Drug/Small Molecule:
diazepam

2D structure

Overview

Generic Names: DAP; Methyldiazepinone
Trade Names: Alboral; Aliseum; Alupram; Amiprol; An-Ding; Ansiolin; Ansiolisina; Apaurin; Apo-Diazepam; Apozepam; Armonil; Assival; Atensine; Atilen; Bensedin; Bialzepam; Calmocitene; Calmpose; Cercine; Ceregulart; Diacepan; Dialag; Dialar; Diapam; Diastat; Diazemuls; Diazemulus; Diazepam Intensol; Diazepan; Diazetard; Dienpax; Dipam; Dipezona; Dizac; Domalium; Duksen; Duxen; E-Pam; Eridan; Eurosan; Evacalm; Faustan; Faustan,; Freudal; Frustan; Gewacalm; Gihitan; Kabivitrum; Kiatrium; LA III; La-Iii; Lamra; Lembrol; Levium; Liberetas; Mandrozep; Morosan; Neurolytril; Noan; Novazam; Novo-Dipam; Paceum; Pacitran; Paranten; Paxate; Paxel; Plidan; Pms-Diazepam; Pro-Pam; Q-Pam; Q-Pam Relanium; Quetinil; Quiatril; Quievita; Relaminal; Relanium; Renborin; Ruhsitus; Saromet; Sedapam; Sedipam; Seduksen; Seduxen; Serenack; Serenamin; Serenzin; Servizepam; Setonil; Sibazon; Sibazone; Solis; Sonacon; Stesolid; Stesolin; Tensopam; Tranimul; Tranqdyn; Tranquase; Tranquirit; Tranquo-Puren; Tranquo-Tablinen; Umbrium; Unisedil; Usempax Ap; Valaxona; Valeo; Valiquid; Valitran; Valium; Valrelease; Vatran; Velium; Vival; Vivol; Zetran; Zipan
PharmGKB Accession Id: PA449283

Description

A benzodiazepine with anticonvulsant, anxiolytic, sedative, muscle relaxant, and amnesic properties and a long duration of action. Its actions are mediated by enhancement of gamma-aminobutyric acid activity. It is used in the treatment of severe anxiety disorders, as a hypnotic in the short-term management of insomnia, as a sedative and premedicant, as an anticonvulsant, and in the management of alcohol withdrawal syndrome. (From Martindale, The Extra Pharmacopoeia, 30th ed, p589) (source: Drug Bank)

Indication

Used in the treatment of severe anxiety disorders, as a hypnotic in the short-term management of insomnia, as a sedative and premedicant, as an anticonvulsant, and in the management of alcohol withdrawal syndrome. (source: Drug Bank)

ATC Therapeutic Category

  • N05BA:Benzodiazepine derivatives

Pharmacology, Interactions, and Contraindications

Mechanism Of Action

Benzodiazepines bind nonspecifically to benzodiazepine receptors which mediate sleep, affects muscle relaxation, anticonvulsant activity, motor coordination, and memory. As benzodiazepine receptors are thought to be coupled to gamma-aminobutyric acid-A (GABA<sub>A</sub>) receptors, this enhances the effects of GABA by increasing GABA affinity for the GABA receptor. Binding of GABA to the site opens the chloride channel, resulting in a hyperpolarized cell membrane that prevents further excitation of the cell. (source: Drug Bank)

Pharmacology

Diazepam, a benzodiazepine, generates the same active metabolite as chlordiazepoxide and clorazepate. In animals, diazepam appears to act on parts of the limbic system, the thalamus and hypothalamus, and induces calming effects. Diazepam, unlike chlorpromazine and reserpine, has no demonstrable peripheral autonomic blocking action, nor does it produce extrapyramidal side effects; however, animals treated with diazepam do have a transient ataxia at higher doses. Diazepam was found to have transient cardiovascular depressor effects in dogs. Long-term experiments in rats revealed no disturbances of endocrine function. Injections into animals have produced localized irritation of tissue surrounding injection sites and some thickening of veins after intravenous use. (source: Drug Bank)

Food Interactions

Avoid alcohol.
Avoid excessive quantities of coffee or tea (caffeine).
Avoid taking with grapefruit or grapefruit juice as grapefruit can significantly increase serum levels of this product.
Take with food. (source: Drug Bank)

Absorption, Distribution, Metabolism, Elimination & Toxicity

Biotransformation

Hepatic via the Cytochrome P450 enzyme system. The main active metabolite is desmethyldiazepam, in addition to minor active metabolites including temazepam and oxazepam. (source: Drug Bank)

Protein Binding

98.5% (source: Drug Bank)

Absorption

Essentially complete, with a bioavailability of 93%. (source: Drug Bank)

Toxicity

Symptoms of overdose include somnolence, confusion, coma, and diminished reflexes. Respiration, pulse and blood pressure should be monitored. (source: Drug Bank)

Isomeric SMILES Code:

CN1c2ccc(cc2C(=NCC1=O)c3ccccc3)Cl (source: Drug Bank)

The following genes are in curated knowledge about this drug.

  Gene Relationship Evidence
Phenotype data available Genotype Data Available Literature annotations available Has annotations
CYP2C19
  •   
  • PD
  • PK
  •   
  • GN
Publications
No phenotype data Genotype Data Available Literature annotations available Not annotated
CYP2E1
  •   
  •   
  • PK
  •   
  •   
Publications
Phenotype data available Genotype Data Available Literature annotations available Not annotated
CYP3A
  •   
  •   
  • PK
  •   
  •   
Publications
Phenotype data available Genotype Data Available Literature annotations available Has annotations
CYP3A4
  •   
  •   
  • PK
  •   
  •   
Publications
Phenotype data available Genotype Data Available Literature annotations available Has annotations
CYP3A5
  •   
  •   
  • PK
  •   
  •   
Publications
No phenotype data No genotype data Literature annotations available Not annotated
DBI
  •   
  • PD
  •   
  •   
  •   
Publications
No phenotype data No genotype data Literature annotations available Not annotated
GABRA1
  •   
  • PD
  •   
  •   
  •   
Publications
No phenotype data No genotype data Literature annotations available Not annotated
GABRA6
  • CO
  •   
  •   
  •   
  • GN
Publications
No phenotype data No genotype data Literature annotations available Not annotated
GABRB2
  •   
  • PD
  •   
  •   
  •   
Publications
No phenotype data No genotype data Literature annotations available Not annotated
GABRG2
  •   
  • PD
  •   
  •   
  •   
Publications
No phenotype data No genotype data Literature annotations available Not annotated
TSPO
  •   
  • PD
  •   
  •   
  •   
Publications

A list of non-curated publications that mention this drug along with other genes is available.

Drug Targets

Gene Description
GABRA1 Uncurated Annotation (source: Drug Bank)
GABRA2 Uncurated Annotation (source: Drug Bank)
GABRA3 Uncurated Annotation (source: Drug Bank)
TSPO Uncurated Annotation (source: Drug Bank)

The following drugs are in curated knowledge about this drug.

  Drug Relationship Evidence
Phenotype data available No genotype data Literature annotations available Not annotated
fluoxetine
  •   
  •   
  •   
  • FA
  •   
Publications

A list of non-curated publications that mention this drug along with other drugs is available.

Drug Interactions

Drug Description
amprenavir Uncurated Annotation Amprenavir increases the effect and toxicity of benzodiazepine (source: Drug Bank)
cimetidine Uncurated Annotation Cimetidine increases the effect of the benzodiazepine (source: Drug Bank)
clarithromycin Uncurated Annotation The macrolide increases the effect of the benzodiazepine (source: Drug Bank)
clozapine Uncurated Annotation Increased risk of toxicity (source: Drug Bank)
digoxin Uncurated Annotation The benzodiazepine increases the effect of digoxin (source: Drug Bank)
erythromycin Uncurated Annotation The macrolide increases the effect of the benzodiazepine (source: Drug Bank)
fluconazole Uncurated Annotation Fluconazole increases the effect of the benzodiazepine (source: Drug Bank)
fosamprenavir Uncurated Annotation Amprenavir increases the effect and toxicity of benzodiazepine (source: Drug Bank)
indinavir Uncurated Annotation The protease inhibitor increases the effect of the benzodiazepine (source: Drug Bank)
itraconazole Uncurated Annotation The imidazole increases the effect of the benzodiazepine (source: Drug Bank)
ketoconazole Uncurated Annotation The imidazole increases the effect of the benzodiazepine (source: Drug Bank)
mephenytoin Uncurated Annotation Possible increased levels of the hydantoin, decrease of benzodiazepine (source: Drug Bank)
nelfinavir Uncurated Annotation The protease inhibitor increases the effect of the benzodiazepine (source: Drug Bank)
omeprazole Uncurated Annotation Omeprazole increases the effect of benzodiazepine (source: Drug Bank)
phenytoin Uncurated Annotation Possible increased levels of the hydantoin, decrease of benzodiazepine (source: Drug Bank)
rifampin Uncurated Annotation Rifampin decreases the effect of benzodiazepine (source: Drug Bank)
ritonavir Uncurated Annotation The protease inhibitor increases the effect of the benzodiazepine (source: Drug Bank)
saquinavir Uncurated Annotation The protease inhibitor increases the effect of the benzodiazepine (source: Drug Bank)
voriconazole Uncurated Annotation The imidazole increases the effect of the benzodiazepine (source: Drug Bank)

Non-Curated Information

A list of non-curated publications that mention this drug along with other diseases is available.

Additional Datasets

These datasets are minimally curated and are sorted alphabetically by title.

  1. Physicochemical determinants of human renal clearance

LinkOuts

Web Resource:
Wikipedia
DrugBank:
DB00829
ChEBI ID:
4494
KEGG Compound ID:
C06948
KEGG Drug ID:
D00293
PubChem Compound ID:
3016
PubChem Substance ID:
153142

Common Searches

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Non-Curated Publications

A list of non-curated publications that mention this drug is available.

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