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Common brand names: Valium tablets, Valium injection

Description: Diazepam relaxes people and makes them sleepy. It is sometimes used to treat seizure and anxiety disorders.

Dental uses: Diazepam helps anxious patients relax before and during dental procedures. It can improve sleep the night before a procedure. Diazepam also is used (along with nonsteroidal anti-inflammatory drugs) to treat muscle pain and spasm in the temporomandibular joint (TMJ).

Dosages for dental purposes: The typical adult dose given by mouth is 2 milligrams to 10 milligrams. It can be taken before bedtime to improve sleep the night before a dental procedure. It also can be taken 1 hour before the procedure. All patients should be given the lowest effective dose to reduce possible side effects. For muscle relaxation in the TMJ, the dose may be repeated 2 to 4 times per day for up to a week.

Diazepam also can be given through a vein in the arm for conscious sedation. This produces a very relaxed, drowsy state. This type of sedation usually is done by an oral surgeon or dental anesthesiologist. The dose varies from patient to patient but usually is between 2 milligrams and 10 milligrams.

Concerns and possible side effects: Tell your dentist and physician about all the medicines you take. This should include over-the-counter vitamins and herbal supplements. Also, let your dentist know if you have had a sensitive or allergic reaction to any medicine. If you are pregnant or nursing, or might be pregnant, talk to your primary care doctor before starting any new medicine. This also includes vitamins and supplements.

When given by mouth, diazepam is very safe. But it does often cause side effects, including:

  • Forgetfulness
  • Impaired thinking
  • Lack of coordination

Because of these effects, and because diazepam makes you sleepy, you should not operate machinery or drive for up to 24 hours after taking it.

Occasionally, diazepam may cause a dry mouth. This goes away.

Certain groups of people should not take diazepam:

  • People with narrow-angle glaucoma -- It can increase the risk of a glaucoma attack.
  • People with sleep apnea
  • Pregnant women -- Diazepam can increase the risk of birth defects, especially if it is taken in the first trimester.

Diazepam given through a vein (intravenously) can produce all of the same side effects as diazepam given by mouth. It should be administered only by people with advanced training in anesthesiology. These include oral surgeons and dental anesthesiologists. Patients must be properly monitored. Monitoring will include blood pressure, electrocardiogram (EKG) and a pulse oximeter. This measures a person's heart rate and, indirectly, breathing. Occasionally, diazepam can impair breathing. If you are going to have any form of intravenous sedation, ask your doctor about his or her level of training and experience with giving anesthesia.

Intravenous diazepam may cause a temporary burning feeling upon injection. It can cause pain near the vein, which can last for more than a week.

Anyone receiving diazepam should not drink alcohol. The combination can result in increased sedation. This can be life threatening.

Certain other drugs may cause diazepam to accumulate in the body and increase the risks of side effects. These include:

  • The antibiotics erythromycin (Eryc) and clarithromycin (Biaxin)
  • Azole antifungal drugs, such as ketoconazole (Nizoral) and fluconazole (Diflucan)
  • The ulcer/gastroesophageal reflux disease drugs cimetidine (Tagamet) and omeprazole (Prilosec)

This list is not complete and it continues to grow. These interactions can be serious. Tell your doctor about any reaction to a prescribed medicine, no matter how minor it might be.

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