Zopam Injection Adverse Reactions

Geriatric and debilitated patients, children (especially the very young), and patients with liver disease or low serum albumin are usually more sensitive to the CNS effects of benzodiazepines. Parenteral administration of benzodiazepines may cause apnea, hypotension, bradycardia, or cardiac arrest, especially in geriatric or severely ill patients and in patients with limited pulmonary reserve or unstable cardiovascular status or if intravenous administration of medication is too rapid.
Parenteral benzodiazepines have produced hypotension or muscular weakness in some patients, especially when used concurrently with narcotics, barbiturates, or alcohol.
Coughing, depressed respiration, dyspnea, hyperventilation, laryngospasm, and pain in throat and chest have been reported when parenteral diazepam was administered in peroral endoscopic procedures.
The following side / adverse effects have been selected on the basis of their potential clinical significance.
Those indicating need for medical attention: Incidence less frequent: Intolerance to benzodiazepines (confusion); mental depression.
Incidence rare: Allergic reaction (skin rash or itching); behaviour problems (including difficulty in concentrating and outbursts of anger); blood dyscrasias, including agranulocytosis, anemia, leukopenia, neutropenia (chills, fever, and / or sore throat; ulcers or sores in mouth or throat, continuing; unusual tiredness or weakness ); thrombocytopenia (unusual bleeding or bruising); extra-pyramidal effects, dystonic (uncontrolled movements of body, including the eyes), hepatic dysfunction (yellow eyes or skin), hypotension; memory impairment; muscle weakness; paradoxical reactions (including hallucinations; insomnia; unusual excitement, nervousness, or irritability); phlebitis or venous thrombosis (redness, swelling, or pain at injection site); seizures.
Incidence of phlebitis or venous thrombosis is more common with diazepam.
There may be an increased incidence and severity of seizures, especially on initiation or abrupt withdrawal of diazepam in patients with epilepsy or history of seizures.
Those indicating need for medical attention only if they continue or are bothersome.
Incidence more frequent: Ataxia (clumsiness or unsteadiness); dizziness or lightheadedness; drowsiness when used as a hypnotic; slurred speech.
Incidence less frequent or rare: Abdominal or stomach cramps or pain; blurred vision or other changes in vision; changes in libido; constipation; diarrhoea; dryness of mouth or increased thirst; euphoria; headache; increased bronchial secretions or watering of mouth; muscle spasm; nausea or vomiting; problems with urination; tachycardia / palpitations; trembling; unusual tiredness or weakness.
Dependence: Dependence may develop after regular use of diazepam or other benzodiazepines, even in therapeutic doses for short periods. Drug dependence is generally characterised by a strong desire to take the drug, a tendency to increase the dose owing to development of tolerance, a physical and psychological dependence on the drug, and a characteristic abstinence syndrome on withdrawal. In the context of benzodiazepine dependence, physical dependence with the development of withdrawal symptoms on drug discontinuation is common. The extent to which tolerance occurs has been debated but appears to occur more often to effects on psychomotor performance than to anxiolytic effects. Drug-seeking behaviour is uncommon with therapeutic doses of benzodiazepines.
Withdrawal symptoms include anxiety, insomnia, head ache, dizziness, tinnitus, loss of appetite, tremor, perspiration, irritability, perceptual disturbances such as hypersensitivity to visual and auditory stimuli and metallic taste, nausea, vomiting, abdominal cramps, palpitations, and orthostatic hypotension. Rare and more serious symptoms include muscle twitching, confusional or paranoid psychosis, convulsions, hallucinations, and delirium tremens. The time at which symptoms develop varies with the duration of action of the benzodiazepine used. Benzodiazepines should not be discontinued abruptly after regular use for even a few weeks, but withdrawn by gradual reduction of the dose over a period of weeks.