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DIAZEPAM RECTUBES 2.5MG RECTAL SOLUTION

Active substance(s): DIAZEPAM / DIAZEPAM / DIAZEPAM

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Check with your doctor or pharmacist before
using Diazepam Rectubes®
• if you have a history of alcoholism or drug abuse
• if you have someone close to you who has recently
died
• if you are elderly, Diazepam Rectubes® can cause
confusion and have effects on muscles causing falls
and injuries
• if you have a personality disorder
• if you have liver disease
• if you suffer from depression
• if you have suicidal thoughts
Warnings about stopping treatment
• Psychiatric side effects – contact your doctor if
you experience side effects such as agitation,
irritability, delusions, rage, inappropriate behaviour,
restlessness, aggressiveness, nightmares or
hallucinations. These side effects are more likely to
occur in children or the elderly.
• Dependence – when taking this medicine there is a
risk of dependence, which increases with the dose
and duration of treatment and also in patients with a
history of alcoholism and drug abuse or personality
disorder. Therefore, you should take Diazepam
Rectubes® for as short period of time as possible.
• Tolerance – if after a few weeks you notice that this
medicine is not working as well as they did when first
starting treatment, you should speak to your doctor.
• Withdrawal – treatment should be gradually
withdrawn. Withdrawal symptoms occur with
Diazepam Rectubes® even when normal doses are
given for short periods of time. See Section 3, ‘If you
stop taking Diazepam Rectubes®.
• Rebound sleeplessness and anxiety
When you stop taking this type of medicine, some of
the symptoms that led to treatment can return more
intensely than before, such as sleep disturbances,
anxiety, restlessness or mood changes. The risk of
this is greater if you stop suddenly.
To avoid these things happening, treatment should be
stopped gradually, under the advice of a doctor.
Other medicines and Diazepam Rectubes®
Tell your doctor or pharmacist if you are taking, have
recently taken or might take any other medicines.
Especially:
• antidepressants (e.g. fluvoxamine, fluoxetine)
• antipsychotics such as clozapine (to treat mental
problems)
• antihistamines (to treat allergies)
• lofexidine (to help relieve symptoms when you stop
taking opioids)
• general anaesthetics
• sedatives (used to give calming effects)
• hypnotics (to help you sleep)
• sodium oxybate (to treat narcolepsy)
• muscle relaxants (e.g. suxamethonium, tubocurarin,
baclofen, tizanidine)
• some strong pain killers such as morphine (opioids)
• barbiturates such as phenobarbital (to treat epilepsy
and mental disorders)
• St John’s wort (h.p) (used to treat depression)
Taking these medicines with diazepam could affect your
mental status, make you very sleepy and suppress your
breathing and blood pressure.

Diazepam RecTubes® contains Benzoic acid,
sodium benzoate, propylene glycol and alcohol
Diazepam RecTubes® contains Benzoic acid and
sodium benzoate which may cause mild irritation to the
skin, eyes and mucous membrane.
The propylene glycol may cause skin irritation.
Diazepam RecTubes® contains alcohol and diazepam,
so you should not drink alcohol as sedation may be
enhanced.
Diazepam RecTubes® contains 15 mg/ml benzyl
alcohol. May cause toxic reactions and allergic
reactions in infants and children up to 3 years old.
3. How to use Diazepam RecTubes®

This medicine is for rectal use only.
The tubes are for single use only.
Always use Diazepam RecTubes® exactly as your
doctor has told you. Check with your doctor if you are
not sure.
Doses
Adults and children above 1 year of age: 0.5mg
per kg of body weight
Elderly: 0.25mg per kg of body weight
If you have breathing problems you may also be given
a lower dose.
After giving into the anus, the medicine is quickly
absorbed and will start to take effect within 5 minutes.
Your doctor will decide the appropriate dose and for
how long you need to take this medicine. The usual
duration of treatment is not longer than 4 weeks. If
needed, your doctor might increase the duration of
treatment.

835142
Artwork No.

English
Language

28/03/2017

UK
Market

Date

8pt (Main Body) / 8pt (Variables)
Min. Point Size

4

420mm x 160mm
Size

Proof No.

See uploaded pdf

Profile

MPI

106002/3
Item Code

Proof By

Diazepam Rectube solution common leaflet
Description

Pharma
Code

N/A

Text Free Area (non-printing)

Process Black

Keyline (non-printing)

IF YOU SIGN THIS PROOF YOU ARE SIGNIFYING
FULL APPROVAL OF DESIGN AND TEXT.

Diazepam Rectubes® with food, drink and alcohol
Do not drink alcohol while you are taking diazepam.
Alcohol may increase the sedative effects of Diazepam
Rectubes® and make you very sleepy.
You should not drink grapefruit juice while taking
diazepam as it causes diazepam to be removed from
the body more slowly and increases the risk of side
effects.
Drinks containing caffeine may reduce the effects of
diazepam.
Pregnancy and breast-feeding
Ask your doctor or pharmacist for advice before taking
any medicine.
You should not take Diazepam Rectubes® if you are
pregnant, planning to become pregnant or are breast
feeding. If you take Diazepam Rectubes® late in
pregnancy or during labour your baby might have a low
body temperature, floppiness and breathing difficulties.
If taken regularly during late pregnancy, your baby may
develop withdrawal symptoms.
Driving and using machinery
Diazepam Rectubes® may make you feel sleepy,
forgetful, have poor coordination and affect your
concentration along with other side effects that can
affect everyday activities (see Possible side effects). It
may also affect how your muscles work. These effects
may continue for several days after discontinuation of
treatment with diazepam. Do not drive, use any tools
or machines, or take part in such activities where, if
affected, you could put yourself or others at risk.
This medicine can affect your ability to drive as it may
make you feel sleepy or dizzy.
• Do not drive whilst taking this medicine until you know
how this medicine affects you.
• It is an offence to drive if this medicine effects your
ability to drive.
• However, you would not be committing an offence if:
- The medicine has been prescribed to treat a medical
or dental problem and
- You have taken it according to the instructions given
by the prescriber or in the information provided with
the medicine and
- It was not affecting your ability to drive safely.
Talk to your doctor or pharmacist if you are not sure
whether it is safe for you to drive while taking this
medicine.

Warning! We cannot accept responsibility for any errors
in this proof after approval. Whilst we take extreme care
at all times to ensure accuracy to our clientʼs brief,
the final responsibility must be taken by our client.

Do not use Diazepam RecTubes®
• if you are allergic to diazepam, benzodiazapines or
any of the other ingredients of this medicine (listed in
section 6).
• if you have acute respiratory depression (slow and/or
shallow breathing)
• if you suffer from depression (with or without anxiety)
or hyperactivity
• if you have a phobia (a fear of a particular object or
situation) or other mental illness
• if you have a condition called myasthenia gravis
which causes muscles to weaken and tire easily
• if you suffer from sleep apnoea (a sleep disorder
where you have abnormal pauses in breathing during
sleep)
• if you have severe liver disorders
• if you have porphyria (an inherited condition causing
skin blisters, abdominal pain and brain or nervous
system disorders)
• if you are planning a pregnancy or are pregnant (see
Pregnancy and breast-feeding)
Warnings and precautions

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2. What you need to know before you take
Diazepam RecTubes®

Wockhardt UK Limited

Diazepam RecTubes® contain diazepam which belongs
to a group of medicines called benzodiazepines.
Diazepam is used to treat:
• severe anxiety and agitation
• muscle spasms
• epilepsy or febrile convulsions
• symptoms of alcohol withdrawal
Diazepam RecTubes® can also be used to provide
sedation before operations (premedication).
Your doctor may prescribe Diazepam RecTubes® for
other uses. Please follow your doctor’s instructions.

Customer

1. What Diazepam RecTubes® are and what they
are used for

• disulfiram (to treat alcohol addiction). Taking this
medicine with diazepam could make you very sleepy
and can cause diazepam to be removed from the
body more slowly than usual.
• medicines for epilepsy e.g. phenytoin and
carbamazepine, as these can reduce the effect of
diazepam. Diazepam can furthermore affect how
phenytoin works.
• theophylline (to treat asthma and other breathing
disorders), as it can weaken the effect of diazepam.
• cimetidine, omeprazole or esomeprazole (stomach
acid reducing medicines), as these can cause
diazepam to be removed from the body more slowly
than usual.
• rifampicin (an antibiotic) as this can cause diazepam
to be removed from the body more quickly than usual.
The effect of diazepam can be weakened.
• atazanavir, ritonavir, delavirdine, efavirenz, indinavir,
nelfinavir or saquinavir (antivirals), fluconazole,
itraconazole, ketoconazole or voriconazole
(anti-fungal medicines) as these can cause diazepam
to be removed from the body more slowly than usual
and therefore increase the risk of side effects.
• isoniazid (used to treat tuberculosis), as it can cause
diazepam to be removed from the body more slowly
than usual.
• oral contraceptives, as they can slow down the
removal of diazepam from the body and increase its
effect. Breakthrough bleeding can occur when taking
diazepam and oral contraceptives together, but the
contraceptive protection is not reduced.
• corticosteroids (medicines used to treat inflammation
in the body) as they can weaken the effect of
diazepam.
• medicines to lower high blood pressure, diuretics
(water tablets), nitrates (for heart conditions),
hydralazine, minoxidil, sodium nitroprusside as these
could lower your blood pressure too much.
• levodopa (used to treat Parkinson’s disease).
Diazepam can reduce the effect of levodopa.
• valproic acid (used to treat epilepsy and mental
disorders) as it can slow down the removal of
diazepam from the body and increase its effect.
• ketamine (an anaesthetic) as diazepam increases the
effect of ketamine.

Measure bar should be 150mm at 100% scale

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 others. It may harm them, even if
their signs of illness are the same as yours.
- If you get any side effects, talk to your doctor or
pharmacist. This includes any possible side effects
not listed in this leaflet. See section 4.
What is in this leaflet
1. What Diazepam RecTubes® are and what they are
used for
2. What you need to know before you use Diazepam
RecTubes®
3. How to use Diazepam RecTubes®
4. Possible side effects
5. How to store Diazepam RecTubes®
6. Contents of the pack and other information

Colours Used

PACKAGE LEAFLET: INFORMATION FOR THE USER
Diazepam RecTubes® 2.5mg Rectal Solution
Diazepam RecTubes® 5mg Rectal Solution
Diazepam RecTubes® 10mg Rectal Solution
(referred to as Diazepam RecTubes® in this leaflet)

If you forget to use Diazepam RecTubes®
If you forget to take a dose take it as soon as you
remember it. If you are about to take the next dose, skip
the missed dose. Do not take a double dose to make up
for a forgotten dose.
If you have any further questions on the use of this
medicine, ask your doctor or pharmacist.
If you stop taking Diazepam Rectubes®
If Diazepam RecTubes® are given continuously for
too long, there is a risk of becoming dependent on
diazepam or developing withdrawal symptoms when
stopped or “rebound phenomenon” whereby the
problem for which you were being treated recurs.
Withdrawal symptoms include: headaches, muscle
pain, extreme anxiety, tension, restlessness,
confusion and irritability. In severe cases you
may experience derealisation, depersonalisation,
hyperacusis, numbness and tingling of the extremities,
hypersensitivity to light, noise and physical contact,
hallucinations or epileptic seizures.
You should not stop the treatment suddenly and it is
recommended that the dose is decreased gradually.
4. Possible side effects

Like all medicines, Diazepam RecTubes® can cause
side effects, although not everybody gets them.
Stop treatment and contact a doctor at once if you
have:
• Symptoms of an allergic reaction e.g. itchy skin, rash,
sudden wheezing, swelling of the face, lips, tongue or
throat, fainting or difficulty breathing or swallowing.
• Respiratory depression (very slow and/or shallow
breathing) (Uncommon)
• Respiratory arrest (cessation of breathing (Rare)
Tell your doctor if you notice any of the following side
effects or notice any other effects not listed:
Very common: affects more than 1 user in 10
• Drowsiness
Common: affects 1 to 10 users in 100
• Fatigue
• Withdrawal symptoms (for possible symptoms please
see ‘If you stop taking Diazepam RecTubes®’ in
Section 3)
• Confusion
• Loss of coordination of muscle movements (ataxia)
and other movement disorders, tremor

5. How to store Diazepam RecTubes®

Keep this medicine out of the sight and reach of
children.
Diazepam RecTubes® should be stored at room
temperature (below 25°C). Store in the original
container to protect from light; do not transfer to another
container. Once foil is opened use immediately.
Do not use Diazepam RecTubes® after the expiry date
which is stated on the tube and the carton. The expiry
date refers to the last day of that month.
Do not throw away any medicines via wastewater or
household waste. Ask your pharmacist how to throw
away medicines you no longer use. These measures
will help protect the environment.
6. Contents of the pack and other information

What Diazepam RecTubes® contains:
The active ingredient is diazepam
The other ingredients are benzoic acid (E21 0), benzyl
alcohol, sodium benzoate (E211), ethanol, propylene
glycol and purified water.
What Diazepam RecTubes look like and contents
of the pack
The pack consists of 2 or 5 white polythene rectal tubes
wrapped individually in alufoil packs and placed in an
outer carton. The tubes have a nozzle attached for
application. The rectal solution is a clear, colourless or
almost yellow solution.
Diazepam RecTubes® are available in the following
strengths:
Diazepam RecTubes 2.5mg in 1.25ml (2mg/ml)
Diazepam RecTubes 5mg in 2.5ml (2mg/ml)
Diazepam RecTubes 10mg in 2.5ml (4mg/ml)
Marketing Authorisation Holder: Wockhardt UK Ltd,
Ash Road North, Wrexham, LL13 9UF, UK.
Manufacturer: CP Pharmaceuticals Ltd, Ash Road
North, Wrexham LL13 9UF, UK.
Other formats: To listen to or request a copy of this
leaflet in Braille, large print or audio please call, free of
charge:0800 198 5000 (UK Only). Please be ready to
give the following information:
Product name

Reference number

Diazepam RecTubes 2.5mg
in 1.25ml Rectal Solution

29831/0067

Diazepam RecTubes 5mg in
2.5ml Rectal Solution

29831/0068

Diazepam RecTubes 10mg
in 2.5ml Rectal Solution

29831/0066

This is a service provided by the Royal National Institute
of Blind People.
This leaflet was last revised in 04/2017.

106002/3

835142
Artwork No.

English
Language

28/03/2017

UK
Market

Date

IF YOU SIGN THIS PROOF YOU ARE SIGNIFYING
FULL APPROVAL OF DESIGN AND TEXT.

8pt (Main Body) / 8pt (Variables)
Min. Point Size

4

420mm x 160mm
Size

Proof No.

See uploaded pdf

Profile

MPI

106002/3
Item Code

Proof By

Diazepam Rectube solution common leaflet
Description

Pharma
Code

N/A

Text Free Area (non-printing)

Process Black

Colours Used

Keyline (non-printing)

Warning! We cannot accept responsibility for any errors
in this proof after approval. Whilst we take extreme care
at all times to ensure accuracy to our clientʼs brief,
the final responsibility must be taken by our client.

Note: A small amount of the solution is intended to be
left in the tube after the dose is given.
7. Maintain the patient's position and hold the buttocks
together for a few minutes to prevent seepage
If you don’t feel better
If your symptoms or the fit are not brought under control
with Diazepam RecTubes®, contact a doctor for advice.
Further doses should only be given only after consulting
a doctor. The maximum dose is of 30mg.
If you use more Diazepam RecTubes® than you
should
If you have used too many rectal tubes (more than
prescribed), or you think a child may have swallowed
any, contact your nearest hospital casualty department
or tell your doctor immediately.
Signs of an overdose include loss of coordination
of muscle movements, sleep-like drowsy state,
confusion, slurred speech, irregular or slow
heartbeat, uncontrolled eye movement and muscle
weakness. An extreme overdose may lead to coma
(unrousable unconsciousness), low body temperature
(hypothermia), low blood pressure, slow pulse and
severe breathing difficulties.

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6. Keep the tube completely pressed together until you
have withdrawn it out of the rectum.

Wockhardt UK Limited

5. Empty the tube by pressing firmly between the thumb
and index finger

Customer

4. Insert the nozzle completely into the rectum, pointing
it downwards
NOTE: In children under 15kgs (33 lbs) insert the
nozzle only halfway

Uncommon: affects 1 to 10 users in 1,000
• Muscle weakness
• Memory loss
• Difficulty in concentrating
• Balance disorders
• Dizziness
• Headache
• Slurred speech
• Stomach and intestinal problems such as feeling or
being sick, constipation, diarrhoea
• Increased salivation (particularly in children)
• Allergic skin reactions in the form of itching, skin
redness and swelling and skin rash
Rare: affects 1 to 10 users in 10,000
• Psychiatric side effects such as excitation, agitation,
restlessness, irritability, aggressiveness, memory
loss, delusion, rages, psychoses, nightmares or
hallucinations. May be or become serious. These
side effects are more likely to occur in children or the
elderly. Talk to your doctor.
• Decreased alertness
• Depression
• Emotional withdrawal
• Insomnia (problems sleeping)
• Heart problems such as slow heartbeat (bradycardia),
heart failure and cessation of heartbeat (cardiac
arrest).
• Low blood pressure, fainting (syncope)
• Increased mucus in the lungs (particularly in children)
• Dry mouth
• Increased appetite
• Changes in certain liver enzymes as seen in blood
tests
• Lack of ability to urinate, loss of bladder control
(leakage of urine)
• Breast enlargement in men
• Impotence, changes in sexual drive (libido)
• Blood disorders (you may develop sore throat, nose
bleeds or infections)
• Unconsciousness
• Jaundice (yellowing of your skin or the white of your
eyes)
Very rare: affects less than 1 user in 10,000
• Low levels of white blood cells (leukopenia)
• Higher level of a certain enzyme in the blood
(transaminase)
Not known: frequency cannot be estimated from the
available data
• Blurred vision, double vision and involuntary eye
movements (these side effects disappear after you
have stopped taking diazepam)
• Temporary pause in breathing
Reporting of side effects
If you get any side effects, talk to your doctor,
pharmacist or nurse. This includes any possible side
effects not listed in this leaflet. You can also report side
effects directly via the national reporting system listed
below
UNITED KINGDOM:
Yellow Card Scheme
Website: www.mhra.gov.uk/yellowcard
MALTA:
ADR Reporting:
Website: www.medicinesauthority.gov.mt.adrportal
By reporting side effects you can help provide more
information on the safety of this medicine.

Measure bar should be 150mm at 100% scale

Step by Step instruction on how to administer the
Diazepam RecTubes®:
1. If possible turn adults to lie on their side, or front for a
child.
2. Tear open the foil pack
3. Remove the tube cap

Expand Transcript

Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.

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