Diazepam is a central nervous system depressant which may potentiate the action of other central nervous system depressants as barbiturates, tranquilizers, narcotics, antidepressants.
Diazepam may increase the action of digoxin.
Cimetidine, erythromycin, azole substances (such as itraconazole or ketoconazole) valproic acid and propanol may slow the metabolism of diazepam. The dose of diazepam may need to be decreased to avoid excessive sedation.
Dexamethasone may decrease the action of diazepam.
The concomitant use with hepatotoxic dosages of other substances should be avoided.
When administered alone, diazepam overdose may cause significant central nervous system depression (confusion, decreased reflexes, coma, etc). Supportive treatment should be given (cardio-respiratory stimulation, oxygen). Hypotension and respiratory and cardiac depression are rare events.
Diazepam is a benzodiazepine derivative thought to depress the sub-cortical levels of the central nervous system (primarily limbic, thalamic and hypothalamic) to produce anxiolytic, sedative, musculoskeletal relaxant and anticonvulsant effects. The exact mechanism of action has not been defined.
Diazepam is highly lipid soluble and is widely distributed throughout the body. It readily crosses the blood-brain barrier and is highly bound to plasma proteins. It is metabolised in the liver to produce several pharmacologically active metabolites (major metabolite in dogs is N-desmethyl-diazepam), which are conjugated with glucuronide and eliminated primarily in the urine.