Diazomil 10mg by Mediate Pharma

Diazomil 10mg by Mediate Pharma

Product Description
Indications:
Diazepam is mainly used to treat anxiety, insomnia, and symptoms of acute alcohol withdrawal. It is also used as a premedication for inducing sedation, anxiolysis or amnesia before certain medical procedures (e.g., endoscopy).

Intravenous diazepam or lorazepam are first line treatments for status epilepticus; However, lorazepam has advantages over diazepam including a higher rate of terminating seizures and a more prolonged anticonvulsant effect. Diazepam is rarely used for the long-term treatment of epilepsy because tolerance to the anticonvulsant effects of diazepam usually develops within 6 to 12 months of treatment, effectively rendering it useless for this purpose. Diazepam is used for the emergency treatment of eclampsia, when IV magnesium sulfate and blood pressure control measures have failed. However, benzodiazepines such as diazepam can be used for their muscle relaxant properties to alleviate pain which is caused by muscle spasms, caused by various dystonias, including blepharospasm Tolerance often develops to the muscle relaxant effects of benzodiazepines such as diazepam. Baclofen or tizanidine is sometimes used as an alternative to diazepam. Tizanidine has been found to be equally effective as other antispasmodic drugs and have superior tolerability than baclofen and diazepam. Benzodiazepines do not have any pain relieving properties of themselves and are generally recommended to be avoided in individuals with pain.

The anticonvulsant effects of diazepam, can help in the treatment of seizures, due to a drug overdose or chemical toxicity as a result of exposure to sarin, VX, soman (or other organophosphate poisons; See #CANA), lindane, chloroquine, physostigmine, or pyrethroids Diazepam is sometimes used intermitently for the prophylaxis of febrile seizures which occur as a result of a high fever in children and neonates under 5 years of age. Long-term use of diazepam for the management of epilepsy is not recommended; however, a subgroup individuals with treatment resistant epilepsy benefit from long-term benzodiazepines and for such individuals clorazepate has been recommended due to its slower onset of tolerance to the anticonvulsant effects.

Diazepam has a broad spectrum of indications (most of which are off-label), including:

Treatment of anxiety, panic attacks, and states of agitation
Treatment of neurovegetative symptoms associated with vertigo
Treatment of the symptoms of alcohol, opiate and benzodiazepine withdrawal
Short-term treatment of insomnia
Treatment of tetanus, together with other measures of intensive-treatment
Adjunctive treatment of spastic muscular paresis (para-/tetraplegia) caused by cerebral or spinal cord conditions such as stroke, multiple sclerosis, spinal cord injury (long-term treatment is coupled with other rehabilitative measures)
Palliative treatment of stiff person syndrome
Pre-/postoperative sedation, anxiolysis and/or amnesia (e.g., before endoscopic or surgical procedures)
Treatment of complications with hallucinogens, such as LSD or overdose of CNS stimulants, such as cocaine, or methamphetamine.
Prophylactic treatment of oxygen toxicity during hyperbaric oxygen therapy
Veterinary uses:
Diazepam is used as a short-term sedative and anxiolytic for cats and dogs. It is also used for short-term treatment of seizures in dogs and short-term and long-term treatment of seizures in cats. It can also be used as an appetite stimulant. For emergent treatment of seizures, the typical dose is 0.5 mg/kg intravenously, or 1–2 mg/kg of the injectable solution administered in the rectum.
Before judicial executions:
The State of California offers diazepam to condemned inmates as a pre-execution sedative as part of their Lethal Injection program.
Dosage:
Dosages should be determined on an individual basis, depending upon the condition to be treated, the severity of symptoms, the body weight of the patient, and any comorbid conditions the patient may have.

Typical dosages for healthy adults range from 2 mg per dose to 10 mg per dose taken 2 to 4 times per day, depending on such factors as body weight and condition being treated. For the elderly or people with liver disorders, initial dose is at the low end of the range, with the dose being increased as required.

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Tramal 100mg by Searle

Tramal 100mg by Searle

Product Description
Pain – Killer Tramadol:
Tramadol is a medication used to treat pain that is moderate to severe. Ultram is the brand name of generic tramadol. Tramadol 50mg comes in regular form as well as a time-released form that comes in 100 mg, 200 mg, or 300 mg to treat chronic pain conditions when treatment is needed throughout the day and night.

Tramadol 50 mg is a synthetic pain reliever that works like morphine, though it is not known exactly how it works. Tramadol will bind to pain receptors in the brain and prevent them from transmitting any pain signals to the nerves in the body. It does not have any increased risk for internal bleeding that can occur from nonsteroidal anti-inflammatory drugs (NSAID).

How to Take Tramadol:

 It is recommended that tramadol should be taken every four to six hours, as the patient needs for pain. A total daily dosage should not exceed 400 mg. The best way for a person with moderate to severe pain to take tramadol is to start with 25 mg per day, and increase by 25 mg every three days until the dose of 100 mg per day is met. Then the person should increase the tramadol dose by 50 mg every three days until they reach the maximum of 200 mg per day, which is the equivalent of taking 50 mg every four hours each day. Because tramadol does not upset the stomach, it can be taken with or without food.

Generic Ultram Tramadol 50 mg:

It is easy to purchase cheap tramadol ultram online. Now 180 tramadol cheap tablets can be purchased, or the customer can purchase amounts such as tramadol 30, tramadol 50, tramadol 60 or tramadol 90 capsule quantities. The number of tablets purchased depends on the length of time the person will be taking the pain medication. For people who are taking 50 mg tramadol for maintenance, or for chronic pain relief, it is better to purchase higher quantities. Purchasing tramadol capsules will eliminate the need to get a new prescription to be refilled so soon.

Ordering 180 Tramadol Online:

Ordering online is easy and convenient. A person contacts a reputable online pharmacy to purchase 50mg tramadol. The pharmacy’s online licensed physician will ask the person to complete a medical history and information as to the necessity of taking the tramadol. Once the physician reviews the medical history information and approves the tramadol, a prescription is sent to the online pharmacy to be filled. The tramadol is then shipped to the person; and overnight shipping is available at most online pharmacies.

This eliminates the need for the person to continually go back to the doctor for refill prescriptions, or having to travel to a local pharmacy to have the prescription refilled. The online pharmacy can even schedule automatic delivery of the tramadol 50mg tab. This means the person needing the medication will always have it on hand, without having to remember to schedule refills.

Buy Tramadol 50mg:

It is easy to buy tramadol 180 capsules for an inexpensive amount. Online pharmacies sell the medication for as little as tramadol 97.00. Tramadol capsules are sold for less than $100 on most online pharmacy sites.
When purchasing any medications from an online pharmacy, especially tramadol 180, always ensure that the online pharmacy is reputable and has an actual telephone number that can be called for customer service questions and answers, and in case of any problems with the delivery of the medication. Reputable pharmacies online will have customer service support to answer any questions, as well as licensed physicians that can serve as consultants to people with questions about any medications.

The pharmacy should also accept credit cards, and it is always best to purchase tramadol with a credit card rather than sending cash or cashier’s checks.

Taking Tramadol:

Tramadol is a powerful pain medication. Caution should be used when taking the medication, and the dosage prescribed by the physician should be followed closely. It is possible to buy tramadol 50 mg without a prescription from a private physician, as the online pharmacy will have licensed physicians to review the customer’s medical history information to ensure that the tramadol is being used for legitimate purposes. If the online physician has any questions about the information the person has provided, he or she may request to speak to the person’s personal physician to verify the medical necessity of taking the tramadol.

These safeguards mean that the person looking to purchase tramadol cheap will be afforded the same high level of professionalism as going to their local pharmacy. It also protects the online pharmacy from distributing tramadol for any reason other than medical necessity. Ordering from online pharmacies is as safe as getting a prescription from a local pharmacy. Ordering tramadol online makes it easier for a person with pain manage that pain effectively.

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Nalbin (Nalbuphine HCL) 10mg

Nalbin (Nalbuphine HCL) 10mg

Product Description

Nalbin:

Generic Name:

Nalbuphine (HCl)

nalbin is a synthetic opiate agonist/antagonist that is chemically related to both naloxone, a narcotic antagonist, and oxymorphone, a potent narcotic analgesic. Used to treat moderate to severe pain associated with acute and chronic medical disorders such as cancer, renal or biliary colic, migraine or vascular headaches, and surgical pain. Another clinical use is obstetrical analgesia during labor and delivery. Some evidence suggests that nalbuphine's respiratory depressant effects do not increase proportionately with increasing doses, thus making this drug safer in patients at risk from respiratory depression. It was approved by the FDA in 1979. Nalbuphin exerts its effects by binding to specific opiate receptors present in the central nervous system, functions as an antagonist at the µ-receptor, however it has agonist action at ?-receptor, Nalbuphine is also an agonist at the d-receptor, but Nalbuphine (HCl) is nalbuphine's action at the ?-receptor that provides analgesia. Actions at the ?-receptors are believed to produce alterations in the perception of pain as well as the emotional response to pain, possibly by altering the release of neurotransmitters from afferent nerves sensitive to painful stimuli.

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Sust M250/10ml x1Vial

Sust M250/10ml x1Vial by Munster Laboratories Switzerland

Product Description
Sustanon 250 (Sust-an-on 250) is a medicine which is used in female-to-male gender reassignment procedures and testosterone replacement therapy. Sustanon 250 contains testosterone decanoate/testosterone isocaproate/testosterone phenylpropionate/testosterone propionate.

Sustanon 250 is a very popular steroid which is highly appreciated by it,s users since it offers several advantages when compared with other testosterone compounds. Sustanon is a mixture of 4 different testosterones which based on the well timed composition, have a synergetic effect. This special feature has positive characteristics for the athlete.The effect or the 4 Testosterones is time released so that Sustanon goes rapidly into the system and remains effective in the body for several weeks. Due to the propionate also included in the steroid, Sustanon is effective after one day and, based on the mixed in decanoates, remain active for 3-4 weeks. Sustanon has a distinct androgenic effect which is coupled with a strong anabolic effect. Therefore it is well suited to build up strength and mass. A rapid increase in body strength and an even increase in body weight occur. Athletes who use Sustanon report a solid muscle growth since it results in less water retention and also aromatizes less than either testosterone enanthate or Cypionate. Indeed many bodybuilders who use Testosterone and fight against distinct water retention and an elevated estrogen level prefer Sustanon over other long- acting Depot Testosterones.

Commonly sustanon is used to put on mass and size while increasing strength. It leads to less water retention and estrogenic side effects.

Sustanon is a very popular steroid which is highly appreciated by its users since it offers several advantages when compared to other testosteron compounds. Sustanon is a mixture of four different testosterones which, based on the well-timed composition, have a synergetic effect.These substances are:

Testosterone propionate 30 mg, Testosterone phenylpropionate 60mg, Testosterone isocaporate 60 mg, Testosterone decanoate 100 mg.

As with other testosterones, Sustanon is an androgenic steroid with a pronounced anabolic effect. Therefore, athletes commonly use Sustanon to put on mass and size while increasing strength. However, unlike other testosterone compounds such as testosterone cypionate and testosterone enanthate, the use of Sustanon leads to less water retention and estrogenic side effects. This characteristic is extremely beneficial to bodybuilders who suffer from gynecomastia yet still seek the powerful anabolic effect of an injectable testosterone. The decreased water retention also makes Sustanon a desirable steroid for bodybuilders and athletes interested in cutting up or building a solid foundation of quality mass. Dosages of Sustanon range from 250 mg every other week, up to 2000 mg or more per week. These dosages seem to be the extremes. A more common dosage would range from 250 mg to 1000 mg per week. Although Sustanon remains active for up to a month, injections should be taken at least once a week to keep testosterone levels stable.

A steroid novice can expect to gain about 20 pounds within a couple of months by using only 250 mg of Sustanon a week. More advanced athletes will obviously need higher dosages to obtain the desired effect. Sustanon is a fairly safe steroid, but in high dosages, some athletes may experience side effects due to an elevated estrogen level. With dosages exceeding 1000 mg a week, it is probably wise to use an antiestrogen such as Nolvadex (tamoxifen citrate) or Proviron (mesterolone). The use of Sustanon will suppress natural testosterone production, so the use of HCG (human chorionic gonadotropin) or Clomid (clomiphene citrate) may be appropriate at the end of a cycle. Sustanon 250 is a good base steroid to use in a stack. Athletes interested in rapid size and strength gains find that Sustanon stacks extremely well with orals such as Anadrol? (oxymetholone) and Dianabol (methandrostenlone). On the other hand, Sustanon also stacks well with Parabolan (trenbolone hexahydrobencylcarbonate), Masteron (drostanolone propionate), and Winstrol (stanozolol) for athletes seeking the hard, ripped look.

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Viagra 50mg by Pfizer

Viagra 50mg by Pfizer

Product Description
Brand Name:
Viagra

Generic Name:
Sildenafil Sitrate

What Is VIAGRA?
VIAGRA is a pill used to treat erectile dysfunction (impotence) in men. It can help many men who have erectile dysfunction get and keep an erection when they become sexually excited (stimulated). You will not get an erection just by taking this medicine. VIAGRA helps a man with erectile dysfunction get an erection only when he is sexually excited.
How VIAGRA Works:
In many men with erectile dysfunction, VIAGRA helps the body's natural erection process. When a man is sexually excited, the penis will fill with enough blood to cause an erection. After sex is over, the erection goes away.

VIAGRA Is Not for Everyone:


VIAGRA is only for patients with erectile dysfunction. VIAGRA is not for newborns, children, or women. Research is underway into the possible effectiveness of Viagra for Women, however until the results are known, we do not recommend the use of VIAGRA by women. Do not let anyone else take your VIAGRA. VIAGRA must be used only under a doctor's supervision.

VIAGRA must never be used by men who are taking any medicines that contain nitrates. Nitrates are found in many prescription medicines that are used to treat angina (chest pain due to heart disease) such as: nitroglycerin (sprays, ointments, skin patches or pastes, and tablets that are swallowed or dissolved in the mouth) isosorbide mononitrate and isosorbide dinitrate (tablets that are swallowed, chewed, or dissolved in the mouth)

Nitrates are also found in illicit drugs such as amyl nitrate or nitrite (\"poppers\"). If you are not sure if any of your medicines contain nitrates, or if you do not understand what nitrates are, ask your doctor or pharmacist. If you take VIAGRA with any nitrate medicine or illicit drug containing nitrates, your blood pressure could suddenly drop to an unsafe level. You could get dizzy, faint, or even have a heart attack or stroke.

What VIAGRA Does Not Do:


VIAGRA does not cure erectile dysfunction. It is a treatment for erectile dysfunction. VIAGRA does not protect you or your partner from getting sexually transmitted diseases, including HIV-the virus that causes AIDS. VIAGRA is not a hormone or an aphrodisiac.

Possible Side Effects:


Like all medicines, VIAGRA can cause some side effects. These effects are usually mild and do not last long. Some of these side effects are more likely to occur with higher doses. VIAGRA is generally well tolerated. Side effects are rare, but if experienced they are usually mild and temporary.

The following is a list of the most common side effects:
Headache, Flushing, Upset Stomach, Stuffy Nose, Urinary Tract Infection, Visual changes such as mild and temporary changes in blue/green colors or increased sensitivity to light, and Diarrhea.

Package:

6 tabs (100 mg/tab)

Description:


 Viagra works by increasing the effects of nitric oxide (NO), a substance that serves many key functions in biological processes throughout the body. One of the most well known and important functions of NO is the dilation of blood vessels. This allows greater blood flow to the muscles, which of course can be valuable to an athlete during competition.

What is more interesting to me is the role of NO on muscles during resistance training. JE Anderson found that NO appears to be a vital signal in the activation of muscle satellite cells in response to damage. Satellite cell activation is the key first step in the repair and hypertrophy of muscle cells after heavy training. Viagra may therefore enhance the hypertrophy response to exercise, working at the most basic and primary level of the process.

In addition to this, there is evidence that suggests that Viagra may work to amplify the "pump" response during training. The pump is thought to happen when contracting muscle fibers signal local vascular relaxation (increasing the blood flow to the working muscles). According to KS Lau and coworkers, NO generated by neuronal NO synthase in contracting skeletal muscle fibers may regulate vascular relaxation via a cGMP-mediated pathway. Since the mechanism of action for Viagra is amplification of the cGMP pathway, there is ample reason to believe that the drug may indeed affect the blood flow and pump to the muscle, and therefore indirectly aid in the hypertrophy response.

Common uses and directions for Viagra:
Normally nerves or blood vessels in men with male erectile dysfunction do not work properly, which prevents them from achieving an erection. Viagra works to restore the blood flow to the penis making it easier to achieve and sustain longer erections.
Viagra increases the blood flow to the penis by helping the arteries in the penis relax and expand. As the arteries in the penis expand and harden, veins that normally carry away blood flow to the penis are compressed resulting in an erection.
Viagra takes at least 30 minutes before it starts to work, and remains active for up to 4 hours. The erection goes away after intercourse.
Men who are currently using medicines that contain nitrates, such as nitroglycerin should not use Viagra because taken together they can lower the blood pressure too much. Viagra should not be used by women or children.

Common uses:


Viagra is used to treat erection difficulties, such as erectile dysfunction (ED).

Directions:


Viagra comes as a tablet containing 100 mg. sildenafil citrate, to take by mouth.
For most men, the recommended dose is 50 mg. taken, as needed, approximately 1 hour before sexual activity. However, sildenafil citrate may be taken anywhere from 4 hours to 0.5 hour before sexual activity. Based on effectiveness and toleration, the dose may be increased to a maximum recommended dose of 100 mg or decreased to 25 mg. The maximum recommended dosing frequency is once per day.

Precautions:


A starting dose of 25 mg. should be considered individuals of the age 65+ and in individuals with hepatic impairment or severe renal impairment.
Given the extent of the interaction with patients receiving concomitant therapy with ritonavir, it is recommended not to exceed a maximum single dose of 25 mg. of Viagra in any 48 hour period.
Sildenafil citrate potentiates the hypotensive effects of nitrates and its administration in patients who use nitric oxide donors or nitrates in any form is therefore contraindicated.
Treatments for erectile dysfunction, including Viagra, should not be generally used in men for whom sexual activity is inadvisable because of their underlying cardiovascular status.
Patients who have suffered a myocardial infarction, stroke, or life-threatening arrhythmia within the last 6 months, patients with resting hypotension or hypertension, patients with cardiac failure or coronary artery disease and patients with retinitis pigmentosa should use Viagra with great caution.
The safety of Viagra is unknown in patients with bleeding disorders and patients with active peptic ulceration.
Viagra should be used with caution by individuals with anatomical deformation of the penis and by individuals who have conditions which may predispose them to priapism.
The safety and efficacy of combinations of Viagra with other treatments for erectile dysfunction have not been studied. Therefore, the use of such combinations is not recommended.

Possible side effects:


The most frequently observed side effects of Viagra includes headache, flushing, dyspepsia and nasal congestion.
Less frequent side effects include erections that will not go away and vision changes. In the event that an erection persists longer than 4 hours, seek immediate medical assistance. Other less frequent side effects include urinary tract infection, abnormal vision, diarrhea, dizziness and rash.
If you notice other effects not listed above, contact your doctor.

Overdose:


If overdose of Viagra is suspected, contact your local poison control center or emergency room immediately.

Additional information
Keep Viagra in a tightly closed container and out of reach of children. Store Viagra at room temperature and away from excess heat and moisture (not in the bathroom).

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Vegah 100mg by Combitic

Vegah 100mg by Combitic

Product Description
Brand Name:
Vega / Vegah

Generic Name:
Sildenafil Sitrate (generic Viagra)

Sildenafil citrate, sold as Viagra, Revatio and under various other trade names, is a drug used to treat erectile dysfunction and pulmonary arterial hypertension (PAH). It was originally developed by British scientists and then brought to market by the US-based pharmaceutical company Pfizer. It acts by inhibiting cGMP-specific phosphodiesterase type 5 (PDE5), an enzyme that promotes degradation of cGMP, which regulates blood flow in the penis. Since becoming available in 1998, sildenafil has been the prime treatment for erectile dysfunction; its primary competitors on the market are tadalafil (Cialis) and vardenafil (Levitra).

Medical uses:
Sexual dysfunction:
The primary indication of sildenafil is treatment of erectile dysfunction (inability to sustain a satisfactory erection to complete intercourse). Its use is now standard treatment for erectile dysfunction in all settings, including diabetes.

People on antidepressants may experience sexual dysfunction, either as a result of their illness or as a result of their treatment. A 2003 study showed that sildenafil improved sexual function in men in this situation.Following up reports from 1999, the same researchers found that sildenafil improved sexual function in female patients on antidepressants as well.

Pulmonary hypertension:
As well as erectile dysfunction, sildenafil citrate is also effective in the rare disease pulmonary arterial hypertension (PAH). It relaxes the arterial wall, leading to decreased pulmonary arterial resistance and pressure. This, in turn, reduces the workload of the right ventricle of the heart and improves symptoms of right-sided heart failure. Because PDE5 is primarily distributed within the arterial wall smooth muscle of the lungs and penis, sildenafil acts selectively in both these areas without inducing vasodilation in other areas of the body. Pfizer submitted an additional registration for sildenafil to the United States Food and Drug Administration (FDA), and sildenafil was approved for this indication in June 2005. The preparation is named Revatio, to avoid confusion with Viagra, and the 20 milligram tablets are white and round. Sildenafil joins bosentan and prostacyclin-based therapies for this condition.

Altitude sickness:
Sildenafil has been shown to be useful for the prevention and treatment of high-altitude pulmonary edema associated with altitude sickness such as that suffered by mountain climbers.While this effect has only recently been discovered, sildenafil is already becoming an accepted treatment for this condition, in particular in situations where the standard treatment of rapid descent has been delayed for some reason.

Dosage:
Viagra pills are blue and diamond-shaped with the word "Pfizer" engraved on one side, and "VGR xx" (where xx stands for "25", "50" or "100", the dose of that pill in milligrams) engraved on the other. It is taken not more than once per day between 30 minutes and 4 hours prior to sexual intercourse.
The dosage for pulmonary arterial hypertension (Revatio) is three times a day. Revatio pills are white, round, film-coated tablets imprinted with "RVT 20" embossed on one side.

Adverse effects:
In clinical trials, the most common adverse effects of sildenafil use included headache, flushing, dyspepsia, nasal congestion and impaired vision, including photophobia and blurred vision. Some sildenafil users have complained of seeing everything tinted blue (cyanopsia). Some complained of blurriness and loss of peripheral vision. In July 2005, the FDA found that sildenafil could lead to vision impairment in rare cases and a number of studies have linked sildenafil use with nonarteritic anterior ischemic optic neuropathy.

Rare but serious adverse effects found through postmarketing surveillance include priapism, severe hypotension, myocardial infarction (heart attack), ventricular arrhythmias, stroke, increased intraocular pressure, and sudden hearing loss. As a result of these postmarketing reports, in October 2007, the FDA announced that the labeling for all PDE5 inhibitors, including sildenafil, required a more prominent warning of the potential risk of sudden hearing loss.

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Valium 10mg/2ml by Roche

Valium 10mg/2ml by Roche

Product Description
Diazepam Injection:
Each mL of this sterile injection contains 5 mg diazepam compounded with 40% propylene glycol, 10% alcohol, 5% sodium benzoate and benzoic acid as buffers, and 1.5% benzyl alcohol as preservative.

Diazepam is a benzodiazepine derivative. Chemically, diazepam is 7-chloro-1,3-dihydro-1-methyl-5-phenyl-2H-1,4-benzodiazepin-2-one. It is a colorless crystalline compound, insoluble in water and has a molecular weight of 284.74. The solution is clear, colorless to slightly yellow.

 Diazepam Injection - Clinical Pharmacology:

In animals, diazepam appears to act on parts of the limbic system, the thalamus and hypothalamus, and induces calming effects. Diazepam, unlike chlorpromazine and reserpine, has no demonstrable peripheral autonomic blocking action, nor does it produce extrapyramidal side effects; however, animals treated with diazepam do have a transient ataxia at higher doses. Diazepam was found to have transient cardiovascular depressor effects in dogs. Long-term experiments in rats revealed no disturbances of endocrine function. Injections into animals have produced localized irritation of tissue surrounding injection sites and some thickening of veins after intravenous use.

Usage in Pregnancy:
An increased risk of congenital malformations associated with the use of minor tranquilizers (diazepam, meprobamate, and chlordiazepoxide) during the first trimester of pregnancy has been suggested in several studies. Because use of these drugs is rarely a matter of urgency, their use during this period should almost always be avoided. The possibility that a woman of childbearing potential may be pregnant at the time of institution of therapy should be considered. Patients should be advised that if they become pregnant during therapy or intend to become pregnant they should communicate with their physicians about the desirability of discontinuing the drug.

In humans, measurable amounts of diazepam were found in maternal and cord blood, indicating placental transfer of the drug. Until additional information is available, Diazepam Injection is not recommended for obstetrical use.

Use in Children:

Efficacy and safety of parenteral diazepam has not been established in the neonate (30 days or less of age).

Prolonged central nervous system depression has been observed in neonates, apparently due to inability to biotransform diazepam into inactive metabolites.

In pediatric use, in order to obtain maximal clinical effect with the minimum amount of drug and thus to reduce the risk of hazardous side effects, such as apnea or prolonged periods of somnolence, it is recommended that the drug be given slowly over a three-minute period in a dosage not to exceed 0.25 mg/kg. After an interval of 15 to 30 minutes the initial dosage can be safely repeated. If, however, relief of symptoms is not obtained after a third administration, adjunctive therapy appropriate to the condition being treated is recommended.

Withdrawal symptoms of the barbiturate type have occurred after the discontinuation of benzodiazepines (see DRUG ABUSE AND DEPENDENCE section).

 Precautions:
Although seizures may be brought under control promptly, a significant proportion of patients experience a return to seizure activity, presumably due to the short-lived effect of diazepam after IV administration. The physician should be prepared to readminister the drug. However, diazepam is not recommended for maintenance, and once seizures are brought under control, consideration should be given to the administration of agents useful in longer term control of seizures.

If diazepam is to be combined with other psychotropic agents or anticonvulsant drugs, careful consideration should be given to the pharmacology of the agents to be employed, particularly with known compounds which may potentiate the action of diazepam, such as phenothiazines, narcotics, barbiturates, MAO inhibitors, and other antidepressants. In highly anxious patients with evidence of accompanying depression, particularly those who may have suicidal tendencies, protective measures may be necessary. The usual precautions in treating patients with impaired hepatic function should be observed. Metabolites of diazepam are excreted by the kidney; to avoid their excess accumulation, caution should be exercised in the administration to patients with compromised kidney function.

Since an increase in cough reflex and laryngospasm may occur with peroral endoscopic procedures, the use of a topical anesthetic agent, and the availability of necessary countermeasures are recommended.

Until additional information is available, Diazepam Injection is not recommended for obstetrical use.

Diazepam injection has produced hypotension or muscular weakness in some patients particularly when used with narcotics, barbiturates, or alcohol.

Lower doses (usually 2 mg to 5 mg) should be used for elderly and debilitated patients.

The clearance of diazepam and certain other benzodiazepines can be delayed in association with Tagamet® (cimetidine) administration. The clinical significance of this is unclear.

 Adverse Reactions:
Side effects most commonly reported were drowsiness, fatigue, and ataxia; venous thrombosis and phlebitis at the site of injection. Other adverse reactions less frequently reported include:

Central Nervous System: Confusion, depression, dysarthria, headache, hypoactivity, slurred speech, syncope, tremor, vertigo.

Gastrointestinal: Constipation, nausea.

Genitourinary: Incontinence, changes in libido, urinary retention.

Cardiovascular: Bradycardia, cardiovascular collapse, hypotension.

EENT: Blurred vision, diplopia, nystagmus.

Skin: Urticaria, skin rash.

Other:

Hiccups, changes in salivation, neutropenia, jaundice. Paradoxical reactions such as acute hyperexcited states, anxiety, hallucinations, increased muscle spasticity, insomnia, rage, sleep disturbances and stimulation have been reported; should these occur, use of the drug should be discontinued. Minor changes in EEG patterns, usually low-voltage fast activity, have been observed in patients during and after diazepam therapy and are of no known significance.

In peroral endoscopic procedures, coughing, depressed respiration, dyspnea, hyperventilation, laryngospasm, and pain in throat or chest have been reported.

Because of isolated reports of neutropenia and jaundice, periodic blood counts and liver function tests are advisable during long-term therapy.

Drug Abuse and Dependence:
Diazepam Injection is classified by the Drug Enforcement Administration as a schedule IV controlled substance.

Withdrawal symptoms, similar in character to those noted with barbiturates and alcohol (e.g., convulsions, tremor, abdominal and muscle cramps, vomiting and sweating), have occurred following abrupt discontinuance of diazepam. The more severe withdrawal symptoms have usually been limited to those patients who received excessive doses over an extended period of time. Generally milder withdrawal symptoms (e.g., dysphoria and insomnia) have been reported following abrupt discontinuance of benzodiazepines taken continuously at therapeutic levels for several months. Consequently, after extended therapy, abrupt discontinuation should generally be avoided and a gradual dosage tapering schedule followed. Addiction-prone individuals (such as drug addicts or alcoholics) should be under careful surveillance when receiving diazepam or other psychotropic agents because of the predisposition of such patients to habituation and dependence.



Diazepam Injection Dosage and Administration:
Dosage should be individualized for maximum beneficial effect. The usual recommended dose in older children and adults ranges from 2 mg to 20 mg IM or IV, depending on the indication and its severity. In some conditions, e.g., tetanus, larger doses may be required. (See dosage for specific indications.) In acute conditions the injection may be repeated within one hour although an interval of 3 to 4 hours is usually satisfactory. Lower doses (usually 2 mg to 5 mg) and slow increase in dosage should be used for elderly or debilitated patients and when other sedative drugs are administered. (See WARNINGS and ADVERSE REACTIONS.)

For dosage in infants above the age of 30 days and children, see the specific indications below. When intravenous use is indicated, facilities for respiratory assistance should be readily available.

Intramuscular: Diazepam Injection should be injected deeply into the muscle.

Intravenous Use:

(See WARNINGS, particularly for use in children.) The solution should be injected slowly, taking at least one minute for each 5 mg (1 mL) given. Do not use small veins, such as those on the dorsum of the hand or wrist. Extreme care should be taken to avoid intra-arterial administration or extravasation.

Do not mix or dilute diazepam with other solutions or drugs in syringe or infusion flask. If it is not feasible to administer diazepam directly IV, it may be injected slowly through the infusion tubing as close as possible to the vein insertion.

Once the acute symptomatology has been properly controlled with diazepam injection, the patient may be placed on oral therapy with diazepam if further treatment is required.

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.

This medication belongs to a class of drugs called benzodiazepines, which act on the brain and nerves (central nervous system) to produce a calming effect. It works by enhancing the effects of a certain natural chemical in the body (GABA) that causes calm.

How to use Valium inj:

This medication is given by injection into a vein or deep into a muscle as directed by your doctor. Giving the medication too fast can cause heart problems. If giving this medication into a vein, inject it slowly into a large vein because the medication is very irritating to the vein. Do not inject this medication into an artery or into the skin.

This medication may be available in a vial, ampule, pre-filled syringe, or pre-filled syringe with autoinjector. The autoinjector automatically delivers a dose of 10 milligrams deep into the muscle. It cannot be used when a lower dose is needed. Do not use the autoinjector for injecting into a vein.

Dosage is based on your medical condition and response to treatment. You will be closely monitored for several hours after receiving this medication. If your doctor orders you to continue to receive this medication, you should be switched to a form that can be taken by mouth as soon as possible.

If you are giving this medication to yourself at home, learn all preparation and usage instructions from your health care professional. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard medical supplies safely.

This medication may cause withdrawal reactions, especially if it has been used regularly for a long time or in high doses. In such cases, withdrawal symptoms (such as shakiness, trouble sleeping, muscle cramps, vomiting, sweating, seizures, mental/mood changes such as anxiety/agitation) may occur if you suddenly stop using this medication. To prevent withdrawal reactions, your doctor may reduce your dose gradually. Consult your doctor or pharmacist for more details, and report any withdrawal reactions immediately.

Rarely, abnormal drug-seeking behavior (addiction) is possible with this medication. Do not increase your dose, take it more frequently, or take it for a longer time than prescribed. Properly stop the medication when so directed.

When used for an extended time, this medication may not work as well and may require different dosing. Talk with your doctor if this medication stops working well.

Warnings:
When used intravenously, the following procedures should be undertaken to reduce the possibility of venous thrombosis, phlebitis, local irritation, swelling, and, rarely, vascular impairment; the solution should be injected slowly, taking at least one minute for each 5 mg (1 mL) given; do not use small veins, such as those on the dorsum of the hand or wrist; extreme care should be taken to avoid intra-arterial administration or extravasation.

Do not mix or dilute Diazepam Injection with other solutions or drugs in syringe or infusion flask. If it is not feasible to administer diazepam directly IV, it may be injected slowly through the infusion tubing as close as possible to the vein insertion.

Extreme care must be used in administering Diazepam Injection, particularly by the IV route, to the elderly, to very ill patients, and to those with limited pulmonary reserve because of the possibility that apnea and/or cardiac arrest may occur. Concomitant use of barbiturates, alcohol or other central nervous system depressants increases depression with increased risk of apnea. Resuscitative equipment including that necessary to support respiration should be readily available.

When diazepam is used with a narcotic analgesic, the dosage of the narcotic should be reduced by at least one-third and administered in small increments. In some cases the use of a narcotic may not be necessary.

Diazepam Injection should not be administered to patients in shock, coma, or in acute alcoholic intoxication with depression of vital signs. As is true of most CNS-acting drugs, patients receiving diazepam should be cautioned against engaging in hazardous occupations requiring complete mental alertness, such as operating machinery or driving a motor vehicle.

Tonic status epilepticus has been precipitated in patients treated with IV diazepam for petit mal status or petit mal variant status.

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