lDIRECTIONS FOR ADMINISTRATION
▶With intravenous useDiazepam is adsorbed by plastics of
infusion bags and giving sets. Emulsion formulation
preferred for intravenous injection.
Forcontinuous intravenous infusionof diazepam
emulsion, dilute to a concentration of max.
400 micrograms/mL with Glucose 5 %or 10 %; max. 6 hours
between addition and completion of infusion. For
continuous intravenous infusionof diazepam solution,
dilute to a concentration of max. 50 micrograms/mL with
Glucose 5 % or Sodium Chloride 0. 9 %.
lPATIENT AND CARER ADVICEPatients given sedatives and
analgesics during minor outpatient procedures should be
very carefully warned about the risks of undertaking
skilled tasks (e.g. driving) afterwards. For intravenous
benzodiazepines the risk extends toat least 24 hours
after administration. Responsible persons should be
available to take patients home afterwards. The dangers of
takingalcoholshould be emphasised.
Medicines for Children leaflet: Diazepam (rectal) for stopping
seizureswww.medicinesforchildren.org.uk/diazepam-rectal-
stopping-seizures- 0
Medicines for Children leaflet: Diazepam for muscle spasm
http://www.medicinesforchildren.org.uk/diazepam-for-muscle-spasm
Driving and skilled tasksMay impair judgement and
increase reaction time, and so affect ability to drive or
perform skilled tasks; they increase the effects of alcohol.
Moreover the hangover effects of a night dose may impair
performance on the following day.
lPROFESSION SPECIFIC INFORMATION
Dental practitioners’formulary
Diazepam Tablets may be prescribed.
Diazepam Oral Solution 2 mg/ 5 mL may be prescribed.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: oral suspension, oral solution,
suppository
Tablet
CAUTIONARY AND ADVISORY LABELS2, 19
▶Diazepam (Non-proprietary)
Diazepam 2 mgDiazepam 2 mg tablets| 28 tabletP£ 1. 10 DT =
£ 0. 33 d| 1000 tabletP£ 160. 71 d
Diazepam 5 mgDiazepam 5 mg tablets| 28 tabletP£ 1. 12 DT =
£ 0. 37 d| 1000 tabletP£ 210. 71 d
Diazepam 10 mgDiazepam 10 mg tablets| 28 tabletP£ 4. 99 DT
=£ 0. 43 d| 500 tabletP£ 113. 04 d
Emulsion for injection
▶Diazemuls(Accord Healthcare Ltd)
Diazepam 5 mg per 1 mlDiazemuls 10 mg/ 2 ml emulsion for injection
ampoules| 10 ampouleP£ 9. 05 d
Solution for injection
EXCIPIENTS:May contain Benzyl alcohol, ethanol, propylene glycol
▶Diazepam (Non-proprietary)
Diazepam 5 mg per 1 mlDiazepam 10 mg/ 2 ml solution for injection
ampoules| 10 ampouleP£ 5. 50 DT = £ 5. 50 d
Oral suspension
▶Diazepam (Non-proprietary)
Diazepam 400 microgram per 1 mlDiazepam 2 mg/ 5 ml oral
suspension| 100 mlP£ 31. 75 – £ 38. 33 DT = £ 31. 75 d
Oral solution
CAUTIONARY AND ADVISORY LABELS2, 19
▶Diazepam (Non-proprietary)
Diazepam 400 microgram per 1 mlDiazepam 2 mg/ 5 ml oral
solution sugar free sugar-free| 100 mlP£ 31. 75 DT =
£ 31. 75 d
Enema
CAUTIONARY AND ADVISORY LABELS2, 19
▶Diazepam (Non-proprietary)
Diazepam 2 mg per 1 mlDiazepam 5 mg RecTubes| 5 tubeP
£ 5. 85 DT = £ 5. 85 d
Diazepam 2. 5 mg/ 1. 25 ml rectal solution tube| 5 tubePsd
Diazepam 2. 5 mg RecTubes| 5 tubeP£ 5. 65 d
Diazepam 5 mg/ 2. 5 ml rectal solution tube| 5 tubeP£ 5. 85 DT =
£ 5. 85 d
Diazepam 4 mg per 1 mlDiazepam 10 mg RecTubes| 5 tubeP
£ 7. 35 DT = £ 7. 35 d
Diazepam 10 mg/ 2. 5 ml rectal solution tube| 5 tubeP£ 7. 35 DT =
£ 7. 35 d
▶Stesolid(Actavis UK Ltd)
Diazepam 2 mg per 1 mlStesolid 5 mg rectal tube| 5 tubeP
£ 6. 89 DT = £ 5. 85 d1.1 Status epilepticus
Other drugs used for Status epilepticusDiazepam, p. 220.
Fosphenytoin sodium, p. 199 .Phenobarbital, p. 216.
Phenytoin, p. 205ANTIEPILEPTICS
Paraldehyde
lINDICATIONS AND DOSE
Status epilepticus
▶BY RECTUM
▶Neonate: 0. 8 mL/kilogram for 1 dose, the dose is based
on the use of a premixed solution of paraldehyde in
olive oil in equal volumes.▶Child: 0. 8 mL/kilogram (max. per dose 20 mL) for
1 dose, the dose is based on the use of a premixed
solution of paraldehyde in olive oil in equal volumeslUNLICENSED USENot licensed for use in children as an
enema.
lCONTRA-INDICATIONSGastric disorders.rectal
administration in colitis
lCAUTIONSBronchopulmonary disease
lINTERACTIONS→Appendix 1 : antiepileptics
lSIDE-EFFECTSRash
lPREGNANCYAvoid unless essential—crosses placenta.
lBREAST FEEDINGAvoid unless essential—present in milk.
lHEPATIC IMPAIRMENTUse with caution.
lPATIENT AND CARER ADVICE
Medicines for Children leaflet: Paraldehyde for seizures
http://www.medicinesforchildren.org.uk/paraldehyde-for-seizureslMEDICINAL FORMS
Forms available from special-order manufacturers include:
enemaANTIEPILEPTICS›BARBITURATES
Thiopental sodium
(Thiopentone sodium)
lINDICATIONS AND DOSE
Prolonged status epilepticus
▶INITIALLY BY SLOW INTRAVENOUS INJECTION
▶Neonate:Initially up to 2 mg/kg, then (by continuous
intravenous infusion) up to 8 mg/kg/hour, adjusted
according to response.▶Child:Initially up to 4 mg/kg, then (by continuous
intravenous infusion) up to 8 mg/kg/hour, adjusted
according to response continued→BNFC 2018 – 2019 Status epilepticus 221
Nervous system4