Prazepam

Oral
Short-term management of anxiety

May be taken with or without food.

Preexisting CNS depression or coma, resp depression, acute pulmonary insufficiency or sleep apnoea; severe hepatic impairment; chronic psychosis, phobic or obsessional states; glaucoma; porphyria. Myasthenia gravis.

Chronic pulmonary insufficiency; elderly or debilitated patients; muscle weakness, impaired liver or kidney function; drowsiness may affect skilled tasks; monitor cardio-respiratory function when used for deep sedation; patients with personality disorders or organic brain changes; pregnancy and lactation; history of alcohol or drug addiction due to risk of depression. resp depression and hypotension with parenteral admin, therefore this route should only be used when facilities for reversing resp depression are available. May precipitate suicide or aggressive behavior, not used alone to treat depression or anxiety associated with depression.

Drowsiness, sedation, muscle weakness and ataxia; less frequently vertigo, headache, confusion, depression, slurred speech, changes in libido, tremor, visual disturbances, urinary retention, GI disturbances, changes in salivation and amnesia; rarely, jaundice, blood disorders and hypersensitivity reactions; pain and thrombophloebitis; raised liver enzyme values; paradoxical excitation.

Impairment of consciousness is quite rapid in overdosage.

Enhanced sedation or resp and CV depression with alcohol, drugs with CNS depressant properties eg, antidepressants, antihistamines, antipsychotics, general anaesthetics, other hypnotics or sedatives, opioid analgesics and cisapride. Decreased serum levels when used with phenytoin. May increase the plasma levels of bupivacaine. Serum levels may be increased by valproate and modafinil.

Description: Prazepam is a long-acting benzodiazepine with general properties similar to diazepam.
Pharmacokinetics:
Metabolism: Extensive first-pass metabolism in the liver.

Anxiolytics