Diazepam Rectal

Diazepam Rectal is a prescription medication used to treat occasionally increased seizures (cluster seizures) in people with epilepsy who also take other seizure medicines. Diazepam Rectal is not for long-term daily use to prevent seizures. 

• Diazepam Rectal is available under various brand names: Diastat, Diastat AcuDial, Diastat Pediatric

Common side effects of Diazepam Rectal include:

• drowsiness, dizziness, headache, feeling nervous.
• problems with coordination or muscle movement.
• flushing (sudden warmth, redness, or tingly feeling).
• stomach pain, diarrhea; or
• rash.

Serious side effects of Diazepam Rectal include:

• hives. 
• difficult breathing. 
• swelling of the face, lips, tongue, or throat.
• weak or shallow breathing, if you are hard to wake up, or if you stop breathing.
• new or worsening seizures.
• unusual changes in mood or behavior.
• thoughts of suicide or hurting yourself.
• confusion, hallucinations.
• sleep problems; or
• anxiety, excitement, anger, or feeling restless.

Rare side effects of Diazepam Rectal include:

• none

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, profuse sweating, or tremors;
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• Serious heart symptoms such as fast, irregular, or pounding heartbeats; fluttering in the chest; shortness of breath; sudden dizziness, lightheadedness, or passing out.

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Adult and pediatric dosage

Tablet: Schedule IV

• 2 mg
• 5 mg
• 10 mg

Oral solution: Schedule IV

• 1 mg/1mL
• 5 mg/mL

Rectal gel: Schedule IV

• 2.5 mg
• 10 mg
• 20 mg

Injectable solution: Schedule IV

• 5 mg/mL

Intramuscular device: Schedule IV

• 5 mg/mL

Seizure Disorder

Adult dosage

• 2-10 mg orally every 6-12 hours as an adjunct, OR
• 0.2 mg/kg per rectum, repeat after 4-12 hours when necessary 

Status Epilepticus

Adult dosage

• 5-10 mg Intravenous /Intramuscular every 5-10min; not to exceed 30 mg, OR
• 0.5 mg/kg PR (using parenteral solution), THEN 0.25 mg/kg in 10 minutes when necessary 

Pediatric dosage

• Potentially toxic dose in patients below 6 years: above 0.5 mg/kg  

Per rectum

• Children 2-6 years: 0.5 mg/kg; may repeat in 4-12 hours when necessary 
• Children 6-12 years: 0.3 mg/kg; may repeat in 4-12 hours when necessary 
• Children above 12 years: 0.2 mg/kg; may repeat in 4-12 hours when necessary 

Intravenous 

• Children 6 months-5 years: 0.2-0.5 mg Intravenous initially repeat every 2-5 minutes; do not exceed 5 mg; may repeat 2-4 hours later when necessary 
• Children above 5 years: 1 mg Intravenous given slowly every 2-5 min; not to exceed 10 mg total dose; may repeat in 2-4 hours if necessary

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Diazepam Rectal has severe interactions with no other drugs.
• Diazepam Rectal has serious interactions with at least 33 other drugs.
• Diazepam Rectal has moderate interactions with at least 257 other drugs.
• Diazepam Rectal has minor interactions with at least 41 other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all your products. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Hypersensitivity to diazepam
• glaucoma.
• asthma, pneumonia, or other breathing disorder.
• liver or kidney disease.
• a drug or alcohol addiction; or
• depression, a mood disorder, or suicidal thoughts or behavior.

Effects of drug abuse

• Addiction, 
• Overdose, or
• Death

Short-Term Effects

• See “What Are Side Effects Associated with Using Diazepam Rectal?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Diazepam Rectal?”

Cautions

• Diazepam can slow or stop your breathing, especially if you have recently used an opioid medication, alcohol, or other drugs that can slow your breathing.
• MISUSE OF THIS MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medication in a place where others cannot get to it.
• This medicine is not for all types of seizures. If you are a caregiver, do not give this medicine unless you know how to recognize a seizure that should be treated with diazepam Rectal.
• Avoid drinking alcohol. Dangerous side effects could occur.
• Grapefruit may interact with diazepam and lead to unwanted side effects. Avoid the use of grapefruit products.
• Avoid driving or hazardous activity until you know how this medicine will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.

Pregnancy and Lactation

• Do not start or stop using seizure medication during pregnancy without your doctor's advice. Having a seizure during pregnancy could harm both mother and baby. Tell your doctor right away if you become pregnant.
• Lactation
  • Do not breastfeed while using diazepam Rectal, and for a short time after you stop using it. Ask your doctor when you can start breastfeeding again.