DIAZEPAM CINFA 10 mg TABLETS

2. What you need to know before taking diazepam cinfa

Do not take diazepam cinfa

• If you are allergic to diazepam or any of the other ingredients of this medicine (listed in section 6).
• If you are allergic (hypersensitive) to other medicines of the benzodiazepine group.
• If you have long-standing breathing difficulties related or not to sleep.
• If you have a disease called "myasthenia gravis", characterized by muscle weakness and fatigue.
• If you have severe respiratory problems (severe respiratory failure).
• If you have severe liver problems (severe liver failure).
• If you are dependent on drugs or alcohol, you should not take diazepam, unless your doctor has formally indicated it.

This medicine is not recommended for the primary treatment of psychotic disorders (severe mental disorders that cause abnormal ideas and perceptions), nor should it be used as the only treatment in patients with depression, alone or associated with anxiety. Your doctor will probably have prescribed another medicine for these cases.

Warnings and precautions

Consult your doctor or pharmacist before starting to take diazepam cinfa.

• If you have any heart, liver or kidney disease.
• If you have breathing difficulties.
• If you have severe muscle weakness.
• If you have other diseases.
• If you have allergies.
• If you have a history of or problems with dependence on drugs or central nervous system depressants, including alcohol.
• If you are taking other medicines.

Your doctor will decide whether it is convenient for you to take a lower dose of diazepam or not to take it at all.

In patients with depression, diazepam only acts on the anxious component, so it does not constitute a treatment for depression in itself and may eventually unmask some signs of it.

If you are epileptic and are undergoing long-term treatment with diazepam, it is not recommended to use the benzodiazepine antagonist Anexate (flumazenil) to reverse the effect of diazepam, as convulsions may appear.

Your doctor will pay special attention to the high risk associated if you are an elderly patient or are severely debilitated.

Children

Do not use this medicine in children under 6 months of age.

The duration of treatment should be as short as possible.

Elderly patients

Elderly patients may need lower doses of diazepam than younger patients. The pharmacological effects of benzodiazepines in elderly patients seem to be greater than in the younger population.

If you are an elderly patient, your doctor may prescribe a lower dose and check your response to treatment. Please follow your doctor's instructions carefully.

Patients with liver disorders

The sedative effect of diazepam is increased in patients with alcoholic cirrhosis.

Other medicines and diazepam cinfa

Tell your doctor or pharmacist if you are taking, have recently taken or may take any other medicine. This is extremely important because the simultaneous use of more than one medicine can increase or decrease its effect.

For example, tranquilizers, sleep inducers and similar medicines act on the brain and nerves and can reinforce the effect of diazepam.

Cimetidine, ketoconazole, fluconazole, voriconazole, fluvoxamine, fluoxetine, hormonal contraceptives, disulfiram, isoniazid, diltiazem, idelalisib, modafinil, armodafinil, esomeprazole and omeprazole temporarily increase the sedative effect of diazepam, increasing the risk of drowsiness. The same happens with grapefruit juice.

On the other hand, medicines such as rifampicin and carbamazepine produce a decrease in the effects of diazepam.

Also, the metabolism of phenytoin may be affected if you are taking diazepam, so if you are taking this medicine, your doctor will adjust the doses of the same.

The sedative effect and cardiopulmonary depression can be increased when combining diazepam with other central nervous system depressants, which can cause coma or death.

Xanthines such as theophylline and caffeine oppose the sedative effects of diazepam.

Therefore, you should not take diazepam with any other medicine, unless your doctor has allowed it.

If you need more information about this, consult your doctor or pharmacist.

Taking diazepam cinfa with food, drinks and alcohol

Alcoholic beverages increase the sedative effects of diazepam, so you should avoid the use of alcoholic beverages during treatment. If you need additional information, consult your doctor.

You should not take diazepam in combination with grapefruit juice, as it can increase the levels of diazepam in your body.

Food and antacids can decrease the speed, but not decrease the absorption of diazepam from the tablet; this can lead to milder effects after a single dose, but does not affect during treatment with multiple doses.

Prokinetic medicines (medicines to improve intestinal transit) increase the absorption of diazepam.

Risk of dependence

The use of benzodiazepines and benzodiazepine-like drugs can lead to physical and psychological dependence. This occurs mainly after uninterrupted use of the medicine for a long time. To minimize the risk of dependence, the following precautions should be taken:

• The use of benzodiazepines will only be done under medical prescription (never because they have been effective in other patients), and never advise them to other people.
• Do not increase the prescribed doses in any way, nor prolong the treatment for longer than recommended.
• Consult your doctor regularly so that he can decide if you should continue the treatment.

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.

If, for strict medical necessity, you take diazepam before or during delivery, hypothermia (abnormally low body temperature), weakness, hypotension and breathing difficulties may appear in the newborn. There have also been cases of withdrawal syndrome in newborns.

Benzodiazepines pass into breast milk, so you should consult your doctor about taking diazepam while breastfeeding.

Driving and using machines

Diazepam can alter your ability to drive or operate machinery, as it can cause drowsiness, decrease your attention or decrease your reaction capacity. The appearance of these effects is more likely at the start of treatment or when the dose is increased. Do not drive or use machines if you experience any of these effects.

diazepam cinfa contains lactose

This medicine contains lactose. If your doctor has told you that you have an intolerance to some sugars, consult with him before taking this medicine.

3. How to take diazepam cinfa

Follow the instructions for administration of this medicine exactly as indicated by your doctor or pharmacist. In case of doubt, consult your doctor or pharmacist again.

Depending on the nature of your illness, your age and weight, your doctor will prescribe the most suitable dose and indicate the duration of your treatment with diazepam.

Remember to take your medicine.

Follow these instructions unless your doctor has given you different instructions:

Adults

Anxiety symptoms:2 to 10 mg, 2 to 4 times a day, depending on the severity of the symptoms.

Symptomatic relief in acute alcohol withdrawal:10 mg, 3 or 4 times during the first 24 hours, reducing to 5 mg 3 or 4 times a day, as needed.

Adjunctive treatment for musculoskeletal spasm:2 to 10 mg, 3 or 4 times a day.

Adjunctive therapy in anticonvulsant therapy: 2 to 10 mg, 2 or 4 times a day.

Dosage in special populations

Use in children:2 to 2.5 mg, 1 or 2 times a day, gradually increasing as needed and tolerated; as a general rule 0.1-0.3 mg/kg per day. Due to the variety of response of children to medicines that act on the central nervous system, treatment should be started with the lowest dose and increased as required. Do not use in children under 6 months of age.

Use in elderly or debilitated patients:2 to 2.5 mg, 1 or 2 times a day, gradually increasing as needed and tolerated.

Treatment should be started with the lowest dose. The maximum dose should not be exceeded.

If you think the action of diazepam is too strong or too weak, tell your doctor or pharmacist.

In elderly patients or those with liver or kidney disorders, or muscle weakness, in children, in debilitated patients or those with low serum albumin levels, the doctor will prescribe a lower dose.

Rules for correct administration

Do not increase the prescribed doses in any way.

Each individual dose should not exceed the indicated limits and the total daily dose should not either, unless your doctor prescribes a higher dose.

The diazepam tablets should be taken without chewing, with a little water or a non-alcoholic drink.

The tablets will be taken at the times that are most necessary, normally in the afternoon or evening. Never change the dose that has been prescribed for you.

Duration of treatment

The duration of treatment should be as short as possible and never more than 2-3 months. Consult your doctor regularly so that he can decide if you should continue the treatment.

Do not prolong the treatment for longer than recommended.

To avoid withdrawal symptoms, you should not stop taking diazepam abruptly, especially if you have been taking it for a long time.

If you take more diazepam cinfa than you should

In case of overdose or accidental ingestion, consult your doctor or pharmacist immediately or call the Toxicology Information Service, telephone 91 562 04 20, indicating the medicine and the amount ingested.

If you forget to take diazepam cinfa

Do not take a double dose to make up for forgotten doses. On the contrary, you should continue with the normal dose.

If you stop treatment with diazepam cinfa

When stopping the administration, restlessness, anxiety, insomnia, lack of concentration, headache and hot flashes may appear. It is not recommended to interrupt the medication abruptly, but to gradually reduce the dose, according to the doctor's instructions.

If you have any other questions about the use of this medicine, ask your doctor or pharmacist.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

If you think any of the side effects you are suffering from is serious, or if you notice any side effects not listed in this package leaflet, tell your doctor or pharmacist.

Most patients tolerate diazepam well, but the most frequent side effects, which occur especially at the beginning of treatment, are fatigue, muscle weakness and drowsiness.

Occasionally, other side effects of the type of confusion, decreased alertness, loss of sensitivity, dizziness, affective disorders, emotional and mood changes, constipation, depression, diplopia (double vision), ataxia (inability to coordinate voluntary muscle movements), difficulty articulating words, digestive changes, changes in heart rhythm, headache, hypotension, circulatory changes, changes in libido (sexual appetite), nausea, dry mouth or hypersalivation (exaggerated salivary secretion), incontinence or urinary retention, skin rashes, stuttering, tremors, vertigo and blurred vision. The most frequent skin reactions are rash (skin inflammation), urticaria (red patches) and pruritus (uncomfortable itching or irritation of the skin that causes the desire to scratch the affected area).

Very rarely, increased transaminases and alkaline phosphatase, jaundice (yellowish appearance of the skin and eyes), as well as cardiac arrest have been reported.

An increased risk of falls and fractures has been observed in elderly patients and in patients who are taking other sedative medicines (including alcoholic beverages) at the same time.

Cardiac failure, respiratory depression, including respiratory failure, may occur.

It is known that when benzodiazepines are used, behavioral side effects such as restlessness, disorientation, agitation, irritability, delirium (incoherence of ideas), outbursts of anger, aggression, nervousness, hostility, anxiety, nightmares, abnormal dreams, hallucinations, psychosis (loss of contact with reality), hyperactivity or inappropriate behavior may occur. These reactions are more frequent in elderly people and children. If you experience these effects, you should stop the treatment and contact your doctor immediately.

Furthermore, the use of benzodiazepines can lead to dependence, mainly when the medicine is taken continuously for a long time. It is not recommended to interrupt the medication abruptly, but to gradually reduce the dose, according to the doctor's instructions.

Anterograde amnesia (difficulty remembering recent events) may appear at normal doses, the risk increases when the dose is increased. The amnestic effects may be associated with behavioral changes.

If you notice any other reaction not described in this package leaflet, consult your doctor or pharmacist.

Reporting of side effects

If you experience any type of side effect, consult your doctor or pharmacist, even if it is a possible side effect that does not appear in this package leaflet. You can also report them directly through the Spanish Pharmacovigilance System for Human Use Medicines: https://www.notificaram.es. By reporting side effects, you can help provide more information on the safety of this medicine.

5. Storage of diazepam cinfa

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date which is stated on the packaging after CAD. The expiry date is the last day of the month indicated.

This medicine does not require special storage conditions.

Medicines should not be disposed of via wastewater or household waste. Place the packaging and any unused medicine in the SIGRE collection point at the pharmacy. If in doubt, ask your pharmacist how to dispose of the packaging and any unused medicine. This will help protect the environment.

6. Packaging Contents and Additional Information

Composition of Diazepam Cinfa

• The active ingredient is diazepam. Each tablet contains 10 mg of diazepam.
• The other components are lactose monohydrate, cornstarch, and magnesium stearate.

Appearance of the Product and Packaging Contents

Round, flat, beveled tablets, white or almost white in color, with the inscription “E1” on one side.

It is presented in PVC/aluminum blisters. Each package contains 25 and 30 tablets.

Marketing Authorization Holder and Manufacturer

Marketing Authorization Holder

Cinfa Laboratories, S.A.

Olaz-Chipi Road, 10. Areta Industrial Estate

31620 Huarte (Navarra) - Spain

Manufacturer

Neuraxpharm Pharmaceuticals, S.L.

Barcelona Avenue, 69

08970 Sant Joan Despí (Barcelona) Spain

or

Cinfa Laboratories, S.A.

Olaz-Chipi Road, 10. Areta Industrial Estate

31620 Huarte (Navarra) - Spain

Date of the Last Revision of this Leaflet:November 2021

Detailed and updated information on this medication is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS) http://www.aemps.gob.es/

You can access detailed and updated information about this medication by scanning the QR code included in the leaflet and packaging with your mobile phone (smartphone). You can also access this information at the following internet address: https://cima.aemps.es/cima/dochtml/p/80699/P_80699.html

QR code to: https://cima.aemps.es/cima/dochtml/p/80699/P_80699.html