Bedside Snapshot
- Use It For
- Status epilepticus with IV access; seizure clusters (home nasal or rectal rescue); severe alcohol withdrawal and delirium tremens; tetanus and muscle spasm
- Adult Dose
- Status epilepticus: 0.15–0.2 mg/kg IV/IO (max 10 mg); repeat once at 5 min if seizing; 2 doses total incl. home and EMS
- No IV/IO: 0.2 mg/kg PR (max 20 mg)
- DTs: example 5–20 mg IV every 5–10 min to light somnolence
- Pediatric Dose
- Status epilepticus: 0.2 mg/kg IV/IO (max 8 mg); if still seizing at 5 min, 0.1 mg/kg (max 4 mg). No IV/IO: PR 0.5 mg/kg (2–5 yr), 0.3 mg/kg (6–11 yr), 0.2 mg/kg (≥12 yr), max 20 mg; IM or IN midazolam preferred
- Onset / Duration
- IV: 2–5 min (most seizures stop within 10 min) / anticonvulsant effect about 30 min, sedation hours; IN or PR: peak level 1.5 hr; IM: peak 1.3–1.5 hr, slow and variable
- Do Not Give / Hold If
- Acute narrow-angle glaucoma; untreated open-angle glaucoma; hypersensitivity; shock, coma or alcohol intoxication with depressed vital signs; 2 benzodiazepine doses already given (count home doses)
- Watch For
- Apnea and hypoventilation (SpO₂, EtCO₂); hypotension (BP every 5 min); seizure recurrence as the effect fades; phlebitis or arterial injury (pain, blanching at the site)
- Reversal / Rescue
- Airway, O₂ and bag-valve mask first. Flumazenil 0.2 mg IV only for iatrogenic oversedation in a non-dependent patient; contraindicated after a benzodiazepine for status epilepticus or in serious TCA overdose
- Must Remember
- The caregiver's Valtoco or Diastat dose is dose 1: give at most one more benzodiazepine dose, then a second-line drug (levetiracetam, fosphenytoin or valproate)
Indications
Emergency & Prehospital
- Convulsive status epilepticus: once a seizure reaches 5 min, the IV benzodiazepine is first line. IV lorazepam and IM midazolam sit alongside it. Still seizing after two doses? Levetiracetam, fosphenytoin or valproate.
- Prolonged seizure with no IV access: IM midazolam is preferred. Rectal diazepam is a reasonable alternative.
- Seizure clusters: caregivers give one of three home products: nasal spray (Valtoco), rectal gel (Diastat) or buccal film (Libervant).
- Seizure in pregnancy or postpartum, no other cause: treat it as eclampsia until proven otherwise. Magnesium sulfate comes first.
- Nerve agent seizures: the military 10 mg autoinjector (CANA) goes in with atropine and pralidoxime.
ED / ICU / Transport
- Alcohol withdrawal and delirium tremens: the preferred long-acting agent for symptom-triggered and front-loaded dosing.
- Alcohol withdrawal seizure: give a fast-acting parenteral benzodiazepine. That is what stops the next seizure.
- Tetanus and severe muscle spasm: an adjunct. Tetanus may need large doses.
- Procedural anxiolysis: given before cardioversion or endoscopy.
- Severe sympathomimetic agitation: for adults, the 2025 AHA Part 10 recommends sedation. Diazepam is off-label for this use.
Other Uses
- Anxiety: short-term relief
- Spasticity: cerebral palsy, paraplegia, stiff-person syndrome (oral adjunct)
Dosing & Administration
Every dose below is an E3 house dose, drawn from AES 2016, NASEMSO v3.0 and the FDA label. When a house dose differs from the FDA label, the "Differs from FDA label" note says so. Read that note before you use the number.
Available Forms
- Injection 5 mg/mL: 2 mL (10 mg) syringe or vial (the EMS form); 10 mL (50 mg) multiple-dose vial; contains propylene glycol, alcohol and benzyl alcohol
- Nasal spray (Valtoco): 5, 7.5 and 10 mg devices; 15 and 20 mg use two devices
- Rectal gel (Diastat and generics): 2.5 mg; 10 mg system (dialed 5–10 mg); 20 mg system (dialed 12.5–20 mg); green "READY" band confirms the dose
- Buccal film (Libervant): 5–15 mg films, weight-banded (6–30 kg); ages 2–5 years only
- Autoinjector: 10 mg, IM only (CANA); tablets: 2, 5 and 10 mg
High-Alert Medication: IV diazepam is on the ISMP high-alert list as a moderate-sedation agent. The usual error is dose stacking across caregiver, EMS and ED doses. Add up the total mg from every source and route before each dose. For children, a second clinician checks the mg and the mL.
Adult Dosing
| Indication | Dose & Route | Repeat / Max | Notes |
|---|---|---|---|
| Status epilepticus, IV or IO | 0.15–0.2 mg/kg IV or IO (actual weight; max 10 mg per dose), no faster than 5 mg/min | Repeat once at 5 min if still seizing; max 2 doses (20 mg total for an adult at the 10 mg cap) | High-alert Count home and EMS doses; then second-line. Differs from FDA label: the label gives 5–10 mg every 10–15 min, max 30 mg; E3 stops at two doses, per AES 2016. |
| Status epilepticus, no IV or IO | 0.2 mg/kg PR (age 12 yr and older), rounded up to the next unit dose | Max 20 mg; single dose | IM midazolam is the first choice in adults; rectal diazepam is an AES Level B alternative. IM diazepam peaks at 1.3–1.5 hr. |
| Seizure cluster, home rescue | 0.2 mg/kg IN (Valtoco) or PR, rounded to the label weight table (5–20 mg) | Max 20 mg per dose, 2 doses per episode; second dose at least 4 hr (IN) or 4–12 hr (PR) later; no more than 1 episode every 5 days or 5 per month | The patient's usual cluster pattern. EMS: a home dose counts as dose 1. |
| Nerve agent seizures (CANA) | 10 mg IM, mid-outer (lateral) thigh | Repeat no sooner than 10 min; cumulative max 30 mg | COR 1, C-EO: benzodiazepines for organophosphate or carbamate seizures and agitation; diazepam first line (2025 AHA Part 10). Give early, with atropine and pralidoxime. |
| Alcohol withdrawal (label dose) | 10 mg IV or IM, then 5–10 mg in 3–4 hr if needed | No label max; CIWA-Ar before each dose | The label applies this to impending or acute DTs too; ASAM 2020 favors front loading or IV titration for severe withdrawal (next row). |
| Severe withdrawal or DTs | Example protocol dose (ASAM 2020 gives no mg dose): 5–20 mg IV every 5–10 min to light somnolence (calm, rousable), then hourly PRN | No fixed max: titrate to light somnolence; very large doses may be needed. Reassess before every dose | ASAM 2020: IV benzodiazepines to light somnolence under an established protocol, watching for over-sedation and respiratory depression; individualize to signs and symptoms; step down to oral symptom-triggered dosing once calm; its cited cohort comparator is 10–20 mg IV hourly until sedated. Resistant: more than 150–200 mg in 3–4 hr or 40–50 mg IV in 1 hr: add phenobarbital, propofol (ventilated) or dexmedetomidine. ICU protocol trigger: 200 mg in 4 hr or one dose above 40 mg IV. Continuous SpO₂ and EtCO₂. |
| Oral front loading | Symptom-triggered: 10 mg PO every 1 hr while CIWA-Ar ≥10. Fixed: 20 mg PO every 2 hr for 3 doses | No fixed max: hold for sedation | ASAM 2020: front-load when CIWA-Ar is ≥19. |
| Procedural (cardioversion, endoscopy) | Cardioversion: 5–15 mg IV 5–10 min before. Endoscopy: titrate IV to slurred speech, usually 10 mg or less | Cardioversion max 15 mg; endoscopy max 20 mg IV | Cut the opioid dose by at least one-third; topical anesthetic for peroral endoscopy. |
| Muscle spasm or tetanus | 5–10 mg IV or IM | Repeat in 3–4 hr if needed; tetanus may need larger doses | Respiratory support must be available. |
| Oral (anxiety, spasm, alcohol withdrawal) | Anxiety 2–10 mg PO 2–4 times daily; spasm 2–10 mg PO 3–4 times daily; withdrawal 10 mg PO 3–4 times in 24 hr, then 5 mg 3–4 times daily as needed | Label regimens use at most 10 mg per dose | Under 65 (label). 65 yr and older or debilitated: 2–2.5 mg once or twice daily. Halve in mild or moderate hepatic impairment. |
Pediatric Dosing
| Indication | Dose (per kg) & Route | Max Single / Max Total | Notes |
|---|---|---|---|
| Status epilepticus, IV or IO (label dose, 3 months to 17 years) | 0.2 mg/kg slow IV or IO over 1 min | First dose max 8 mg; if still seizing at 5 min, 0.1 mg/kg (max 4 mg); max 2 doses | High-alert 16% had severe or life-threatening respiratory depression in the label trial. Matches the FDA label (0.2 mg/kg, max 8 mg; then 0.1 mg/kg, max 4 mg at 5 min). Above 40 kg, use the adult dose (protocol-dependent; the label caps the first dose at 8 mg up to age 17). |
| Status epilepticus, no IV or IO | PR by age (rectal gel label): 0.5 mg/kg (2–5 yr), 0.3 mg/kg (6–11 yr), 0.2 mg/kg (12 yr and older) | Max 20 mg; single dose | IM or IN midazolam preferred. The rectal gel label is written for seizure clusters; status epilepticus rectal dosing is not separately labelled. |
| Seizure cluster, home rescue (2 yr and older) | IN or PR by age: 0.5 mg/kg (2–5 yr), 0.3 mg/kg (6–11 yr), 0.2 mg/kg (12 yr and older); buccal film by weight, ages 2–5 only | Max 20 mg per dose; 2 doses per episode; second dose at least 4 hr (IN, buccal) or 4–12 hr (PR) later | Not studied under 2 years (IN). Weight-banded doses need updating as the child grows. |
| Tetanus | Over 30 days to 4 yr: 1–2 mg IV or IM, slowly. 5 yr and older: 5–10 mg | Every 3–4 hr as needed | Fixed mg doses (label); respiratory support must be available. |
| Neonates (30 days or younger) | Not established | — | Benzyl alcohol (gasping syndrome); prolonged CNS depression. No labelled dose from 31 days to 3 months (the label starts at 3 months): use the neonatal seizure protocol and specialist advice. |
Dosing Support & Administration
For weight-based dosing, see pediatric weight-based dosing and Broselow tape.
- Do not dilute or mix: give it undiluted. Diazepam is insoluble in water and precipitates.
- Push rate: adults at least 1 min per 5 mg (1 mL); children with status epilepticus over 1 min
- Line: large vein, never the back of the hand or wrist; avoid intra-arterial injection and extravasation. IO: IV doses and push rates apply
- IM: reserve deep IM for when no other option exists. Absorption is slow and variable.
- Nasal spray: do not prime; one device per dose
Dosing Notes:
- Older or debilitated adults: start at 2–5 mg IV and titrate to sedation. Status epilepticus dosing gets no age reduction. Give the full dose with airway support ready.
- Pediatric doses apply up to 40 kg or 14 years (NASEMSO v3.0, p. 13, not verified because the PDF returned 403). Above that, use the adult dose. The switch depends on local protocol. The label caps the first dose at 8 mg up to age 17.
Contraindications & Precautions
Contraindications
- Known hypersensitivity to diazepam
- Acute narrow-angle glaucoma; open-angle glaucoma unless treated (injection)
- IV injection with the autoinjector (IM device only)
- Oral tablets: generic labels also list myasthenia gravis, severe respiratory insufficiency, severe hepatic insufficiency, sleep apnea and age under 6 months. The Valium label advises against use in severe hepatic impairment and under 6 months.
Precautions
- Older, very ill, chronic lung disease or unstable cardiovascular status: the label warns that IV doses can cause apnea or cardiac arrest.
- Absence (petit mal) status: IV diazepam has triggered tonic status epilepticus
- Very high cumulative IV doses: propylene glycol toxicity is reported above 900 mg/day in alcohol withdrawal. Renal or hepatic dysfunction raises the risk.
- Neonates and premature infants: benzyl alcohol and immature metabolism
- Depression or substance use disorder: suicidal thoughts (antiepileptic class warning) and misuse
- Late pregnancy and labor: neonatal sedation and withdrawal can follow. The injection label does not recommend obstetrical use.
Hold / Reassess If
- Seizure activity has stopped: no further benzodiazepine doses
- Two benzodiazepine doses already given, including home or EMS doses: move to second-line therapy
- SpO₂ <90%, falling respiratory rate or EtCO₂ >50 mmHg: stop and support ventilation
- Shock, coma, or alcohol intoxication with depressed vital signs (label): do not give the injection. SBP <90 mmHg: treat the cause and reassess
FDA Boxed Warning:
- Opioids: add opioids and you risk profound sedation, respiratory depression, coma and death.
- Abuse, misuse and addiction: overdose or death can follow, often when alcohol or other drugs are also in the picture.
- Dependence and withdrawal: quitting cold after more use than recommended can bring on life-threatening withdrawal. Taper it down instead.
Adverse Effects & Toxicity
Common
- Drowsiness, fatigue and ataxia (somnolence 23% with rectal gel)
- Venous thrombosis and phlebitis at the injection site
- Confusion, slurred speech, headache and amnesia. Paradoxical agitation: stop the drug.
- Nasal discomfort (5%), altered taste and nosebleed with the nasal spray
Serious / Life-Threatening
| Effect | Recognition | Management |
|---|---|---|
| Respiratory depression and apnea | Falling RR, SpO₂ <90%, rising EtCO₂, snoring or obstruction | Jaw thrust, O₂, bag-valve mask ventilation; intubate if needed. No flumazenil after seizure treatment |
| Hypotension, bradycardia, collapse | BP every 5 min after IV doses; worse with opioids, barbiturates or alcohol | Supine, IV fluid bolus, vasopressor per protocol; stop further doses |
| Seizure recurrence | Return of seizures as the anticonvulsant effect fades | Start a long-acting antiseizure drug; do not rely on repeated diazepam |
| Propylene glycol toxicity | Anion-gap acidosis, high osmolality, rising lactate, acute kidney injury after very high doses | Stop the injection, switch agent, supportive care |
| Phlebitis, thrombosis, intra-arterial injury | Pain, swelling or blanching at or beyond the site | Stop the injection |
Overdose & Toxicity Management
- Signs: drowsiness and slurred speech progress to hypotonia, respiratory depression and coma. Markedly abnormal BP, HR or RR points to a co-ingestant such as alcohol or opioids.
- Immediate management: airway, ventilation, IV fluids; check glucose; contact Poison Control (1-800-222-1222)
- Flumazenil: dosing is on the flumazenil page. It is contraindicated after a benzodiazepine for status epilepticus, in serious cyclic antidepressant overdose and with seizures in dependent patients. Diazepam outlasts it, so expect resedation.
Monitoring
| Parameter | When / How Often | Target / Act If |
|---|---|---|
| Clinical: seizures and mental status | Continuously; time every dose and its total mg | Still seizing 5 min after an adequate benzodiazepine dose (adequate: diazepam at least 10 mg in adults; 0.3 mg/kg in children under 32 kg, ESETT) or after the second dose: give the second-line drug now (do not wait for 20 min). Not waking: consider nonconvulsive seizures (EEG) |
| Clinical: SpO₂, respiratory rate, EtCO₂ | Continuous from the first dose until awake; waveform EtCO₂ during transport | SpO₂ <90%, shallow breathing or EtCO₂ >50 mmHg: reposition, O₂, bag-valve mask ventilation |
| Clinical: BP, HR and IV site | Baseline, then every 5 min after each IV dose; IV site during and after each push | SBP <90 mmHg: fluids, hold further doses. Pain, swelling or blanching: stop; treat as extravasation or intra-arterial injection |
| Clinical: withdrawal score and sedation | CIWA-Ar before each dose; RASS during front loading | Dose while CIWA-Ar ≥10; stop at light somnolence (calm, rousable) |
| Laboratory: glucose | Fingerstick on arrival in every seizure | |
| Laboratory: high-dose IV therapy | Anion-gap acidosis, rising lactate, high osmolality or osmolar gap, or rising creatinine: suspect propylene glycol toxicity; change agent. Watch for hyponatremia, per ASAM 2020 | |
| Clinical: after flumazenil | Observe for resedation | Diazepam outlasts flumazenil (half-life about 1 hr): observe longer after a diazepam dose |
Interactions & Compatibility
Clinically Significant Interactions
| Drug / Class | Effect | What To Do |
|---|---|---|
| Opioids (fentanyl, morphine, others) | Profound sedation, respiratory depression, coma, death (boxed warning) | Lowest doses; reduce the opioid by at least one-third; continuous SpO₂ and EtCO₂ |
| Alcohol, barbiturates (phenobarbital), antipsychotics, other sedatives | Additive CNS and respiratory depression; hypotension | Expect airway support when phenobarbital follows diazepam |
| CYP2C19 / CYP3A4 inhibitors (azoles, cimetidine, fluvoxamine, fluoxetine, PPIs, diltiazem, isoniazid) | Higher diazepam levels, longer half-life, sedation | Lower or less frequent doses; watch for delayed oversedation |
| CYP inducers (rifampin, carbamazepine, phenytoin, phenobarbital, dexamethasone) | Lower diazepam exposure and effect | May need higher doses; titrate to effect |
| Flumazenil | Precipitated withdrawal and seizures | Avoid in dependent patients, seizure patients and mixed overdose |
IV Compatibility
- Give undiluted; do not mix or dilute in a syringe or infusion bag. If a direct push is not possible, inject slowly into the tubing as close to the vein as possible.
- Do not add to infusion bags; choose another agent for continuous infusion. Verify with an institutional compatibility resource.
Special Populations
- Pediatrics: children 2–5 years given 0.5 mg/kg nasally reach about twice the adult exposure in the label simulation. Paradoxical reactions are more common. Doses are in the Pediatric Dosing table.
- Neonates: safety and efficacy are not established at 30 days or younger. The label's pediatric status epilepticus dosing starts at 3 months. Half-life runs about 50–95 hr, and the injection contains benzyl alcohol.
- Pregnancy: observational studies show no clear link to major birth defects. Late in pregnancy or in labor, use can cause neonatal sedation and withdrawal. Treat maternal status epilepticus without delay, and monitor the newborn. NAAED Pregnancy Registry: 1-888-233-2334. A seizing pregnant or postpartum patient is treated as eclampsia (NASEMSO v3.0). Magnesium sulfate comes first. A benzodiazepine follows if the seizure continues despite magnesium.
- Lactation: diazepam enters breast milk and can cause infant sedation, poor feeding and poor weight gain. The injection label does not recommend breastfeeding during treatment. The rectal gel label says to wait an appropriate period after a dose.
- Older adults: the half-life climbs from about 15 hr at age 18 to about 100 hr at 95, in a single-dose IV study. For sedation, start at 2–5 mg IV or 2–2.5 mg PO once or twice daily. For status epilepticus, give the full weight-based dose (max 10 mg). AES does not reduce it for age.
- Renal impairment: no specific adjustment is established. The active metabolites are renally excreted, and propylene glycol accumulates with very high IV doses.
- Hepatic impairment: in cirrhosis the half-life runs 2–5 times longer, with individual values over 500 hr, and clearance halves. Oral: halve the dose in mild or moderate impairment. The Valium label does not recommend it in severe impairment. Parenteral: smaller, less frequent doses. ASAM 2020 suggests a less hepatically cleared agent for alcohol withdrawal when liver disease is significant.
- Obesity: diazepam is highly lipophilic, and no obesity dosing is validated. In most adults, the 10 mg per-dose cap governs status epilepticus dosing.
- Chronic benzodiazepine users: their tolerance may blunt the response.
Field & Transport Considerations
- Scope: paramedic, RN and critical-care transport give IV, PR and IN doses. Caregivers give the home rescue products. Scope varies by state and agency protocol.
- Storage: keep every form at 20–25 °C (68–77 °F). The nasal spray and rectal gel also allow 15–30 °C (59–86 °F). Protect the injection and nasal spray from light, and never freeze the nasal spray. Schedule IV means secure storage, counts and witnessed waste.
- Carried concentration: only 5 mg/mL is carried, so 10 mg is 2 mL. For children, say the dose in mg and mL at the cross-check.
- Home rescue on scene: ask which product was given (Valtoco, Diastat, buccal film, nasal or buccal midazolam), the dose, the time and any leakage. That dose counts as dose 1. Give at most one more benzodiazepine dose, then a second-line drug (doses per ESETT 2019): levetiracetam 60 mg/kg IV over 10 min (max 4,500 mg. For age 3 months to under 2 years: 40 mg/kg, max 2,500 mg over 5 min), fosphenytoin 20 mg PE/kg IV (max 1,500 mg PE), or valproate 40 mg/kg IV over 10 min (max 3,000 mg, for age 2 years and older). Avoid valproate in pregnancy or possible pregnancy unless no alternative exists, in liver disease, and in mitochondrial or urea-cycle disease. Use fosphenytoin or levetiracetam instead.
- Nerve agent / CBRN: give the anticonvulsant early, alongside atropine and pralidoxime, per the agency chemical protocol. For the midazolam autoinjector, see the midazolam page.
- Handoff: seizure onset time; every benzodiazepine dose with time, route and mg (including caregiver doses); airway interventions; glucose; current mental status.
Clinical Pearls
A third benzodiazepine dose adds apnea, not control: in community pediatric status epilepticus, more than two doses were linked to respiratory depression and seizures lasting over 60 minutes. Count the caregiver's dose too. Then move to levetiracetam, fosphenytoin or valproate.
Why IM diazepam disappoints: Diazepam won't dissolve in water, which is why it rides in propylene glycol and alcohol. Even by autoinjector, IM levels take about 1.5 hr to peak, and up to 6 hr. For IM use, see the midazolam page.
Short action, long half-life: A single IV dose stops seizures within minutes. Within about 30 minutes it redistributes out of the brain, and seizures recur. The active metabolite desmethyldiazepam lasts up to 100 hr, so repeat doses accumulate.
Choosing a benzodiazepine: Got IV access? Lorazepam and diazepam are both first-line. No IV at all? Reach for IM midazolam. Rectal or nasal diazepam covers the home or backup role.
Nerve agents: early treatment: early, effective treatment may prevent the slide into respiratory and cardiac arrest. Benzodiazepines are one of the listed treatments, alongside atropine, decontamination and oximes (2025 AHA Part 10).
Pharmacology
Mechanism of Action
- Binds the benzodiazepine site of the GABA-A receptor → GABA-mediated inhibition gets stronger → seizures stop, anxiety eases, the patient sedates, amnesia sets in and skeletal muscle relaxes.
- Highly lipophilic → it enters the brain within minutes, then redistributes into body tissues → a short anticonvulsant effect, despite a long half-life.
Pharmacokinetics
| Route | Onset | Peak | Duration |
|---|---|---|---|
| IV | 2–5 min; most seizures stop within 10 min | Immediate | Anticonvulsant effect about 30 min (redistribution); sedation lasts hours |
| IM | Slow and variable | 1.3–1.5 hr (range 0.7–6 hr) | — |
| IN (Valtoco) | — | About 1.5 hr; bioavailability 97% | — |
| PR (rectal gel) | — | About 1.5 hr; bioavailability 90% | — |
| PO | — | 1–1.5 hr (0.25–2.5 hr; slower with food) | — |
- Half-life: distribution takes about 0.5 hr in children (IV) and about 1 hr in adults. Elimination runs about 15 hr at age 18, rising to about 100 hr at 95. Rectal gel and nasal spray studies show about 46–49 hr.
- Metabolism: hepatic, through CYP2C19 and CYP3A4, then glucuronidation. Desmethyldiazepam is the major active metabolite, with a half-life up to 100 hr. Temazepam and oxazepam are minor.
- Elimination and binding: mostly out in urine, as glucuronides. It accumulates with repeated dosing. It is about 98% protein bound. Vd 0.8–1 L/kg. It crosses the blood-brain barrier and placenta.
Names & Classification
- Generic Name
- Diazepam
- Brand Names
- Valium (tablets); Valtoco (nasal spray); Diastat AcuDial (rectal gel); Libervant (buccal film). The injection and the autoinjector are generic.
- Pharmacologic Class
- Benzodiazepine (GABA-A receptor positive allosteric modulator)
- Therapeutic Class
- Anticonvulsant; anxiolytic; sedative; skeletal muscle relaxant adjunct
- Controlled Substance
- C-IV (DEA Schedule IV)
- ISMP High-Alert
- Yes: moderate sedation agents, IV
- Look-Alike / Sound-Alike
- diazePAM ↔ dilTIAZem (ISMP confused drug names; tall man letters in ADCs and EHR pick lists). Also product and route mix-ups (nasal spray, rectal gel, buccal film, injection)
References
- Hospira, Inc. (2023). Diazepam Injection, USP, 5 mg/mL: Prescribing information (LAB-0837-7.0). DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7e7dd743-a87b-4ab3-b6ae-f116cd0c8b0f
- Neurelis, Inc. (2025). VALTOCO (diazepam nasal spray): Prescribing information. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=1a8bcc90-68fa-474d-832c-0df01e825f39
- Navinta LLC. (2026). Diazepam rectal gel rectal delivery system: Prescribing information. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b5b17a28-2cab-4c0d-8f9d-7b224e4d0989
- Meridian Medical Technologies LLC. (2023). Diazepam autoinjector: Prescribing information. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=fa352464-14c8-49e9-b8b7-5a968b1cfa93
- Waylis Therapeutics LLC. (2026). VALIUM (diazepam) tablets: Prescribing information. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=260e2041-2bb3-482f-850e-b5d47a7bdbe6
- Aquestive Therapeutics. (2024). Libervant (diazepam) buccal film: Prescribing information. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=12527569-8eb3-4624-b3c0-5c0e0c5f88c9
- Glauser, T., Shinnar, S., Gloss, D., et al. (2016). Evidence-based guideline: Treatment of convulsive status epilepticus in children and adults. Epilepsy Currents, 16(1), 48–61. https://doi.org/10.5698/1535-7597-16.1.48
- Chin, R. F., Neville, B. G., Peckham, C., Wade, A., Bedford, H., & Scott, R. C. (2008). Treatment of community-onset, childhood convulsive status epilepticus: a prospective, population-based study. The Lancet Neurology, 7(8), 696–703. https://doi.org/10.1016/S1474-4422(08)70141-8
- American Society of Addiction Medicine. (2020). The ASAM clinical practice guideline on alcohol withdrawal management. Journal of Addiction Medicine, 14(3S Suppl 1), 1–72. https://doi.org/10.1097/ADM.0000000000000668
- National Association of State EMS Officials. (2022). NASEMSO National Model EMS Clinical Guidelines, Version 3.0: Seizures (p. 102), Eclampsia (p. 173). https://nasemso.org/docs.ashx?id=1444322
- American Heart Association. (2025). 2025 AHA Guidelines for CPR and ECC, Part 10: Adult and Pediatric Special Circumstances of Resuscitation. https://cpr.heart.org/en/resuscitation-science/cpr-and-ecc-guidelines/adult-and-pediatric-special-circumstances-of-resuscitation
- Dhaliwal, J. S., Rosani, A., & Saadabadi, A. (2023). Diazepam. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK537022/
Medical Disclaimer
- For Educational Purposes Only: This content is intended for educational reference and should not be used for clinical decision-making.
- Not a Substitute for Professional Judgment: Always consult your local protocols, institutional guidelines, and supervising physicians.
- Verify Before Acting: Users are responsible for verifying information through authoritative sources before any clinical application.
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