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Generic Name:

diazepam, Rectal gel

All Brands

  • Diastat
SECTION 1 of 5

Highlights for diazepam

Rectal gel
1

Diazepam is used to treat anxiety, alcohol withdrawal, muscle spasms, and certain types of seizures.

2

This drug can interfere with your judgment, thinking, and motor skills. You shouldn’t drink alcohol or use other drugs that can also slow down your brain’s activity while you’re on diazepam. You also shouldn’t drive, operate machinery, or do other tasks that require alertness until you know how this drug affects you.

3

Diazepam is available in several different forms, including oral tablet, oral solution, and rectal gel.

4

Diazepam can be habit-forming. It can lead to dependence and tolerance, meaning that you’ll need more of the drug for it to work. Keep it in a safe place, and never give it to anyone else because it may harm them. Selling or giving away this medication is against the law.

5

You shouldn’t stop taking diazepam without talking to your doctor first. Stopping this drug can cause severe withdrawal symptoms. Your risk may be higher if you’ve been on diazepam for a long time.

IMPORTANT INFORMATION

Sedation

This drug can slow down your brain’s activity and interfere with your judgment, thinking, and motor skills. You shouldn’t drink alcohol or use other drugs that can also slow down your brain’s activity while you’re on diazepam. You also shouldn’t drive, operate machinery, or do other tasks that require alertness until you know how this drug affects you.

Drug administration

This drug should only be given to you by a caregiver who is trained on how to administer it correctly. Your doctor will show your caregiver how to give you this drug.

What is diazepam?

Diazepam is a controlled substance drug. It is available in these forms: oral tablet, oral solution, oral solution concentrate, and rectal gel.

Diazepam is available in its generic form. Generic drugs usually cost less. In some cases they may not be available in every strength or form as the brand. Talk to your healthcare provider to see if the generic will work for you.

This drug may be used as part of a combination therapy. That means you need to take it with other drugs.

Why it's used

Diazepam rectal gel is used for short-term control of breakthrough seizures. It’s used in people with severe epilepsy who are already on other drugs to treat seizures.

How it works

Diazepam belongs to a class of drugs called benzodiazepines. A class of drugs refers to medications that work similarly. They have a similar chemical structure and are often used to treat similar conditions.

More Details

How it works

Diazepam belongs to a class of drugs called benzodiazepines. A class of drugs refers to medications that work similarly. They have a similar chemical structure and are often used to treat similar conditions.

Diazepam increases the activity of gamma aminobutyric acid (GABA), a special chemical that can send signals throughout your nervous system. If you don’t have enough GABA, your body may be in an excited state and cause you to have anxiety, get muscle spasms, or have seizures. When you take this drug, you’ll have more GABA in your body. This will help decrease your anxiety, muscle spasms, and seizures.

 

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SECTION 2 of 5

diazepam Side Effects

Rectal gel

Most Common Side Effects

The most common side effects that occur with diazepam include:

  • drowsiness

  • dizziness

  • headache

  • abdominal pain

  • nervousness

  • dilation of your blood vessels

  • diarrhea

  • inability to control muscle movements (ataxia)

  • a feeling of intense excitement or happiness (euphoria)

  • loss of coordination

  • asthma

  • runny or stuffy nose

  • skin rash

  • lack of energy

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

If you experience any of these serious side effects, call your doctor right away. If your symptoms are potentially life threatening or if you think you’re experiencing a medical emergency, call 9-1-1.

Serious side effects that can occur with diazepam include:

  • Worsening of seizures. Symptoms can include:

    • increase in frequency
    • increase in severity
  • Changes in the brain or how you think. Symptoms can include:

    • depression
    • confusion
    • feelings of the room spinning (vertigo)
    • slowed or slurred speech
    • double or blurred vision
    • thoughts of suicide
    • memory loss
  • Unexpected reactions. Symptoms can include:

    • extreme excitement
    • anxiety
    • hallucinations
    • increased muscle spasms
    • trouble sleeping
    • agitation
  • Liver problems. Symptoms can include:

    • yellowing of your skin or whites of your eyes (jaundice)
  • Bladder problems. Symptoms can include:

    • inability to urinate
    • inability to hold urine
  • Increase or decrease in sex drive.

  • Withdrawal. Symptoms can include:

    • tremor
    • abdominal or muscle cramps
    • sweating
    • convulsions
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Diazepam can slow down your brain’s activity and interfere with your judgment, thinking, and motor skills. You shouldn’t drink alcohol or use other drugs that can also slow down your brain’s activity while you’re on diazepam. You also shouldn’t drive, operate machinery, or do other tasks that require alertness until you know how this drug affects you.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 5

diazepam May Interact with Other Medications

Rectal gel

Diazepam can interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions.

Food interactions

You shouldn’t drink grapefruit juice while taking diazepam. It will stop your liver from processing this drug correctly, causing more of it to stay in your body longer. This may increase your risk for side effects.

Alcohol interaction

You shouldn’t drink alcohol while taking diazepam. This drug can interfere with your judgment, thinking, and motor skills. It can also make you drowsy and cause your breathing to slow down or stop.

Also, your body also processes alcohol and this drug in similar ways. That means that if you drink alcohol, this drug might take longer to leave your body. This may cause worse side effects.

Medications that might interact with this drug

Acid-suppressing drugs

These drugs make it harder for the body to absorb diazepam. If you take them together, you may not get the full dose of diazepam and it may not work as well. These drugs include:

  • famotidine
  • omeprazole
  • pantoprazole
  • ranitidine

Allergy or cold drugs

Taking certain drugs that treat allergies or colds along with diazepam can increase your risk of drowsiness or sleepiness. It can also cause your breathing to slow down or stop. These drugs include:

  • diphenhydramine
  • chlorpheniramine
  • promethazine
  • hydroxyzine

Antidepressants

Taking certain antidepressants with diazepam can increase your risk of drowsiness or sleepiness. It can also cause your breathing to slow down or stop. These drugs include:

  • amitriptyline
  • nortriptyline
  • doxepin
  • mirtazapine
  • trazodone

Antifungal drugs

These drugs block the enzyme that breaks down diazepam. This can increase the levels of diazepam in your body, putting you at higher risk for side effects such as drowsiness. These drugs include:

  • ketoconazole
  • fluconazole
  • itraconazole

Antipsychotic drugs

Taking certain antipsychotic drugs with diazepam can increase your risk of drowsiness or sleepiness. It can also cause your breathing to slow down or stop. These drugs include:

  • haloperidol
  • chlorpromazine
  • quetiapine
  • risperidone
  • olanzapine
  • clozapine

Anxiety drugs

Taking certain anxiety drugs with diazepam can increase your risk of drowsiness or sleepiness. It can also cause your breathing to slow down or stop. These drugs include:

  • lorazepam
  • clonazepam
  • alprazolam

Motion sickness drugs

Taking certain motion sickness drugs with diazepam can increase your risk of drowsiness or sleepiness. It can also cause your breathing to slow down or stop. These drugs include:

  • meclizine
  • dimenhydrinate

Other anti-seizure drugs

Taking certain anti-seizure drugs with diazepam can increase your risk of drowsiness or sleepiness. It can also cause your breathing to slow down or stop. These drugs include:

  • phenobarbital
  • phenytoin
  • levetiracetam
  • carbamazepine
  • topiramate
  • divalproex
  • valproate

Phenytoin, phenobarbital, and carbamazepine also affect the enzyme that breaks down diazepam. This can increase the levels of diazepam in your body, putting you at higher risk for these side effects.

Pain drugs

Taking certain pain drugs with diazepam can increase your risk of drowsiness or sleepiness. It can also cause your breathing to slow down or stop. These drugs include:

  • oxycodone
  • hydrocodone
  • morphine
  • hydromorphone
  • codeine

Sleep drugs

Taking certain sleep drugs with diazepam can increase your risk of drowsiness or sleepiness. It can also cause your breathing to slow down or stop. These drugs include:

  • zolpidem
  • eszopiclone
  • suvorexant
  • temazepam
  • triazolam

Tuberculosis drugs

These drugs make your body process diazepam faster, so there will be lower levels of the drug in your body. If you take them with diazepam, it may not work as well. These drugs include:

  • rifampin
  • rifabutin
  • rifapentine

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Diazepam warnings
kidney disease
People with kidney disease

Diazepam is removed from your body by your kidneys. If you have kidney problems, more of the drug may stay in your body longer, putting you at risk for side effects. Your doctor may adjust your dose and monitor you more closely.

glaucoma
People with acute narrow angle glaucoma

Talk to your doctor if you have glaucoma. Diazepam may be used in people with open angle glaucoma, but it shouldn’t be used in people with acute narrow angle glaucoma.

drug or alcohol abuse
People with a history of drug or alcohol abuse

Let your doctor know if you’ve had problems with drug or alcohol abuse. You may have a higher risk for becoming addicted, dependent, or tolerant to diazepam.

liver disease
People with liver disease

Diazepam is processed by your liver. If you have liver problems, more of this drug may stay in your body, putting you at risk for side effects. Your doctor may adjust your dose of diazepam and monitor you more closely. If you have severe liver disease, you shouldn’t take this drug.

mental health
People with mental health issues

Let your doctor know if you have a history of severe depression, or if you’ve ever thought about or tried to commit suicide. Diazepam may make these problems worse. Your doctor will monitor you more closely.

myesthenia gravis
People with myasthenia gravis

If you have myasthenia gravis, you shouldn’t take diazepam. Myasthenia gravis is a disease that causes extreme muscle weakness and tiredness.

breathing problems
People with breathing problems

Let your doctor know if you have breathing problems. Diazepam affects your central nervous system and may make it more difficult for you to breathe or cause you to stop breathing. Your doctor may start you on a lower dose and monitor you more closely. If your breathing problems are severe or if you have sleep apnea, your doctor may prescribe a different medication for you instead.

pregnant women
Pregnant women

Diazepam is a category D pregnancy drug. That means two things:

  1. Studies show a risk of adverse effects to the fetus when the mother takes the drug.
  2. The benefits of taking the drug during pregnancy may outweigh the potential risks in certain cases.

Taking this drug during pregnancy may cause babies to be born with deformities, muscle weakness, breathing and eating problems, low body temperatures, and withdrawal symptoms.

Tell your doctor if you’re pregnant or plan to become pregnant. Diazepam should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

breastfeeding
Women who are breast-feeding

Diazepam passes into breast milk and can cause serious effects in a child who is breastfed.

You and your doctor may need to decide if you’ll take diazepam or breastfeed.

for seniors
For seniors

Seniors may have a higher risk of side effects, such as motor ataxia (loss of muscle coordination while you move). This drug may also have more of a sedative effect in seniors. You may experience more dizziness, sleepiness, confusion, or a slowing or stopping of breathing. Your doctor will prescribe the lowest dose possible to control your symptoms.

for children
For children

Keep this drug out of the reach of children.

The safety and effectiveness of diazepam in children under the age of 2 years hasn’t been established.

allergies
Allergies

Diazepam can cause a severe allergic reaction. Symptoms include:

  • trouble breathing
  • swelling of your throat or tongue
  • hives
  • rash

Don’t take this drug again if you’ve ever had an allergic reaction to it before. Taking it a second time after an allergic reaction could be fatal.

SECTION 4 of 5

How to Take diazepam (Dosage)

Rectal gel

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Breakthrough seizures in people with epilepsy

Generic: diazepam

Form: Rectal gel
Strengths: 2.5 mg, 10 mg, and 20 mg

Brand: Diastat

Form: Rectal gel
Strengths: 2.5 mg

Brand: Diastat AcuDial

Form: Rectal gel
Strengths: 10 mg, 20 mg
Adult dosage (ages 18–64 years)
  • The recommended dose is 0.2 mg/kg (body weight).
  • If your doctor prescribes a second dose, it should be given 4–12 hours after the first dose.
  • Do not use diazepam to treat:
    • more than 5 episodes per month or
    • more than 1 episode every 5 days.
Child dosage (ages 0–1 year)

This medicine hasn’t been studied in children and shouldn’t be used in children under the age of 2 years old.

Child dosage (ages 2–5 year)
  • The recommended dose is 0.5 mg/kg (body weight).
  • If your doctor prescribes a second dose, it should be given 4–12 hours after the first dose.
  • Do not use diazepam to treat:
    • more than 5 episodes per month or
    • more than 1 episode every 5 days.
Child dosage (ages 6–11 year)
  • The recommended dose is 0.3 mg/kg (body weight).
  • If your doctor prescribes a second dose, it should be given 4–12 hours after the first dose.
  • Do not use diazepam to treat:
    • more than 5 episodes per month or
    • more than 1 episode every 5 days.
Child dosage (ages 12–17 year)
  • The recommended dose is 0.2 mg/kg (body weight).
  • If your doctor prescribes a second dose, it should be given 4–12 hours after the first dose.
  • Do not use diazepam to treat:
    • more than 5 episodes per month or
    • more than 1 episode every 5 days.
Senior dosage (ages 65 years and older)
  • The recommended dose is 0.2 mg/kg (body weight), but this may be decreased to prevent side effects.
  • If your doctor prescribes a second dose, it should be given 4–12 hours after the first dose.
  • Do not use diazepam to treat:
    • more than 5 episodes per month or
    • more than 1 episode every 5 days.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Diazepam comes with serious risks if you don’t take it as prescribed.

If you miss a dose

This medication should only be used on an as-needed basis for breakthrough seizures.

If you don’t take it

If you don’t take it, your seizure may not stop.

If you take too much

Taking too much of this drug can cause depression of your central nervous system (CNS). Symptoms include:

  • drowsiness
  • confusion
  • tiredness
  • poor reflexes
  • slowing or stopping of your breathing
  • dangerously low blood pressure
  • coma

This may even be fatal. If you think that you’ve taken too much, call your doctor or go to the emergency room right away.

You may be given the drug flumazenil to reverse a benzodiazepine overdose. This drug may increase your risk of seizures.

How to tell the drug is working

Your breakthrough seizure should stop.

Diazepam is used for short-term treatment.

Store diazepam carefully

  • Store diazepam at room temperature between 59°F (15°C) and 86°F (30°C).
  • Keep it away from high temperature.
  • Keep your drugs away from areas where they could get wet, such as bathrooms. Store this drug away from moisture and damp locations.

This drug may be refilled if your doctor authorizes it on the prescription

It may only be refilled up to five times within six months after the prescription was given. After five refills or six months, whichever occurs first, you’ll need a new prescription from your doctor.

Travel

When traveling with your medication:

  • Always carry your medication with you in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t hurt your medication.
  • You may need to show airport staff your pharmacy’s label to clearly identify the medication. Keep the original prescription label with you when traveling.
  • Don’t leave this medication in the car, especially when the temperature is hot or freezing.
  • Since this is a controlled substance, it might be difficult to get refills. Make sure that you have enough medication before you leave on your trip.

Self-management

Instructions for the caregiver giving you diazepam:

You shouldn’t give diazepam rectal gel until you feel comfortable using it. Your doctor will tell you exactly when and how to use diazepam rectal gel.

To help the person with seizures:

  • You must be able to tell the difference between cluster and ordinary seizures.
  • You should understand the exact conditions for when to treat with diazepam rectal gel.
  • You must know how and for how long you should check the person after giving the medication.

To know what responses to expect:

  • You need to know how soon seizures should stop or decrease after giving the drug.
  • You need to know what you should do if the seizures don’t stop or if there’s a change in the person’s breathing, behavior, and condition.

If you have any questions or feel unsure about using the treatment, call the doctor before using diazepam.

Clinical monitoring

Before starting and during your treatment with diazepam, your doctor will check the following:

  • Seizures: Your doctor will check if your seizures are under control.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.

SECTION 5 of 5

How Much Does diazepam Cost?

Rectal gel

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These prices represent the lowest priced national pharmacies for diazepam on GoodRx. They may be lower than your insurance.

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on August 10, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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