Dizepax 2.5 mg/20 mg Tablet: Complete Medicine Guide
Clinical Reference Standards: CDSCO (Central Drugs Standard Control Organisation), Indian Pharmacopoeia (IP) & WHO | Last Updated: September 2026
When to Call Your Doctor IMMEDIATELY
- Severe drowsiness or difficulty staying awake
- Slow, shallow, or irregular breathing
- Fainting or severe dizziness
- Chest pain or palpitations
- Severe allergic reaction (rash, swelling of face/lips/throat)
- Confusion, hallucinations, or unusual agitation
- Yellowing of skin or eyes
- Seizures or tremors
If experiencing severe symptoms, call emergency services immediately.
What is syziral 2.5 mg/20 mg tablet used for?
This medicine is a combination of diazepam (a benzodiazepine) and propranolol (a beta-blocker) used for short-term relief of anxiety with prominent physical symptoms. It works by calming the brain and reducing heart rate and tremors. It is prescription-only and should not be stopped abruptly.
- Generic Name: Diazepam (2.5mg) + Propranolol (20mg)
- Manufacturer: Psycormedies
- Form: Allopathy
- Pregnancy Category: Consult doctor
- Prescription Required: Yes
🇮🇳 syziral 2.5 mg/20 mg tablet के बारे में (Hindi Summary)
उपयोग: यह दवा डायजेपाम और प्रोप्रानोलोल का संयोजन है, जिसका उपयोग चिंता (एंग्जायटी) के इलाज में किया जाता है, खासकर जब चिंता के साथ दिल की धड़कन तेज होना, कंपन, और पसीना आना जैसे शारीरिक लक्षण भी हों। यह दवा दिमाग को शांत करती है और हृदय की गति को कम करती है। यह केवल डॉक्टर के पर्चे पर ही मिलती है और इसे अचानक बंद नहीं करना चाहिए।
साइड इफेक्ट्स: इस दवा के सामान्य दुष्प्रभावों में नींद आना, थकान, चक्कर आना, हाथ-पैर ठंडे होना, मुँह सूखना और कमजोरी शामिल हैं। कुछ लोगों को धड़कन धीमी होना, ब्लड प्रेशर कम होना, या पेट में गड़बड़ी हो सकती है। गंभीर दुष्प्रभाव दुर्लभ हैं, लेकिन सांस लेने में कठिनाई, बेहोशी, या गंभीर एलर्जी हो तो तुरंत डॉक्टर से मिलें।
सुरक्षा सलाह: इस दवा को डॉक्टर के बताए अनुसार ही लें। इसे अचानक बंद न करें, क्योंकि इससे चिंता, अनिद्रा, कंपन या दौरे पड़ सकते हैं। दवा लेने के बाद गाड़ी चलाने या मशीन चलाने से बचें क्योंकि इससे नींद और चक्कर आ सकते हैं। शराब का सेवन बिल्कुल न करें। यदि आप गर्भवती हैं, स्तनपान करा रही हैं, या आपको अस्थमा, हृदय रोग, या लीवर की समस्या है, तो डॉक्टर को बताएं।
💊 syziral 2.5 mg/20 mg tablet Uses & Benefits
[{"condition":"Anxiety disorders with prominent physical symptoms","description":"This combination is used for short-term relief of anxiety that includes both psychological worry and physical symptoms such as palpitations, tremors, and sweating.","evidence":"Limited to moderate; combination use is based on clinical practice rather than large randomized trials."},{"condition":"Situational anxiety (e.g., before surgery or dental procedures)","description":"May be prescribed for short-term control of acute anxiety in specific situations where both calming and heart-rate control are beneficial.","evidence":"Limited; use is individualized."},{"condition":"Anxiety associated with cardiovascular reactivity","description":"Propranolol helps reduce adrenaline-driven symptoms like rapid heartbeat and tremor, while diazepam addresses central anxiety.","evidence":"Limited; combination not widely studied."}]
Off-label uses: [{"condition":"Performance anxiety (e.g., public speaking)","description":"Propranolol is sometimes used off-label for performance anxiety, but the addition of diazepam is not standard and increases sedation risk.","evidence":"Limited and not recommended for routine use."},{"condition":"Tension-type headache with anxiety","description":"Rarely, this combination may be used when anxiety and muscle tension coexist, but evidence is weak.","evidence":"Insufficient"}]
Primary treatment for: Anxiety disorders
Also treats: Situational anxiety, Panic disorder with somatic symptoms, Anxiety with cardiovascular reactivity
📋 Drug Information
| Generic Name(s) | Diazepam (2.5mg) + Propranolol (20mg) |
| Brand Name | syziral 2.5 mg/20 mg tablet |
| Manufacturer | Psycormedies |
| Packaging / Form | Varies by brand (Allopathy) |
| Therapeutic Class | NEURO CNS |
| Action Class | |
| Route of Administration | Oral |
| Storage | Store at room temperature between 15°C and 30°C (59°F to 86°F). Protect from light and moisture. Keep in the original container, tightly closed. Do not refrigerate unless specified. Keep out of reach of children and pets. |
| Shelf Life | Typically 24 months from the date of manufacture, but refer to the expiry date printed on the pack. |
| WHO Guideline | Not established from the available information. |
| ICMR Guideline | Not established from the available information. |
👨⚕️ Doctor's Practical Tips
Evidence-based practical advice from experienced clinicians
🔍 Is This Medicine Right for Your Symptom?
Educational reference. Always consult a doctor for diagnosis.
🔬 How This Medicine Works (Pharmacology)
Pharmacokinetics
How It Works
This medicine combines two active ingredients with distinct mechanisms. Diazepam binds to the benzodiazepine site on the GABA-A receptor complex, enhancing the inhibitory neurotransmitter GABA, which reduces neuronal excitability and produces anxiolytic, sedative, muscle relaxant, and anticonvulsant effects. Propranolol is a non-selective beta-adrenergic receptor antagonist that blocks beta-1 and beta-2 receptors, reducing heart rate, cardiac output, and renin release, and blunting the physical manifestations of anxiety such as tachycardia, tremor, and sweating. The combination aims to address both central anxiety and peripheral sympathetic overactivity.
Mechanism Steps
💡 How to Take syziral 2.5 mg/20 mg tablet
Strength: Tablet containing Diazepam 2.5 mg and Propranolol 20 mg.
Dosage Information
| Adult Dosage | The usual adult dose of this combination is one tablet taken orally one to three times daily, depending on the severity of anxiety and the patient's response. However, the exact dose and frequency must be individualized by a qualified clinician based on indication, age, weight, renal and hepatic function, and concurrent medications. Do not self-adjust the dose. The maximum daily dose should not exceed the prescribed amount. Treatment is usually short-term, and gradual tapering is required when stopping. |
| Pediatric Dosage | Pediatric dosing is not established from available information. Consult a pediatrician. |
| Elderly Dosage | Elderly patients are more sensitive to the effects of diazepam and propranolol. Lower initial doses and slower titration are recommended. Regular monitoring for sedation, falls, and cardiovascular effects is essential. Dose must be individualized by a qualified clinician. |
| Renal Impairment | No specific dose adjustment guidelines are established for this combination in renal impairment. Use with caution and monitor for increased side effects. Dose must be individualized by a qualified clinician. |
| Hepatic Impairment | In hepatic impairment, both diazepam and propranolol metabolism may be reduced. Lower doses and careful monitoring are advised. Dose must be individualized by a qualified clinician. |
| Maximum Daily Dose | The maximum daily dose is not fixed and depends on the prescribed regimen. Do not exceed the dose prescribed by your doctor. |
Dosage Timeline
🍽️ Food Timing Guide
⏰ What to Do If You Miss a Dose
⚠️ Side Effects of syziral 2.5 mg/20 mg tablet
✅ Common Side Effects
🚨 Serious Side Effects
⚠️ Rare Side Effects
Consult your doctor if you experience any unusual symptoms.
🔬 Drug Interactions
| Drug | Severity | Effect |
|---|---|---|
| Warfarin | Moderate | |
| Metformin | Minor | |
| Insulin | Moderate | |
| Clonidine | Major | |
| Digoxin | Moderate | |
| Theophylline | Moderate | |
| Fluoxetine | Major | |
| Omeprazole | Minor | |
| Phenytoin | Moderate | |
| Levodopa | Moderate |
🚨 Major Interactions
- CNS depressants (e.g., opioids, alcohol, barbiturates)
- Calcium channel blockers (e.g., verapamil, diltiazem)
- MAO inhibitors
- CYP2D6 inhibitors (e.g., fluoxetine, paroxetine)
⚡ Moderate Interactions
- Antihypertensives
- NSAIDs
- CYP3A4 inhibitors (e.g., ketoconazole, ritonavir)
- Rifampicin
🍷 Alcohol Interaction
Alcohol should be strictly avoided while taking this medicine. Alcohol enhances the sedative effects of diazepam and can lead to dangerous respiratory depression, profound drowsiness, and impaired coordination. It may also worsen propranolol-related dizziness and low blood pressure.
🔎 Check Your Other Medicines
Educational tool. Always confirm with your doctor or pharmacist.
🛡️ Safety & Warnings
🚫 Contraindications
["Hypersensitivity to diazepam, propranolol, or any component of the formulation","Severe respiratory insufficiency or chronic obstructive pulmonary disease","Asthma or bronchospastic disease","Severe liver impairment","Narrow-angle glaucoma","Myasthenia gravis","Severe heart failure, heart block, or cardiogenic shock","Pregnancy and breastfeeding (unless specialist advises otherwise)","History of substance misuse"]
⚠️ Warnings & Precautions
["May cause drowsiness and impair ability to drive or operate machinery.","Risk of dependence and withdrawal with prolonged diazepam use.","Do not stop abruptly; taper gradually under medical supervision.","Avoid alcohol and other CNS depressants.","Use with caution in elderly and debilitated patients.","May mask symptoms of hypoglycemia in diabetics.","Can worsen asthma or COPD due to propranolol.","May cause bradycardia and hypotension; monitor vital signs.","Not recommended for children unless specifically prescribed.","Inform your doctor if you have thyroid disease, as propranolol can mask thyrotoxicosis."]
🤱 Lactation Safety
Both diazepam and propranolol pass into breast milk. Diazepam may cause sedation and poor feeding in the infant. Propranolol may cause bradycardia and hypoglycemia. Breastfeeding is not recommended while taking this medicine unless advised by a doctor.
💊 Overdose Management
Overdose of this medicine can cause severe drowsiness, confusion, respiratory depression, bradycardia, hypotension, and cardiac arrest. Seek emergency medical attention immediately. Treatment is supportive and may include gastric lavage, activated charcoal, intravenous fluids, and use of flumazenil for benzodiazepine toxicity (with caution). Propranolol overdose may require glucagon, atropine, or pacing. Do not attempt to manage overdose at home.
⏰ Missed Dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose to make up for a missed one. If you are unsure, consult your doctor or pharmacist.
Additional Safety Advice
Always take this medicine exactly as prescribed by your doctor. Do not increase, decrease, or stop the dose suddenly, as abrupt withdrawal of diazepam can cause anxiety rebound, insomnia, tremors, or seizures. Avoid driving or operating heavy machinery until you know how this medicine affects you, because it can cause drowsiness and slow reaction times. Do not drink alcohol while taking this medicine, as it can dangerously increase sedation and respiratory depression. Inform your doctor if you have asthma, diabetes, thyroid problems, heart disease, liver or kidney disease, or a history of depression or substance misuse. Do not share this medicine with others, even if they have similar symptoms. Keep this medicine out of reach of children. If you are pregnant, planning pregnancy, or breastfeeding, consult your doctor before using this medicine. Regular follow-up is important to assess effectiveness and to taper the dose safely when stopping treatment.
👴 Special Considerations for Elderly
💡 For Patients Above 65
Elderly patients are more sensitive to the sedative and cardiovascular effects of this medicine. Lower doses and careful monitoring are recommended. There is an increased risk of falls, confusion, and cognitive impairment. Regular review of the need for continued treatment is essential.
🤰 Pregnancy Planning (TTC)
This medicine is not recommended during pregnancy or when planning pregnancy. Both diazepam and propranolol may harm the developing fetus. Consult your doctor for alternative treatments if you are pregnant or planning to conceive.
🏥 Post-Surgery Considerations
Inform your surgeon and anesthesiologist if you are taking this medicine before surgery. It may interact with anesthetic agents and increase the risk of sedation and cardiovascular depression. Your doctor may advise temporary discontinuation or dose adjustment.
🦷 Dental Procedures
Inform your dentist if you are taking this medicine before any dental procedure. It may interact with local anesthetics containing epinephrine and increase the risk of cardiovascular effects. Sedation may also be prolonged.
💚 Lifestyle Tips for Better Results
🏋️ Exercise Considerations
This medicine can cause drowsiness, dizziness, and reduced heart rate, which may affect your ability to exercise safely. Avoid strenuous exercise until you know how the medicine affects you. Stay hydrated and rise slowly from sitting or lying positions to prevent dizziness.
🥗 Diet Recommendations
💼 Impact on Daily Work & Life
This medicine can cause drowsiness and slow reaction times, which may affect your ability to drive, operate machinery, or perform tasks requiring alertness. It is advisable to discuss work adjustments with your employer if your job involves such activities. Avoid making important decisions until you know how the medicine affects you.
🛑 When to Stop This Medicine
Do not stop this medicine without consulting your doctor. Your doctor will gradually reduce the dose over time to prevent withdrawal symptoms. If you experience severe side effects or wish to discontinue, contact your healthcare provider for a safe tapering plan.
📅 Long-Term Use Effects
Long-term use of this medicine, especially the diazepam component, can lead to tolerance, dependence, and withdrawal symptoms upon discontinuation. Propranolol may cause persistent bradycardia, hypotension, and reduced exercise tolerance. Regular monitoring of heart rate, blood pressure, and mental status is recommended. Periodic review is necessary to assess the need for continued treatment.
🌿 Non-Medicine Approaches
These can complement medicine but do not replace prescribed treatment.
A first-line psychological treatment for anxiety disorders that can complement or replace medication.
Evidence: Well-establishedOften used for long-term management of anxiety with a better safety profile than benzodiazepines.
Evidence: Well-establishedCan help reduce anxiety symptoms and improve overall well-being.
Evidence: Moderate💉 Vaccination Considerations
💉 If You're Getting Vaccinated
No specific vaccine interactions are established for this medicine. However, inform your healthcare provider about all medications before receiving any vaccine.
📦 Storage Guide
✅ DO
Store at room temperature (15-30°C)
❌ DON'T
Do not refrigerate unless specified
✅ DO
Keep in original container
❌ DON'T
Do not transfer to unmarked containers
✅ DO
Keep away from direct sunlight
❌ DON'T
Do not store in bathroom cabinet
✈️ Traveling with This Medicine
When traveling, carry this medicine in its original packaging along with a copy of your prescription. Keep it in your hand luggage to avoid loss or temperature extremes. If crossing time zones, consult your doctor about adjusting the dosing schedule. Store at room temperature and avoid direct sunlight. Check customs regulations for controlled substances before traveling internationally.
💰 Cost Analysis & Savings
👥 Real Patient Stories
Educational, anonymized scenarios. Individual results may vary.
💬 Questions Patients Often Ask
A: This medicine usually starts working within 30 to 60 minutes after taking a dose. However, the full effect on anxiety may take a few days of regular use.
A: It is usually prescribed for short-term use. Long-term daily use should only be under strict medical supervision due to the risk of dependence.
A: If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double dose.
A: No, you should never stop this medicine abruptly. Your doctor will gradually reduce the dose to prevent withdrawal symptoms.
🤔 Common Patient Concerns
🔄 Substitutes for syziral 2.5 mg/20 mg tablet
View AllAlternative brands with exact same active ingredient:
-
volcan 2.5 mg/20 mg tabletThrift Pharmaceuticals ₹14.91 31.9% COSTLIER
-
neuropax 2.5 mg/20 mg tabletReliance Formulation Pvt Ltd ₹18.75 65.9% COSTLIER
-
tensyn plus 2.5 mg/20 mg tabletSynokem Pharmaceuticals Ltd ₹26.72 136.5% COSTLIER
-
bipnolol d 2.5mg/20mg tabletCuris Lifecare ₹30.94 173.8% COSTLIER
-
dizeral 2.5 mg/20 mg tabletUnimarck Healthcare Ltd ₹30.94 173.8% COSTLIER
Medical Note: Always consult your doctor before switching medications.
🛑 Myths vs. Facts
- Myth: This medicine is a permanent cure for anxiety.
Fact: It provides short-term symptom relief but is not a cure. Psychological therapies and lifestyle changes are important for long-term management. - Myth: It is safe to stop this medicine suddenly once you feel better.
Fact: Abrupt discontinuation can cause withdrawal symptoms and rebound anxiety. Always taper under medical supervision. - Myth: This medicine can be taken for years without any risk.
Fact: Prolonged use of diazepam can lead to tolerance and dependence. Regular review is essential.
🔄 Alternative Options
Generic Alternatives
- Diazepam 2.5 mg + Propranolol 20 mg tablet (generic)
Brand Alternatives
- Dizepax 2.5 mg/20 mg tablet