diazepam
Enable an AI agent to recognise diazepam, assess the identity and usability of a particular material or medicinal presentation, and determine which handling or use actions require additional evidence or authority.
Research draft, second pass
A second pass drafted this model: the structure a model of this thing needs, and what is known about it in the world. The line under this one says how the second half was obtained - researched against sources, or recalled without web access, in which case nothing here was read anywhere and every claim is a lead to verify. Unreviewed either way.
Researched by: Codex + Grok
Purpose and description
Enable an AI agent to recognise diazepam, assess the identity and usability of a particular material or medicinal presentation, and determine which handling or use actions require additional evidence or authority.
Diazepam is a long-acting 1,4-benzodiazepine (7-chloro-1-methyl-5-phenyl-1,3-dihydro-2H-1,4-benzodiazepin-2-one) that positively modulates GABA-A receptors and is used as an anxiolytic, anticonvulsant, skeletal-muscle relaxant, and alcohol-withdrawal agent.
It can be Reconcile a diazepam identity claim with product records, batch documentation and analytical findings.; Compare labelled and measured diazepam content while preserving units and measurement uncertainty.; Check whether a proposed handling or administration route matches the exact preparation and governing instructions.; Flag storage excursions, quality failures, identity conflicts or applicable recalls for quarantine and review.; Pass exposure and interaction concerns to an authorised clinical workflow with the supporting evidence.; Check and record authority for transfer, dispensing or disposal under the applicable local rules..
Distinguishing features
Require an explicit diazepam ingredient identity supported by a traceable product record or appropriate analytical evidence; a benzodiazepine class designation alone is insufficient.
Distinguish diazepam from its metabolites and other benzodiazepines using substance-specific identification evidence rather than treating a class-level screening result as identification.
Separate the diazepam substance from a branded preparation: an authenticated Valium product identifies a diazepam-containing product, not a different active substance. Reference: [DailyMed Valium label](https://www.dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=554baee5-b171-4452-a50a-41a0946f956c&type=display).
Distinguish bulk diazepam from a finished preparation by recording its matrix, concentration and intended purpose; equal diazepam mass does not establish route compatibility.
Treat tablet appearance, seller terminology and claimed calming effects as supporting observations rather than sufficient tests of diazepam identity.
Scope
+ Chemical identity and evidence distinguishing diazepam from other benzodiazepines, metabolites and unidentified material.
+ Diazepam content, formulation and route compatibility of a represented sample or preparation.
+ Quality, storage history and fitness for a stated pharmaceutical or analytical purpose.
+ Diazepam-specific exposure, interaction and discontinuation constraints that require clinical review.
+ Traceability and jurisdiction-dependent authority for possession, supply, administration and disposal.
- Patient diagnosis, complete medical history and individual treatment selection.
- Prescription authorship, personalised dosing and taper design.
- Complete commercial product, packaging or delivery-device specifications.
- Manufacturing plant operations and detailed chemical synthesis procedures.
- Independent models of other benzodiazepines and diazepam metabolites.
- Full medication administration, emergency response and waste-management workflows.
Characteristics
- Identity evidence
- claimed | documentation-supported | analytically-supported | conflicting | unknown Determines whether the agent can identify the material as diazepam and with what evidential limits.
- Material role
- active pharmaceutical ingredient | finished medicinal preparation | analytical reference material | unidentified sample | other Prevents research material or bulk substance from being treated as a ready-to-administer medicine.
- Preparation and authorised route
- Link to exact formulation, product label and permitted route or routes; unknown permitted Route and preparation govern handling and cannot be inferred from the active ingredient alone.
- Diazepam amount or concentration
- mg per unit, mg/mL or mass fraction, with denominator, method and labelled versus measured status Separates active substance quantity from total preparation mass, liquid volume and device contents.
- Quality assessment
- not assessed | meets named specification | fails named specification | inconclusive A quality judgement is meaningful only against an identified specification and intended use.
- Storage and use-period status
- within documented conditions | excursion awaiting assessment | expired | opening limit exceeded | history unknown Supports a decision to retain, quarantine or refer a preparation for assessment.
- Batch and source traceability
- Links to manufacturer or supplier, batch, product identifier and supporting records Connects authenticity, quality findings and recalls to the actual material.
- Exposure context
- Links to administered amount, route, time, repeated exposure and relevant co-exposures Allows clinical models to assess residual effects and interactions without interpreting package strength as patient exposure.
- Action authorisation
- verified for stated action | restricted | prohibited | unresolved, with jurisdiction and effective date Permission to possess a preparation does not establish permission to supply or administer it.
Where this came from
wikidata · CC0 1.0
Also registered as vr.tr.diazepam
Drafted structure
Bundle to layer to finding to question, as the second pass will find it: 6 bundles · 11 layers · 18 findings · 28 questions.
Diazepam identity Establish what is being called diazepam and how that identity is supported.
A class name, brand claim or observed effect cannot establish the identity of the physical material.
Substance boundary
Separate diazepam itself from related substances and preparations containing it.
Identity anchor
Record the authoritative substance identity and the evidence connecting the represented material to it.
- Which authoritative chemical record defines the diazepam identity used here? definition
- Does this record represent diazepam substance, a diazepam-containing preparation or merely a claim about an unidentified sample? boundary
Identity verification
Assess evidence that distinguishes diazepam from similar or substituted material.
Specificity of evidence
Preserve what documentation or testing establishes, including unresolved mixtures and conflicting results.
- What authenticated product documentation or analytical result supports the diazepam claim? provenance
- Can the identification method distinguish diazepam from other benzodiazepines and relevant metabolites in this sample matrix? measurement
Preparation and content Describe the physical presentation and the diazepam quantity available within it.
The active ingredient alone does not establish administration route, excipient suitability or delivered amount.
Formulation and route
Connect the preparation to its specific route and composition constraints.
Route compatibility
Require preparation-specific evidence before accepting a route. An injection label, for example, specifies routes and excipients for that product. Reference: [DailyMed diazepam injection label](https://www.dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a0813073-d0b0-4fd7-b307-56f69c910c82).
- Which routes does the exact diazepam preparation's current label permit? action
- Which excipients, sterility requirements or delivery-system features constrain the proposed use? boundary
Active content
Distinguish labelled strength, measured content and deliverable quantity.
Quantity basis
Record diazepam quantity with a precise denominator and evidence, without treating it as a patient-specific dose.
- What is the labelled or measured diazepam amount per tablet, volume or delivery unit, and how was it established? measurement
- Does the stated quantity describe container contents, a selectable device setting or the amount actually delivered? boundary
Quality and preservation Assess whether the identified diazepam material remains suitable for its stated purpose.
Correct identity and nominal strength do not establish acceptable purity, integrity or storage history.
Quality evidence
Tie assessment to the material role, batch and applicable specification.
Fitness for purpose
Separate identity confirmation from content, impurity and preparation-specific quality assessments.
- Which specification governs this diazepam material, and which batch-specific results support compliance? provenance
- Which required tests of content, impurities or preparation integrity are missing, inconclusive or outside acceptance limits? measurement
Storage history
Evaluate preservation against instructions for the actual formulation and container.
Continued usability
Record expiry, opening or preparation events, container condition and excursions without inferring stability from appearance alone.
- What storage, light-protection and use-period instructions apply to this exact diazepam preparation? provenance
- Does the documented history support continued use, or require quarantine and a product-specific stability assessment? action
Exposure and clinical constraints Represent the diazepam-specific information needed by a clinical decision-maker.
Safe decisions require exposure history and clinical context that cannot be derived from the physical preparation alone.
Exposure persistence
Connect the material to time-dependent exposure assessment without assigning a universal duration of effect.
Residual exposure assessment
Require sourced interpretation of repeated administration, elimination and relevant metabolites before judging that prior exposure has ended.
- What amounts, routes and administration times are documented, including repeated exposure? provenance
- Which product pharmacology and patient-specific factors must the clinical model consider when assessing residual diazepam-related effects? boundary
Clinical review triggers
Identify evidence that must accompany proposed initiation, continuation or discontinuation.
Interaction and withdrawal review
Record review requirements for opioid or other CNS-depressant co-exposure and dependence or withdrawal concerns. Reference: [DailyMed diazepam tablet label](https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=34ac0b9d-d4ad-4aaa-8bee-902365f4e9a8).
- Are relevant co-exposures, contraindications and precautions documented and reviewed against the exact product label? action
- Does prior diazepam use require an authorised discontinuation or dose-reduction plan before the proposed change? action
Traceability and permitted actions Connect the diazepam material to accountable custody and current authority for a proposed action.
Physical availability does not establish authenticity, supply eligibility or permission for clinical use.
Supply traceability
Maintain the evidence needed to investigate the provenance and disposition of a specific batch or package.
Authenticated supply record
Link the material to manufacturer, supplier and batch evidence, preserving discrepancies for investigation.
- Can this diazepam package or bulk lot be traced to an authenticated supplier and matching batch record? provenance
- Does a recall, packaging discrepancy or unexplained custody gap require withholding it from supply or use? action
Action-specific authority
Evaluate the proposed action under the applicable jurisdiction and institutional context.
Permission evidence
Record current diazepam control requirements and the actor's authority without assigning one legal status globally.
- Which current jurisdiction-specific requirements govern possession, transfer, dispensing, administration or disposal of this diazepam material? provenance
- What prescription, professional authority, custody record or disposal authorisation must be verified for the proposed action? action
Evidence and external alignment What the world already says about this thing, gathered so the model can be checked against it.
A model that cannot be lined up against existing standards, identifiers and practice cannot be adopted by anyone who already uses them.
Reported evidence
Findings from the breadth pass, kept separate from the structural claims.
Kinds and varieties
Reported by the breadth pass; each item needs checking against its source before it becomes normative.
- oral scored tablets (typically 2 mg, 5 mg, 10 mg)
- oral solution and concentrated oral solution
- injectable solution in a propylene-glycol vehicle (intravenous or intramuscular)
- lipid-emulsion injection (Diazemuls-type)
- rectal gel or rectal tube for community seizure rescue
- intranasal spray for seizure clusters
- buccal film for paediatric seizure clusters
- Which of these kinds and varieties hold for the sense of diazepam this model covers, and on what evidence? provenance
Identifiers and schemes
Reported by the breadth pass; each item needs checking against its source before it becomes normative.
- INN - diazepam - WHO International Nonproprietary Name; USAN and BAN use the same stem.
- CAS Registry Number - 439-14-5 - Parent compound.
- PubChem CID - 3016 - NCBI PubChem compound record.
- Wikidata - Q210402 - Item for the chemical/drug.
- UNII - Q3JTX2Q7TU - FDA Global Substance Registration System.
- ATC - N05BA01 - WHO ATC; veterinary counterpart QN05BA01.
- DrugBank - DB00829 - DrugBank accession.
- RxNorm RXCUI - 3322 - NLM RxNorm ingredient.
- ChEBI - CHEBI:49575 - Chemical Entities of Biological Interest.
- KEGG DRUG - D00293 - KEGG drug entry.
- Which of these identifiers and schemes hold for the sense of diazepam this model covers, and on what evidence? provenance
Standards and regulation
Reported by the breadth pass; each item needs checking against its source before it becomes normative.
- United Nations Convention on Psychotropic Substances (1971): Schedule IV, issued by the UN Commission on Narcotic Drugs / INCB.
- United States Controlled Substances Act: Schedule IV, enforced by DEA; FDA-approved benzodiazepines including diazepam are C-IV, while unapproved designer analogues are Schedule I.
- US FDA labelling: approved indications for anxiety, muscle spasm/spasticity, preoperative anxiolysis, and seizure adjunct/status epilepticus; class boxed warning (2020) for abuse, dependence and withdrawal.
- WHO Model List of Essential Medicines: diazepam is a core-list medicine (ATC N05BA01); oral use for anxiety is limited to short-term emergency management of acute severe symptoms.
- WHO mhGAP guideline (2023): strong recommendation against benzodiazepines for generalised anxiety or panic disorder in adults.
- National scheduling: US Schedule IV; Canada Schedule IV; UK Class C (CD POM); Australia S4 (prescription only); Germany prescription-only, Anlage III at higher doses; Brazil Class B1; Sweden Förteckning IV.
- Which of these standards and regulation hold for the sense of diazepam this model covers, and on what evidence? provenance
Real-world use
Reported by the breadth pass; each item needs checking against its source before it becomes normative.
- Oral tablets and solution prescribed for short-term severe anxiety, muscle spasm, alcohol-withdrawal symptom control, and as a taper/equivalence vehicle when switching benzodiazepines.
- Intravenous injection in emergency departments and intensive care for status epilepticus and acute agitation; intramuscular use is slower and less favoured than IV.
- Rectal gel (US Diastat/AcuDial) and rectal tubes (European Stesolid-type) issued to carers as out-of-hospital rescue for seizure clusters.
- Intranasal spray (US Valtoco) and buccal film used as alternative community rescue routes, especially where rectal administration is impractical.
- Procedural premedication for endoscopy, dentistry and surgery to provide anxiolysis, sedation and anterograde amnesia.
- Still widely dispensed but no longer the leading US benzodiazepine: IQVIA/DEA reported about 8.6 million US diazepam prescriptions in 2025, behind alprazolam, clonazepam and lorazepam.
- Which of these real-world use hold for the sense of diazepam this model covers, and on what evidence? provenance
Typical measurements
Reported by the breadth pass; each item needs checking against its source before it becomes normative.
- usual oral tablet strength - 2-10 - mg
- adult oral anxiety dose - 2-10 mg, 2-4 times daily - mg/day (commonly 4-40)
- parent-drug elimination half-life - 20-100 (often cited 21-70 or 24-48) - h
- nordiazepam (desmethyldiazepam) half-life - 32-200 (often 49-179) - h
- oral onset of action - 15-60 - min
- intravenous onset of action - 1-3 - min
- therapeutic plasma concentration - 0.1-2 (up to about 2.5) - mg/L
- plasma protein binding - 96-99 - %
- oral benzodiazepine equivalence (reference dose) - 10 - mg oral diazepam
- injectable concentration - 5 - mg/mL
- Which of these typical measurements hold for the sense of diazepam this model covers, and on what evidence? provenance
Failure modes and hazards
Reported by the breadth pass; each item needs checking against its source before it becomes normative.
- Physical dependence, tolerance and withdrawal (including rebound anxiety, tremor and seizures) after more than brief use; abrupt stop after prolonged dosing is hazardous.
- Additive CNS and respiratory depression with alcohol, opioids and other sedatives; lone overdose is usually not fatal, combined overdose is.
- Falls, ataxia and cognitive impairment, especially in older adults.
- Accumulation of long-lived nordiazepam in hepatic impairment and in the elderly; NHS advice is not to switch patients with liver disease onto diazepam.
- Propylene-glycol vehicle in conventional IV solution: venous irritation/thrombophlebitis and, with prolonged infusion, glycol toxicity/lactic acidosis; lipid emulsion exists to avoid that vehicle.
- Loss of anticonvulsant effect if infused for more than about 24 hours.
- Paradoxical agitation or disinhibition in some patients.
- Neonatal hypotonia and withdrawal after late-pregnancy exposure.
- Diversion and illicit circulation; diazepam remains among benzodiazepines most often reported in US law-enforcement seizures, though volumes have fallen.
- Which of these failure modes and hazards hold for the sense of diazepam this model covers, and on what evidence? provenance
Regional variation
Reported by the breadth pass; each item needs checking against its source before it becomes normative.
- Brand naming: Valium is the historic global brand; Stesolid is common in Nordic/UK rectal-tube practice; Diastat and Valtoco are US rescue brands; Relanium (Poland), Seduxen/Sibazon (former Soviet practice), Faustan (German-speaking/Eastern Europe), Apaurin, and Diazemuls (UK/Canada emulsion injection) are local product names for the same INN.
- Seizure-rescue formulation: US practice centres on rectal gel (Diastat) and nasal spray (Valtoco); much of Europe uses rectal tubes (Stesolid) and increasingly buccal or nasal midazolam instead of rectal diazepam.
- Legal class is consistently a lower-schedule psychotropic (UN IV / US IV / UK Class C / AU S4) but the national schedule name and prescription-repeat rules differ.
- WHO essential-list policy now treats oral diazepam as emergency short-course anxiolysis only, while injectable diazepam remains an essential anticonvulsant option alongside midazolam.
- Which of these regional variation hold for the sense of diazepam this model covers, and on what evidence? provenance
Neighbouring kinds and how to tell them apart
Reported by the breadth pass; each item needs checking against its source before it becomes normative.
- lorazepam - Lorazepam has no long-acting active metabolite and is cleared mainly by glucuronidation; diazepam is metabolised by CYP enzymes to nordiazepam, temazepam and oxazepam. In status epilepticus, IV lorazepam is often preferred because anticonvulsant effect outlasts diazepam's redistribution. Analytical separation is by LC-MS/GC-MS of parent drug and the nordiazepam/oxazepam/temazepam metabolite pattern unique to diazepam (and a few prodrugs).
- midazolam - Midazolam is water-soluble, ultra-short-acting (half-life about 1-4 h) and preferred for IM/intranasal prehospital seizure rescue and procedural sedation; diazepam is highly lipophilic, long-acting, and poorly suited to the same IM kinetics. Identity is by structure (imidazole-benzodiazepine vs 1,4-benzodiazepin-2-one) and half-life.
- clonazepam - Clonazepam is a 7-nitro benzodiazepine used mainly as maintenance anticonvulsant/anxiolytic, without diazepam's nordiazepam metabolite chain; potency is higher (about 0.25 mg clonazepam ≈ 5 mg diazepam). Separate by nitro vs chloro substitution and metabolite panel (7-aminoclonazepam vs nordiazepam).
- alprazolam - Alprazolam is a shorter-acting triazolobenzodiazepine used mainly for anxiety/panic and is the most dispensed US benzodiazepine; diazepam is longer-acting and still used for withdrawal, spasm and seizure rescue. Equivalent oral dose is about 0.5 mg alprazolam ≈ 10 mg diazepam; LC-MS distinguishes the triazolo core from diazepam.
- chlordiazepoxide - Both are long-acting and used in alcohol withdrawal; chlordiazepoxide is an N-oxide 1,4-benzodiazepine (Librium class) that also feeds nordiazepam. Distinguish by parent-drug assay and by the absence of diazepam as the administered molecule.
- nordiazepam (desmethyldiazepam) - Nordiazepam is diazepam's major active metabolite and a marketed drug in some countries; a finding of nordiazepam plus oxazepam/temazepam without parent diazepam may reflect nordiazepam dosing or late sampling after diazepam. Timing plus parent-drug detection separates them.
- diclazepam (2'-chloro-diazepam) - A designer analogue that metabolises to delorazepam/lorazepam-related products; it is not an FDA-approved medicine and in the US falls with other designer benzodiazepines under Schedule I, whereas diazepam is Schedule IV. Separate by the extra aromatic chlorine and the metabolite profile.
- Which of these neighbouring kinds and how to tell them apart hold for the sense of diazepam this model covers, and on what evidence? provenance
Sources
- Diazepam - Clinical uses, routes, legal scheduling by country, CAS/UNII/ATC/DrugBank identifiers, half-life ranges, WHO Essential Medicines listing, and FDA boxed-warning history.
- Diazepam | C16H13ClN2O | CID 3016 - Molecular formula, PubChem CID, Wikidata Q210402, RxCUI, ATC N05BA01, MeSH synonyms including Valium, Diazemuls, Stesolid, Relanium and Seduxen, and GABA-A mechanism summary.
- Diazepam - FDA-labelled indications (anxiety, muscle spasm/spasticity, preoperative anxiolysis, refractory epilepsy, status epilepticus), off-label ICU sedation, and GABA mechanism.
- Benzodiazepines - US Schedule IV control of approved benzodiazepines, 2025 US dispensing volume for diazepam, and law-enforcement encounter counts.
- Diazepam - WHO Model List of Essential Medicines - INN, ATC N05BA01, core-list status, restriction of oral use to short-term emergency anxiety, and UN 1971 psychotropic Schedule IV classification.
- Diazepam (oral route) - Adult and paediatric oral dosing bands, branded oral products, and overdose/CNS-depressant interaction hazards.
- Diazepam (rectal route) - Rectal gel (Diastat) as a weight-based rescue treatment for seizure clusters.
- Oral benzodiazepines and choosing equivalent doses - Diazepam as the oral equivalence reference, long-acting classification, licensed UK uses, and caution against accumulation in hepatic impairment.
- Benzodiazepines in epilepsy: pharmacology and pharmacokinetics - Oral/rectal bioavailability, protein binding, parent and nordiazepam half-lives, and CYP-mediated metabolism to nordiazepam, temazepam and oxazepam.
- Evolution Toward Designer Benzodiazepines in Drug-Facilitated Sexual Assault Cases - Therapeutic daily oral dose range, therapeutic plasma concentration band, onset, lipid solubility, and half-life used to separate diazepam from other benzodiazepines.
What the second pass must settle
- Does an existing Vercy world model already own diazepam or a concept boundary that requires this registry entry to link to it?
- Which authoritative substance identifiers and analytical standards should anchor diazepam identification across pharmaceutical and non-pharmaceutical samples?
- Which formulations, delivery systems and human or veterinary contexts must the model support in its intended jurisdictions?
- Which product-specific quality, compatibility and storage-excursion evidence is sufficient to determine usability for each supported preparation?
- Which current local control rules and clinical escalation protocols should be linked, and who is responsible for keeping them current?