Introduction

1.1 Background
Benzodiazepines are a class of sedative or sedative drugs used to help calm the
mind and relax the muscles. Benzodiazepines are used as treatment for
conditions, such as:
a. Anxiety disorder
b. Panic attacks
c. Sedative before surgery
d. Insomnia
e. Tense muscles (muscle spasms)
f. seizures
g. Alcohol dependence syndrome
This drug works by affecting the central nervous system, which will make the
nerves of the brain less sensitive to stimulation, causing a calming effect.
1.2 The types of drugs that are classified as benzodiazepines:
a. Alprazolam
b. Chlordiazepoxide
c. Clobazam
d. Clonazepam
e. Diazepam
f. Estazolam
g. Lorazepam
h. Midazolam
1.3 Benzodiazepine Side Effects
Drug reactions in each person is different. Side effects that may arise after
using benzodiazepine drugs:
 a. Sleepy
b. Dizzy
c. dazed
d. Weak
e. Memory impairment
f. Body balance disorders
g. Akathisia (movement disorder)
h. seizures
i. Nauseous
j. Vomit
k. Constipation
l. Dry mouth
m. Weight gain
n. Appetite is difficult to control
o. Decreased sexual appetite
p. Depressed respiratory system
q. Blood pressure dropped dramatically
r. Desire to commit suicide.
1.4 Types, Trademarks, and Dosage of Benzodiazepines
The following are the types of drugs that belong to the benzodiazepine class.
For a detailed description of side effects, warnings or interactions, please
seeAZ drug.
1.4.1 Alprazolam
Alprazolam trademarks: Alprazolam 0.5, Alviz, Apazol, Atarax,
Calmet, Frixitas, Opizolam,Xanax
Drug form: Tablets
  As a short-term treatment for anxiety disorders
Mature:250-500 mcg, 3 times a day. If needed, the dose can be
increased every 3-4 days up to 3-4 mg per day. The duration of
treatment should not exceed 8-12 weeks.
Elderly:250 mcg, 2-3 times a day. Dosage can be increased if
needed.
 Panic attacks
Adults (regular tablets):The initial dose is 0.5 mg, 3 times a day.
The dose can be increased gradually up to 1 mg every 3-4 days. In
severe conditions, the maximum dose is 10 mg per day.
Adults (slow release tablets / extended release):0.5-1 mg, once a
day. Dosage can be increased every 3-4 days, a maximum of 3-6
mg per day.
Elderly:The initial dose is 250 mcg, 2-3 times daily. Dosage can
be increased gradually if needed.
1.4.2 Chlordiazepoxide
TrademarkChlordiazepoxide: Analsik, Braxidin, Cliad, Clixid, Librax,
Melidox, Sanmag.
Drug form: Tablets
 Anxiety disorder
Mature:30 mg per day, divided into several doses. For serious
anxiety disorders, the maximum dose is 100 mg per day.
 Muscle spasms
Adult: 10-30 mg per day, divided into several doses.
 Insomnia
Adult: 10-30 mg per day, taken before going to bed at night.
  Alcohol withdrawal syndrome
Adult: 25-100 mg daily, as needed. The maximum dose is 300 mg
per day
1.4.3 Clobazam
TrademarkClobazam: Anxibloc, Asabium, Clobazam, Clofritis,
Frisium, Proclozam.
Drug form: Tablets
 Severe anxiety disorder
Mature:The initial dose is 20-30 mg per day, once daily taken at
night or in divided doses, for 2-4 weeks. The maximum dose is 60
mg per day.
Elderly:10-20 mg per day.
 Supportive therapy forepilepsy
Mature:20-30 mg per day. Dosage can be increased if necessary,
up to 60 mg per day.
Children over 6 years old: Initial dose is 5 mg per day, maximum
60 mg.
Elderly: The initial dose is 5 mg per day. Dosage can be increased
gradually according to the development of the condition.
1.4.4 Clonazepam
TrademarkClonazepam: Clonazepam, Riklon 2, Rivotril
Drug form: Tablets
 Panic attacks
Mature:Initial dose is 0.25 mg, 2 times a day. Dosage can be
increased after 3 days to 1-4 mg per day.
 Epilepsy
Mature:The initial dose is 1 mg, which is given every night. The
 dose may be increased after 2-4 weeks, up to 20 mg per day.
Children aged 10 and under or weighing less than 31 kg:0.01-
0.05 mg/kgBW per day, which is divided into 2-3 doses. The dose
may be increased to 0.25-0.5 after 3 days, until seizures are
controlled.
Elderly:0.5 mg, which is taken at night, for 4 days.
1.4.5 Diazepam
Diazepam trademarks: Diazepam, Neurindo, Neurodial, Neuroval,
Opineuron, Potent, Proneuron, Stesolid, Valdimex, Valisanbe
a. Drug form: Tablets
 Severe anxiety disorder
Children and adults:2 mg, 3 times a day, up to 30 mg per day.
Elderly:Not more than half the adult dose.
 Insomnia
Adult: 5-15 mg, taken before going to bed at night.
Children: 1-2.5 mg, 3-4 times a day. Dosage can be increased if
needed.
Elderly: Not more than half the adult dose.
 Muscle spasms
Adult: 2-15 mg per day, divided into several doses. Dosage can
be increased up to 60 mg per day if accompanied by other
conditions, egcerebral palsy.
Children:2-40 mg per day, divided into several doses.
Elderly:Not more than half the adult dose.
 seizures
Mature:2-60 mg per day, divided into several doses.
Elderly:Not more than half the adult dose.
  Sedative before surgery
Adult: 5-20 mg.
Children: 2-10 mg.
Elderly: Not more than half the adult dose
 Alcohol withdrawal syndrome
Mature:5-20 mg, which may be given again after 2-4 hours if
needed.
Elderly:Not more than half the adult dose.
b. Drug form: Injection through a vein (intravenous / IV)
 Sedative before surgery
Children and adults:100-200 mcg/kgBB.
Elderly:Not more than half the above dose.
c. Form of drug: Injection, can be IV or injection into the muscle
(intramuscular / IM)
 Severe anxiety disorder
Mature:Maximum 10 mg in one shot, which can be re-injected
after 4 hours.
Elderly:Not more than half the above dose.
 Alcohol withdrawal syndrome
Adult: 10-20 mg.
Elderly: Not more than half of the above dose.
 Muscle spasms
Adult: 10 mg, which may be reinjected after 4 hours.
Children: 0.04-0.3 mg/kg, every 2-4 hours, up to 0.6 mg/kg
over 8 hours.
Elderly: Not more than half the adult dose.
  seizures
Adult: 5-10 mg by IV injection, and repeated every 10-15
minutes until the dose reaches 30 mg.
Infants aged 30 days – children aged 5 years:0.1-0.5 mg by
IV injection, can be injected again every 2-5 minutes until the
dose reaches 5-10 mg.
Children over 5 years:1 mg repeated every 2-5 minutes,
maximum dose of 10 mg per day.
Elderly:Not more than half the adult dose.
d. Drug form: Rectal preparations (suppositories)
 Severe anxiety disorders and muscle spasms
Mature:500 mcg/kg, may be repeated after 12 hours if needed.
Elderly:Not more than half the adult dose.
 seizures
Mature:200 -500 mcg/kgBB, which can be used again after 4-
12 hours if needed. The maximum dose is 30 mg per day.
Children aged 2-5 years:500 micrograms/kgBB.
Children aged 6-11 years:300 mcg/kgBB.
Children aged 12 years or older:200 mcg/kgBB.
The above dose is reapplied once after 4-12 hours if needed.
Elderly:Not more than half the adult dose.
1.4.6 Estazolam
TrademarkEstazolam: Alena, Esilgan
Drug form: Tablets
Insomnia
Mature:1-2 mg, which is taken before bedtime.
Elderly:0.5-1 mg, which is taken before bedtime
 1.4.7 Lorazepam
TrademarkLorazepam: Ativan, Lorazepam, Loxipaz, Merlopam,
Renaquil
Drug form: Tablets
 Anxiety disorder
Mature:1-4 mg daily, in divided doses, for 2-4 weeks.
Elderly:Not more than half the adult dose
 Insomnia
Mature:1-2 mg, taken before bedtime.
Elderly:Not more than half the above dose.
Sedative before surgery
Mature:2-3 mg, given the night before surgery. Then, followed by 2-4 mg 1-2
hours before surgery.
Children aged 5-13 years:0.05 mg/kg, given approximately 1 hour before