In acute and severe cases as a monotherapy or with other agents
2 to 10 mg every 3 to 6 hours as needed up to 40 mg/day; the choice of dose based on response and tolerability.
Anxiety disorders as a monotherapy or with other agents (alternative agent):
Note valium used for symptoms relief as a short-term therapy until concurrent therapy is effective for example use for less than 12 weeks. Long-term therapy may be considered only for select patients when other treatments are ineffective or poorly tolerated.
The initial dose is 2 to 5 mg once or twice daily; increase gradually according to the response and tolerability up to 40 mg/day in 2 to 4 divided doses.
Dose ranges from 2 to 10 mg once 30 to 60 minutes before the procedure; if dosa needed again due to incomplete response, may repeat the dose (50% of the initial dose) after 30 to 60 minutes.
The initial dose is 2 mg twice daily or 5 mg at bedtime; may be increased gradually according to the response and tolerability, up to 40 to 60 mg/day in 3 to 4 divided doses.
Symptom-triggered regimen: 5 to 20 mg as needed until appropriate sedation achieved; dose and frequency determined by withdrawal symptom severity.
Fixed-dose regimen: 10 mg every 6 hours for 1 day, then 5 mg every 6 hours for 2 days; additional doses may be considered based on withdrawal symptoms.
Note: Symptom-triggered regimens preferred over fixed-dose regimens.
1 mg to 5 mg every 12 hours for 24 to 48 hours.
In patients receiving extended or higher-dose valium therapy, unless safety concerns require a more rapid withdrawal, gradually withdraw to detect reemerging symptoms and minimize rebound and withdrawal symptoms.
The total daily dose should be tapered by 10% to 20% every 1 to 2 weeks according to the response and tolerability. The optimal taper rate is not constant and duration will vary, tapering may take up to 6 months for easier withdrawal and tolerability.
For example, reduce the dose every week by 25% until half of the dose remains. Thereafter, continue to reduce 12% every 4 to 7 days.
No dosage adjustments are provided for valium use.
Valium isn’t dialyzable only 0% to 5% so no supplemental dose is necessary.
The oral tablets are contraindicated in severe hepatic impairment, use with caution because clearance of valium may decrease significantly.
Start with a low Initial dose if age is more than 65 years: 2 to 2.5 mg 1 to 2 times daily; increase gradually according to response and tolerability.
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