Description
Benzodiazepines (ben-zoe-dye-AZ-e-peens) belong to the group of medicines called central nervous system (CNS) depressants (medicines that slow down the nervous system).
Some benzodiazepines are used to relieve nervousness or tension. Others are used in the treatment of insomnia (trouble in sleeping). However, if used regularly (for example, every day) for insomnia, they are usually not effective for more than a few weeks.
One of the benzodiazepines, diazepam, is also used to help relax muscles or relieve muscle spasm. Another benzodiazepine, alprazolam, is also used in the treatment of panic disorder. Clonazepam, clorazepate, and diazepam are also used to treat certain convulsive (seizure) disorders, such as epilepsy. The benzodiazepines may also be used for other conditions as determined by your doctor.
Benzodiazepines should not be used for nervousness or tension caused by the stress of everyday life.
These medicines are available only with your doctor's prescription, in the following dosage forms:
Oral - Alprazolam
- Oral solution (U.S.)
- Tablets (U.S. and Canada)
- Bromazepam
- Chlordiazepoxide
- Capsules (U.S. and Canada)
- Tablets (U.S.)
- Clonazepam
- Tablets (U.S. and Canada)
- Clorazepate
- Capsules (U.S. and Canada)
- Tablets (U.S.)
- Diazepam
- Extended-release capsules (U.S.)
- Oral solution (U.S. and Canada)
- Tablets (U.S. and Canada)
- Estazolam
- Flurazepam
- Capsules (U.S. and Canada)
- Tablets (Canada)
- Halazepam
- Ketazolam
- Lorazepam
- Oral solution (U.S.)
- Tablets (U.S. and Canada)
- Sublingual tablets (Canada)
- Nitrazepam
- Oxazepam
- Capsules (U.S.)
- Tablets (U.S. and Canada)
- Prazepam
- Capsules (U.S.)
- Tablets (U.S.)
- Quazepam
- Temazepam
- Capsules (U.S. and Canada)
- Tablets (U.S.)
- Triazolam
- Tablets (U.S. and Canada)
Parenteral - Chlordiazepoxide
- Injection (U.S. and Canada)
- Diazepam
- Injection (U.S. and Canada)
- Lorazepam
- Injection (U.S. and Canada)
Rectal - Diazepam
- For rectal solution (U.S. and Canada)
Proper Use of This Medicine
For patients taking diazepam extended-release capsules:
- Swallow capsules whole.
- Do not crush, break, or chew the capsules before swallowing.
For patients taking lorazepam oral solution:
- Each dose may be diluted with water, soda or soda-like beverages, or semisolid food, such as applesauce or pudding.
For patients taking lorazepam sublingual tablets:
- Do not chew or swallow the tablet. This medicine is meant to be absorbed through the lining of the mouth. Place the tablet under your tongue (sublingual) and let it slowly dissolve there. Do not swallow for at least 2 minutes.
Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. If too much is taken, it may become habit-forming (causing mental or physical dependence).
If you think this medicine is not working properly after you have taken it for a few weeks, do not increase the dose. Instead, check with your doctor.
For patients taking this medicine for epilepsy or other seizure disorder:
- In order for this medicine to control your seizures, it must be taken every day in regularly spaced doses as ordered by your doctor. This is necessary to keep a constant amount of the medicine in the blood. To help keep the amount constant, do not miss any doses.
For patients taking this medicine for insomnia:
- Do not take this medicine when your schedule does not permit you to get a full night's sleep (7 to 8 hours). If you must wake up before this, you may continue to feel drowsy and may experience memory problems, because the effects of the medicine have not had time to wear off.
For patients taking flurazepam:
- When you begin to take this medicine, your sleeping problem will improve somewhat the first night. However, 2 or 3 nights may pass before you receive the full effects of this medicine.
Dosing—The dose of benzodiazepines will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of benzodiazepines. If your dose is different, do not change it unless your doctor tells you to do so.
The number of capsules or tablets, or the amount of solution that you take, or the number of injections you receive, depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are taking benzodiazepines.
For alprazolam - For oral dosage form (solution or tablets):
- For anxiety:
- Adults—At first, 0.25 to 0.5 milligrams (mg) three times a day. Your doctor may increase your dose if needed. However, the dose is usually not more than 4 mg a day.
- Children up to 18 years of age—Use and dose must be determined by your doctor.
- Older adults—At first, 0.25 mg two to three times a day. Your doctor may increase your dose if needed.
- For panic disorder:
- Adults—At first, 0.5 mg three times a day. Your doctor may increase your dose if needed. However, the dose is usually not more than 10 mg a day.
- Children up to 18 years of age—Use and dose must be determined by your doctor.
For bromazepam - For oral dosage form (tablets):
- For anxiety:
- Adults—6 to 30 milligrams (mg) a day, taken in smaller doses during the day.
- Children up to 18 years of age—Use and dose must be determined by your doctor.
- Older adults—At first, up to 3 mg a day. Your doctor may change your dose if needed.
For chlordiazepoxide - For oral dosage form (capsules or tablets):
- For anxiety:
- Adults—5 to 25 milligrams (mg) three or four times a day.
- Children 6 years of age and over—5 mg two to four times a day. Your doctor may increase your dose if needed.
- Children up to 6 years of age—Use and dose must be determined by your doctor.
- Older adults—At first, 5 mg two to four times a day. Your doctor may increase your dose if needed.
- For sedation during withdrawal from alcohol:
- Adults—At first, 50 to 100 mg, repeated if needed. However, the dose is usually not more than 400 mg a day.
- Children—Use and dose must be determined by your doctor.
- For injection dosage form:
- For anxiety:
- Adults—At first, 50 to 100 mg, injected into a muscle or vein. Then, if needed, 25 to 50 mg three or four times a day.
- Teenagers—25 to 50 mg, injected into a muscle or vein.
- Children up to 12 years of age—Use and dose must be determined by your doctor.
- Older adults—25 to 50 mg, injected into a muscle or vein.
- For sedation during withdrawal from alcohol:
- Adults—At first, 50 to 100 mg, injected into a muscle or vein. If needed, the dose may be repeated in two to four hours.
- Children—Use and dose must be determined by your doctor.
For clonazepam - For oral dosage form (tablets):
- For control of seizures:
- Adults—At first, 0.5 milligrams (mg) three times a day. Your doctor may increase your dose if needed. However, the dose is usually not more than 20 mg a day.
- Infants and children up to 10 years of age—Dose is based on weight and must be determined by your doctor.
For clorazepate - For oral dosage form (capsules or tablets):
- For anxiety:
- Adults and teenagers—7.5 to 15 milligrams (mg) two to four times a day. Or your doctor may want you to start by taking 15 mg at bedtime.
- Children up to 12 years of age—Use and dose must be determined by your doctor.
- Older adults—At first, 3.75 to 15 mg a day. Your doctor may increase your dose if needed.
- For sedation during withdrawal from alcohol:
- Adults and teenagers—At first, 30 mg. Your doctor will set up a schedule that will gradually reduce your dose.
- Children up to 12 years of age—Use and dose must be determined by your doctor.
- For control of seizures:
- Adults and teenagers—At first, up to 7.5 mg taken three times a day. Your doctor may increase your dose if needed. However, the dose is usually not more than 90 mg a day.
- Children 9 to 12 years of age—At first, 7.5 mg two times a day. Your doctor may increase your dose if needed. However, the dose is usually not more than 60 mg a day.
- Children up to 9 years of age—Use and dose must be determined by your doctor.
For diazepam - For oral dosage form (extended-release capsules):
- For anxiety:
- Adults—15 to 30 milligrams (mg) once a day.
- Children 6 months of age and over—15 mg once a day.
- Children up to 6 months of age—Use is not recommended.
- Older adults—15 mg once a day.
- For relaxing muscles:
- Adults—15 to 30 mg once a day.
- Children 6 months of age and over—15 mg once a day.
- Children up to 6 months of age—Use is not recommended.
- Older adults—15 mg once a day.
- For oral dosage form (solution or tablets):
- For anxiety:
- Adults—2 to 10 mg two to four times a day.
- Children 6 months of age and over—Dose is based on body weight or size and must be determined by your doctor.
- Children up to 6 months of age—Use is not recommended.
- Older adults—2 to 2.5 mg one or two times a day. Your doctor may increase your dose if needed.
- For sedation during withdrawal from alcohol:
- Adults—At first, 10 mg three or four times a day. Your doctor will set up a schedule that will gradually decrease your dose.
- Children—Use and dose must be determined by your doctor.
- For control of seizures:
- Adults—2 to 10 mg taken two to four times a day.
- Children 6 months of age and over—Dose is based on body weight or size and must be determined by your doctor.
- Children up to 6 months of age—Use is not recommended.
- Older adults—2 to 2.5 mg one or two times a day. Your doctor may increase your dose if needed.
- For relaxing muscles:
- Adults—2 to 10 mg three or four times a day.
- Children 6 months of age and over—Dose is based on body weight or size and must be determined by your doctor.
- Children up to 6 months of age—Use is not recommended.
- Older adults—2 to 2.5 mg one or two times a day. Your doctor may increase your dose if needed.
- For injection dosage form:
- For anxiety:
- Adults—2 to 10 mg, injected into a muscle or vein.
- Children—Use and dose must be determined by your doctor.
- For older adults—2 to 5 mg, injected into a muscle or vein.
- For sedation during withdrawal from alcohol:
- Adults—At first, 10 mg injected into a muscle or vein. If needed, 5 to 10 mg may be given three or four hours later.
- Children—Use and dose must be determined by your doctor.
- For sedation before surgery or other procedures:
- Adults—5 to 20 mg, injected into a muscle or vein.
- Children—Use and dose must be determined by your doctor.
- Older adults—2 to 5 mg, injected into a muscle or vein.
- For control of seizures:
- Adults—At first, 5 to 10 mg, usually injected into a vein. If needed, the dose may be repeated.
- Children 5 years of age and older—At first, 1 mg injected into a vein every two to five minutes. The dose may need to be repeated.
- Infants over 30 days of age and children up to 5 years of age—At first, 0.2 to 0.5 mg injected into a vein every two to five minutes. The dose may need to be repeated.
- Newborns and infants up to 30 days of age: Use and dose must be determined by your doctor.
- Older adults—2 to 5 mg, injected into a muscle or vein.
- For relaxing muscle spasms:
- Adults—At first, 5 to 10 mg injected into a muscle or vein. The dose may be repeated in three or four hours.
- Children: Use and dose must be determined by your doctor.
- Older adults—2 to 5 mg, injected into a muscle or vein.
- For relaxing muscles in tetanus:
- Adults—At first, 5 to 10 mg injected into a muscle or vein. Your doctor may increase your dose if needed.
- Children 5 years of age and older—5 to 10 mg, injected into a muscle or vein. The dose may be repeated every three to four hours if needed.
- Infants over 30 days of age and children up to 5 years of age—1 to 2 mg, injected into a muscle or vein. The dose may be repeated every three to four hours if needed.
- Newborns and infants up to 30 days of age: Use and dose must be determined by your doctor.
- For rectal dosage form (solution):
- For control of seizures:
- Adults and teenagers—Dose is based on body weight and must be determined by your doctor.
- Children—Dose is based on body weight and must be determined by your doctor.
For estazolam - For oral dosage form (tablets):
- For trouble in sleeping:
- Adults—1 milligram (mg) at bedtime.
- Children up to 18 years of age—Use and dose must be determined by your doctor.
For flurazepam - For oral dosage form (capsules or tablets):
- For trouble in sleeping:
- Adults—15 or 30 milligrams (mg) at bedtime.
- Children up to 15 years of age—Use and dose must be determined by your doctor.
- Older adults—At first, 15 mg at bedtime. Your doctor may increase your dose if needed.
For halazepam - For oral dosage form (tablets):
- For anxiety:
- Adults—20 to 40 milligrams (mg) three or four times a day.
- Children up to 18 years of age—Use and dose must be determined by your doctor.
- Older adults—20 mg one or two times a day.
For ketazolam - For oral dosage form (capsules):
- For anxiety:
- Adults—15 milligrams (mg) one or two times a day. Your doctor may increase your dose if needed.
- Children up to 18 years of age—Use and dose must be determined by your doctor.
- Infants—Use is not recommended.
- Older adults—15 mg once a day.
For lorazepam - For oral dosage form (solution or tablets):
- For anxiety:
- Adults—1 to 3 milligrams (mg) two or three times a day.
- Children up to 12 years of age—Use and dose must be determined by your doctor.
- Older adults—0.5 to 2 mg a day, taken in smaller doses during the day.
- For trouble in sleeping:
- Adults—2 to 4 mg taken at bedtime.
- Children up to 12 years of age—Use and dose must be determined by your doctor.
- For sublingual tablet dosage form:
- For anxiety:
- Adults—2 to 3 mg a day, in smaller doses placed under the tongue during the day. Your doctor may increase your dose if needed. However, the dose is usually not more than 6 mg a day.
- Children 6 to 18 years of age—Use and dose must be determined by your doctor.
- Children up to 6 years of age—Use is not recommended.
- Older adults—At first, 0.5 mg a day. Your doctor may increase your dose if needed.
- For sedation before surgery:
- Adults—Dose is based on body weight and is usually 0.05 mg per kilogram (0.023 mg per pound) of body weight, placed under the tongue, one to two hours before surgery. The dose is usually not more than 4 mg.
- Children—Use and dose must be determined by your doctor.
- For injection dosage form:
- For sedation before surgery or other procedures:
- Adults—Dose is based on body weight and will be determined by your doctor. However, the dose is usually not more than 4 mg, injected into a muscle or vein.
- Children up to 18 years of age—Use and dose must be determined by your doctor.
For nitrazepam - For oral dosage form (tablets):
- For trouble in sleeping:
- Adults—5 to 10 milligrams (mg) at bedtime.
- Children—Use and dose must be determined by your doctor.
- Older adults—At first, 2.5 mg taken at bedtime. Your doctor may increase your dose if needed.
- For control of seizures:
- Children up to 30 kilograms (66 pounds) of body weight—Dose is based on body weight and is usually 0.3 to 1 mg per kilogram (0.14 to 0.45 mg per pound) of body weight per day, taken in smaller doses three times during the day. Your doctor may increase your dose if needed.
For oxazepam - For oral dosage form (capsules or tablets):
- For anxiety:
- Adults—10 to 30 milligrams (mg) three or four times a day.
- Children 6 to 12 years of age—Use and dose must be determined by your doctor.
- Children up to 6 years of age—Use is not recommended.
- Older adults—At first, 10 mg three times a day. Your doctor may increase your dose if needed. However, the dose is usually not more than 15 mg taken four times a day.
- For sedation during withdrawal from alcohol:
- Adults—15 to 30 mg three or four times a day.
- Children—Use and dose must be determined by your doctor.
For prazepam - For oral dosage form (capsules or tablets):
- For anxiety:
- Adults—10 milligrams (mg) three times a day, or 20 to 40 mg taken at bedtime.
- Children—Use and dose must be determined by your doctor.
- Older adults—At first, 10 to 15 mg a day, taken in smaller doses during the day. Your doctor may increase your dose if needed.
For quazepam - For oral dosage form (tablets):
- For trouble in sleeping:
- Adults—7.5 to 15 milligrams (mg) taken at bedtime.
- Children up to 18 years of age—Use and dose must be determined by your doctor.
For temazepam - For oral dosage form (capsules or tablets):
- For trouble in sleeping:
- Adults—15 milligrams (mg) taken at bedtime.
- Children up to 18 years of age—Use and dose must be determined by your doctor.
- Older adults—At first, 7.5 mg at bedtime. Your doctor may increase your dose if needed.
For triazolam - For oral dosage form (tablets):
- For trouble in sleeping:
- Adults—125 to 250 micrograms (mcg) taken at bedtime.
- Children up to 18 years of age—Use and dose must be determined by your doctor.
- Older adults—At first, 125 mcg at bedtime. Your doctor may increase your dose if needed.
Missed dose—If you are taking this medicine regularly (for example, every day as for epilepsy) and you miss a dose, take it right away if you remember within an hour or so of the missed dose. However, if you do not remember until later, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Storage—To store this medicine:
- Keep out of the reach of children. Overdose of benzodiazepines may be especially dangerous in children.
- Store away from heat and direct light.
- Do not store the capsule or tablet form of this medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
- Keep the liquid form of this medicine from freezing.
- Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.
Side Effects of This Medicine
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
Less common or rare
Behavior problems, including difficulty in concentrating and outbursts of anger; confusion or mental depression; convulsions (seizures); hallucinations (seeing, hearing, or feeling things that are not there); hypotension (low blood pressure); impaired memory—may be more common with triazolam; muscle weakness; skin rash or itching; sore throat, fever, and chills; trouble in sleeping; ulcers or sores in mouth or throat (continuing); uncontrolled movements of body, including the eyes; unusual bleeding or bruising; unusual excitement, nervousness, or irritability; unusual tiredness or weakness (severe); yellow eyes or skin
Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:
Not all of the side effects listed above have been reported for each of these medicines, but they have been reported for at least one of them. All of the benzodiazepines are similar, so any of the above side effects may occur with any of these medicines.
For patients having chlordiazepoxide, diazepam, or lorazepam injected:
- Check with your doctor if there is redness, swelling, or pain at the place of injection.
After you stop using this medicine, your body may need time to adjust. If you took this medicine in high doses or for a long time, this may take up to 3 weeks. During this period of time check with your doctor if you notice any of the following side effects:
Less common
Abdominal or stomach cramps; confusion; fast or pounding heartbeat; increased sense of hearing; increased sensitivity to touch and pain; increased sweating; loss of sense of reality; mental depression; muscle cramps; nausea or vomiting; sensitivity of eyes to light; tingling, burning, or prickly sensations; trembling
Rare
Confusion as to time, place, or person; convulsions (seizures); feelings of suspicion or distrust; hallucinations (seeing, hearing, or feeling things that are not there)
Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.
Revised: 08/04/92
Interim revision: 08/17/94
Note: The information contained herein has been devised without reference to cultural, dietary, societal, language, prescribing or dispensing conditions (including those imposed by law), other than those of the United States, which might affect the information provided. Information is for your personal use only and may not be sold or redistributed. Copyright ® 2001 Micromedex, Inc. All rights reserved. USPDI® and Advice for the Patient? are registered trademarks USP used under license to Micromedex, Inc. Patient Education Leaflets is a trademark of Micromedex, Inc.
