Diazepam tablets

Calm® 5 (Diazepam tablets)

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Calm® 5 (Diazepam tablets)

Calm 5 tablets contains Diazepam, a benzodiazepine with anticonvulsant, anxiolytic, sedative, muscle relaxant and amnesic properties.

Its actions are mediated by enhancement of the activity of gamma aminobutyric acid (GABA), a major inhibitory neurotransmitter in the brain.


On oral administration, Diazepam is readily and completely absorbed from the gastrointestinal tract, peak plasma concentration occurring within about 30 to 90 minutes. It has a biphasic half-life with initial rapid distribution phase followed by a prolonged terminal elimination phase of 1 or 2 days, its action is further prolonged by the even longer half life of 2 to 5 days of its principal active metabolite, desmethyldiazepam.

Diazepam is extensively metabolised in the liver and is excreted in the urine, mainly in the form of its metabolites, either free or in conjugated form.


Calm 5 tablets are used in treatment of severe anxiety disorders, as hypnotic in the short-term management of insomnia, as sedative and premedicant, as an anticonvulsant, particularly in the management of status epilepticus and febrile convulsions, in the control of muscle spasm as an tetanus and in the management of alcohol withdrawal symptoms.

Dosage and administration

Calm 5 tablets are administered by the oral route. In view of the risk of dependence, diazepam should always be given in the lowest doses which can control symptoms and in short courses, treatment should not normally continue beyond 4 weeks and should always be withdrawn gradually. Intermittent treatment regimens may decrease the risk of dependence.


Adults: as indicated in the table below

Anxiety disorders2.5mg three times daily, increased up to 30mg daily in divided doses
Insomnia associated with anxietyA single dose of 5mg to 30mg before retiring to bed
Muscle spasm2.5mg to 15mg daily in divided doses increased in severe spastic disorders such as cerebral palsy. As an adjunctive in some types of epilepsy up to 60mg daily in divided doses.
Management of mild to moderate symptoms of alcohol withdrawal2.5mg three times daily, increased up to 30mg daily in divided doses
For premedication before dental or minor surgical proceduresA single dose of 5mg to 20mg

Children: The recommended initial dose of diazepam for children is 0.1mg to 0.2mg per kg body weight orally but up to 0.8mg per kg body weight daily has been given.

Dosage recommendation of diazepam for premature infants is not generally given since they may be unable to metabolise the drug.

Precautions, warnings and adverse effects

  1. Calm 5 tablets should be avoided in patients with pre-existing CNS depression or coma, acute pulmonary insufficiency, or sleep apnoea and used with caution in those with chronic pulmonary insufficiency, impaired hepatic or renal function and in elderly or debilitated patients.
  2. Calm 5 tablets are contraindicated in patients with known hypersensitivity to diazepam or other benzodiazepines and in those with chronic psychosis or phobic obsessional states.
  3. The preparation is not recommended for use in pregnant patients during first trimester or late pregnancy.
  4. Drug dependence may develop after regular use of diazepam or other benzodiazepines, even in therapeutic doses for short periods.
  5. The most frequent adverse effect adverse effects occasionally associated with diazepam include drowsiness, sedation and ataxia and other less frequent effects including vertigo, headache, confusion, mental depression, slurred speech or dysarthria, changes in libido, tremor, visual disturbances and hypersensitivity reactions.
  6. It is recommended that withdrawal of diazepam therapy should be gradual as abrupt withdrawal may result in confusion, toxic pyschosis, convulsions or a condition resembling delirium tremens.
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