Does diazepam lower blood pressure
Table of Contents
Does diazepam lower blood pressure?
Does diazepam lower blood pressure is an important question, you will find the answer by reading this topic.
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What is blood pressure?
Blood pressure is the pressure force blood in the circulatory system to deliver nutrient and oxygen to tissues and organs, not only that role but to remove toxic waste products pf metabolism including carbon dioxide that exhale with every breath and toxin that clear through liver and kidney.
What is the normal range of blood pressure?
The normal blood pressure range should be less than 120 systolic pressure, 80 diastolic pressure, regardless of your age you need to keep your pressure at this level.
How to measure blood pressure?
- A sphygmomanometer is a device we use to measure blood pressure, it consists of a rubber armband-the cuff that is inflated by hand, inflated until no blood can flow. Then the air is let out.
- The reading is expressed in terms of millimeters of mercury, abbreviated to mmHg.
How to keep your blood pressure under control and healthy?
There are few tips to keep your blood pressure under control without medication:
- Weight loss is one of the most effective lifestyle modifications to control your blood pressure.
- Physical activity and regular exercise: 30 minutes per day can lower blood pressure by about 5-8 mm Hg.
Example of aerobic exercise that helps you:
- Walking
- Cycling
- Swimming
- Jogging
- Dancing
- Eat a healthy diet: diet rich in fruits, vegetables, whole grains, and low-fat dairy products and skimps on saturated fat and cholesterol.
- Reduce sodium in your diet: small reduction in sodium in your diet has a great effect in reducing your elevated blood pressure.
- Limit alcohol intake
- Quit smoking: Quitting smoking can reduce your risk of heart disease and improve your overall health.
- Reduce your stress: avoiding stress triggers and make time to relax will help you.
- Regularly monitor your blood pressure and visit your doctor if you cannot control it.
- Cut back on caffeine: effect of caffeine on elevated blood pressure does not clear till now, talk to your doctor about the effect of caffeine on your blood pressure.
What is diazepam?
Diazepam: is a medicine of the benzodiazepines family, commonly used for treating the following condition:
- Anxiety disorder
- Muscle spasm
- Alcohol withdrawal symptom
- Insomnia
- Restless leg syndrome
- Seizures
How can you take diazepam?
You can take diazepam by:
- Mouth
- inserted to the rectum.
- Injected into muscle.
- Injected into a vein.
- Nasal spray
Warning and precautions:
- An allergic reaction may occur when using diazepam, this reaction includes swelling of lips, tongue, and face.
- Respiratory depression especially when used with opioids.
- Sedation: you must be cautioned about performing a task that requires mental alertness (e.g., driving, operating machinery).
- Hepatic impairment: oral tablet is contraindicated in patients with severe hepatic impairments.
- Renal impairment: Use with caution.
- Glaucoma
- Abuse, misuse may lead to physical dependence.
Side effect:
- Diarrhea
- Muscle weakness.
- Respiratory depression.
- Urinary retention.
- Blurred vision.
- Abdominal pain.
- Change in salivation.
Drug-drug interaction:
Many medications may affect the efficacy of diazepam if it is used concomitant with diazepam.
Effect of diazepam may decrease by:
- Tocilizumab
- Theophylline derivatives.
Drugs should be avoided in concomitant use with diazepam:
- Fusidic acid (systemic).
- Metronidazole (systemic).
Does diazepam lower blood pressure?
Does diazepam lower blood pressure is a good question, as it is known that benzodiazepine has a hypotensive effect.
What is hypotension?
It is a drop in blood pressure, may cause the following symptom:
- Clammy skin.
- Blurred vision.
Many studies have shown that there was a significant decrease in systolic blood pressure after the administration of diazepam.
But the mechanism is still not known.
One of these studies answered the question does diazepam lower blood pressure?
A total of 30 subjects were included in the analysis of this study, and Aim was to assess the effects of evening chronic administration of diazepam on 24-hour blood pressure and heart rate in healthy young adults.
By the end of the study, the results show that there was a significant reduction in systolic blood pressure, were observed in the morning hours.
Things must not do when you take diazepam:
- Do not drive or operate machinery until you know how diazepam affects you.
- Do not take diazepam for a longer time than your doctor has prescribed.
- Do not stop taking diazepam or lower the dose without first checking your doctor.
- Do not suddenly stop taking diazepam if you suffer from a seizure.
- Do not give diazepam to anyone else even if their symptoms seem like yours.
- Be careful if you are elderly, drinking alcohol, or taking other medications.
Diazepam and pregnancy
Table of Contents
Diazepam and pregnancy
Diazepam and pregnancy is a very important topic, we will try here to illustrate the risk of using diazepam during pregnancy, and give you more information about it
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What is diazepam?
Diazepam is a benzodiazepine drug, used as an anti-anxiety medication, to treat muscle spasms and fits (seizure) in combination with other anti-seizure drugs. Diazepam and
Also, there is off-label use in treating insomnia, a symptom of alcohol withdrawal.
Diazepam is found in different forms: tablets, liquid, rectal gels, injection: intravenous injection, and intramuscular.
Precautions:
- Abuse, misuse, and addiction: the continued use of diazepam for several weeks may lead to physical dependence.
- Sedation and respiratory depression when concomitant use with opioids.
- The hepatic disorder is considered a contraindication for using diazepam.
- Renal impairment needs caution for use.
Adverse reactions:
- Drowsiness
- Hypotension
- Abdominal pain
- Diarrhea
- Agitation
- Dizziness
- Asthma
- Nasal congestion
- Pruritus
- Urinary tract infection
- Neutropenia
- Mydriasis
- Hyperkinetic muscle activity
- Cough
- Ataxia
- Skin rash
- Muscle weakness
- Urinary retention
- Incontinence ( inability to control urination or defecation)
- Change in salivation
- Fatigue
- Dysarthria
- Jaundice
- Thrombophlebitis
- Tissue necrosis
- Carpal tunnel syndrome
What should I need to monitor during the use of diazepam?
- Heart rate
- Respiratory rate
- Blood pressure
- Mental status
- Liver enzyme
- CBC
- Serum creatinine
- You shouldn’t use diazepam if you have an allergy to benzodiazepine (a pharmacological group that diazepam belongs to).
Will using another medication affect diazepam efficacy?
- Concomitant use of another medication may have a great effect on diazepam, that’s why there is a list of medication should be avoided during using diazepam
- Abametapir
- Azelastine
- Bromperidol
- Conivaptan
- Fusidic acid ( systemic)
- Metronidazole(systemic)
- Olanzapine
- Orphenadrine
- Thalidomide
- Oxomemazine
Another list of medications may decrease the diazepam effect
- Dabrafenib
- Deferasirox
- Enzalutamide
- Erdafitinib
- Ombitasvir
- Ritonavir
- Theophylline derivatives
- Tocilizumab
List of medication increase diazepam effect:
- Conivaptan
- Bromopride
- Disulfiram
- Metronidazole
- Ritonavir
- Magnesium sulfate
- Melatonin
Special population:
- Elderly: The effect of diazepam is extended in an elderly patient, that’s required the use of the smallest effective dose and increased gradually as tolerated to avoid undesirable side effects.
- Obese: benzodiazepine in an obese patient may have prolonged action.
- Psychotic: not recommended in place of appropriate therapy.
- Pediatric: can be used in a specified dose.
- Breastfeeding: sedation and weight loss have been observed in infants exposed to diazepam through breast milk.
Diazepam and pregnancy
Although the safety of diazepam in pregnant women hasn’t been established, It should not be used in the first and third trimesters.
Floppy infant syndrome can occur if the product is administered during the late phase of pregnancy or labor at high doses.
Floppy infant syndrome is hypotonia (low muscle tone), sluggishness, and trouble latching on feed.
Teratogenic effects have been observed however there’s a need for additional studies
- Infant risk may include :
- Premature birth
- Low birth weight
- Hypoglycemia
- Respiratory problem
- Smaller head circumference
- Cleft lip
- Cleft palate
Any pregnant woman should talk to her healthcare provider before stopping or changing the dose. A sudden stop of diazepam may cause withdrawal symptoms, which may include:
- Headache
- Nausea
- Vomiting
- Stomach pain
- Cramps
- Tremors
- Increase blood pressure
- Increase heart rate
- Confusion
- Seizure
- Mood swings
- Depression
- Panic attack
- Rebound anxiety
- Drug craving
Gradually decreasing the dose till stopping diazepam under medical supervision is a good way to minimize any adverse effect that may occur
What is the withdrawal symptom in the infant after delivery?
After delivery, withdrawal symptoms may occur spontaneously or after several days, that symptoms may include :
- Breathing problem
- Jitteriness
- Excessive crying
- Trouble maintaining body temperature
- Floppy infant syndrome
- Sleeping problem
- Seizures
- Stuffy nose
- Sneezing
- Poor feeding
- Vomiting
- Diarrhea
- Dehydration
- Sweating
- Yawing
All these symptoms may be required to stay in hospital for monitoring, and by several weeks all symptoms disappear.
After all that, there is no data said that there is a long term effect on behavior by using diazepam during pregnancy
Diazepam and breastfeeding
It is not recommended to take diazepam during breastfeeding, as diazepam and its metabolites are present in breast milk. Due to the long half-life of diazepam, it accumulates in the breastfed infant. Infants should be closely monitored for drowsiness, decreased feeding, and poor weight gain.
Overdose of diazepam
If you accidentally take an overdose you need to call your doctor immediately.
Sign and symptoms of overdose
- poor coordination or trouble speaking
- feeling sleepy
- a slow or irregular heartbeat
- uncontrolled eye movements
- muscle weakness
- feeling overexcited
to make sure it is safe for you to start diazepam, talk to your health care provider if you have any of the following condition
- have an allergic reaction to diazepam
- muscle weakness conditions like myasthenia gravis
- breathing problem conditions like sleep apnea
- having depression or other behavioral condition
- have a problem related to alcohol or drug abuse
- age over 65
- have general anesthesia for an operation
- severe liver disease
- have kidney problem
- have arteriosclerosis
- have narrow-angle glaucoma
- seizures
Diazepam and Propranolol
Table of Contents
Diazepam and Propranolol
Diazepam and propranolol are two different drugs that can be used for the same purpose which is treating anxiety.
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They are also used for other reasons.
Diazepam and propranolol can be used individually and in combination with each other.
Using them in combination increases the effect of diazepam being more effective in treating anxiety than diazepam on its own.
So, let’s get to know diazepam and propranolol.
Family, uses, and indications:
Propranolol is from a drug family called beta-blockers, which are usually used to treat hypertension (high blood pressure) and heart problems, and used off-label in treating anxiety, and diazepam belongs to a drug family called benzodiazepines, a family used to treat anxiety.
So, diazepam and propranolol are common in treating anxiety.
Propranolol and beta-blockers are used for the physical symptoms (symptoms occurring to the body) of anxiety-like fast heart rate, chest tightness, and sweating, they are not related to the psychological and emotional symptoms like worrying and stress feeling.
Diazepam and benzodiazepines cause sedation, but they can be taken during acute bouts of anxiety and panic attacks, relieving stress and worry.
How do diazepam and propranolol work?
Beta-blockers and propranolol block certain neurotransmitters called epinephrine and norepinephrine, which help in dilating blood vessels, and decreasing heart rate and blood pressure.
Benzodiazepines and diazepam work by enhancing the activity of certain neurotransmitters called GABA (Gama Amino-butyric acid) that produces a calming effect on the brain and nerves.
Side effects:
There are common side effects between diazepam and propranolol and uncommon ones.
Common side effects are diarrhea, rash, blurred vision, diplopia (double vision), insomnia (sleeping problem), muscle spasms and stiffness, and fatigue.
The uncommon side effects of propranolol different from diazepam are stomach cramps, nausea, vomiting, disorientation (loss of sense of direction), hair loss, weakness, sexual dysfunction.
Uncommon side effects of diazepam different from propranolol are drowsiness, euphoria (intense excitement and happiness), loss of balance, excitability due to paradoxical reactions, rage, confusion, and speech problems.
Withdrawal symptoms:
Diazepam and propranolol are common in another aspect, both of them should not be stopped suddenly, they must be withdrawn gradually or they may cause withdrawal symptoms.
Propranolol may cause withdrawal symptoms like heart attacks, worsened chest pain (angina), serious abnormal rhythm of the heart, or even sudden death.
Diazepam may also cause withdrawal symptoms, especially after long use, like insomnia, headaches, nausea, vomiting, lightheadedness, sweating, anxiety, fatigue, and seizures.
Warning: Diazepam may cause dependency and addiction, especially when using high doses for a long duration, also a trigger effect when you have a history of abuse or addiction to any drugs or alcohol.
Drug-drug interactions with diazepam and propranolol:
Propranolol interactions
- Propranolol with thioridazine or chlorpromazine may cause a decrease in blood pressure (hypotension) and abnormal rhythms of the heart because they interfere with the elimination of propranolol and increase the concentration of the drug in the blood.
- Combination with clonidine may cause a dangerous increase in blood pressure, that’s why close monitoring should be done after the starting or stopping of the concurrent use of clonidine and propranolol, as stopping them suddenly may also cause an increase in blood pressure.
- Phenobarbital and similarities increase the breaking and blood levels of propranolol which may reduce the effectiveness of the drug.
- Aspirin and NSAIDs (Non-steroidal anti-inflammatory drugs) may reduce the effects of propranolol by reducing the effects of prostaglandins that help in controlling the blood pressure.
- Propranolol elongates hypoglycemia (low blood sugar) and masks the symptoms in diabetic patients.
Diazepam interactions
- CNS (Central Nervous System) depressants that cause sedation to increase the sedative effects of diazepam, alcohol can cause the same effects.
- Drugs that inhibit the liver enzymes responsible for eliminating diazepam and causing prolongation of their effects, their doses may be decreased if concomitantly used like:
- cimetidine
- ketoconazole
- itraconazole
- omeprazole
- erythromycin
- clarithromycin
- darunavir
- fluvoxamine
- fluoxetine
- On the opposite, drugs increasing the elimination of diazepam by liver enzymes and decreasing the levels of diazepam, like carbamazepine, rifampin, and St. John’s wort.
Warnings and precautions:
- Before taking propranolol, you have to tell your doctor if you have:
- Asthma
- Bradycardia (very slow heartbeats)
- Sick sinus syndrome (a serious heart condition) or another heart problem called AV block (a condition that needs a pacemaker)
- Muscle disorder
- Breathing problems like bronchitis or emphysema
- Diabetes or low blood pressure
- Congestive heart failure
- Depression
- Liver or kidney problems
- A thyroid disorder
- A condition caused by a tumor of the adrenal gland called pheochromocytoma
- Raynaud’s syndrome (circulation problem)
Before taking diazepam, you have to tell your doctor if you have:
- Myasthenia gravis (a condition causing weakness of muscles)
- A severe breathing problem
- Sleep apnea (breathing stops for a short period during sleep)
- Eye problems like narrow-angle glaucoma or uncontrolled open-angle glaucoma
- Severe liver diseases
The combination between diazepam and propranolol may be effective due to increasing the medical effects of diazepam but also should be taken with care as the side effects also may increase.
Omeprazole and Diazepam
Table of Contents
Omeprazole and Diazepam
Omeprazole and diazepam are two completely different drugs, with different uses, and mechanisms of action.
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So, what happens when combining omeprazole and diazepam?
First, we have to understand the nature of both drugs.
Omeprazole is a proton pump inhibitor drug, a family of drugs that help to reduce the production of acid in the stomach.
Acid is responsible for ulcers in the esophagus, stomach, and duodenum.
Decreasing the acid prevents the formation of ulcers, and if they are already formed, they help in their healing.
Omeprazole also helps in relieving acid reflux, heartburn, swallowing difficulties, and persistent cough.
It is available in many dosage forms, packets, suspension, delayed-release tablets, delayed-release capsules, and orally disintegrating tablets, with many concentrations.
It takes from 1 to 4 days to work and has a full effect.
Omeprazole can be used as an over-the-counter drug, that’s why you have to read the package instructions carefully, and don’t take it for more than 14 days unless you reviewed the case with a doctor.
It can be taken concomitantly with antacids like sucralfate.
Side effects:
Common side effects
- Headache
- Abdominal pain
- Diarrhea
- Nausea
- Vomiting
- Flatulence
- Dizziness
- Upper respiratory infection
- Acid regurgitation
- Constipation
- Rash
- Cough
Less common side effects
- Fracture of bone because of it increases the chance of osteoporosis
- Hepatotoxicity
- Agranulocytosis (life-threatening medical condition concluding low white blood cells)
- Anorexia (eating disorder related to a mental health condition)
- Gastric polyps (abnormal growth of the stomach lining)
- Hip fracture
- Alopecia (hair loss)
- Atrophic gastritis (inflammation of the gastric mucosa)
- Interstitial nephritis (kidney problem)
- Pancreatitis (inflammation in the pancreas)
- Rhabdomyolysis (a serious medical condition caused by muscle injury)
- Metallic taste
- Abnormal dreams
- Toxic epidermal necrolysis (a very serious and rare skin condition)
Warnings:
- Omeprazole may cause a serious hypersensitivity reaction, take care of any signs of hives, blisters, and swelling of the face, lips, and tongue.
- Omeprazole and proton pump inhibitors family may cause a serious condition of diarrhea called CDAD
- If you are suffering from liver disease, you will need to decrease the dosage.
- Omeprazole was proven to cause carcinoid tumors with increased doses in rats, but this condition was not confirmed in humans.
- It may decrease the activity of Clopidogrel (a drug used to prevent blood clots).
Pregnancy:
While the woman is pregnant, it is always better to treat any conditions like indigestion without using drugs.
Indigestion can be managed by eating smaller meals and avoid spicy and fatty meals.
However, omeprazole can be taken safely in pregnancy.
Breastfeeding:
Omeprazole is known to be secreted in mother’s milk in small amounts, however, it is safe to be taken while breastfeeding.
Back to the relation between omeprazole and diazepam, let’s now talk about diazepam.
Diazepam is a member of the benzodiazepines family.
Benzodiazepines are drugs slowing down the messages between the brain and body, they are also minor tranquilizers.
Diazepam is used in treating anxiety, alcohol withdrawal symptoms, seizures, relaxation of muscle spasms, and to induce sedation before surgeries and dental procedures.
It is available in many dosage forms, tablets, oral solutions, rectal gels, injectable solutions, and intramuscular devices.
Side effects:
Happens in 1 – 10% of patients
- Ataxia (disorder causing symptoms similar to those when you are drunk, problems with balance, speech, and coordination)
- Euphoria (extensive excitement and happiness)
- Incoordination
- Somnolence (drowsiness and sleepiness)
- Rash
- Diarrhea
Common side effects
- Hypotension
- Fatigue
- Muscle weakness
- Respiratory depression
- Urinary retention
- Depression
- Incontinence (inability to control urination and defecation)
- Blurred vision
- Headache
- Changes in salivation
- Muscles responsible for speech are damaged
Warnings:
Opioids are a group of drugs widely known for pain-relieving, like morphine which is naturally produced from the poppy plant, and fentanyl which is synthesized in a laboratory.
A combination of diazepam and opioids is very dangerous, that may result in profound sedation, respiratory depression, coma, and death.
- FDA (Food and drug administration) addressed that benzodiazepines may cause serious addiction, abuse, and misuse.
These may result in overdosing and death.
- Diazepam should not be stopped suddenly, if so, irritating and maybe even life-threatening withdrawal symptoms.
Withdrawal symptoms:
- Tremors
- Anxiety
- Confusion
- Seizures
The withdrawal period may last from 3 to 4 weeks.
- Diazepam using may disable your ability to drive and to perform hazardous activities, you should not do any of them before understanding how your body will react to the drug.
Pregnancy:
Diazepam pregnancy category: D
It should only be used in life-threatening conditions when no other alternative is available.
Breastfeeding:
Diazepam is secreted in human milk and may cause harm to the baby.
It should not be used during lactation, alternative drugs or feeding options may be recommended.
Omeprazole and diazepam should be used together with extreme care, omeprazole may increase the concentration of diazepam in blood, which may cause an increase in the side effects caused by diazepam.
Using them together may need a dose adjustment or monitoring by your medical health provider.
A combination of drugs may be dangerous, need close monitoring, or mildly interacted, always tell your doctor about the drugs you are taking before taking another one.
Diazepam and Asthma
Table of Contents
Diazepam and Asthma
Diazepam and asthma can be discussed from two points of view,
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one is the use of Diazepam in respiratory failure associated with Status Asthmaticus who need mechanical ventilation, the other point is that Diazepam and Asthma should be used with extreme caution as it may lead to apnea or cardiac arrest.
But first, before the discussion of the relationship between diazepam and asthma, we have to know about diazepam and asthma.
Asthma is a medical condition where the airways are narrow, swell, and produce extra mucus, which can cause breathing difficulties, triggering cough, and wheezing when breathing.
For some patients, Asthma may be a minor problem, and for others, it is a major problem, which interferes with the quality of life, and can lead to asthmatic attacks which can be life-threatening.
Asthma is a chronic medical condition that has no cure but can be controlled.
Symptoms:
Symptoms of Asthma differ from one patient to another.
They include,
- Short or shallow breathing
- Tightness or pain in the chest
- Wheezing with exhalation, which is especially common in children
- Shortness of breath, coughing, and wheezing can also interfere with your sleeping
- Cold and Flu worsens the coughing and wheezing attacks
Signs of worsened Asthma:
- More frequent signs and symptoms
- Breathing difficulties increase
- The use of a quick-relief inhaler is more frequent
Factors worsening Asthma:
- It may be worsened by exercise
- It may be increased by chemical fumes, gases, and dust
- It also may be increased by allergens like pollen grains, mold spores, cockroach wastes, and others
Asthma attacks can be deadly, always monitor your symptoms with your doctor to control the symptoms and avoid the worsening of them.
How about Diazepam?
Diazepam is one of the benzodiazepines family, that works by inducing the effect of some neurotransmitters in the brain which produces a calming effect.
It is used in treating anxiety disorders, alcohol withdrawal symptoms, muscle spasms and stiffness, and as adjunctive therapy in treating seizures.
It is also used in inducing sedation before having surgery or having an endoscopy.
According to our first point of view about Diazepam and Asthma, Diazepam is used in inducing sedation in the ICU (Intensive Care Unit) to put the patient on mechanical ventilation to treat the respiratory failure associated with Status Asthmaticus to help to restore ventilation and gas exchange.
Diazepam is given by a dosage of 0.2 – 0.3 mg/Kg every 1 – 3 hours.
Dosing and administration:
Diazepam is available in many dosage forms, tablets, oral solutions, rectal gels, injectable solutions, and intramuscular devices.
Oral solutions are only taken with the calibrated dropper coming with the drug, or with any special measuring device.
Don’t use the household spoons to avoid incorrect dosing.
If you are going to use the injectable methods, inspect the product for particulates, and for change in color before administration.
If you are using the intravenous injection, ensure there are facilities to assist respiration if needed.
Don’t use the small veins found in the hand or wrist, and inject it slowly for 1 minute for each 5 mg.
Storage:
When using the oral solution, throw the bottle after 90 days of opening.
Store it away from light.
Store it at a temperature between 68 and 77 degrees F.
Contraindications and precautions:
- If you experienced extreme hypersensitivity to diazepam or other benzodiazepines.
- When using the intravenous method, inject it very slowly, and don’t use small veins, to avoid venous thrombosis (a blood clot in the vein), phlebitis (inflammation of the vein), and irritation at the site of injection.
- Diazepam may cause depression and suicidal thoughts, if they already exist, they may be worsened by the use of diazepam, and so, you have to be monitored carefully if you are going to use diazepam or other anti-epileptic drugs.
- The doctor prescribes the smallest dose effective to reduce the risk of side effects and overdose.
- Activities requiring mental alertness should not be done when using drugs causing CNS (Central Nervous System) depression without understanding the effect of the drug on your mental alertness, activities like operating heavy machinery, and driving, as this may lead to bad falls, and dangerous accidents.
- Using diazepam with other CNS depressants such as opioids may cause severe side effects like profound sedation (unconsciousness where the patient can’t be awakened easily), respiratory depression, coma, and death.
The other point of view of Diazepam and Asthma, diazepam is not used in patients with severe respiratory problems and sleep apnea (Inability to breathe while sleeping for a short period), and used with extreme caution in patients with asthma, pneumonia, or neurologic damage as they may cause apnea (stop of breathing) or cardiac arrest.
So, diazepam is a life-saving drug when used when mechanical ventilation is needed to induce sedation in case of very severe status asthmaticus, and if it is going to be used with asthmatic patients, it should be used with extreme caution as it may cause severe side effects.
Diazepam and Tramadol
Table of Contents
Diazepam and Tramadol
Mixing diazepam and tramadol may lead to serious side effects, but first, we should know about diazepam and tramadol individually.
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What is tramadol?
Tramadol is a synthetic opioid analgesic that has narcotic-like painkiller action, used in treating moderate to severe pain cases in adults.
Warnings:
- Seizures were reported in patients using tramadol.
They happen more frequently if you are taking higher doses more than recommended if you already suffer from a seizure disorder, or with those taking antidepressants or opioid medications.
- If you have ever suffered from suicidal thoughts, behaviors, or if you are susceptible to addiction or abuse, you shouldn’t use tramadol in these cases.
- You should not also use it if you have severe breathing problems, stomach or intestines blockage.
Before taking tramadol, you should not take it if:
- You are allergic to tramadol
- You have breathing problems or severe asthma
- You have obstructive stomach or bowel (like paralytic ileus)
- You are consuming alcohol, using sedatives, tranquilizers, and narcotic medications
- You are taking a drug from the group MAO inhibitors or took it in the past 14 days (like isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine)
Tramadol is not used in children younger than 12 years old.
It is not given to any patient younger than 18 years old who removed the tonsils or adenoids recently.
Don’t give tramadol to patients between 12 and 18 years old who have breathing problems.
Tramadol and pregnancy are contraindicated.
It may cause withdrawal side effects that may even lead to death.
It was noticed that babies nursing to mothers taking tramadol signs of severe drowsiness and shallow breathing, talk to your doctor about alternative drugs or feeding options.
To make sure tramadol is suitable for your condition, you have to tell your doctor if you have ever had:
- liver problems
- Kidney problems
- Breathing problems like sleep apnea (stop of breathing for a short period while sleeping)
- urination problems
- Gallbladder, pancreas, or thyroid problems
- Stomach problems
- Mental problems
- Suicidal thoughts or behaviors
Mixing alcohol with tramadol cause serious side effects leading to death.
Don’t perform hazardous activities or operate heavy machines while taking tramadol as drowsiness may cause serious falls or accidents.
What is diazepam?
Diazepam is a benzodiazepine drug, used in treating anxiety disorders, alcohol withdrawal symptoms, muscle spasms, and stiffness, and as adjunctive therapy in treating seizures.
It is also used to help you get in relaxation before any surgical or dental procedures.
Diazepam is available in many dosage forms, tablets, oral solutions, rectal gels, injectable solutions, and intramuscular devices.
Warnings:
- Diazepam may cause slow or shallow breathing, especially if used with an opioid medication, alcohol, or other drugs that may cause slow or shallow breathing
- Unfortunately, diazepam may cause addiction, overdose, which may lead to death, use this drug exactly as the doctor prescribed to avoid these side effects
- Diazepam may cause a severe allergic reaction, including swelling of face, lips, and tongue, don’t use it if you have ever experienced allergy with diazepam or other benzodiazepines
- Efficacy and safety have not been established in children younger than 6 months, so they should not be used at that age
Before taking diazepam, you have to tell your doctor if you have ever had:
- Myasthenia gravis (a medical condition causing weakened and tired muscles)
- Severe breathing problems
- Sleep apnea (stop of breathing for a short period while sleeping)
- Narrow-angle glaucoma
- Uncontrolled open-angle glaucoma
- Severe liver problems
Having seizures during pregnancy may harm both mother and baby, but as well diazepam should not be used started not stopped during pregnancy without the doctor’s advice.
It may cause dependence if was used during pregnancy, which may cause deadly withdrawal symptoms in newborn babies.
Diazepam should not be used in breastfeeding mothers, talk to your doctor about alternative drugs or feeding options.
To make sure tramadol is suitable for your condition, you have to tell your doctor if you have ever had:
- Breathing problems
- Glaucoma
- Kidney problems
- Liver problems
- Seizures, unless you are taking it for the same reason
- An addiction to drugs or alcohol
- Depression
- Suicidal thoughts or behaviors
Diazepam and tramadol are CNS (Central Nervous System) depressants.
The combination of diazepam and tramadol abolished seizures, but the CNS depression caused by this combination is very severe.
Serious side effects caused by diazepam and tramadol combination include respiratory distress, coma, and death.
If the combination between them is conditional, dose adjustment or more frequent monitoring must be done to safely use both medications.
But using alternatives is more appropriate.
Consuming alcohol with diazepam and tramadol, or using unprescribed medications can be very dangerous if done without the supervision of your doctor.
Don’t alter the doses, frequency, or duration of use without consultation from your doctor.
Diazepam and tramadol may cause dizziness, drowsiness, concentration difficulties, and judgment, speed, and motor coordination impairment.
So, don’t combine diazepam and tramadol, as it may be really dangerous.
What is Xanax used for
What is Xanax used for?
Xanax is approved by the FDA to be used to treat anxiety and panic disorder, Xanax is a very potent drug belonging to the benzodiazepines group and we will discuss here what is Xanax used for?
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Xanax is converted through the liver by hepatic microsomal oxidation, yielding hydroxyalprazolam, and is metabolized by cytochrome P450 (CYP) 3A4.
The FDA’s approval for Xanax depended on two large, randomized, clinical trials that analyzed the efficacy and tolerability of Xanax versus placebo (no_effect drug).
For targeting symptoms of panic disorder, the plasma concentration of Xanax should range between 20 and 40 ng/mL, as higher concentrations are associated with more central nervous system CNS depressant effects.
The most common side effects of Xanax include depression, dizziness, fatigue, drowsiness, headache, memory impairment, and dysarthria.
In a review of Xanax efficacy as monotherapy for the treatment of depression, anxiety, and panic disorder, 84 studies of Xanax have been reviewed versus other drugs and/or placebo and it was found that Xanax was superior to placebo and as effective or superior to all comparator benzodiazepines, including lorazepam, diazepam, and bromazepam and all comparator antidepressants, including dothiepin, imipramine, amitriptyline, and buspirone for the treatment of anxiety disorder.
The review found that the onset of the action of Xanax was significantly more rapid compared with amitriptyline, propranolol, and imipramine.
However, a meta-analysis of randomized controlled trials comparing Xanax with other benzodiazepines as antipanic agents found no significant difference in clinical efficacy if compared with other agents.
About the overdose, the studies found that Xanax is relatively more toxic than other benzodiazepines.
The antidepressant Xanax has not been systematically evaluated so its use as an antidepressant is still off-label. In a review of 25 studies included 2643 participants, Xanax was found to be superior to placebo, and as effective as all comparator antidepressants including doxepin, imipramine, amitriptyline, desipramine, clomipramine, and dothiepin for the treatment of neurotic and moderate depression, whereas the other antidepressants were perhaps superior to Xanax for the treatment of severe depression.
“neurotic depression” was defined as depressive symptoms associated with major personality disorders. According to the review, data collected from several studies concluded that the onset of antidepressant effect was significantly more rapid for Xanax compared with the other antidepressants, and Xanax was just as well-tolerated as all comparator medications.
A Cochrane review of Xanax’s efficacy as antidepressant monotherapy evaluated 21 more recent randomized controlled trials and found that Xanax was superior to placebo and as effective as the tricyclic antidepressants, including dothiepin, desipramine, amitriptyline, doxepin, and imipramine. However, this review included heterogeneous, or poor-quality studies and only pointed to the short-term effects, thus the conclusion was not significantly confirmed.
The clinical trials involved Xanax didn’t include any comparison between the newer antidepressant drugs called selective serotonin reuptake inhibitors SSRIs However, while the available data show that Xanax monotherapy is as effective as other benzodiazepines for the treatment of anxiety and panic disorders, this must be weight with its propensity for dependence, tolerance, and rebound anxiety.
What is Xanax used for? And how much do you need from it?
1- Anxiety: (monotherapy or adjunctive therapy): start with 0.25g three times daily, increase the dose according to efficacy and tolerability by less than or equal to 1mg by day at intervals ≥3 days to reach a usual dose of 2 to 6 mg/day in 3 to 4 divided doses. The dose may reach 8 mg/day for an optimal response the maximum dose is 10 mg/day. Increase the dose slowly with doses >4 mg/day to minimize the chance of adverse effects, periodically reassess and consider dosage reduction.
Xanax should only be used for a short term until the main therapy becomes effective. The duration should not exceed 12 weeks. Long-term, low-dose therapy (eg, 2 mg/day) can be an option for patients not controlled on other treatments or with patients who cannot tolerate other treatments well. Benzodiazepines may worsen symptoms in patients suffering from posttraumatic stress disorder PSD.
2- Procedural anxiety: Xanax can be used as a premedication before general anesthesia, a dose of 0.5 mg can be used 30 to 90 minutes before the procedure and may be repeated after 30 to 60 minutes.
3-Vertigo as an alternative agent in acute episodes and only reserved for those lasting several hours to days.
Discontinuation of Xanax:
Gradually withdraw the high doses of benzodiazepines to minimize the rebound symptoms of withdrawal.
The optimal tapering plan will vary from person to person but you can taper the total daily dose by 10% to 25% every 1 to 2 weeks based on response and tolerability.
The tapering period may last for more than 6 months.
For patients on high doses, you can taper rapidly in the beginning and slow the reduction rate over time.
This was a brief about what Xanax is used for And it’s clinical uses it.
What does Xanax feel like
Table of Contents
What does Xanax feel like?
Xanax is the trade name for the active ingredient Alprazolam, used to treat anxiety and panic disorders, in addition to other specific types of them and other off-label use.
It takes less than one hour to work producing a calming effect.
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What does Xanax feel like?
The effects of Xanax appear and disappear rapidly.
Some people take it for recreational reasons to produce a calming effect.
But these fast effects may lead to misuse or addiction, unfortunately.
What does Xanax feel like?
The feel of Xanax differs according to many factors.
- The mental status of the patient at the time he takes the drug
- Age
- Weight
- Metabolism (The process of converting Xanax into inactive form to be excreted from the body)
- Dosage
What does Xanax feel like if you are using it to treat anxiety and panic disorders?
After taking the first dose of the medication, you will feel normal and calm.
The sedation caused by Xanax helps to alleviate the symptoms of anxiety and feeling calmer.
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What does Xanax feel like if you are using it for recreational uses?
The patients using Xanax recreationally say they feel sedated or calm.
Xanax may also lead to falling asleep or passing out.
Some patients reported memory impairment or blacking out without remembering what happened for several hours.
Higher doses are more likely to cause these symptoms more than lower doses.
To avoid these reactions happening from higher doses, you have to understand the right way to take the drug and the usual doses taken.
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Dosing and administration:
There are usual doses of every drug but the best way to take any drug is the individualized dose based on the medical condition, age, and weight of the patient.
The presence of another chronic medical condition also affects the dose prescribed.
Before taking Xanax, read the medication guide carefully and ask the doctor or the pharmacist about any misunderstandings.
Never take higher doses or longer duration than determined by your doctor.
This drug may cause abuse or addiction, don’t share this drug with another person; this drug should be taken with a prescription and under the supervision of a doctor.
Xanax is usually taken for 4 months to treat anxiety disorder and for 10 weeks maximum to treat panic disorder.
Call your doctor immediately if the symptoms don’t improve or worsen.
Using Xanax for a long time, you will need to make medical tests frequently.
Xanax is a drug that causes dependence and should not be stopped at once.
The dose must be decreased gradually or it may cause withdrawal symptoms which can be extremely serious.
Withdrawal symptoms:
- Depression
- Suicidal thoughts or behaviors
- Confusion
- Hostility
- Hallucinations
- Racing thoughts
- Uncontrolled muscle movements
- Seizures
Regular doses of Xanax:
Regular dose for adults in treating anxiety:
- 25 to 0.5 mg taken 3 times per day
- Maximum dose: 4 mg per day
Regular dose for adults in treating panic disorder:
- 5 mg taken 3 times per day
- Maximum dose: 10 mg per day
Regular dose for elders in treating anxiety:
- 25 mg taken 2 or 3 times per day
Regular dose for elders in treating panic disorder:
- 25 mg taken 2 or 3 times per day
If you missed a dose, take once you remember, if it is the time for the next one, don’t take double doses.
Taking too much Xanax may cause overdose which may be extremely dangerous.
Overdose symptoms:
- Extreme drowsiness
- Confusion
- Muscle weakness
- Loss of balance
- Incoordination
- Lightheadedness
- Fainting
If you suffered from any of these symptoms, go to the nearest emergency room.
What does Xanax feel like when concomitantly used with Alcohol?
Alcohol increases the effects of Xanax and increases the time for the drug to get out of the body.
You may suffer from extreme lethargy and memory loss for a long time.
Not just alcohol, but combining Xanax with any other drug can be dangerous leading to deadly side effects.
These side effects include:
- Breathing difficulties
- Extreme drowsiness
- Confusion
- Seizures
These drugs include many drugs, some are completely contraindicated, some of them may cause serious side effects and an alternative drug should be used, and some when used concomitantly with Xanax should be closely monitored.
Contraindicated drugs:
- ketoconazole
- tipranavir
Serious, use an alternative:
- abametapir
- apalutamide
- benzhydrocodone/acetaminophen
- calcium/magnesium/potassium/sodium oxybates
- carbamazepine
- chloramphenicol
- cimetidine
- clarithromycin
- cobicistat
- erythromycin base
- erythromycin ethylsuccinate
- erythromycin lactobionate
- erythromycin stearate
- hydrocodone
- idelalisib
- itraconazole
- ivosidenib
- ketoconazole
- lonafarnib
- lopinavir
- metoclopramide intranasal
- nefazodone
- rifabutin
- rifampin
- saquinavir
- selinexor
- sodium oxybate
- St John’s Wort
- sufentanil SL
- valerian
- voxelotor
These drugs can increase the effects of Xanax and the time which is taken to eliminate it from the system which may be leading to an overdose.
Don’t take Xanax before consulting with your doctor about the chronic medical conditions you are suffering from and the drugs taken.
Xanax is a very good drug in treating anxiety and panic disorders, but if you will know how to use it correctly.
Xanax side effects
Table of Contents
Xanax side effects
Xanax is the most used benzodiazepine, used for the treatment of anxiety and panic disorder is classified as a highly addictive substance and this absolutely limits its clinical benefits, especially that some physicians prescribe it for longer periods than recommended. And even the clinical trials do not completely clarify the abuse liability of Xanax it still the most used one. We will discuss here the most common Xanax side effects.
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Possible Xanax side effects
Xanax is like all other drugs that can cause side effects by different severity levels, do not stop Xanax treatment by yourself as if it may cause harm to you if you stopped it immediately.
Treatment with Xanax can cause serious behavioral or psychiatric effects you should monitor for it:
- Agitation
- Restlessness
- Aggressiveness
- Irritability
- Violent anger
- False beliefs
- Nightmares
- Hallucinations
- Sudden wheeziness
- Difficulty in swallowing or breathing
- Swelling of face, eyelids, or lips, itching or rash (especially if spread all over the body)
When to see your doctor immediately:
- Memory loss (amnesia)
- Yellowing of the skin and whites of the eyes (jaundice), as the dose or treatment, may be changed in these cases
Other side effects that may occur are:
Very common: can occur by a percent more than 10%
- Sleepiness and drowsiness
- Jerky, uncoordinated movements
- Inability to remember bits of information
- Slurred speech
- Dizziness
- light-headedness
- Headaches
- Constipation
- Dry mouth
- Tiredness
- Irritability
Common: can occur by a percent less than 10%
- Loss of appetite
- Confusion and disorientation
- Increased sex drive (men and women)
- and erectile dysfunction
- Nervousness or feeling anxious or agitated
- Insomnia (inability to sleep or disturbed sleep)
- Unsteadiness like if you are drunk especially during the day
- Loss of alertness or concentration
- Inability to stay awake, feeling sluggish
- Shakiness or trembling
- Double or blurred vision
- Feeling sick
- Skin reactions
- Change in your weight
Uncommon: occur by 1%
- Feeling elated or over-excited, which causes unusual behavior
- Hallucination
- Feeling agitated or angry
- Incontinence
- Cramping pain in the lower back and thighs, which may indicate the menstrual disorder
- Muscle spasms or weakness
Not known: cannot be estimated how frequent they may occur from available data
- Too much prolactin production can lead to irregular periods in women
- Feeling hostile or aggressive
- Abnormal thoughts
- Twisting or jerking movements
- Being hyperactive
- Stomach upsets
- Liver problem and increase in liver function tests in blood with or without inflammation of the liver (hepatitis)
- Imbalance to part of the nervous system
Symptoms may also include:
- fast heartbeat
- unstable blood pressure (feeling dizzy, light-headed, or faint)
- A serious allergic reaction causes swelling of the face or throat, Swelling of the ankles, feet, or fingers
- Skin reaction caused by sensitivity to sunlight
- Difficulty urinating or bladder control problems
- Vision disturbances, increase blood pressure in the eyes
Xanax stopping
See your doctor before stop taking Xanax as the dose should be decreased gradually. Rebound effects can occur if decrease the dose suddenly or stop taking Xanax. These effects called withdrawal symptoms as you became restless or anxious or can’t get asleep.
These symptoms can be resolved if you retake Xanax or increase the dose again discuss this with your doctor or pharmacist.
Dependence and withdrawal
Xanax has a high possibility of dependence while you are taking them and withdrawal symptoms can occur if you stop it suddenly.
Withdrawal symptoms are more common if you:
- Stop treatment suddenly
- Have been taking high doses
- Use the drug for a long duration
- Have a history of alcohol or drug abuse
This can cause effects such as
- Headaches
- Muscle pain
- Extreme anxiety
- Tension
- Restlessness
- Confusion
- Mood changes
- Difficulty sleeping and irritability
severe withdrawal symptoms can be some the following :
- nausea (feeling sick)
- Vomiting
- Sweating
- Stomach cramps
- Muscle cramps
- A feeling of unreality or detachment
- Sensitivity to light or sound or physical touch.
- Numbness and tingling of the feet and hands
- Hallucinations
- Tremor or epileptic fits
Xanax tolerance
Xanax tolerance is a phenomenon where the effect of Xanax after several weeks is no longer enough for you and you feel that you need to increase the dose to reach the same usual effect. It is important not to take Xanax more than the doctor told you as this can lead to overdose.
Xanax overdose
If you had:
- Drowsiness
- Feeling cold
- Confusion
- Slurred speech
- Decrease in blood pressure
- Difficulty breathing
These symptoms may indicate overdose, seek medical advice if you have one of them.
Missed dose if you suffer from Xanax side effects
Take the forgotten dose as soon as you remember but not with the next dose, don’t ever duplicate your dose.
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Xanax overdose
Table of Contents
Xanax overdose
Xanax is alprazolam, which has two forms regular Xanax and Xanax XR.
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They belong to a group of drugs called benzodiazepines, working as anxiolytics.
Xanax works in the management of anxiety, panic disorder, and anxiety associated with depression, and premenstrual syndrome (off-label).
To understand the Xanax overdose and the symptoms caused due to it, we have to understand the dosage and administration.
Administration:
Xanax is only available in oral dosage forms.
Tablets, extended-release tablets, orally disintegrating tablets, and oral solutions with many concentrations.
Extended-release tablets are swallowed as a whole without crushing, chewing, or breaking.
Orally disintegrating tablets are taken out of the cover just before taking it as it is highly affected by air and moist.
Oral solutions are taken with a special measuring device or measuring syringe, don’t use the household spoons to make sure you are taking the correct dose.
Dosage:
It is not used in children younger than 18 years old.
Adults
Treatment of anxiety:
0.25 – 0.5 mg 3 to 4 times per day
The dose is increased gradually in 3 – 4 days
The dose not to exceed 4 mg per day
Treatment of panic disorder:
Immediate-release tablets
0.5 mg every 8 hours
The average dose is between 5 – 6 mg per day
The dose not to exceed 10 mg per day divided into 3 doses
Extended-release tablets
0.5 – 1 mg every day
The average dose is between 3 – 6 mg per day
Treatment of anxiety associated with depression:
1 – 4 mg per day divided into 3 doses
Treatment of premenstrual disorder:
0.25 mg every 6 – 12 hours
Start the treatment on day 16 – 18 of menses
The dose not to exceed 3 – 4 mg per day
Dosing modifications:
Renal impairment: it is not studied and must be used with caution
Advanced hepatic impairment:
Immediate release: The dose is decreased to 0.25 mg every 8 – 12 hours, and maybe increased if needed as tolerated
Extended-release: 0.5 mg per day, and maybe increased if needed as tolerated
Geriatrics
Treatment of panic disorder:
Immediate-release tablets
The starting dose is decreased to 0.25 mg every 2 or 3 times per day
The dose is increased if necessary and tolerated to 5 – 6 mg per day as an average dose
Extended-release tablets
Start the dose by 0.5 mg per day
The dose is increased if necessary and tolerated to 3 – 6 mg per day
Treatment of anxiety associated with depression:
The initial dose is decreased to 0.25 mg every 8 – 12 hours
The dose is increased if necessary and tolerated to 1 – 4 mg per day
Dosing considerations:
The doctor prescribes the lowest effective dose to avoid undesirable side effects like ataxia (disorder affecting coordination, balance, and speech) and oversedation.
If you miss a dose, take it as soon as you can, if it is the time for the next dose; don’t take two doses at one time.
If you take two doses at one time, you may be subjected to Xanax overdose.
Xanax overdose symptoms:
- Extreme drowsiness
- Confusion
- Muscle weakness
- Loss of balance or co-ordination
- Light-headedness
- Fainting
If you feel any of these symptoms, you must seek medical attention at once.
Mixing Xanax with other drugs or with alcohol especially increases Xanax overdose susceptibility.
Another factor is taking the drug for high doses and a long duration.
When drinking alcohol while using Xanax dangerous side effects or even death may occur.
Xanax side effects:
Not just overdosing causes side effects but also the regular dose does that but with different aspects and extents.
Consult with your doctor at once if you feel:
- Weak or slow breathing
- Lightheadedness that may proceed to faint
- Seizures
- Hallucinations
- Hyperactivity
- Decreased need for sleeping
- Racing thoughts
- Agitation or talkativeness
- Double vision
- Jaundice (yellow skin and eyes due to liver problems)
Falls and accidents are more common in elders as the drug stays in their systems.
Common side effects:
- Ataxia
- Cognitive dysfunction
- Constipation
- Urination difficulties
- Drowsiness
- Dysarthria (motor speech disorder)
- Fatigue
- Memory problems
- Skin rash
- Weight changes
- Anxiety
- Blurred vision
- Diarrhea
- Insomnia (sleeping disorder)
- Decreased libido (sexual drive)
- Increased or decreased appetite
Less common side effects:
- Hypotension
- Sexual disorder
- Muscle twitchings
- Increased libido
Warnings:
- Xanax may lead to addiction, misusing the drug may be extremely dangerous, take this medication under the supervision of a doctor to avoid any abuse.
- Opioids are specifically dangerous when combined with Xanax, severe drowsiness and shallow breathing is the top side effects of this combination.
- Xanax is a federally controlled substance that has to be used under the control of a doctor.
- Xanax can cause severe allergic reactions, if you suffered from any blisters, hives, and swelling of the face, lips, and limbs, consult with your doctor immediately to stop the drug.
- Xanax is a drug that should not be stopped immediately and stopped gradually to avoid withdrawal symptoms.
Xanax is an antianxiety drug used for several types of anxiety and panic disorders use it correctly and you will have the most benefit from it.
































