Diazepam Pensa 2.5 mg tablets

Package leaflet: Information for the user

Introduction

Package leaflet: information for the user

Diazepam pensa 2.5 mg tablets

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

• Keep this leaflet. You may need to read it again.

If you have any further questions, ask your doctor or pharmacist.

• This medicine has been prescribed for you only. Do not pass it on to other people, even if they have the same symptoms as you, because it may harm them.
• If you experience any side effects, talk to your doctor or pharmacist, even if the side effects are not listed in this leaflet. See section 4.

Contents of the leaflet:

1. What Diazepam pensa is and what it is used for
2. What you need to know before taking Diazepam pensa
3. How to take Diazepam pensa
4. Possible side effects
5. How to store Diazepam pensa
6. Contents of the pack and other information

1. What Diazepam pensa is and what it is used for

Diazepam pensa contains the active substance diazepam, which belongs to a group of medicines called benzodiazepines.

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

Doctors prescribe diazepam for people experiencing symptoms of anxiety, agitation, and psychological tension caused by psychoneurotic conditions and transient situational disorders. Benzodiazepines are only indicated for the treatment of severe disorders that significantly limit a person's activity or subject them to considerable stress.

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

Diazepam helps relieve muscle pain caused by muscle or joint spasms, inflammation, trauma, etc. It may also be used to treat spasms resulting from conditions such as cerebral palsy (a group of disorders affecting a person's ability to move, maintain balance and posture), paraplegia (paralysis of the lower half of the body, affecting both legs), as well as in athetosis (continuous, involuntary, slow, and writhing movements of fingers and hands) and generalized stiffness syndrome.

Diazepam may be used as an adjunctive treatment (a treatment given after the primary treatment to increase the likelihood of recovery) for seizure disorders (such as epilepsy, convulsions), but it has not been shown to be effective as sole therapy. In such cases, your doctor will periodically evaluate the usefulness of the medicine for your condition.

2. What you need to know before starting to take Diazepam pensa

Do not take Diazepam pensa

• If you are allergic to diazepam or to any of the other ingredients of this medicine (listed in section 6).
• If you are allergic (hypersensitive) to other medicines in the benzodiazepine group.
• If you suffer from breathing difficulties, long-term, whether related to sleep or not.
• If you have a disease called "myasthenia gravis," which is characterized by muscle weakness and fatigue.
• If you suffer from severe respiratory problems (severe respiratory insufficiency).
• If you suffer from severe liver problems (severe hepatic insufficiency).
• If you have drug or alcohol dependence, you should not take diazepam unless your doctor has specifically instructed you to do so.

This medicine is not recommended for the primary treatment of psychotic disorders (severe mental disorders causing abnormal thoughts and perceptions), nor should it be used as the sole treatment in patients with depression, either alone or associated with anxiety. Your doctor will likely have prescribed another medicine for these conditions.

Warnings and precautions

Talk to your doctor or pharmacist before starting to take Diazepam pensa

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

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

In patients with depression, diazepam acts only on the anxious component and therefore does not constitute treatment for depression itself; it may even unmask some symptoms of depression.

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

Special caution will be taken by your doctor due to the high risk if you are elderly or severely weakened.

Children

The duration of treatment should be as short as possible.

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

Elderly patients

Elderly patients may require lower doses of diazepam than younger patients. The pharmacological effects of benzodiazepines appear to be greater in elderly patients than in younger individuals.

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

Patients with hepatic impairment

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

Other medicines and Diazepam pensa

Tell your doctor or pharmacist if you are taking, have recently taken, or might need to take any other medicines. This is extremely important because taking more than one medicine at the same time may increase or decrease their effects. For example, sedatives, sleep-inducing medicines, and similar drugs act on the brain and nerves and may enhance the effect of diazepam.

Cisapride, 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 applies to grapefruit juice.

Conversely, medicines such as rifampicin and carbamazepine reduce the effects of diazepam.

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

The sedative effect and cardiorespiratory depression may increase when diazepam is combined with other central nervous system depressants, possibly leading to coma or death.

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

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

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

Taking Diazepam pensa with food, drinks, and alcohol

Alcoholic beverages increase the sedative effects of Diazepam pensa; therefore, avoid consuming alcoholic drinks during treatment. If you need further information, consult your doctor.

Diazepam should not be taken together with grapefruit juice, as it may increase diazepam levels in your body.

Food and antacids may slow down, but will not reduce, the absorption of diazepam from the tablet; this may lead to milder effects after a single dose, but does not affect 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 may lead to physical and psychological dependence. This occurs mainly after prolonged, uninterrupted use of the medicine. To minimize the risk of dependence, the following precautions should be observed:

• Benzodiazepines should only be taken under medical prescription (never because they worked for someone else), and you should never recommend them to others.
• Do not increase the doses prescribed by your doctor, nor extend the treatment beyond the recommended duration.
• Consult your doctor regularly so they can decide whether treatment should continue.

Pregnancy and breastfeeding

Consult your doctor or pharmacist before using any medicine.

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.

If, due to strict medical necessity, you take diazepam before or during childbirth, the newborn may experience hypothermia (abnormally low body temperature), weakness, hypotension, and breathing difficulties. Cases of withdrawal syndrome in newborns have also been reported.

Benzodiazepines pass into breast milk; therefore, you should consult your doctor about whether or not to take diazepam during breastfeeding.

Driving and using machines

Do not drive or operate tools or machinery, as this medicine may cause sedation, amnesia, difficulty concentrating, and muscle weakness, all of which may negatively affect your ability to drive or operate machinery. Your doctor must decide when you can resume these activities. This effect is increased if you have also consumed alcohol.

Diazepam pensa contains lactose

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

3. How to take Diazepam pensa

Follow exactly the administration instructions for this medicine as indicated by your physician. If in doubt, consult your doctor or pharmacist again.

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

Remember to take your medication.

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

Adults:

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

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

Other diazepam formulations may be more suitable for the symptomatic relief of acute alcohol withdrawal.

Adjuvant for relief of musculoskeletal spasm: 2 to 10 mg, 3 or 4 times daily.

Adjuvant in anticonvulsant therapy: 2 to 10 mg, 2 or 4 times daily.

Dosing in special populations

Use in children: 2 to 2.5 mg, 1 or 2 times daily, gradually increased according to needs and tolerance; as a general rule, 0.1–0.3 mg/kg daily. Due to the variable response of children to drugs acting on the CNS, treatment should begin with the lowest dose and be increased as required. Do not use in children under 6 months of age.

In elderly patients or in the presence of debilitating diseases: 2 to 2.5 mg, 1 or 2 times daily, then gradually increased as needed and tolerated.

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

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

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

Instructions for proper administration

Under no circumstances should the doses prescribed by your doctor be increased.

Each individual dose must not exceed the limits indicated, nor should the total daily dose, unless your doctor prescribes a higher dose.

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

The tablets should be taken at the times when they are most needed, usually in the afternoon or evening. Never change the prescribed dose on your own.

Duration of treatment

The treatment duration should be as short as possible and never exceed 2–3 months. Consult your doctor regularly to determine whether treatment should continue.

Do not prolong the treatment beyond the recommended period.

To avoid withdrawal symptoms, diazepam should not be discontinued abruptly, especially if it has been taken for a long time.

If you take more Diazepam pensa than you should

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

If you forget to take Diazepam pensa

Do not take a double dose to make up for missed doses. Instead, continue with your normal dose.

If you stop taking Diazepam pensa

When administration is discontinued, symptoms such as restlessness, anxiety, insomnia, difficulty concentrating, headache, and hot flushes may occur. Abrupt discontinuation of the medication is generally not recommended; instead, the dose should be gradually reduced according to your doctor's instructions.

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

4. Possible adverse effects

Like all medicines, this medicine can cause adverse effects, although not everyone will experience them.

If you consider any of the adverse effects you experience to be severe, or if you notice any adverse effects not listed in this leaflet, inform your doctor or pharmacist.

Most patients tolerate this medicine well, but the most common adverse effects, which occur especially at the beginning of treatment, are fatigue, muscle weakness and drowsiness.

Occasionally, other adverse effects have been reported such as confusion, reduced level of alertness, loss of sensation, dizziness, affective disorders, emotional and mood disturbances, constipation, depression, diplopia (double vision), ataxia (inability to coordinate voluntary muscle movements), difficulty articulating speech, gastrointestinal disturbances, changes in heart rhythm, headache, hypotension, circulatory disturbances, changes in libido (sexual drive), nausea, dry mouth or hypersalivation (excessive salivary secretion), urinary incontinence or urinary retention, skin rashes, stammering, tremor, vertigo and blurred vision. The most frequent skin reactions are rash (skin inflammation), urticaria (red, itchy raised areas) and pruritus (tingling or irritating discomfort of the skin causing an urge to scratch the affected area).

Very rarely, elevated transaminases and alkaline phosphatase levels, jaundice (yellowing 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 sedative medicines simultaneously (including alcoholic beverages).

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

It is known that when benzodiazepines are used, adverse behavioural effects such as restlessness, disorientation, agitation, irritability, delirium (incoherent thinking), rage attacks, aggressiveness, nervousness, hostility, anxiety, nightmares, abnormal dreams, hallucinations, psychosis (loss of contact with reality), hyperactivity or inappropriate behaviour may occur. These reactions are more frequent in elderly patients and in children. If you experience any of these effects, you must stop treatment and contact your doctor immediately.

In addition, the use of benzodiazepines may lead to dependence, particularly when the medicine is taken continuously over a long period. Generally, abruptly stopping the medication is not recommended, and discontinuation should always follow your doctor's instructions.

Anterograde amnesia (difficulty remembering recent events) may occur at normal doses, and the risk increases with higher doses. Amnesic effects may be associated with behavioural disturbances.

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

Reporting of adverse effects

If you experience any adverse effect, consult your doctor or pharmacist, even if it is a possible adverse effect not listed in this leaflet. You may also report them directly via the Spanish Pharmacovigilance System for Human Medicines: www.notificaRAM.es. By reporting adverse effects, you can help provide more information on the safety of this medicine.

5. Storage of Diazepam pensa

Keep this medicine out of sight and reach of children.

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

This medicine does not require any special storage conditions.

Medicines must not be disposed of via wastewater or household waste. Return unused medicines and their containers to the SIGRE collection point at your pharmacy. Ask your pharmacist how to dispose of medicines and containers you no longer need. This helps protect the environment.

6. Contents of the container and additional information

Composition of Diazepam pensa

• The active substance is diazepam. Each tablet contains 2.5 mg of diazepam.
• The other components are lactose monohydrate, corn starch, magnesium stearate, low-substituted hydroxypropylcellulose, red iron oxide (E-172), and yellow iron oxide (E-172).

Appearance of the product and contents of the pack

The tablets are light salmon-colored, round, biconvex, printed with "D 2.5" on one side and smooth on the other.

Diazepam pensa 2.5 mg tablets are available in blister packs (Aluminum/PVC) containing 40 tablets.

Marketing Authorization Holder and Manufacturer

Marketing Authorization Holder:

Towa Pharmaceutical, S.A.
C/ de Sant Martí, 75-97
08107 Martorelles (Barcelona)
Spain

Manufacturer:

LABORATORIOS NORMON, S.A.
Ronda de Valdecarrizo, 6 - 28760 Tres Cantos - Madrid (SPAIN)

Date of the most recent review of this leaflet: September 2022

Detailed and up-to-date information on this medicine is available on the website of the Spanish Agency of Medicines and Health Products (AEMPS) http://www.aemps.gob.es/