypnotic effect. It has anticonvulsant, central muscle relaxant characteristics.
The effect of the drug on the body is due to the activation of benzodiazepine receptors. It increases their inhibitory effect on the transport of nerve impulses. It enhances the work of benzodiazepine endings, which are located in the allosteric center, reduces the excited state of the brain, and also slows down the work of spinal polysynaptic reflexes.
The anxiolytic effect of the drug on the human body is expressed in its effect on the complex of the limbic system, which is reflected in a decrease in emotional stress, a decrease in anxiety, fear and anxiety.
Sedative properties are characterized by an effect on the brain stem, as well as on the nuclei of the thalamus, of a non-specific nature. Here medicine reduces symptoms of neurotic origin.
A hypnotic effect on a person occurs as a result of inhibition of the cellular tissue related to the brain stem.
The anticonvulsant property is expressed in an increase in presynaptic inhibition, a slowdown in epileptogenic activity, where the focus of excitation is not neutralized.
The muscle relaxant central manifestation is aimed at blocking the spinal polysynaptic afferent inhibitory channels. Directional deceleration of motor nerves and muscle functions is acceptable.
Due to the power-law symptomatic activity, both a decrease in blood pressure and an expansion of the coronary walls of the vessels can be observed. The sensitivity of the pain threshold increases. Parasympathetic and sympathoadrenal paroxysms are extinguished. Decreased production of gastric juice at night.
The effectiveness of taking Relanium (analogues of the active substance are also used to treat neurotic and neurosis-like disorders) manifests itself on days 2-7 of treatment.
The drug does not affect the pronounced symptoms psychotic disorder such as hallucinations, delusions, affective states. In rare cases, it helps to relieve nervous tension.
Use the drug before endoscopic and surgical intervention for premedication, before administering to the patient general anesthesia. They reduce anxiety and anxiety in myocardial infarction.
The drug is widely used in the field of psychiatry, neurology and in order to facilitate the process of giving birth to women. The doctor may prescribe a medicine if the placenta began to exfoliate ahead of time, as well as in case of premature birth.
"Relanium" (analogues in tablets without a doctor's prescription are not dispensed) is contraindicated in myasthenia gravis, which occurs in severe form, it is not prescribed for coma, shock and closed glaucoma. The prohibition is the syndrome. They do not prescribe medicine to people who are in a drunken state. Do not prescribe the drug to persons with acute attacks of poisoning and in the presence of severe diseases of the respiratory system.
Do not use the drug in acute respiratory failure, in infancy up to one month. Do not prescribe the drug to pregnant and lactating women, as well as patients with hypersensitivity to benzodiazepines.
Use the drug with extreme caution should persons with absences and Lennox-Gastaut syndrome, as well as patients with epilepsy. Patients with renal and hepatic insufficiency, people diagnosed with cerebral and spinal ataxia and suffering from hyperkinesis should be under observation. This category also includes patients with major depressive disorders, hypoproteinemia and the elderly.
Doses and use of the drug
The dosage for each patient should be selected individually, taking into account the disease, its course, as well as the patient's response to the active substance in its composition. As a rule, treatment begins with small doses, gradually increasing them. The daily portion of the drug should be divided into 3-4 doses. The main part, which is about 2/3 of the recommended dosage, should be consumed in the evening.
For adults with neurological, psychosomatic and anxiety-phobic conditions, the drug is prescribed once, at a dose of 2.5 to 5 mg. The daily norm for the adult population ranges from 5-20 mg.
Claims that it is impossible to use more than 10 mg of the drug "Relanium" (tablets) at a time.
Seizures are treated at a dosage of 2.5-10 mg, this amount should be divided into 2-4 doses.
If the drug is used in complex therapy, then the initial daily rate should range from 20-40 mg, and the maintenance daily dosage is 15-20 mg.
Treatment of spasticity, rigidity and muscle contractures should be carried out with a daily rate of 5-20 mg.
In cachetic and elderly patients, as well as in persons with slow liver function, the elimination period of the drug is greatly increased.
When prescribing Relanium tablets for children, the dosage should be prescribed taking into account the age of the child. You should also pay attention to the physical development of the baby, his well-being and reaction to the drug. Treatment begins with a daily rate of 1.25 and 2.5 mg. This dose is divided into four doses.
Treatment that occurs due to unreasonable anxiety begins with a dosage of 5-10 mg, the drug is administered intravenously. If necessary, the medication can be re-introduced after 3-4 hours.
With tetanus, the solution is administered intravenously or intramuscularly at 10 mg. You can use the drug intravenously - drip. To do this, 100 mg of "Relanium" is diluted with 500 ml of sodium chloride (0.9%), which can be replaced with glucose (5%). The drug is administered at a rate of 5-15 mg per hour.
If the patient has status epilepticus, then the medication is prescribed intramuscularly or intravenously at a rate of 10-20 mg. If necessary, the procedure is repeated after 3-4 hours.
Spasm from the muscles of the skeleton is removed by administering 10 mg intravenously, a couple of hours before surgery.
In the field of obstetrics, 10-20 mg are prescribed intramuscularly as soon as the cervix opens by 2-3 fingers.
After the fifth week of life, you can use the drug for newborns. For such children, the drug is injected slowly into a vein at the rate of 100-300 mcg per kilogram of weight. The maximum daily allowance is 5 mg. The procedure can be repeated after 2-4 hours.
The drug "Relanium" is prescribed for children aged five years and older. The dosage (intramuscularly the drug is not administered at this age) is 10 mg per day. The drug is injected slowly into a vein at 1 mg, with an interval of 2-5 minutes, until the dose volume approaches the maximum of 10 mg. If necessary, the procedure is repeated after a few hours.
Patient reviews
Always in the pharmacy you can find analogues of the drug "Relanium". Reviews about him are mostly positive. Patients note that it acts quickly and effectively. Within a few minutes relieves cramps, soothes, helps to cope with anxiety, stress and depression. In some cases, it is used for patients before surgery. Helps lower blood pressure. Improves well-being during severe shocks, depression, removes tension in muscle tissue. Indispensable for emergency care, but with frequent use is addictive.
Many people after using it noted side effects in the form of increased excitability, nausea, vomiting and disruption of the gastrointestinal tract.
In patients with epilepsy, this drug is always at hand, within a few minutes after injection into a vein, it removes the symptoms of the disease and quickly brings the patient back to normal.
There are people for whom this drug does not work. Even the introduction of large doses of the drug did not lull them to sleep and did not calm them down, then the doctors replaced this drug with its analogues, which acted for fifteen minutes.
If for some reason this drug did not fit, then you can always replace it with similar medicines, which in their effect can be very effective than the Relanium tranquilizer. Analogues in tablets (without a doctor's prescription they are not sold in the pharmacy network), these are:
- "Apaurin".
- "Relium".
- "Reladorm".
- "Sibazon".
- "Seduxen".
- Valium Roche.
- "Diazepam".
- "Diazepex".
Many of the above drugs are also produced in the form of a solution for injection. So, the analogues of "Relanium" in injections are as follows:
- "Diazepabene".
- Valium Roche.
- "Diazepam".
- "Apaurin".
- "Relium".
- "Sibazon".
- "Seduxen".
All of the above drugs are similar to each other in terms of the active substance - diazepam, but differ in terms of the manufacturer and price.
The drug "Seduxen" as a direct analogue of "Relanium"
An analogue of "Relanium" in ampoules can be found in any pharmacy. For example, the medicine "Seduxen". The drug is produced both in the form of a solution for injection and in tablets. It refers to strong tranquilizers, benzodiazepine derivatives.
It is used for neurosis, epilepsy, muscle spasms, convulsions, insomnia and depression. They are given premedication, anesthesia before surgical intervention. It is used for drug poisoning.
Relanium is a fairly well-known drug of the tranquilizer group, its action is aimed at the central nervous system and the body as a whole. Medication may be accompanied side effects Therefore, you can take it only as directed by a doctor.
Relanium belongs to the second generation anxiolytics, it has a depressing effect on the central nervous system.
The drug has a sedative, anticonvulsant, hypnotic, anxiolytic, muscle relaxant effect.
Relanium belongs to the category of strong tranquilizers, it should be taken only on the recommendation of a doctor.
pharmachologic effect
Under the influence of the drug, the excitability of the subcortical structures of the brain decreases, and polysynaptic spinal reflexes are inhibited.
Anxiolytic action is accompanied by the removal of fear, anxiety, anxiety and emotional stress. Its main manifestations are expressed in the impact on the subcortical areas, the drug is prescribed as a sedative against seizures, it acts as a muscle relaxant and hypnotic.
Anxiolytic properties are associated with the impact on the amygdala complex of the limbic system, they are manifested in a decrease in emotional stress, a decrease in anxiety, fear, and anxiety.
The sedative effect is manifested in the reduction of anxiety and fear, the main mechanism of action is associated with the inhibition of the cells of the reticular formation of the brain.
In chronic alcoholism or withdrawal syndrome, there is a weakening of negativism, tremor, agitation, tremor, hallucinations, and alcoholic delirium.
Indications for use
Relanium is prescribed in the following cases:
- neurotic and neurosis-like disorders, accompanied by anxiety;
- conditions accompanied by increased muscle tone (including tetanus and acute circulatory disorders of the brain);
- epileptic seizures and convulsive conditions of various etiologies;
- psychomotor agitation caused by anxiety;
- withdrawal syndrome and delirium in alcoholism;
- arterial hypertension, accompanied by anxiety and excitability, hypertensive crisis, vasospasm, menopausal and menstrual disorders.
The drug is also prescribed for premedication and ataralgesia in surgical and obstetric practice during diagnostics (in combination with analgesic and other neurotropic drugs).
Mode of application
In accordance with the instructions, the drug is intended for intramuscular or intravenous administration, the exact dosage is calculated taking into account the body's response to the drug, the patient's state of health plays an important role, clinical picture underlying and concomitant diseases.
Dosage:
| 10 mg intramuscularly | with spasms of skeletal muscles 1-2 hours before the operation. |
| 5-10 mg intravenously slowly | removal of psychomotor agitation caused by anxiety, after 3-4 hours again in the same dose. |
| 10-20 mg IV or IM | status epilepticus, after 3-4 hours it is possible to re-administer the same amount of the drug. |
| 10-20 mg intramuscularly | when the cervix dilates. |
| 10 mg intravenously slowly or deep intramuscularly | with tetanus. |
Release form, composition
Relanium is available in a solution for intravenous and intramuscular administration, packaged in 2 ml ampoules, 5 ampoules in plastic holders, in a cardboard box 1,2, 10 holders).
The main active ingredient is diazepam, 1 ml of the solution contains 5 mg.
Interaction with other drugs
The drug enters into the following drug interactions:
Relanium must not be mixed in the same syringe with any drugs.
Side effects
Relanium may be accompanied by the following side effects:
| allergic reactions | Itching, skin rash. |
| CNS and peripheral nervous system | Fatigue, dizziness, decreased concentration, anterograde amnesia, disorientation, dullness of emotions, slowing down of motor and mental reactions, ataxia, drowsiness, dystonic extrapyramidal reactions, depression, confusion, tremor, catalepsy, headache, asthenia, dysarthria, euphoria, muscle weakness, hyporeflexia, suicidal tendencies, hallucinations, outbursts of aggression, confusion, fear, anxiety, muscle spasm, psychomotor agitation, sleep disturbances. |
| Digestive system | Increasing activity alkaline phosphatase and hepatic transaminases, jaundice, decreased appetite, heartburn, gastralgia, vomiting, constipation, nausea, hiccups, abnormal liver function, hypersalivation or dry mouth. |
| Hematopoietic system | Thrombocytopenia, agranulocytosis, neutropenia, anemia, leukopenia. |
| reproductive system | Decreased or increased libido, dysmenorrhea |
| Respiratory system | respiratory depression (with rapid administration of the drug). |
| urinary system | Urinary incontinence or urinary retention, impaired renal function. |
| The cardiovascular system | Arterial hypotension, tachycardia. |
| Local reactions | Venous thrombosis, phlebitis. |
| Other | Addiction, drug dependence, weight loss, depression of the respiratory center, bulimia, diplopia. |
A sharp decrease in dosage or discontinuation of administration can provoke a withdrawal syndrome.
Overdose
An overdose of the drug is accompanied by the following symptoms:
Particularly severe conditions may be accompanied by collapse, respiratory and cardiac arrests, there is a possibility of a coma.
- washing the organs of the digestive system;
- intake of absorbents;
- urgent and powerful diuresis.
In addition, careful monitoring of the patient's condition is required, the introduction of maintenance therapy is indicated. Particular attention should be paid blood pressure, and the normalization of the functioning of the organs of the respiratory system, it may also be necessary to connect to artificial respiration devices (only in the hospital).
Elderly patients should be especially careful, as a reduced dosage is prescribed for their treatment.
Contraindications
Relanium is contraindicated in the following cases:
- severe form of myasthenia gravis;
- coma;
- hypersensitivity to the components of the drug and benzodiazepines;
- acute respiratory failure;
- acute intoxication with drugs that have a depressing effect on the central nervous system;
- severe obstructive pulmonary disease;
- angle-closure glaucoma;
- sleep apnea syndrome.
Caution should be exercised in the following cases:
- epilepsy or epileptic seizures;
- absences, Lennox-Gastaut syndrome;
- renal/liver failure;
- spinal and cerebral ataxia;
- hypoproteinemia;
- organic diseases of the brain;
- hyperkinesis.
When treating patients with depression, medical supervision is required, since the drug can be used for suicidal purposes.
During pregnancy
During pregnancy and lactation, it is recommended to stop taking the drug.
Terms and conditions of storage
Price
average price in Russia is 110 rubles.
average price in Ukraine- 141 UAH
Analogues
Analogues of Relanium are diazepam, Seduxen, Relium, Apaurin.