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PRESCRIBED FOR: Diazepam is used for the treatment of anxiety disorders. Diazepam also is used for the treatment of agitation, tremors, delirium, seizures, and hallucinations resulting from alcohol withdrawal. It is used for the treatment of seizures and relief of muscle spasms in some neurological diseases. DOSING: Diazepam may be taken with or without food. Diazepam is metabolized by the liver and excreted mainly by the kidney. Dosages of diazepam may need to be lowered in patients with abnormal kidney function. The usual oral diazepam dose is 2-10 mg given 2-4 times daily. The usual rectal dose is 0.2-0.5 mg/kg and depends on the age of the patient. DRUG INTERACTIONS: Alcohol or medications that cause sedation may add to the sedative effects of diazepam. Patients taking benzodiazepines should avoid such combinations. Cimetidine (Tagamet), ketoconazole (Nizoral), omeprazole (Prilosec, Rapinex), fluvoxamine (Luvox), and fluoxetine (Prozac) may prolong the effects of diazepam by inhibiting liver enzymes that break down diazepam. Dosages may need to be decreased when these drugs are used with diazepam. PREGNANCY: Benzodiazepines, such as diazepam, can cause fetal abnormalities and should not be used during pregnancy. NURSING MOTHERS: Diazepam is excreted in breast milk and can affect nursing infants. Therefore, diazepam should not be used by women who are nursing. SIDE EFFECTS: The most frequent side effects of diazepam are drowsiness, fatigue, and ataxia (loss of balance). Rarely, diazepam causes a paradoxical reaction with excitability, muscle spasm, lack of sleep, and rage. Confusion, depression, speech problems, and double vision are also rare side effects of diazepam. Diazepam can lead to addiction (dependency), especially when higher dosages are used over prolonged periods of time. In patients addicted to diazepam or after prolonged use, abrupt discontinuation of the medicine may cause symptoms of withdrawal (insomnia, headaches, nausea, vomiting, lightheadedness, sweating, anxiety, and fatigue). Seizures can occur in more severe cases of withdrawal. Therefore, after extended use, diazepam should be slowly tapered under a doctor's supervision rather than abruptly stopping the medication.