Bensedin (also known as Diazepam) is a medicine from the group of benzodiazepines, which is primarily used to relieve anxiety and fears. It provides anxiolytic, sedative, anticonvulsant, central muscle relaxant effect. Bensedin can be used for delirium tremens treatment, insomnia treatment, for preparing for surgery as well as for epileptic seizures treatment especially to treat a condition known as “status epileptics”.
Bensedin belongs to a class of drugs called benzodiazepines which act on the brain and nerves (central nervous system) to produce a calming effect. The mechanism of action is associated with an increased inhibitory effect of GABA in the CNS. Muscle relaxant effect is also due to the inhibition of spinal reflexes. Benzodiazepines produce a variety of effects by modulating the GABA subtype of the GABA receptor, the most prolific inhibitory receptor within the brain. Bensedin is used to treat anxiety, acute alcohol withdrawal, and seizures, to relieve muscle spasms and to provide sedation before medical procedures. It works by enhancing the effects of a certain natural chemical in the body (GABA).
Bensedin acts to suppress seizures through interaction with y-aminobutyric acid (GABA) receptors of the A-type (GABAA). Benzodiazepines bind nonspecifically to benzodiazepine receptors which mediate sleep, affects muscle relaxation, anticonvulsant activity, motor coordination, and memory. As benzodiazepine receptors are thought to be coupled to gamma-aminobutyric acid-A (GABAA) receptors, this enhances the effects of GABA by increasing GABA affinity for the GABA receptor. Binding of GABA to the site opens the chloride channel, resulting in a hyperpolarized cell membrane that prevents further excitation of the cell. It is believed that Bensedin enhances the actions of GABA by causing GABA to bind more tightly to the GABAA receptor.
Bensedin is rapidly and completely absorbed from the gastrointestinal tract. The peak plasma concentration is achieved in 30-90 minutes after oral ingestion. On IM injection, absorption is complete, though not always more rapid comparing to oral administration. Bensedin and its metabolites are highly bound to plasma protein (Bensedin 98%). Bensedin and its metabolites cross the blood-brain and placental barriers and are also found in breast milk in concentrations approximately 1/10 of those in maternal plasma. Metabolized in the liver; excreted by the kidneys – 70%.
Bensedin is not the drug for daily use. Do not use it more than 5 times per month, unless your doctor told you to do that. It is recommended to wait at least 5 days, after you have used Bensedin, before taking it again. Bensedin is used in the treatment of anxiety disorders, alcohol withdrawal symptoms, muscle spasms, sometimes can be used with other medications to treat seizures. Each tablet contains Diazepam 10 mg.
Bensedin is recommended for the treatment of:
- Neuroses, borderline states with symptoms of stress, restlessness, anxiety, fear.
- Sleep disturbance, motor stimulation of various etiologies in neurology and psychiatry, withdrawal syndrome in chronic alcoholism.
- Spastic conditions associated with lesions of the brain or spinal cord, and myositis, bursitis, arthritis, accompanied by a voltage of skeletal muscle.
- Status epilepticus.
- Premedication before anesthesia as a component of combined anesthesia.
- Relief labor, premature birth, abruption placenta, tetanus.
Dosage and administration
The daily dose ranges from 0.5 mg to 60 mg. Recommended doses of Bensedin are set individually and will be different for each patient. The information below includes only the average doses of Bensedin. Use Bensedin as directed by your doctor – if your dose is different, do not change it unless your doctor tells you to do that. The number of daily doses, the time allowed between doses and the length of the time you take the medicine – all that depends on your medical problem and the reason why you are taking the medicine. Use Bensedin exactly as prescribed. Do not increase your dose, take it more frequently or use it for a longer period of time than prescribed because this drug can be habit-forming.
The dose for control and seizures:
- Adults, teenagers, and children 2 years of age and older: Dose is based on body weight. Consult your doctor and use this medication exactly as prescribed.
- Children younger than 2 years of age: Dose must be determined by the doctor.
Avoid eating grapefruit or drinking grapefruit juice while being treated with Bensedin. Grapefruit juice can increase the amount of certain medications in your bloodstream. Talk with your doctor or pharmacist for more details. Always inform your doctor if your condition persists or worsens.
Side effects of Bensedin which may occur are: drowsiness, dizziness, fatigue, constipation, blurred vision, headache, mental/mood changes (e.g., memory problems, agitation, hallucinations), slurred speech, clumsiness, trouble walking, decreased/increased interest in sex, tremor, trouble urinating, sleep disturbances, stomach/abdominal pain, persistent nausea, vomiting, yellowing eyes or skin, dark urine, persistent sore throat or fever. Notify your doctor immediately if any of these side effects occur.
Medical attention should be sought immediately in case signs of an allergic reaction occur such as: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
Bensedin has been assigned to pregnancy category D by the FDA, should not be used in the 1 trimester of pregnancy, except in cases of extreme necessity. It has been stated that there is an increased risk of congenital malformations and other developmental abnormalities associated with the use of benzodiazepine drugs. It may cause neonatal flaccidity, respiratory and feeding difficulties, as well as hypothermia in children born to mothers who have been receiving benzodiazepines late in pregnancy. Special care should be taken if Bensedin was used during labour and delivery, high single doses may produce irregularities in the fetal heart rate (FHR) and hypotonia, poor sucking, hypothermia, moderate respiratory depression in the neonate.
Special instructions and precautions
Talk to your doctor before taking Bensedin in order to find out if you are allergic to it, or to other benzodiazepines (e.g., alprazolam, lorazepam). Bensedin may contain inactive ingredients, which can cause allergic reactions. Consult your doctor or pharmacist before you start using Bensedin if you have: glaucoma (narrow-angle), a certain muscle disease (myasthenia gravis), breathing trouble during sleep (sleep apnea). Bensedin can make you dizzy, drowsy or cause blurred vision. People driving or conducting activities which require alertness or clear vision should exercise caution in using alprazolam. Also avoid alcoholic beverages.
Bensedin (Diazepam) drug interactions
Bensedin may interact with other drugs, including prescription and over-the-counter medicines, vitamins and herbs. Be aware that if you are taking these drugs together, such interaction can be harmful and can cause serious side effects. Taking Bensedin with other drugs that make you sleepy or slow your breathing can cause dangerous or life-threatening side effects.
Consult your doctor about all medicines you use. Examples of the drugs which should not be taken concomitantly with Bensedin:
– Sleeping pills.
– Narcotic pain medicine.
– Muscle relaxer.
– Medicine for anxiety, depression or seizures.
– Cimetidine, omeprazole, phenytoin.
– An antibiotic-clarithromycin, erythromycin, telithromycin.
– Antifungal medicine – itraconazole, ketoconazole,voriconazole.
– Heart or blood pressure medication such as diltiazem, nicardipine, quinidine, verapamil etc.
– HIV/AIDS medicine – atazanavir, delavirdine, fosamprenavir, indinavir, nelfinavir, saquinavir, ritonavir.
Overdose may include one or more of the following symptoms: somnolence, confusion, coma, and diminished reflexes. Benzodiazepines commonly cause drowsiness, ataxia, dysarthria and nystagmus. Overdose of Bensedin is seldom life-threatening if Bensedin is taken alone, but may lead to areflexia, apnea, hypotension, cardiorespiratory depression and coma. Benzodiazepine respiratory depressant effects are more serious in patients with respiratory disease. That is prohibited to take Bensedin with alcohol. Benzodiazepines increase the effects of other central nervous system (CNS) depressants, including alcohol.
In case of emergency/overdose treatment should be taken: induction of vomiting, and the appointment of activated charcoal (if the patient is conscious), gastric lavage through a tube (if patient is unconscious), symptomatic therapy, monitor vital functions: respiration, pulse and blood pressure should be monitored, if necessary – artificial ventilation. With the development of excitation barbiturates should not be used. In hospital conditions used a benzodiazepine receptor antagonist flumazenil as specific antidote. Hemodialysis is ineffective.