Leaflet: information for the user

diazepam cinfa 10 mg EFG tablets

Read this leaflet carefully before you start taking this medicine, because it contains important information for you.

• Keep this leaflet, as you may need to read it again.
• If you have any questions, ask your doctor or pharmacist.
• This medicine has been prescribed for you only, and you must not give it to others even if they have the same symptoms as you, as it may harm them.
• If you experience any side effects, consult your doctor or pharmacist, even if they are not listed in this leaflet. See section 4.

diazepam cinfa contains as active ingredient diazepam, which belongs to the group of medicines called benzodiazepines.

diazepam has tranquilizing, sedative, muscle relaxant and anticonvulsant effects.

Doctors prescribe diazepam to people who present symptoms of anxiety, agitation and psychological tension produced by psychoneurotic states and transient situational disorders. Benzodiazepines are only indicated for the treatment of an intense disorder, which limits their activity or subjects them to a situation of important stress.

It may also be useful for the relief of symptoms of acute agitation, tremor and hallucinations in patients with alcohol withdrawal syndrome.

This medicine contributes to the relief of muscle pain caused by spasms or inflammation of muscles or joints, traumas, etc. It can also be used to combat spasms originating from diseases such as cerebral palsy (a group of disorders that affect a person's ability to move, maintain balance and posture) and paraplegia (paralysis of the lower half of the body, which affects both legs), as well as in atetosis (slow, involuntary, continuous and extravagant movements of fingers and hands) and in generalized rigidity syndrome.

This medicine may be used as an adjunctive treatment (treatment administered after the main treatment to increase the chances of a cure) of convulsive disorders (such as epilepsy, seizures), but it has not been proven useful as a single treatment. In these cases, your doctor will periodically evaluate the usefulness of the medicine for your case.

Do not take diazepam cinfa

• If you are allergic to diazepam or any of the other components of this medication (listed in section 6).
• If you are allergic (hypersensitive) to other medications in the benzodiazepine group.
• If you have respiratory difficulties (related or unrelated to sleep) for a long time.
• If you have a condition called "myasthenia gravis", characterized by muscle weakness and fatigue.
• If you have severe respiratory problems (severe respiratory insufficiency).
• If you have severe liver problems (severe hepatic insufficiency).
• If you are dependent on drugs or alcohol, do not take diazepam unless your doctor has formally instructed you to do so.

This medication 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 sole treatment for depression, alone or associated with anxiety. Your doctor has probably prescribed another medication 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 respiratory difficulties.
• If you have severe muscle weakness.
• If you have other diseases.
• If you have allergies.
• If you have a history or problems of dependence on drugs or central nervous system depressants, including alcohol.
• If you are taking other medications.

Your doctor will decide whether you should take a lower dose of diazepam or not take it at all.

In patients with depression, diazepam only acts on the anxious component, so it is not a treatment for depression itself and may eventually unmask some of its symptoms.

If you are epilepticand are following a long-term treatment with diazepam, do not use the benzodiazepine antagonist Anexate (flumazenil) to reverse the effect of diazepam, as this may cause seizures.

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

Children

Do not use this medication 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 appear 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 dysfunction

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

Other medications and diazepam cinfa

Inform your doctor or pharmacist if you are taking, have taken recently, or may need to take any other medication. This is extremely important because the simultaneous use of multiple medications can increase or decrease their effect.

For example, tranquilizers, sleep inducers, and similar medications 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, omeprazole, and esomeprazole temporarily increase the sedative effect of diazepam, increasing the risk of drowsiness. The same occurs with grapefruit juice.

On the other hand, medications such as rifampicin and carbamazepine reduce the effects of diazepam.

Similarly, the metabolism of phenytoin may be affected if you are taking diazepam, so if you are taking this medication, your doctor will adjust the doses accordingly.

Combining diazepam with other central nervous system depressants can increase the sedative effect and respiratory depression, potentially causing coma or death.

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

Therefore, do not take diazepam with any other medication 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 avoid using alcoholic beverages during treatment. If you need additional information, consult your doctor.

Do not take diazepam in combination with grapefruit juice, as this can increase the levels of diazepam in your body.

Food and antacids can slow down the absorption of diazepam from the tablet, but will not decrease it; this may lead to milder effects after a single dose, but does not affect during multiple-dose treatment.

Prokinetic medications (medications 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 taking the medication continuously for a long time. To minimize the risk of dependence, consider the following precautions:

• Take benzodiazepines only under medical prescription (never because they have worked for other patients), and never advise others to do so.
• Do not increase the prescribed doses or prolong treatment beyond the recommended duration.
• Consult your doctor regularly to decide whether to continue treatment.

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, or think you may be pregnant, consult your doctor or pharmacist before using this medication.

If you take diazepam before or during delivery, the newborn may experience hypothermia (abnormally low body temperature), weakness, hypotension, and respiratory difficulties. Additionally, cases of withdrawal syndrome in newborns have been reported.

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

Driving and operating machinery

Diazepam can impair your ability to drive or operate machinery, as it can cause drowsiness, decrease attention, or decrease reaction time. The appearance of these effects is more likely at the beginning of treatment or when increasing the dose. Do not drive or operate machinery if you experience any of these effects.

diazepam cinfa contains lactose

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

Follow exactly the administration instructions of this medication 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 will indicate the duration of your treatment with diazepam.

Remember to take your medication.

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.

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

Musculoskeletal spasm relief:2 to 10 mg, 3 or 4 times a day.

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

Posology in special populations

Use in children:2 to 2.5 mg, 1 or 2 times a day, increasing gradually as needed and tolerated; as a general rule, 0.1-0.3 mg/kg per day. Due to the variety of responses of children to medications acting on the CNS, treatment should begin with the lowest dose and increase as needed. Do not use in children under 6 months of age.

Use in elderly or in the presence of debilitating diseases:2 to 2.5 mg, 1 or 2 times a day, increasing gradually as needed and tolerated.

Treatment should begin with the lowest dose. Do not exceed the maximum dose.

If you estimate that the action of diazepam is too strong or too weak, inform your doctor or pharmacist.

In elderly patients or those with liver or kidney disease, 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, in any way, the doses prescribed by your doctor.

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

Diazepam tablets should be taken without chewing, with a little water or a non-alcoholic beverage.

Diazepam tablets should be taken at the hours when they are most needed, usually in the afternoon or evening. Never change the dose that has been prescribed for you.

Treatment duration

The duration of treatment should be the shortest possible and never exceed 2-3 months. Consult your doctor regularly to decide if treatment should continue.

Do not prolong treatment beyond the recommended time.

To avoid withdrawal symptoms, do 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 Toxicological Information Service, phone 91 562 04 20, indicating the medication and the amount ingested.

If you forget to take diazepam cinfa

Do not take a double dose to compensate for the missed doses. Instead, continue with the normal dose.

If you interrupt treatment with diazepam cinfa

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

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

Like all medicines, this medicine may cause side effects, although not everyone will experience them.

If you consider that any of the side effects you are experiencing are severe or if you notice any side effect not mentioned in this leaflet, inform your doctor or pharmacist.

Most patients tolerate diazepam well, but the most common 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, emotional disturbances, mood changes, constipation, depression, double vision, ataxia (inability to coordinate voluntary muscle movements), difficulty articulating words, digestive changes, heart rhythm alterations, headache, hypotension, circulatory changes, changes in libido (sexual appetite), nausea, dry mouth or hypersalivation (excessive salivation), incontinence or urinary retention, skin eruptions, stuttering, tremor, vertigo, and blurred vision have been described. The most common skin reactions are inflammation (skin inflammation), urticaria (red patches), and pruritus (itching or uncomfortable skin irritation that causes the desire to scratch the affected area).

Very rarely, an increase in transaminases and alkaline phosphatase, jaundice (yellowish discoloration of the skin and eyes), and cardiac arrest have been reported.

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

Heart failure, respiratory depression, including respiratory insufficiency, may occur.

It is known that when benzodiazepines are used, side effects on behavior 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 side effects, you should discontinue treatment and contact your doctor immediately.

On the other hand, the use of benzodiazepines can lead to dependence, mainly when the medication is taken continuously for a long time. It is generally not recommended to stop treatment abruptly, always following the doctor's instructions.

Amnesia (difficulty remembering recent events) may appear at normal doses, and the risk increases with increased doses. Amnesic effects may be associated with behavioral changes.

If you observe 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 that does not appear in this leaflet.You can also report them directly through the Spanish System for Pharmacovigilance of Medicines for Human Use: https://www.notificaram.es.By reporting side effects, you can contribute to providing more information on the safety of this medicine.

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

Do not use this medication after the expiration date that appears on the packaging after CAD. The expiration date is the last day of the month indicated.

This medication does not require special conditions for conservation.

Medications should not be disposed of through drains or in the trash. Dispose of packaging and medications you no longer need at the SIGRE collection point at the pharmacy. If in doubt, ask your pharmacist how to dispose of packaging and medications you no longer need. By doing so, you will help protect the environment.

Diazepam Cinfa Composition

Appearance of the product and contents of the packaging

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

Presented in PVC/aluminum blisters. Each package contains 25 and 30 tablets.

Marketing authorization holder and responsible manufacturer

Marketing authorization holder

Laboratorios Cinfa, S.A.

Carretera Olaz-Chipi, 10. Polígono Industrial Areta

31620 Huarte (Navarra) - Spain

Responsible manufacturer

Neuraxpharm Pharmaceuticals, S.L.

Avda. Barcelona, 69

08970 Sant Joan Despí (Barcelona) Spain

or

Laboratorios Cinfa, S.A.

Carretera Olaz-Chipi, 10. Polígono Industrial Areta

31620 Huarte (Navarra) - Spain

Last review date of this leaflet: November 2021

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

You can access detailed and updated information on this medicine by scanning the QR code included in the leaflet and packaging with your 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