uses
What is diazepam used for?Rectal diazepam is commonly used to treat a certain type of seizure disorder (epilepsy) called seizure clusters, also known as acute repetitive seizures.Rectal diazepam may also be used for other conditions as determined by your healthcare provider.Diazepam is also available in other dosage forms. See Valtoco nasal spray and Diazepam for information about other dosage forms. How does diazepam work (mechanism of action)?Rectal diazepam produces a calming effect on the brain and nerves, which helps to prevent seizures.How is rectal diazepam supplied (dosage forms)?Brands and other namesDiastatDiastat AcuDialDosage forms and strengths2.5 mg/0.5 mL; 10 mg/2 mL; 20 mg/4 mL rectal gelHow should I store diazepam?Rectal diazepam should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.
how to use
gel that is inserted into the rectum
drug interactions
Does rectal diazepam interact with foods or drinks?Eating grapefruit or drinking grapefruit juice may increase diazepam levels and side effects.Do not drink alcohol while taking rectal diazepam. The risk of serious problems such as severe dizziness, sleepiness, and trouble breathing may be increased if you drink alcohol while taking rectal diazepam.Does rectal diazepam interact with other medicines (drug interactions)?Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. In particular, make sure to discuss if you are using any of the following before taking rectal diazepam.An opioid, such as oxycodone, morphine, codeine, or fentanyl, which is a medicine used for certain types of painAny other medicine that causes dizziness and sleepiness, such as prescription pain medicines, sleep medicines, and medicines for anxietyFlumazenil (Romazicon), which is a medicine used to manage benzodiazepine overdoseSome other medicines may alter the blood levels of diazepam. Tell your healthcare provider about all medicines that you take or have recently taken.This may not be a complete list of medicines that can interact with rectal diazepam. Always check with your healthcare provider.
side effects
What are the most common side effects of rectal diazepam?The most common side effects of rectal diazepam are listed below. Tell your healthcare provider if you have any of these side effects that bother you.Drowsiness (or sleepiness)HeadacheThere may be other side effects of rectal diazepam that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.What are the serious side effects of rectal diazepam?While less common, the most serious side effects of rectal diazepam are described below, along with what to do if they happen.Severe Allergic Reactions. Rectal diazepam may cause allergic reactions, which can be serious. Stop using rectal diazepam and get help right away if you have any of the following symptoms of a serious allergic reaction.Breathing problems or wheezingRacing heartFever or general ill feelingSwollen lymph nodesSwelling of the face, lips, mouth, tongue, or throatTrouble swallowing or throat tightnessItching, skin rash, or pale red bumps on the skin called hivesNausea or vomitingDizziness, feeling lightheaded, or faintingStomach crampsJoint painSuicidal Thoughts and Actions. Rectal diazepam may cause suicidal thoughts or actions in a small number of people. If you are about to harm yourself, call 911 or call or text 988, the Suicide & Crisis Lifeline. Call your healthcare provider right away if you have any of the following symptoms.New or increased thoughts of suicide or deathSuicide attemptNew or increased feelings of anxiety, depression, or other unusual changes in mood or behaviorRisk of Misuse and Addiction. Misusing rectal diazepam can lead to serious side effects like coma or death. Misuse means taking a medicine in a way other than how it was prescribed. Use rectal diazepam exactly as prescribed. Tell your healthcare provider if you feel that rectal diazepam is not working. Call your healthcare provider right away or go to the nearest emergency room if you experience any of the following serious symptoms.Sudden confusion or feeling disorientedFeeling paranoidSuicidal thoughts or actionsSeizuresTrouble breathingDependence and Withdrawal Reactions. Rectal diazepam can cause physical dependence, which means your body relies on the medicine to function properly. If you stop rectal diazepam suddenly, it could lead to withdrawal symptoms, which may be life-threatening. Do not stop taking rectal diazepam without talking with your healthcare provider. Your healthcare provider will tell you how to stop rectal diazepam to reduce the risk of withdrawal reactions. Call your healthcare provider right away or go to the nearest emergency room if you experience any of the following serious symptoms.Unusual movements, responses, or expressionsSeizuresSudden and severe mental or nervous system changesSeeing or hearing things that others do not see or hear, also called hallucinationsAn extreme increase in activity or talkingLosing touch with realitySome people may experience the following symptoms of a withdrawal reaction that can last for several weeks to more than 12 months.AnxietyTrouble remembering, learning, or concentratingDepressionProblems sleepingFeeling like insects are crawling under the skinWeaknessShakingMuscle twitchingBurning or prickling feeling in the hands, arms, legs, or feetRinging in the earsRisk With Opioid Medicines. Taking rectal diazepam with an opioid medicine, such as codeine, morphine, and oxycodone, may lead to severe drowsiness, breathing problems, coma, and death. Get emergency help right away if you experience the following symptoms.Slow or shallow breathingBreathing stops (which may lead to the heart stopping)Excessive sleepiness or trouble staying awake Decreased Alertness or Coordination. Rectal diazepam can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how rectal diazepam affects you.
overdose and misseddose
What should I do if I accidentally use too much rectal diazepam?If you or someone else has used too much rectal diazepam, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.What should I do if I miss a dose of diazepam?Rectal diazepam is meant to be used only when needed. Use it as your healthcare provider recommends. Do not take double or extra doses.
warnings and Precautions
Who should not use rectal diazepam?Allergies to Ingredients. People who are allergic to any of the following should not use rectal diazepam.DiazepamDiastatAny of the ingredients in the specific product dispensedYour pharmacist can tell you all of the ingredients in the specific rectal diazepam products they stock.Acute Narrow Angle Glaucoma. Do not use rectal diazepam if you have acute narrow-angle glaucoma. There are different types of glaucoma. If you do not know what type you have, talk with your healthcare provider before taking rectal diazepam.What should I know about rectal diazepam before using it?Do not use rectal diazepam unless it has been prescribed to you by a healthcare provider. Use it as prescribed.Do not share rectal diazepam with other people, even if they have the same condition as you. It may harm them.Keep rectal diazepam out of the reach of children. Rectal diazepam is a controlled substance because it can be misused or lead to dependence. Store rectal diazepam in a safe place to protect it from theft. It is illegal to sell or give away this medicine.Rectal diazepam can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how rectal diazepam affects you.Your healthcare provider will show you or your caregiver how to administer diazepam rectal gel. A patient instruction sheet is enclosed in your medicine container. Make sure that your caregiver understands how to prepare and use this medicine. If you have any questions, talk to your healthcare provider.What should I tell my healthcare provider before using rectal diazepam?Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if diazepam is right for you.In particular, make sure that you discuss any of the following.Mental Health Problems. Tell your healthcare provider about your recent and current mental health problems, especially if you have had depression, thoughts of suicide or dying, or have ever attempted suicide.Substance Use Disorder. Rectal diazepam is a controlled substance and may be misused or lead to dependence. Tell your healthcare provider if you have a history of a drug or alcohol disorder. Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.Liver problemsKidney problemsLung disease or breathing problems, including asthma, pneumonia, or severe respiratory insufficiencyOther Medicines and Supplements. Rectal diazepam may interact with other medicines and supplements. Before using rectal diazepam, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.Pregnancy. It is not known if or how rectal diazepam could affect pregnancy or harm an unborn baby. Taking rectal diazepam during the later stages of pregnancy can cause withdrawal and the following symptoms in newborns.Breathing problemsSluggishLow muscle toneJitteryFussiness or irritabilityRestlessnessShakingExcessive cryingFeeding problemsTell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should use rectal diazepam while you are pregnant or trying to get pregnant. If you become pregnant, talk to your healthcare provider about registering with the National Pregnancy Registry for Psychiatric Medications. This registry collects information about the safety of psychiatric medicines during pregnancy. You can register by calling 866-961-2388 or online at https://womensmentalhealth.org/pregnancyregistry/.Breastfeeding. Diazepam passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should use rectal diazepam while breastfeeding.