DIAZEPAM

Benzodiazepine with anticonvulsant, sedative, antiepileptic, muscle relaxant, and anxiolytic properties

Dosage Forms

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Rectal tube

2mg/ml

Suppository

2.5mg

Tablet

5 mg

Injection

5mg/ml

Uses

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  • Spasms in tetanus
  • Febrile convulsions due to severe malaria, respiratory tract infections, and urinary tract infections
  • Status epilepticus
  • Convulsions due to poisoning
  • Anxiety
  • Convulsions due to eclampsia in pregnant women
  • Adjunct therapy in acute alcohol withdrawal syndrome

Dose and Duration

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Control spasms in tetanus (alternating with chlorpromazine)
Adult:2–3 mg/kg by NG tube every 4–6 hours.
Child:0.5–1 mg/kg by NG tube every 4–6 hours

Continue for as long as spasms last

Febrile convulsions, status epilepticus, convulsions due to poisoning
Adult and child > 12 years:10‒20 mg rectally
Child 2‒12 years: 5‒10 mg rectally
Child 1 month‒2 years: 5mg rectally
Child < 1 month: 1.25‒2.5 mg rectally

Repeat after 10 minutes if necessary

OR

Adult and child > 12 years: 10 mg by slow IV injection (1 ml per minute)
Child <12 years: 300‒400 micrograms/kg (max 10 mg)

Repeat after 10 minutes if necessary

Acute alcohol withdrawal
Adult:5–20 mg repeated every 2–4 hours if necessary
Anxiety
Adult:5 mg 1–2 times daily; increase if necessary to 15–30 mg daily in divided doses
Eclampsia in pregnancy
Give 10 mg by IV slowly (over 2 minutes)

Contraindications

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  • Severe respiratory depression
  • Acute alcohol intoxication
  • Coma
  • Shock
  • Severe liver disease
  • Depression
  • Obsessive psychoses
  • Chronic anxiety
  • Post-traumatic stress syndrome

Side Effects

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  • Drowsiness, sedation, sleep disturbance
  • Amnesia (temporary loss of memory), confusion, excitability, irritability, hallucinations
  • Hypotension, slow heartbeat
  • Dependence

Interactions

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  • Alcohol (increased sedative effect)
  • Morphine (increased sedative effect)
  • Chlorpromazine (increased sedative effect)
  • Chlorpheniramine (increased sedative effect)
  • Promethazine (increased sedative effect)
  • Phenobarbital (increased sedative effect)

Patient Instructions

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  • Do not take alcohol while on treatment
  • May cause drowsiness; do not drive or operate machinery

Pregnancy

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  • Can be used

Breastfeeding

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  • Can be used

⚠️ Caution

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  • Alternative to magnesium sulphate in eclampsia
  • Diazepam is addictive; avoid prolonged use (no more than 7 days) and give the lowest possible dose for the shortest period. Dependence and tolerance occur when used for more than 10–15 days.
  • Do not stop treatment abruptly to minimise withdrawal effect
  • Reduce dose by half in elderly and in patients with severe kidney and liver disease
  • In pregnancy, only use if benefit outweighs risk