Διαζεπάμη

Long-acting benzodiazepine with anticonvulsant, sedative, muscle relaxant and anxiolytic actions. It is metabolized to desmethyldiazepam (nordazepam), temazepam, and oxazepam. Oral, rectal, vaginal and parenteral administration 2 to 4 times a day.

It is excreted in milk in an amount that may be clinically significant. ^{(Borgatta 1997, Dusci 1990, Wesson 1985, Brandt 1976, Cole 1975, Erkkola 1972, Patrick 1972)}

Levels in infant plasma have been measured ^{(Erkkola 1972)}, and found to be more than 5 times lower than the corresponding maternal levels. ^{(Wesson 1985)}

Some authors have not observed problems in infants whose mothers took it^{. (Kelly2012, Erkkola 1972)}

Others have reported sedation and poor suctioning in the infant ^{(Wesson 1985, Patrick 1972)}, especially with repeated or high doses and during the neonatal period ^{(Davanzo 2013)}. There is an increased risk of weight loss and jaundice in newborns whose mothers are given doses of diazepam greater than 0.1 mg/kg. ^{(Gilders 2021)}

Vaginal administration has a lower bioavailability than oral, reaching low plasma levels, although with a longer elimination time. ^{(Larish 2019)} 

The long elimination half-life of its active metabolite, desmethyldiazepam ^{(Jochemsen 1984)}, makes it inadvisable during breastfeeding.

The occasional use and low doses of benzodiazepines are compatible with breastfeeding ^{(Kelly 2012, Rubin 2004, Iqbal 2002, WHO 2002, Hägg 2000, McElhatton 1994, Lee 1993, Kanto 1982)}. Diazepam at low and isolated doses and monitoring the infant does not contraindicate breastfeeding. ^{(Uguz 2021)}. It is advisable to monitor drowsiness and adequate feeding of the infant.

Choose short-acting benzodiazepines and use the lowest effective dose ^{(Rowe 2013, WHO 2002)}, especially during the neonatal period and in prematurity, as they can accumulate in the infant during chronic use. ^{(Davanzo 2013, Sachs 2013, Amir 2011)}

Bed-sharing with the baby is not recommended if this medicine is being taken due to increased risk of suffocation or sudden infant death. ^{(UNICEF 2018, 2017, 2014 and 2013, Landa 2012, ABM 2008, UNICEF 2006)}

See below the information of these related products:

• Nordazepam (Unsafe. Moderate/severe adverse effects. Compatible under certain circumstances. Follow-up recommended. Use safer alternative or discontinue breastfeeding from 5 to 7 T ½ . Read Commentary.)
• Temazepam (Safe substance and/or breastfeeding is the best option.)