Relium. The use of Relium in neurological practice: instructions and reviews What is Relium prescribed for?

Dosage form

Film-coated tablets, 5 mg

Compound

One film-coated tablet contains

Active substance - diazepam 5 mg,
excipients: potato starch, sodium carboxymethyl starch, gelatin, polysorbate 80, talc, magnesium stearate, lactose monohydrate, quinoline yellow dye (E104),

shell: hypromellose, macrogol 6000

Description

Tablets are round in shape, with a biconvex surface, yellow-coated, without spots, defects or cracks

Pharmacotherapeutic group

Psychotropic drugs. Anxiolytics. Benzodiazepine derivatives.

Diazepam

ATX code N05BA01

Pharmacological properties

Pharmacokinetics

Diazepam is well absorbed from the digestive tract; bioavailability is about 98%. After oral administration of 20 mg of diazepam, the maximum concentration in the blood is reached after 0.9–1.3 hours and is 500 ng/ml. The half-life of diazepam is 24-48 hours; binds to blood proteins by 94–99%.

Diazepam shows great affinity for adipose tissue. Passes through the blood-brain and placental barriers; penetrates into mother's milk.

Diazepam is metabolized in the liver. As a result of this process, active metabolites are formed: N-desmethyldiazepam (nordiazepam), temazepam, oxazepam, which then bind to glucuronic acid.

Diazepam and its metabolites are excreted mainly in the urine.

Pharmacodynamics

Diazepam belongs to the group of 1,4-benzodiazepine derivatives. It has a depressant effect on many structures of the central nervous system (brain, cerebellum, limbic system, hypothalamus, spinal trunk). The mechanism of action of diazepam is largely related to gamma-aminobutyric acid (GABA) and the receptor complex, which includes the chloride channel, GABA-A receptor, and benzodiazepine receptor. Diazepam stimulates the binding of GABA to the GABA-A receptor and potentiates the biological effect of GABA (the mediator of diazepam action). The consequence of activation of the GABA-A receptor is an increase in the passage of Cl¯ ions into the neuron and its hyperpolarization, resulting in inhibition of neuron activity. Diazepam has a pronounced anxiolytic, sedative, and anticonvulsant effect. It also has a hypnotic effect and reduces the tone of skeletal muscles.

Indications for use

Short-term symptomatic treatment:

Neurotic syndromes, also against the background of somatic disorders

Anxiety states also associated with somatic diseases (oncological diseases, coronary heart disease, arterial hypertension, gastric and duodenal ulcers)

Sleep disorders

Symptoms of agitation in alcohol withdrawal syndrome

Diseases accompanied by muscle hypertonicity, for example, spastic conditions after cerebral strokes, injuries, multiple sclerosis, discopathy, torticollis

In traumatology and motor rehabilitation to reduce hypertonicity of skeletal muscles

Premedication (in preparation for some surgical interventions and diagnostic procedures)

Conditions of nervous tension and anxiety associated with problems of everyday life are not an indication for the use of the drug.

To avoid complications, the drug must be taken strictly as prescribed by the doctor.

Directions for use and doses

Relium should be used in accordance with your doctor's recommendations.

If in doubt, consult a doctor.

Adults

– Conditions of anxiety and restlessness: from 5 to 10 mg per day in 1-2 divided doses.

– Manifestations of alcohol withdrawal syndrome: up to 30 mg per day in divided doses, on average 10 mg 3 times a day. In justified cases, especially with alcoholic psychoses, the dose can be increased to 60 mg per day (it is necessary to monitor possible breathing problems).

– Insomnia: 5 to 10 mg 0.5 hours before bedtime.

– Spastic muscle conditions: from 5 to 15 mg per day in divided doses, in severe cases the daily dose can be increased to 60 mg.

If during treatment the patient feels that the effect of the drug is too strong or weak, he should consult a doctor.

Elderly patients

Elderly patients are more sensitive to drugs that affect the central nervous system. The doses used should not exceed half the dose recommended for adult patients.

Patients with liver and (or) renal failure

Caution should be exercised when treating patients with impaired liver and/or kidney function. It may be necessary to reduce the dose of the drug. The doctor individually selects the dose for each patient, depending on the degree of failure of the affected organ.

Duration of treatment

The duration of treatment depends on the patient's condition.

The decision on the method of treatment and its duration is made by the doctor.

Mode of application

The tablets are taken orally with a small amount of water.

If the drug has been taken for a long time, for several days, you should not suddenly stop taking it. It is always necessary to gradually reduce the dose under the supervision of a physician. Abruptly stopping the drug can cause sleep and mood disturbances, and impaired concentration.

Particularly dangerous may be the sudden cessation of treatment, which was carried out over a long period of time and with the use of diazepam in doses exceeding the average. Withdrawal symptoms in this case are more pronounced.

If you miss a dose of Relium

If the drug was not taken at exactly the prescribed time, it is necessary to take it as quickly as possible (if there is still a lot of time before the next dose of the drug) or continue to take the drug regularly.

Do not take a double dose to make up for a missed dose.

Side effects

The number and severity of side effects depend on the individual sensitivity of the patient and the dose, as a rule, are mild in nature and disappear after stopping the drug.

Cardiac disorders: bradycardia, chest pain.

Disorders of the blood and lymphatic system: disorders of the morphological composition of the blood (leukopenia, neutropenia, agranulocytosis, anemia, thrombocytopenia).

Nervous system disorders: drowsiness, slow reaction, headache and dizziness, confusion and disorientation, ataxia, myasthenia gravis. These effects are most often observed at the beginning of treatment, in elderly patients, and usually disappear during ongoing therapy. If these reactions increase, an appropriate dose reduction will usually reduce their severity and frequency.

Sometimes, as with taking other benzodiazepines, especially in large doses, dysarthria with slurred speech and incorrect pronunciation, anterograde amnesia, and memory impairment may develop. Benzodiazepines may enhance the symptoms of extrapyramidal disorders (catalepsy, dystonia) associated with the use of antipsychotics.

Ophthalmological disorders: visual impairment (blurred vision, diplopia).

Gastrointestinal disorders: sore throat, nausea, stomach disorders, dry mouth rarely appears, heartburn, hiccups, gastralgia, constipation.

Renal and urinary tract disorders: urinary retention, urinary incontinence, renal dysfunction.

Musculoskeletal and connective tissue disorders: muscle tremors, muscle weakness.

Metabolic and nutritional disorders: lack of appetite.

Vascular disorders: slight decrease in blood pressure.

General disorders and reactions at the injection site: general weakness, fainting.

Hypersensitivity reactions:

Immune system disorders: Anaphylactic reactions have been reported very rarely.

Skin and subcutaneous tissue disorders: allergic skin reactions (rash, itching, urticaria).

Disorders of the liver and biliary tract: a slight increase in the activity of aminotransferase and alkaline phosphatase, liver dysfunction, accompanied by jaundice.

Disorders of the reproductive system and mammary glands: menstrual irregularities, increased or decreased libido.

Mental disorders:

paradoxical reactions - psychomotor restlessness, insomnia, increased agitation and aggressiveness, muscle tremors, convulsions.

Paradoxical reactions are most often observed after drinking alcohol, in elderly patients and in patients with mental illness.

Mental and physical dependence may develop during treatment with diazepam in therapeutic doses. Abruptly stopping the drug may lead to withdrawal syndrome. Patients who abuse alcohol or drugs are more prone to developing drug dependence.

During treatment with diazepam, existing undiagnosed depression may be revealed.

Some patients may experience other side effects while using Relium. If any of the above or other adverse events not listed in this instruction occur, you should report them to your doctor.

Contraindications

Hypersensitivity to 1,4-benzodiazepine or any component of the drug

Severe respiratory failure regardless of cause

Sleep apnea syndrome

Severe liver and kidney failure

Acute alcohol intoxication with weakened function of vital organs

History of drug dependence

Myasthenia gravis

Angle-closure glaucoma

Pregnancy and lactation

Children under 18 years of age

Hereditary galactose intolerance, Lapp-lactase enzyme deficiency, glucose-galactose malabsorption

Drug interactions

You should tell your doctor about all medications you have recently taken, even those sold without a prescription.

The inhibitory effect of diazepam on the central nervous system is enhanced by the following drugs: psychotropic drugs, narcotic analgesics, antidepressants, MAO inhibitors, drugs for general anesthesia, sleeping pills, sedatives, sedative antihistamines.

The simultaneous use of narcotic analgesics can cause pronounced euphoria, which can quickly lead to drug dependence.

Drinking alcohol during treatment with diazepam enhances the depressant effect on the central nervous system and can lead to the development of paradoxical reactions such as psychomotor agitation, aggressive behavior, respiratory depression and even coma.

Isoniazid, erythromycin, disulfiram, cimetidine, fluvoxamine, fluoxetine, omeprazole, and oral contraceptives inhibit the biotransformation processes of diazepam (reduce the clearance of diazepam), which can potentiate the pharmacological effect of the drug.

Rifampicin, an inducer of liver enzymes, accelerates the metabolism of diazepam (increases the clearance of diazepam) and weakens the pharmacological effect of the drug. Theophylline and tobacco smoking may have a similar effect on the metabolism of diazepam.

Concomitant use of diazepam with antiepileptic drugs in patients can lead to increased side effects and toxicity, especially in the case of drugs from the group of hydantoin derivatives or barbiturates, as well as combination drugs containing these substances. Therefore, special care must be taken when selecting the dosage, especially in the initial period of treatment.

Diazepam interacts with levodopa (helps weaken its effect), with phenytoin and drugs that reduce skeletal muscle hypertonicity (helping to enhance their effect).

special instructions

When using the drug Relium, you must take into account the following warnings:

If after 7-14 days of treatment the patient does not observe improvement or a relapse of insomnia occurs, it is necessary to inform the doctor.

General information regarding observed effects after treatment with benzodiazepines and other similar drugs that should be considered when using the drug Relium:

Tolerance

Regular use of benzodiazepines or drugs with similar effects, including Relium, for several weeks may lead to a decrease in their effectiveness.

Drug addiction

The use of Relium, as well as other benzodiazepines or drugs with similar effects, can lead to the development of mental and physical drug dependence. The risk of developing drug dependence increases with the dose and duration of treatment, and increases in patients with alcohol dependence or drug dependence.

If drug dependence develops, abrupt cessation of drug use may lead to withdrawal syndrome.

Characteristic manifestations of withdrawal syndrome are: headache, muscle pain, agitation and emotional tension, restlessness, states of confusion and disorientation, irritability, insomnia. In severe cases, derealization, personality disturbances, tactile, acoustic and light hyperesthesia, a crawling sensation and numbness of the limbs, hallucinations or seizures may develop.

Antegrade amnesia

Relium, like benzodiazepines and similar drugs, can cause antegrade amnesia.

Paradoxical reactions

The drug Relium, as well as benzodiazepines and similar drugs, can cause paradoxical reactions, such as motor restlessness, agitation, irritability, aggressiveness, hostility, nightmares, hallucinations, psychosis, somnambulism, personality disorders, severe insomnia. These reactions are much more common in elderly patients or in patients with alcohol dependence.

If such symptoms appear, you should consult a doctor.

Specific patient groups

In elderly patients, smaller doses of the drug Relium should be used (see section “Method of administration and dosage”), due to increased side effects, mainly disturbances in orientation and coordination of movements (falls, injuries).

Patients with liver, kidney failure or chronic respiratory failure should inform their doctor about these diseases before using the drug Relium.

Use for depression

Before using the drug Relium, the patient must inform the doctor about all mental illnesses. For patients with symptoms of endogenous depression or anxiety associated with depression, the doctor should prescribe several medications at the same time. Use of Relium alone in patients with depression may result in increased symptoms of depression, including suicidal thoughts.

Patients with alcohol, drug or drug addiction should take Relium under the strict supervision of a physician. In this group of patients, the likelihood of addiction and the development of drug dependence is high, so patients should inform their doctor about these bad habits before using the drug Relium.

The drug Relium in patients with porphyria may lead to increased symptoms of this disease. Patients with porphyria should inform their doctor about this disease before treatment with Relium.

Patients with glaucoma should consult an ophthalmologist before treatment with Relium.

In case of long-term treatment with Relium, the doctor should prescribe periodic blood tests (morphological analysis with smear) and liver function tests.

Use of the drug Relium with food and drinks

During treatment with Relium and for another 3 days after its completion, you should not drink any alcoholic beverages.

Important information about some components of the drug Relium

If the patient has an intolerance to any sugars, he must inform the doctor before taking the drug.

A physician should be consulted even if the above warnings relate to situations observed in the past.

Features of the effect of the drug on the ability to drive a vehicle or potentially dangerous machinery

During treatment with Relium and for another 3 days after its completion, you should not drive vehicles or operate moving mechanical devices. The ability to drive vehicles and operate mechanical devices may be limited due to the possible occurrence of drowsiness, decreased concentration, or other side effects that reduce concentration (see section “Side Effects”).

Overdose

Symptoms: disturbance of consciousness, drowsiness, confusion, slurred speech. In severe poisoning, the following may develop: ataxia, hypotension, muscle weakness, respiratory failure, coma and even death.

Poisoning caused by the simultaneous use of diazepam and alcohol or other drugs that have a depressant effect on the central nervous system can be life-threatening.

Treatment: primarily symptomatic, consists of monitoring and maintaining the body’s basic vital functions (breathing, pulse, blood pressure). Activated carbon can be used to reduce the absorption of diazepam. The specific antidote is flumazenil (a competitive inhibitor of the benzodiazepine receptor).

Shelf life

The drug should not be used after the expiration date indicated on the package.

Conditions for dispensing from pharmacies

On prescription

Manufacturer

Tarkhoma Pharmaceutical Plant "Polfa" Joint Stock Company

st. A. Fleminga 2, 03-176, Warsaw, Poland

Compound

1 ml of injection solution contains: active ingredient: diazepam 5 mg
excipients: propylene glycol 455 mg, ethyl alcohol 100 mg,
benzyl alcohol 15.5 mg, sodium benzoate 49 mg, benzoic acid 1 mg, water for injection up to 1 ml.

Description

Transparent, colorless or light yellow solution.

pharmachologic effect

Diazepam belongs to the group of 1,4-benzodiazepine derivatives. It has a depressing effect on many structures of the central nervous system associated with the regulation of emotional activity.
The drug Relium has anxiolytic, sedative and anticonvulsant effects. It also has a hypnotic effect and reduces skeletal muscle tone.
Diazepam and its metabolites are excreted primarily in the urine.

Indications for use

Emergency short-term symptomatic treatment:
- states of strong psychotic agitation and anxiety;
- acute alcohol withdrawal syndrome (delirium tremens)",
- tetanus and spastic conditions of various etiologies;
- status epilepticus;
- for premedication - preparation for surgical operations and painful diagnostic procedures, such as endoscopy.
The drug must be taken strictly as prescribed by the doctor.
Conditions of nervous tension and anxiety associated with problems of everyday life are not an indication for the use of the drug.

Contraindications

The drug Relium should not be used in patients:
- with hypersensitivity to benzodiazepine derivatives or to any component of the drug;
- with severe respiratory failure
- with sleep apnea syndrome;
- with severe liver and kidney failure;
- with myasthenia.
The drug should not be used in cases of phobias, obsessive disorders or mental illness.

Pregnancy and lactation

Pregnancy

The drug should not be used in pregnant women.
Lactation
Before using any medicine, consult your doctor or pharmacist.
Diazepam passes into mother's milk. Therefore, if it becomes necessary to administer a drug to a breastfeeding mother, it is necessary to stop breastfeeding the baby.

Directions for use and doses

The drug Relium should always be used in accordance with the doctor's recommendations. If in doubt, consult a doctor. Adults
- In states of severe psychotic agitation and anxiety accompanying psychoorganic syndromes and psychoses: 5-10 mg intramuscularly or intravenously. The dose must be repeated after 4 hours.
- For acute alcohol withdrawal syndrome: first 10 mg intramuscularly or intravenously, and then 5-10 mg after 3-4 hours.
- For acute spastic muscle conditions: 5-10 mg intramuscularly or intravenously. The dose can be repeated after 4 hours.
- For tetanus: 0.1-0.3 mg/kg body weight every 4 hours as an intravenous injection or at a dose of 3-10 mg/kg body weight every 24 hours as an intravenous infusion. The number of doses depends on the patient's response to the drug.
- For epileptic seizures and status: 0.15-0.25 mg/kg body weight (usually 10-20 mg) intravenously. If necessary, the dose can be repeated after 30-60 minutes. After stopping the attacks, to prevent further ones, diazepam can be administered as an intravenous infusion at a maximum dose of 3 mg/kg body weight per day.
- For premedication (preparation for surgical operations and painful diagnostic procedures, such as endoscopy): 0.1-0.2 mg/kg body weight.
Children
For status epilepticus: 0.2-0.3 mg/kg body weight as intravenous administration. If the condition does not improve after 5 minutes, the dose can be repeated.
Due to the content of benzyl alcohol, the drug should not be used in newborns (see paragraph “Important information about some components of the drug Relium”),
Elderly patients
Elderly patients are more sensitive to drugs that act on the central nervous system. The doses used should not exceed half the dose recommended for adult patients.
For patients with liver and (or) kidney failure, the doctor selects the dosage individually, depending on the failure of the diseased organ.
If, while using the drug, the patient feels that the effect of the drug is too strong or weak, he should consult a doctor.
Duration of treatment
The doctor should limit the duration of treatment with Relium to a minimum (7 to 14 days).
In individual cases, after assessing the patient's condition, the doctor may decide to extend the maximum treatment time.
Mode of application
The drug can be administered intramuscularly or intravenously.
Except in emergency cases, another person should always be present when administering a drug intravenously; a resuscitation kit should also be available at all times. It is recommended that patients remain under medical supervision for at least another hour after administration of the drug.
A responsible adult must be present at home with the patient at all times.
The method of use and preparation of solutions is given at the end of the instructions for use in the paragraph “Information intended exclusively for medical personnel and healthcare workers.”

Side effect

Like all medicines, Relium can cause side effects, although not everyone gets them.
The number and severity of side effects depend on the individual sensitivity of the patient and the dose. Side effects are usually mild and disappear after stopping the use of the drug.
- Cardiac disorders: bradycardia, chest pain.
- Disorders of the blood and lymphatic system: disorders of the morphological composition of the blood.
- Nervous system disorders: drowsiness, slow reaction, headache and dizziness, states of confusion and disorientation, ataxia. These actions are observed most often at the beginning of treatment, in elderly patients
age and, as a rule, disappear during treatment, the reaction is correspondingly reduced (doses, routine) intensifies the severity
and the frequency of their occurrence. “ -
Sometimes, as with other benzodiazepines, especially after use
large doses, dysarthria may develop with slurred speech and incorrect
pronunciation, memory impairment, libido impairment.
- Ophthalmological disorders: visual impairment (blurred vision, diplopia).
- Gastrointestinal disorders: nausea, gastric upset, dry mouth are rare.
- Renal and urinary tract disorders: urinary retention, urinary incontinence.
- Musculoskeletal and connective tissue disorders: muscle tremors, muscle atony.
- Metabolic and nutritional disorders: lack of appetite.
- Vascular disorders: slight decrease in blood pressure.
- General disorders and disorders at the injection site: general weakness, fainting. With rapid intravenous administration, depression of blood circulation and respiration was observed. Keeping the patient horizontal throughout the administration or intravenous infusion and following the recommended rate of diazepam administration almost completely prevents the development of complications of this type. Sometimes phlebitis may develop at the injection site.
With intramuscular injections, pain and sometimes erythema at the injection site often appear.
- Hypersensitivity reactions:
Immune system disorders: Anaphylactic reactions are very rare.
Skin and subcutaneous tissue disorders: allergic skin reactions (rash, itching, urticaria).
- Disorders of the liver and biliary tract: a slight increase in aminotransferase activity, impaired liver function, accompanied by jaundice.
- Disorders of the genital organs and mammary glands: menstruation disorders.
- Mental disorders:
paradoxical reactions - psychomotor agitation, insomnia, increased excitability and aggressiveness, muscle tremors, convulsions.
Paradoxical reactions are most often observed after drinking alcohol in elderly patients and in patients with mental illness. Mental and physical dependence can develop when diazepam is used in therapeutic doses. Abrupt cessation of treatment may lead to withdrawal syndrome.
Patients who abuse alcohol or drugs are more prone to developing drug dependence.
During treatment with diazepam, previously undiagnosed depression may appear.
Some patients may experience other side effects while using the drug Relium.
If any of the above or other side effects not listed in this leaflet occur, you should report them to your doctor or pharmacist.

Overdose

If the drug Relium is administered in a dose greater than prescribed
Symptoms of a diazepam overdose are: disturbances of consciousness, drowsiness, confusion, slurred speech. In severe cases of poisoning, the following may appear: ataxia, hypotension, muscle weakness, respiratory failure, coma and even death.
If the drug is administered in a dose greater than recommended, you should immediately consult a doctor or pharmacist.
If you miss a dose of Relium
If you miss taking the drug at the prescribed time, you must take it as quickly as possible, if there is still a lot of time before the next dose is administered, or continue regular use of the drug.
Do not administer a double dose to make up for a missed dose.

Interaction with other drugs

You should tell your doctor about all medications you have recently taken, even those taken without a prescription.
- The inhibitory effect of diazepam on the central nervous system is enhanced by the following drugs: antipsychotic drugs, narcotic analgesics, antidepressants, MAO inhibitors, drugs for general anesthesia, sleeping pills, sedative drugs, sedative antihistamines.
In patients receiving parenteral drugs that have a depressant effect on the function of the central nervous system in combination with intravenously administered diazepam, respiratory and circulatory depression may develop. Elderly patients require special attention.
- The simultaneous use of narcotic analgesics can cause pronounced euphoria, which can lead to a more rapid development of drug dependence.
- If intravenous administration of diazepam is necessary simultaneously with opiate painkillers (for example, in dentistry), it is recommended that diazepam be administered after the use of the anesthetic drug, in a dose selected individually for each patient.
- Drinking alcohol during treatment with diazepam enhances the depressant effect on the central nervous system and can lead to the development of paradoxical reactions such as psychomotor agitation, aggressive behavior, respiratory depression and even coma.
- Isoniazid, erythromycin, disulfiram, cimetidine, fluvoxamine, fluoxetine, omeprazole, oral contraceptives inhibit the biotransformation processes of diazepam (reduce the clearance of diazepam), which can lead to potentiation of its pharmacological action.
- Rifampicin, an inducer of liver enzymes, accelerates the metabolism of diazepam (increases the clearance of diazepam) and weakens its pharmacological effect. Theophylline and tobacco smoking may have a similar effect on the metabolism of diazepam.
- Simultaneous use in patients with kleileptic
drugs can lead to toxicity,
especially in the case of drugs from the group of hydantoin derivatives or barbiturates, as well as combination drugs containing these substances. Therefore, special care must be taken when selecting the dosage, especially in the initial period of treatment.
- Diazepam interacts with levodopa (causing a weakening of its effect), with phenytoin and drugs that reduce skeletal muscle tone (causing an increase in their effect).
Pharmaceutical incompatibility
Relium should not be mixed with other medications in the same syringe or infusion bottle.

Features of application

General information regarding observed effects during treatment with benzodiazepines and other drugs of similar action, which should be taken into account when using the drug Relium:
Tolerance
Regular use of benzodiazepines or drugs with similar effects, including the drug Relium, for several weeks, may lead to a decrease in their effectiveness.
Drug addiction
The use of the drug Relium, as well as other benzodiazepines or drugs of similar action, can lead to the development of mental and physical drug dependence. The risk of developing drug dependence increases with the dose and duration of treatment, and increases in patients with alcohol dependence, addiction to drugs or medications.
If drug dependence develops, abrupt cessation of drug use may lead to withdrawal syndrome. Characteristic manifestations of withdrawal syndrome are: headache, muscle pain, agitation and emotional tension, restlessness, states of confusion and disorientation, irritability, insomnia. In severe cases, derealization, personality disturbances, tactile, acoustic and light hyperesthesia, a crawling sensation and numbness of the limbs, hallucinations or seizures may appear.
Anterograde amnesia
The drug Relium, as well as other benzodiazepines and similar drugs, can cause anterograde amnesia. This condition most often occurs several hours after using the drug, especially in a large dose. To reduce the risk of developing amnesia, patients treated with Relium should take the drug half an hour before bedtime and have adequate conditions for complete, uninterrupted 7-8 hours of sleep.
Paradoxical reactions
Relium, as well as other benzodiazepines and similar drugs, can cause paradoxical reactions, which include: restlessness, agitation, irritability, aggressiveness, hostility, nightmares
dreams, hallucinations, psychosis, somnambulism, personality disorders, severe insomnia. These reactions are much more common in elderly patients or patients with alcohol dependence. If such symptoms occur, you should consult a doctor.
Special patient groups
Elderly patients should take medication
the drug Relium (see paragraph “Method of administration and dosage”), due to
with increased side effects, mainly orientation disturbances
and coordination of movements (falls, injuries).
Patients with hepatic, renal or chronic respiratory failure should inform their doctor about these diseases before using the drug Relium.
Use for depression
Before using the drug Relium, the patient must inform the doctor about all mental illnesses. For patients with symptoms of endogenous depression or anxiety associated with depression, the doctor should prescribe the use of several medications at the same time. The use of only the drug Relium in patients with depression may lead to increased symptoms of depression, including suicidal thoughts.
Patients with alcohol dependence, as well as dependence on drugs or medications, should inform their doctor about these bad habits before using the drug Relium. In this group of patients, the likelihood of addiction and the development of mental and physical dependence is high. Therefore, such patients should use the drug Relium only under the strict supervision of a physician.
The drug Relium in patients with porphyria may lead to increased symptoms of this disease. Patients with porphyria should inform their doctor about this disease before treatment with Relium.
During treatment with Relium and for another 3 days after its completion, you should not drink any alcoholic beverages.
A physician should be consulted even if the above warnings relate to situations observed in the past.

Compound

1 tablet of Relium contains:

Diazepam – 5 mg;

Excipients including magnesium stearate, potato starch, sodium starch glycolate (type A), talc, polysorbate 80, gelatin, color, lactose monohydrate, polyethylene glycol 6000, cellulose acetyl phthalate.

pharmachologic effect

Relium is an anxiolytic, anticonvulsant and sedative drug. Relium contains diazepam, a medicinal substance derived from a 1,4-benzodiazepine compound.

Diazepam promotes inhibition of several structures in the central nervous system, in particular, when taking diazepam, depression of the cerebellum, hypothalamus, cerebral cortex, limbic system and spinal column is noted.

The action of diazepam is associated with a receptor complex that includes the chloride channel, the benzodiazepine receptor and the GABA-A receptor, as well as gamma-aminobutyric acid.

When taking diazepam, the binding of gamma-aminobutyric acid to the corresponding GABA-A receptor is stimulated and the biological effect of GABA (the mediator of the effects of diazepam) is enhanced. After activation of the GABA-A receptor, there is an increase in the passage of chlorine ions into neurons, resulting in hyperpolarization of the neuron and inhibition of its activity.

Diazepam has a significant anxiolytic effect, reduces the severity of seizures (including cerebral etiology), and also has sedative and hypnotic activity and reduces the tone of skeletal muscles.

After oral administration, diazepam is absorbed with a bioavailability of about 98%. Peak levels of diazepam in serum are recorded 0.9-1.3 hours after taking Relium and are 500 ng/ml.

The half-life of the active substance of the drug Relium ranges from 24 to 48 hours. About 94-99% of diazepam in serum is in bound form.

There is a high affinity of diazepam for adipose tissue, as well as the ability of diazepam to penetrate the hematoplacental and blood-brain barriers.

Diazepam is found in some quantities in breast milk.

Diazepam is metabolized in the liver, derivatives: nordiazepam (N-desmethyldiazepam), oxazepam and temazepam, which are subsequently bound by glucuronic acid.

Excretion of diazepam and derivatives is carried out primarily by the urinary system.

Indications for use

Relium is used in the treatment of adult patients with anxiety disorders.

Relium can be used for severe sleep disorders (insomnia), including in patients with critical pathological conditions.

The drug is prescribed for muscle spasms that are associated with spasms of cerebral origin.

Relium can be used as a premedication for minor surgical interventions.

The drug can also be used in complex treatment regimens for patients with epilepsy.

Mode of application

Doses of the drug Relium must be selected personally for each patient. Therapy should always begin with the lowest effective doses recommended for specific conditions.

The tablets can be taken regardless of food.

Average dosage of the drug Relium:

Patients with insomnia, which is associated with anxiety, are usually prescribed diazepam in a daily dose of 5-15 mg. In this case, it is recommended to take the drug 20-30 minutes before your planned bedtime.

Patients with spastic conditions are prescribed diazepam in a daily dose of 5-15 mg (the dose is divided into several doses with a single dose of 5 mg). In rare cases (mainly with spasms of cerebral origin), the dose can be increased to 60 mg of the drug per day.

For premedication, 5-20 mg of diazepam is usually prescribed.

During therapy, it is necessary to use only the minimum doses that provide a therapeutic effect (increasing the daily dose is recommended with caution and only if there is a significant need to enhance the effect).

Using a full dose of Relium for more than 4 weeks in a row is not recommended.

Duration of therapy with Relium:

The maximum duration of therapy for insomnia is 4 weeks, for anxiety conditions – 8-12 weeks (these periods also include the time required to discontinue the drug Relium).

Rebound phenomenon and withdrawal syndrome:

With abrupt cessation of diazepam therapy, withdrawal syndrome occurs, the symptoms of which are headache, agitation, muscle pain, anxiety, emotional tension, irritability and confusion. In cases of severe withdrawal syndrome, the development of disturbances in the perception of the surrounding world, tactile, light and acoustic hyperesthesia, depersonalization, numbness of the limbs, hallucinations and epileptic attacks is also noted.

The rebound phenomenon can develop with an abrupt cessation of treatment with diazepam, which is accompanied by a rapid reduction of symptoms (emotional lability, restlessness, anxiety, sleep disturbances).

The withdrawal of diazepam therapy should be carried out gradually (the time of the withdrawal period should be directly proportional to the time of taking the drug). Reducing the dose of Relium during the withdrawal period must be carried out under the constant supervision of a physician.

At the beginning of treatment, the doctor should inform the patient about the duration of therapy and the features of discontinuation of the drug Relium, as well as the possibility of developing the rebound phenomenon.

During therapy with benzodiazepines that have a short duration of action, withdrawal syndrome may occur between doses (especially when treating with high doses of benzodiazepines). If the patient is receiving long-acting benzodiazepines, they should not be replaced with short-acting drugs (due to the likelihood of withdrawal syndrome).

Changes in the dose of the drug Relium for patients of certain categories:

Patients over 65 years of age have a higher sensitivity to drugs that affect the nervous system. When prescribing diazepam to elderly patients, the recommended dose should be halved.

Patients with impaired renal or hepatic function should administer Relium with caution and monitor the effect and serum levels of diazepam. If necessary, for kidney and liver disorders, the dose of Relium is reduced.

If after 7-11 days of taking Relium there is no improvement or a relapse of insomnia occurs during therapy, you should consult a doctor.

Side effects

During diazepam therapy, the most frequently reported development was drowsiness, fatigue and muscle weakness, which spontaneously disappear after a few days. In addition, these side effects can be eliminated by reducing the dose of diazepam.

Relium can also cause the following undesirable effects:

• heart and blood vessels: chest pain, circulatory failure, bradycardia, arterial hypotension, heart failure (up to cardiac arrest);
• nervous system: dysarthria, loss of consciousness, mood lability, headache, tremor, speech disorders, dizziness, disorientation, aggression and anger. As the dose of diazepam increases, the likelihood of anterograde amnesia increases (the development of abnormal behavior associated with amnestic effects is possible);
• psyche: agitation, hallucinations, anxiety, irritability, hostility, psychosis, nightmares, behavior changes and deviant behavior (with the development of deviant behavior and behavioral changes, the drug must be discontinued). It is also possible to develop decreased attention, depressive states, emotional poverty and confusion;
• blood: neutropenia, changes in blood composition;
• sensory organs: diplopia, vertigo, decreased visual acuity;
• digestive system: anorexia, vomiting, hypersalivation or dry mouth, colic, nausea, stool disorders.

Other side effects of the drug Relium: urinary retention or incontinence, jaundice, increased activity of liver enzymes, liver dysfunction, respiratory failure, increased risk of bone fractures, pain in muscles, bones and joints, convulsions, hyperhidrosis, ECG changes.

Allergic reactions during diazepam therapy can manifest themselves in the form of urticaria, itching or rash, as well as anaphylactic reactions.

Long-term use of the drug Relium can lead to the development of drug dependence, as a result of which, when diazepam is discontinued, the development of a rebound phenomenon or withdrawal syndrome cannot be ruled out. Abuse of benzodiazepines has been reported in some cases.

Contraindications

The use of the drug Relium is strictly contraindicated in patients with:

• intolerance to benzodiazepines, as well as additional ingredients of tablets;
• sleep apnea syndrome and severe respiratory failure;
• myasthenia gravis;
• severe forms of kidney and liver failure;
• obsessive or phobic states, chronic forms of psychosis, as well as drug and alcohol addiction (except for cases of abstinence).

In patients with depression, the use of diazepam is allowed only in complex treatment; monotherapy with Relium is contraindicated in such patients.

Relium is not used in pediatrics (given the dose of the active component in the tablet, precise dosing for children is impossible).

Relium should be prescribed with caution to patients with:

• personal history of alcoholism or drug addiction;
• chronic respiratory failure;
• porphyria;
• glaucoma (especially angle-closure glaucoma).

Relium is also prescribed with caution to elderly people (due to the significant risk of side effects of diazepam in such patients).

Driving is prohibited during the entire course of treatment with diazepam, as well as for 3 days after completion of therapy.

Pregnancy

Relium is strictly contraindicated for pregnant women. Women of childbearing potential should use proven methods of contraception when taking diazepam.

If it is impossible to avoid the use of diazepam during lactation, it is necessary to stop breastfeeding the newborn.

Drug interactions

Alcohol consumption is (strictly) contraindicated during treatment with diazepam, as well as for 3 days after completion of taking Relium.

The conversion of diazepam in the liver occurs with the participation of CYP3A and CYP2C19, so drugs that affect the activity of these isoenzymes can potentially alter the effectiveness and plasma concentrations of diazepam. In particular, inhibitors of CYP3A and CYP2C19 include omeprazole, ketoconazole, fluoxetine, cimetidine and fluvoxamine - these drugs, when taken simultaneously with Relium tablets, can increase the risk of side effects of diazepam, as well as enhance its sedative effect.

There is evidence that there are no clinically significant interactions when taking phenytoin and diazepam in combination.

Cisapride, when taken in combination with the drug Relium, may temporarily enhance the sedative effect (by accelerating the absorption of diazepam).

Rifampicin (as an inducer of liver enzymes), when taken in combination, accelerates the conversion of diazepam and reduces its therapeutic effect. Theoretically, concomitant use of theophylline or smoking could have a similar effect on diazepam.

It is possible to enhance the effect of diazepam (due to slowing down metabolism) when taking the drug Relium in combination with oral contraceptives, disulfiram, erythromycin and isoniazid.

The sedative effect, as well as the effect of the drug Relium on the respiratory and cardiovascular system, can be enhanced when combined with substances that depress the nervous system (tranquilizers, sedatives, antipsychotics, narcotic analgesics, hypnotics and antihistamines, ethyl alcohol, monoamine oxyase inhibitors and anesthetics).

Relium reduces the effectiveness of levodopa when taken in combination.

Diazepam, when taken simultaneously, potentiates the effects of phenytoin and drugs that reduce excessive skeletal muscle tone.

Overdose

In case of an overdose of diazepam, the development of ataxia, drowsiness, nystagmus and dysarthria is noted. During studies with an overdose of the drug Relium, the development of inhibition of reflexes (up to areflexia), arterial hypotension, apnea, depression of cardiac and vascular function, as well as coma was also noted. In isolated cases, an overdose created a threat to life.

The coma that developed as a result of an overdose of diazepam lasted several hours, but could be longer or cyclical (especially in older people).

In patients with diseases of the respiratory system, respiratory depression is more pronounced due to an overdose of diazepam.

There was a mutual increase in depression of the nervous system with simultaneous use of benzodiazepines and other drugs of similar action (including ethanol), which led to the development of overdose with lower doses of diazepam.

Treatment of diazepam overdose:

• Therapy aimed at eliminating symptoms: for depression of the nervous system in a hospital setting, flumazenil (a benzodiazepine antagonist) is prescribed. Flumazenil is quickly eliminated by the body, so after its use it is necessary to continue to monitor the patient. Flumazenil should be used with caution when concomitantly using drugs that lower the seizure threshold.
  If the patient develops agitation, the use of barbiturates is prohibited.
• Supportive therapy: monitoring the functions of the respiratory, nervous and cardiovascular systems, performing artificial respiration (if the patient is unconscious).

Measures aimed at reducing the absorption of diazepam: prescribing enterosorbents (gastric lavage is not a recommended measure in case of an overdose of Relium tablets).

Relium is an anxiolytic drug (tranquilizer).

Release form and composition

• film-coated tablets (20 pcs. in blisters, 1 blister in a cardboard package);
• solution for intravenous and intramuscular administration (2 ml in colorless glass ampoules, 5 ampoules in a PVC tray, 1, 5 or 10 trays in a cardboard pack, equipped with tamper evident stickers).

Active substance – diazepam:

• 1 tablet – 5 mg;
• 1 ampoule with solution – 10 mg.

Additional components of the tablets:

• excipients: magnesium stearate, gelatin, potato starch, talc, Tween 80, lactose, quinoline yellow dye E 104;
• shell composition: polyethylene glycol 6000 and cellulose acetate phthalate.

Excipients of the solution: water for injection, benzyl alcohol, sodium benzoate, ethanol (ethyl alcohol) 96%, benzoic acid, propylene glycol.

Indications for use

• relief of anxiety-related psychomotor agitation;
• treatment of neurosis-like and neurotic disorders with anxiety, including somatic diseases (peptic ulcer of the stomach and duodenum, heart failure, cancer, arterial hypertension);
• relief of epileptic seizures and convulsive conditions of various origins;
• therapy for conditions accompanied by increased muscle tone (including acute cerebrovascular accidents, tetanus, etc.), as well as post-traumatic conditions;
• relief of delirium and withdrawal syndrome in alcoholism;
• clinic of internal diseases: vascular spasms, hypertensive crisis, menstrual and menopausal disorders (as part of complex therapy);
• premedication and ataralgesia during diagnostic procedures and surgical operations (in combination with analgesics and other neurotropic drugs).

Contraindications

Absolute:

• respiratory disorders of central origin;
• respiratory failure of various etiologies;
• glaucoma;
• head injuries;
• depressive states with suicidal tendencies;
• myasthenia gravis;
• disturbance of consciousness;
• acute intoxication with drugs that have a depressing effect on the central nervous system (narcotics, hypnotics or psychotropics);
• acute alcohol intoxication with weakening of vital functions;
• coma;
• absence seizure or Lennox-Gastaut syndrome;
• children up to 5 weeks;
• pregnancy (especially the first trimester) and breastfeeding;
• individual intolerance to the components of Relium or other benzodiazepine derivatives.

Carefully:

• history of epilepsy or epileptic seizures;
• hypoproteinemia;
• psychosis;
• sleep apnea;
• organic brain diseases;
• hyperkinesis;
• porphyria;
• spinal and cerebral ataxias;
• renal and/or liver failure;
• history of alcohol, drug or drug addiction;
• elderly age.

Directions for use and dosage

In tablet form, Relium should be taken orally. Recommended doses for adults depending on indication:

• insomnia: 5-10 mg 30 minutes before bedtime for a short course;
• alcohol withdrawal syndrome: 10 mg 3 times a day, in some cases the daily dose can be increased to 60 mg;
• spastic muscle conditions: 5-15 mg per day in several doses, if the need arises, the daily dose can be increased to 60 mg.

• 8-18 years – 5-8 mg in 2 doses;
• 4-7 years – 4-6 mg in 2-3 doses;
• 2-3 years – 2-5 mg in 2-3 doses.

In solution form, Relium is administered intravenously (IV) or intramuscularly (IM, deep into large muscles). Recommended doses for adults:

• severe phobic disorders: 5-10 mg intravenously or intramuscularly, re-administered after 3-4 hours if necessary;
• acute cases of anxiety and restlessness: 2-5 mg IV or IM, if necessary, re-administered after 3-4 hours;
• alcohol withdrawal syndrome: IV or IM 10 mg once, then, if necessary, after 3-4 hours an additional 5-10 mg is administered;
• tetanus, athetosis, muscle spasms: 5-10 mg IV or IM. For tetanus, the dose may be increased;
• status epilepticus and severe recurrent convulsive seizures: IV or IM 5-10 mg once, repeat injections if necessary - first after 10-15 minutes, then after 2-4 hours, maximum dose - 30 mg;
• premedication: slowly IV 10 mg (in some cases the dose is increased to 20 mg, but provided that the patient does not receive narcotic analgesics) or IM 5-10 mg, 30 minutes before the intervention;
• electropulse therapy: iv 5-10 mg 5-10 minutes before the start of the procedure;
• complex therapy of vascular spasms, hypertensive crisis, hypertension, menstrual or menopausal disorders: the average single dose is 5-10 mg, specific doses, frequency of administration and duration of treatment are determined individually.

• tetanus: slowly intravenously or intramuscularly, for children from the 5th week of life - 1-2 mg, for children over 5 years old - 5-10 mg, if necessary, the drug is re-administered after 3-4 hours;
• severe, recurrent seizures, status epilepticus: slowly IV (under control of respiratory function), children from 5 weeks to 5 years - 0.2-0.5 mg for 2-5 minutes (maximum - up to 5 mg), children over 5 years old - 1 mg for 2-5 minutes (maximum - up to 10 mg). If necessary, the drug is re-administered after 2-4 hours.

For elderly people, exhausted and weakened patients, the standard dose for adults is usually reduced by 2 times.

Immediately before intravenous administration, the Relium solution is diluted with saline or 5% glucose solution to a volume of 10 ml. The drug is administered at a rate of up to 4 ml per minute. For intravenous drip infusion, 10 ampoules of Relium (100 mg) are diluted with 500 ml of 5% glucose solution or saline and administered at a rate of 40 ml/hour.

Side effects

• from the nervous system: at the beginning of treatment (especially in older people) - slowed reactions, drowsiness, confusion, disorientation, headache, dizziness, impaired concentration, increased fatigue, slowed mental and motor reactions, dulled emotions, lethargy, antegrade amnesia; rarely - dystonic extrapyramidal reactions (uncontrolled body movements, including the eyes), hyporeflexia, depressed mood, dysarthria, numbness, euphoria, depression, paradoxical reactions (psychomotor agitation, acute agitation, hallucinations, anxiety, muscle spasms, fear, irritability , confusion, insomnia, aggressive outbursts, suicidal tendencies);
• from the digestive system: salivation or dry mouth, hiccups, heartburn, anorexia, vomiting, gastralgia, increased activity of liver transaminases and alkaline phosphatase, liver dysfunction, jaundice;
• from the genitourinary system: libido disorders, dysmenorrhea, renal dysfunction;
• from the cardiovascular system: rapid heartbeat, decreased blood pressure, tachycardia;
• from the hematopoietic organs: neutropenia, thrombocytopenia, leukopenia, anemia, agranulocytosis (its symptoms: weakness or unusual fatigue, hyperthermia, chills, sore throat);
• allergic reactions: very rarely - skin reactions (itching, rash, urticaria), anaphylactic reactions;
• local reactions: pain, erythema, phlebitis at the injection site;
• other: addiction, drug dependence; rarely - weight loss, visual impairment (blurredness, diplopia), impaired external respiration function, depression of the respiratory center, bulimia;
• effect on the fetus: when using the drug by women during pregnancy (especially in the first trimester) - teratogenicity; in newborns whose mothers were treated with Relium - respiratory failure, depression of the central nervous system, suppression of the sucking reflex;
• when used in obstetrics: hypothermia, muscle hypotension, dyspnea.

If the drug is administered intravenously too quickly, respiratory and circulatory depression may occur (these complications can be prevented by keeping the patient horizontal during the entire time of intravenous infusion or injection and observing the recommended rate of administration of the drug).

In case of a sharp reduction in dose or sudden withdrawal of Relium, withdrawal syndrome may develop, its symptoms: disturbances of perception (including photophobia, hyperacusis and paresthesia), sleep disturbance, headache, agitation, nervousness, anxiety, irritability, depersonalization, dysphoria, feeling of fear, increased sweating, anxiety, tremor, depression, hallucinations, convulsions, tachycardia, spasm of smooth muscles of internal organs and skeletal muscles, nausea, vomiting; in rare cases - acute psychosis.

special instructions

Sometimes when diluting the drug, cloudiness may occur, which should disappear within a few minutes. If this does not happen, such a solution cannot be administered.

Relium solution should be administered intravenously slowly. Too rapid administration can lead to a decrease in blood pressure, respiratory depression and even cardiac arrest.

Do not mix the solution with other medications in the same syringe or infusion bottle.

Except in emergency cases, another medical professional should always be present when Relium is administered intravenously. There should be a resuscitation kit in the office. After the injection, the patient should be under medical supervision for at least an hour. A responsible adult should be present at home with the patient at all times.

During treatment and for 5 days after its completion, it is prohibited to drink alcohol, you should refrain from driving a car and performing other potentially dangerous activities.

Due to the risk of withdrawal syndrome, therapy should not be abruptly stopped.

If paradoxical reactions develop, the drug must be discontinued.

Patients with severe depression should be under special supervision, as they may use Relium to realize suicidal intentions.

With repeated use of diazepam, its effect weakens due to the development of tolerance.

The use of the drug in doses above 30 mg (especially intravenously or intramuscularly) within 15 hours before or during labor may cause metabolic disturbances in the newborn in response to cold stress, decreased muscle tone, and weak sucking (the so-called lethargic child), hypothermia, decreased blood pressure, respiratory depression up to apnea.

Children (especially young children) have increased sensitivity to the central nervous system depressant effects of benzodiazepines.

Diazepam may worsen the symptoms of porphyria.

Benzyl alcohol, which is part of Relium, can cause hypersensitivity reactions, and in children under 3 years old - allergic and toxic reactions.

Preparations containing benzyl alcohol are not recommended for use in infants less than 5 weeks of age due to the risk of developing a fatal toxic syndrome manifested by hypotension, central nervous system depression, metabolic acidosis, renal failure, difficulty breathing, and possibly intracranial hemorrhage and epileptic seizures. seizures.

Relium contains ethyl alcohol (100 mg in 1 ml of solution), this should be taken into account when prescribing it to children and patients at risk (patients with epilepsy, renal failure and alcoholism).

Sodium benzoate, which is part of the drug (49 mg in 1 ml of solution), increases the risk of developing jaundice in newborns.

Propylene glycol (one of the excipients of the solution) can cause allergic reactions. Benzoic acid – irritation of the skin, conjunctiva and mucous membranes, in patients with bronchial asthma – allergies or asthma attacks.

In patients with severe hepatic impairment, benzodiazepines and similar drugs may accelerate the development of hepatic encephalopathy. These drugs should be prescribed with caution to patients with a history of alcohol, drug or drug dependence.

With long-term use of diazepam in case of abrupt withdrawal of the drug, the risk of psychophysical drug dependence and the development of withdrawal syndrome increases.

With prolonged treatment, it is necessary to monitor the peripheral blood picture and liver function.

Drug interactions

Effect of diazepam on other drugs:

• reduces the effect of levodopa;
• enhances the effect of muscle relaxants;
• promotes an increase in the concentration of low-polarity cardiac glycosides in the blood serum and the development of digitalis intoxication;
• may increase the toxicity of zidovudine.

Effect of drugs on diazepam:

• smoking speeds up metabolism and weakens the effect;
• inducers of microsomal liver enzymes (for example, rifampicin) accelerate metabolism and reduce efficiency;
• microsomal oxidation inhibitors (including oral contraceptives, valproic acid, metoprolol, ketoconazole, fluoxetine, disulfiram, propoxyphene, omeprazole, isoniazid, cimetidine, propranolol, erythromycin) prolong the half-life and enhance the effect;
• alcohol enhances the inhibitory effect on the central nervous system and can lead to the development of such paradoxical reactions as respiratory depression, aggressive behavior, psychomotor agitation and even coma;
• clozapine increases respiratory depression;
• theophylline in low doses can reduce and even change the effect;
• drugs that block tubular secretion interfere with the process of conjugation of diazepam in the liver, as a result of which absorption is accelerated and the duration of action increases;
• narcotic analgesics increase euphoria and lead to an increase in psychological dependence, enhance the inhibitory effect on the central nervous system;
• antihypertensive drugs increase the severity of the decrease in blood pressure;
• monoamine oxidase inhibitors, psychostimulants, analeptics alter activity;
• agents for general anesthesia, psychotropic drugs, neuroleptics, narcotic analgesics, opioids, antidepressants, as well as anticholinergic, sympathicolytic, antiepileptic, antihistamine, sedative and hypnotic drugs increase the inhibitory effect on the central nervous system.
Rating:

Reasons for taking Relium tablets:

Relium was prescribed by a doctor for very severe stress, which led to emotional imbalance (hysterics, sudden changes in mood, sleep disturbance and lack of sleep at all). Due to the strong emotional tension and stress that I experienced, it was very difficult to fall asleep and my sleep was disturbing. Sometimes I couldn’t fall asleep all night, sometimes I could wake up at 3-4 in the morning and could not fall asleep again and had constant anxious thoughts. The stress was caused by the death of a loved one; she could not cope without medication.

Instructions for use:

Adults for neuroses, neurasthenia, hysteria, spastic paralysis, prevention of epileptic seizures: 2-10 mg 3-4 times a day. Withdrawal syndrome in patients with alcoholism: 10 mg 3-4 times on the first day, followed by a daily dose reduction of 5 mg 3-4 times a day. In elderly patients, a single dose is 1-2.5 mg 3-4 times a day. If necessary, the dose is gradually increased. For children, the dosage is prescribed individually depending on age and disease.

The dosage prescribed by the doctor was 2 tablets per day, at the end of the course I switched to half a tablet. The tablet is very small, but it was possible to break it. Taken at lunch and before bed. I washed it down with water (half a glass).

Indications for use:

Neuroses, neurasthenia, hysteria, reactive depression, agoraphobia, insomnia associated with a violation of the phase of falling asleep, Meniere's disease, spastic paralysis, withdrawal syndrome in patients with alcoholism, status epilepticus, epilepsy, premedication before surgical interventions and endoscopic manipulations; LSD poisoning.

Relium analogues:

The active ingredient in Relium is diazepam. Although Relium is an imported drug, its price is humane (from 30 to 50 rubles). This is the lowest price among Relium's analogues. Here are some of them:

• Relanium (price about 100 rubles), also made in Poland. Relanium is a prescription drug; you cannot buy Relanium without a prescription.
• Sibazon (price about 30 rubles), made in Russia. Sold by prescription.
• Also analogues of Relium are tablets and injection solutions Seduxen and Apaurin.

Once again I want to repeat that the drugs are strong, so they are all sold strictly according to a doctor’s prescription. This strict use is due not only to the large list of side effects, but also to the fact that it is addictive.




Contraindications:

Hypersensitivity, acute diseases of the liver and kidneys with impairment of their functions, myasthenia gravis, angle-closure glaucoma, first trimester of pregnancy, breastfeeding.

Side effect:

Addiction, paradoxical reactions (development of anxiety, hallucinations, convulsions, insomnia), decreased reaction speed and concentration, drowsiness, deterioration of short-term memory, ataxia, dysarthria, headache, dizziness, hypotension, bradycardia, with prolonged use, liver and kidney damage, atony intestines, decreased libido and potency, reactions at the injection site, withdrawal syndrome, aftereffect syndrome (decreased performance, muscle weakness), allergic reactions.

I didn’t read reviews on Relium before using it, I didn’t have time for that, I trusted the doctor and didn’t regret it. I had no side effects.

Pros:

1. Efficiency. After taking Relium tablets, the effect occurred after about 1.5-2 hours. There was a feeling of calm, anxiety and nervous tension passed.
2. Healthy and sound sleep. As I wrote above, I took the pill before bed. After this, there were no problems falling asleep, the sleep was sound and without waking up in the middle of the night. In the morning there was no feeling of sleepiness. But after taking the next pill in the afternoon (after lunch), drowsiness began again, but at the same time a feeling of calm and even a slight increase in mood.
3. A cheap medicine that is affordable for everyone (30-50 rubles).

Minuses:

1. There are a huge number of side effects and it is not known whether any of them will work or can be avoided. Luckily, I didn’t experience any side effects.
2. A very strong drug that can be addictive. I moved away from it gradually, reducing the dosage. First, I reduced it from 2 tablets a day to 1 tablet, then only half at night. Therefore, there was no withdrawal effect.

What helped me get out of depression? Drug treatment (Relium and Grandaxin), family support, bicycle and spring.