Warnings

When giving benzodiazepines to those who have psychiatric illnesses, alcoholism, drug addiction, or both, caution should be taken to prevent abuse and overuse.

Except for the treatment of epilepsy and pre- or postoperative care, this treatment is typically not recommended for patients under the age of 18 years. For this group of patients, the lowest effective dose should be utilized. Diazepam shouldn't be administered to infants younger than 6 months old because its safety and effectiveness have not been determined.

Apnea or cardiac arrest may occur in elderly or seriously unwell patients. Use of additional central nervous system depressants concurrently raises this risk. For this population, the minimum effective dose ought to be applied. Even at identical blood plasma levels, older persons are more vulnerable to the effects of benzodiazepines and metabolize them far more slowly than younger adults. It is advised to keep diazepam dosages about half of what is given to younger patients and to keep treatment to a maximum of two weeks. For older patients, long-acting benzodiazepines like diazepam are not advised. Due to a significantly elevated risk of falls in older people, diazepam can also be harmful.

Benzodiazepines, like diazepam, are lipophilic and quickly permeate membranes, allowing for rapid entry into the placenta and substantial drug absorption. Floppy newborn syndrome can occur if benzodiazepines, such as diazepam, are used in late pregnancy, especially at high doses. Diazepam use in the third trimester of pregnancy increases the chance of a severe benzodiazepine withdrawal syndrome in the newborn, which can include symptoms including hypotonia, refusal to suckle, apneic episodes, cyanosis, and poor metabolic reactions to cold stress. Sedation in the newborn and floppy infant syndrome can also happen. It has been documented that the signs of newborn benzodiazepine withdrawal syndrome and floppy infant syndrome can last for weeks or even months after birth.