Benzodiazepines (Systemic)
Before Using This MedicineIn deciding to use a medicine,
the risks of taking the medicine must be weighed against the good it will
do. This is a decision you and your doctor will make. For benzodiazepines,
the following should be considered:
Allergies - Tell your doctor if you have ever had any unusual or
allergic reaction to benzodiazepines. Also tell your health care professional
if you are allergic to any other substances, such as foods, preservatives,
or dyes. Certain benzodiazepine products may contain lactose, parabens, or
soybean oil.
Pregnancy - Chlordiazepoxide and diazepam have been reported
to increase the chance of birth defects when used during the first 3 months
of pregnancy. Although similar problems have not been reported with the other
benzodiazepines, the chance always exists since all of the benzodiazepines
are related. Studies in animals have shown that clonazepam, lorazepam, and temazepam
cause birth defects or other problems, including death of the animal fetus.
Too much use of a benzodiazepine during pregnancy may cause the baby to
become dependent on the medicine. This may lead to withdrawal side effects
after birth. Also, use of benzodiazepines during pregnancy, especially during
the last weeks, may cause body temperature problems, breathing problems, difficulty
in feeding, drowsiness, or muscle weakness in the newborn infant.
Benzodiazepines given just before or during labor may cause weakness in
the newborn infant. When diazepam is given in high doses (especially by injection)
within 15 hours before delivery, it may cause breathing problems, muscle weakness,
difficulty in feeding, and body temperature problems in the newborn infant.
Breast-feeding - Benzodiazepines may pass into the breast milk and
cause drowsiness, difficulty in feeding, and weight loss in nursing babies
of mothers taking these medicines.
Children - Most of the side effects of these medicines are more
likely to occur in children, especially the very young. These patients are
usually more sensitive than adults to the effects of benzodiazepines. It is possible that using clonazepam for long periods of time may cause
unwanted effects on physical and mental growth in children. If such effects
do occur, they may not be noticed until many years later. Before this medicine
is given to children for long periods of time, you should discuss its use
with your child's doctor.
Older adults - Most of the side effects of these medicines are more
likely to occur in the elderly, who are usually more sensitive to the effects
of benzodiazepines. Taking benzodiazepines for trouble in sleeping may cause more daytime drowsiness
in elderly patients than in younger adults. In addition, falls and related
injuries are more likely to occur in elderly patients taking benzodiazepines.
Other medicines - Although certain medicines should not be used
together at all, in other cases two different medicines may be used together
even if an interaction might occur. In these cases, your doctor may want to
change the dose, or other precautions may be necessary. When you are taking
or receiving benzodiazepines it is especially important that your health care
professional know if you are taking any of the following:
-
Central nervous system (CNS) depressants (medicines that cause drowsiness) - The
CNS depressant effects of either these medicines or benzodiazepines may be
increased; your doctor may want to change the dose of either or both medicines
-
Fluvoxamine (e.g., Luvox) or
-
Itraconazole (e.g., Sporanox) or
-
Ketoconazole (e.g., Nizoral) or
-
Nefazodone (e.g., Serzone) - Higher blood levels of benzodiazepines
may occur, increasing the chance that side effects will occur; your doctor
may want to change the dose of either or both medicines, or give you a different
medicine
Other medical problems - The presence of other medical
problems may affect the use of benzodiazepines. Make sure you tell your doctor
if you have any other medical problems, especially:
-
Alcohol abuse (or history of) or
-
Drug abuse or dependence (or history of) - Dependence on benzodiazepines
may be more likely to develop
-
Brain disease - CNS depression and other side effects of benzodiazepines
may be more likely to occur
-
Difficulty in swallowing (in children) or
-
Emphysema, asthma, bronchitis, or other chronic lung disease or
-
Glaucoma or
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Hyperactivity or
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Mental depression or
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Mental illness (severe) or
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Myasthenia gravis or
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Porphyria or
-
Sleep apnea (temporary stopping of breathing during sleep) - Benzodiazepines
may make these conditions worse
-
Epilepsy or history of seizures - Although some benzodiazepines
are used in treating epilepsy, starting or suddenly stopping treatment with
these medicines may increase seizures
-
Kidney or liver disease - Higher blood levels of benzodiazepines
may result, increasing the chance that side effects will occur
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