Directly conjugated with glucuronic acid. Several references consider it safe.

Benzodiazepine anxiolytic. Eliminated by direct conjugation with glucuronic acid. Conflicting experimental evidence of porphyrinogenicity (Martindale) MFM James, RJ Hift. Porphyrias. Br J Anaesth 2000; 85, 143-53: use with care. EPI-list: safe South African list: use French list: use Australian list: safe (conflicting evidence) See Holoryd S et al. Psychotropic drugs in acute... (PMID10511069): safe (n=1). Kauppinen and Mustajoki. Prognosis of acute porphyria... Medicine 1992; 71: 1-13: tolerated (N=1). Used in porphyria ward (Sweden)

Uneventful use reported in 12 patients with acute porphyria.