Indications: anxiety, insomnia, adjunctive treatment of acute alcohol withdrawal; epilepsy; febrile convulsions; muscle spasm; peri-operative use.

Cautions: may alter reaction time and patient's ability to drive or operate machinery. respiratory disease, muscle weakness and myasthenia gravis, history of drug or alcohol abuse, marked personality disorder, pregnancy, breast-feeding, reduce dose in elderly and debilitated, and in hepatic impairment (avoid if severe), renal impairment; avoid prolonged use (and abrupt withdrawal thereafter); porphyria; when given parenterally, close observation required until full recovery from sedation.

Contra-indications: respiratory depression; marked neuromuscular respiratory weakness including unstable myasthenia gravis; acute pulmonary insufficiency; sleep apnoea syndrome; severe hepatic impairment; not for chronic psychosis; should not be used alone in depression or in anxiety with depression; avoid injections containing benzyl alcohol in neonates.

Side Effects: drowsiness and lightheadedness the next day; confusion and ataxia (especially in the elderly); amnesia; dependence; paradoxical increase in aggression; muscle weakness; occasionally: headache, vertigo, hypotension, salivation changes, gastro-intestinal disturbances, visual disturbances, dysarthria, tremor, changes in libido, incontinence, urinary retention; blood disorders and jaundice; skin reactions; on intravenous injection, pain, thrombophlebitis, and rarely apnoea.

Dose: by mouth, anxiety, 2 mg 3 times daily increased in severe anxiety to 15-30 mg daily in divided doses.

Elderly patients, half adult dose.

Child in night terrors and somnambulism 1-5 mg daily at bedtime.

Insomnia associated with anxiety - 5-15 mg at bedtime. By IM or slow IV injection, (at a rate of not more than 5mg/minute), for severe anxiety, control of acute panic attacks, and acute alcohol withdrawal, 10 mg repeated if necessary after 4 hours.

By IV infusion, max. of 3 mg/kg over 24 hours.

≡chlordiazepoxide 15 mg

≡loprazolam 0.5–1 mg

≡lorazepam 500 mcg

≡lormetazepam 0.5–1 mg

≡nitrazepam 5 mg

≡oxazepam 15 mg

≡temazepam 10 mg