AA Pharma Diazepam Special Precautions

Use in Emotional Disorders: Diazepam is not recommended in the treatment of psychotic or severely depressed patients. Precautions are indicated for severely depressed patients or those who show evidence of impending depression, particularly the recognition that suicidal tendencies may be present and protective measures may be necessary.
Since excitement and other paradoxical reactions may result from the use of the drug in psychotic patients, it should not be used in ambulatory patients suspected of having psychotic tendencies.
Use in Epileptic Patients: Since Diazepam may exacerbate grand mal seizures in some patients, caution is required when it is used in epileptic patients. An adjustment may be necessary in their anti-convulsive medication. Abrupt withdrawal of Diazepam in these patients should also be avoided.
Potentiation of Drug Effects: Careful consideration should be given if Diazepam is to be combined with other psychotropic agents (phenothiazines, barbiturates, and MAO inhibitors and other anti-depressants) because the pharmacological action of these agents might potentiate the action of Diazepam. Since this drug has a central nervous system depressant effect, patients should be advised against the simultaneous ingestion of alcohol and other central nervous system depressant drugs during Diazepam therapy.
Drug Dependence: Abrupt cessation of large doses of Diazepam after prolonged periods may precipitate acute withdrawal symptoms, including convulsions, and, in these cases, the drug should be discontinued gradually. Caution should be exercised when it is considered necessary to administer Diazepam to addiction-prone individuals.
General: Patients receiving Diazepam should be advised to proceed cautiously wherever mental alertness and physical coordination are required.
The usual precautions in treating patients with impaired renal and hepatic functions should be observed. If Diazepam is administered for protracted periods, periodic blood counts and liver function tests are advisable.
Use in the Elderly: Elderly and debilitated patients or those with organic brain disorders have been found to be prone to central nervous system depression following even low doses. For there patients, it is recommended that the dosage be limited to the smallest effective amount to preclude development of ataxia, oversedation or other possible adverse effects.