DIAZEPAM VIR 2 mg TABLETS

2. What you need to know before you take Diazepam Vir

Do not take Diazepam Vir

• If you are allergic to diazepam or any of the other components of this medicine (listed in section 6).
• If you are allergic to other medicines in the benzodiazepine group.
• If you have breathing difficulties related or not to sleepfor a long time.
• If you have a disease called "myasthenia gravis", which is 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 drug or alcohol dependent, you should not take diazepam unless your doctor formally indicates 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.

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

Warnings and precautions

Consult your doctor or pharmacist before starting to take this medicine.

• If you have any 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 drug or alcohol dependence
• If you are taking other medicines

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

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

Other medicines and Diazepam Vir

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.

Therefore, you should not take diazepam with other medicines unless your doctor is informed and approves it beforehand. For example, tranquilizers, sleep inducers, and similar medicines act on the brain and nerves and can reinforce the effect of this medicine.

Cisapride, cimetidine, ketoconazole, fluvoxamine, fluoxetine, and omeprazole temporarily increase the sedative effect of diazepam, increasing the risk of drowsiness.

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.

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

Taking Diazepam Vir with food, drinks, and alcohol

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

Risk of dependence

The use of benzodiazepines can lead to 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 worked for 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 decides whether to continue treatment.

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, think you may be pregnant, or plan to become pregnant, consult your doctor or pharmacist before using this medicine. The doctor will then decide whether it is convenient for you to take this medicine.

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

Driving and using machines

Diazepam may 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.

Use in elderly people

Elderly people may need lower doses of diazepam than younger patients. If you are an elderly person, your doctor may prescribe a lower dose and check your response to treatment. Please follow your doctor's instructions carefully.

Diazepam Vir contains lactose

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

3. How to take Diazepam Vir

Follow exactly the administration instructions of the medicine 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 Vir.

Remember to take your medicine.

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

Use in 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 muscle spasms:2 to 10 mg, 3 or 4 times a day.

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

Use in children

From 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 people or in the presence of debilitating diseases

From 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 effect of this medicine is too strong or too weak, tell your doctor or pharmacist.

In elderly patients who have 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.

Guidelines for correct administration

Do not increase the doses prescribed by the doctor 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 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 decides whether to continue treatment.

Do not prolong treatment for longer than recommended.

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

If you take more Diazepam Vir than you should

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

If you forget to take Diazepam Vir

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

If you stop taking Diazepam Vir

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 rather 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 mentioned in this 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 and drowsiness.

Occasionally, other side effects of the type of confusion, impaired alertness, loss of sensitivity, constipation, depression, diplopia (double vision), ataxia (inability to coordinate voluntary muscle movements), difficulty articulating words, digestive disorders, alteration of heart rhythm, headache, hypotension, circulatory disorders, increased or decreased 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.

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

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

Anterograde amnesia (difficulty remembering recent events) may occur at normal doses, and the risk increases when the dose is increased. Amnestic effects may be associated with behavioral disorders.

If you notice any other reaction not described in this 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 not listed in this 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 Vir

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

This medicine does not require special storage conditions.

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

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 you have any doubts, ask your pharmacist how to dispose of the packaging and any unused medicine. This will help protect the environment.

6. Contents of the pack and further information

Composition of Diazepam Vir

The active substance is diazepam. Each tablet contains 2 mg of diazepam.

The other components are lactose, cornstarch, and magnesium stearate (E470b).

Appearance of the product and contents of the pack

Diazepam Vir 2 mg tablets are round, white or almost white, and scored on one side. The tablet can be divided into equal doses.

Diazepam Vir 2 mg tablets are available in packs of 30 or 100 tablets.

Marketing authorization holder and manufacturer

Industria Química y Farmacéutica VIR, S.A.

C/ Laguna 66-70, Polígono Industrial URTINSA II

28923 Alcorcón (Madrid)

Spain

This leaflet was approved in April 2022

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