Strenil 5 mg Tablet

Long-acting benzodiazepine for:

• Short-term relief of severe anxiety
• Alcohol withdrawal
• Muscle spasm (e.g. back spasm, tetanus, cerebral palsy spasticity)
• Prolonged seizures and status epilepticus (rectal tube or IV)
• Febrile convulsions in children (rectal)
• Sedation before procedures
• Short-term insomnia associated with anxiety

Anxiety (adults): 2 mg three times daily, increased if needed to 15–30 mg daily in divided doses; elderly half dose.

Insomnia with anxiety: 5–15 mg at bedtime.

Muscle spasm: 2–15 mg daily in divided doses (up to 60 mg in spasticity).

Alcohol withdrawal: 10–20 mg, repeated as needed under supervision, then tapered.

Prolonged seizure — rectal tube: adults and children over 12: 10–20 mg; 2–12 years: 5–10 mg; 1 month–2 years: 5 mg. Repeat once after 10–15 minutes if needed; call emergency services.

IV (hospital): 10 mg slowly (adults), repeat after 10 minutes if needed.

• Use for the shortest time, usually not more than 2–4 weeks for anxiety/insomnia.
• Do not stop suddenly after regular use.

• Severe respiratory depression, acute pulmonary insufficiency
• Sleep apnoea
• Myasthenia gravis
• Severe liver impairment
• Phobias or obsessional states alone; chronic psychosis
• Allergy to benzodiazepines

Common: drowsiness, tiredness, unsteadiness, muscle weakness, dizziness, reduced concentration, next-day hangover.

Less common: confusion (elderly), memory loss, slurred speech, headache, low blood pressure, blurred vision.

Serious: dependence and withdrawal, paradoxical agitation/aggression, falls in elderly, breathing depression (especially IV or with opioids/alcohol), injection-site thrombophlebitis.

• Do not drive or operate machinery; avoid alcohol.
• Elderly: lower doses, fall risk.
• History of substance misuse, depression or suicidal thoughts: caution.
• Long half-life — effects can accumulate over days.
• Keep rectal tubes and tablets out of reach of children.

Avoid regular use in pregnancy, especially the first and last trimesters (floppy infant syndrome, withdrawal). May be used for status epilepticus or eclampsia when essential. Avoid while breastfeeding (accumulates in the baby).

• Opioids, alcohol, other sedatives, antipsychotics, antihistamines, antidepressants (profound sedation, breathing depression)
• Cimetidine, omeprazole, fluvoxamine, fluconazole, ketoconazole, isoniazid, disulfiram (raise levels)
• Rifampicin, carbamazepine, phenytoin (lower levels); diazepam may alter phenytoin levels
• Smoking may reduce effect

Drowsiness, confusion, slurred speech, unsteadiness, slow breathing, coma — dangerous with alcohol or opioids. Emergency care; flumazenil in hospital.

Store below 30°C, protected from light.