Diazepam and pregnancy

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

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

 

Omeprazole and Diazepam

 

Diazepam and Asthma