Diazepam Valium



CLASS: Benzodiazepine Mechanism of Action:

Acts on parts of the limbic system, the thalamus, and hypothalamus producing calming effects; decreases seizures by increasing the seizure threshold; transient analgesia; amnesic; sedative.

Indications and Field Use:

Grand mal seizures, especially status epilepticus. Transient analgesia/amnesia for medical procedures (e.g., fracture reduction, cardioversion, pacing). Delirium tremens. Treat the cause first.


Hypersensitivity (allergy) Glaucoma, acute narrow angle (relative) Allergy to soy protein (Diazepam rectal gel only)

Adverse Reactions:

CV: Bradycardia, hypotension, cardiovascular collapse; venous thrombosis; phlebitis; vascular spasm

Resp: Respiratory arrest; may be prolonged in neonate CNS: Somnolence, confusion, coma, diminished reflexes; s/s may be prolonged in

neonate Other: Burning proximal to IV injection site; local irritation; swelling; extravasation will

cause tissue necrosis


Incompatibilities/Drug Interactions:

Do not mix or dilute diazepam with other solutions or drugs in syringe, tubing or IV container.

Adult Dosage:

2 mg increments slow IV push. Administer no faster than 5 mg/minute. Status epilepticus: 5-10 mg IV push. May repeat at intervals of 10-15 min., to a total of 30 mg.

Pediatric Dosage:

IV Dose: 0.2-0.3 mg/kg every 15-30 minutes (max. of 1.0 mg/kg); administer IV over at least 3 minutes or until seizure activity subsides. IV Dose after rectal dose: 0.1 mg/kg with same administration instructions. Rectal dose (<6 years): 0.3-0.5 mg/kg rectally at IV push rate; may repeat in 15- 30 min at 0.25 mg/kg.

Status epilepticus: Neonates: 0.15-0.5 mg/kg IV

Infants (>30 days old) 0.2-0.5 mg IV every 2-5 minutes to a max of 5 mg Children (>5 yrs old) 1 mg every 2-5 minutes, to a max of 10 mg

Routes of Administration:

Slow IV push Rectally for children < 6 years

Onset of Action:


Peak Effects:


Duration of Action:

20 minutes to 50 minutes

Dosage Forms/Packaging:

10 mg/2 ml prefilled syringes, ampules and vials

Diazepam Rectal Delivery Gel (optional) - 10 mg twin pack pediatric (total 20 mg)

Arizona Drug Box Supply Range:


Special Notes:

> Valium must be injected slowly and small veins such as those on the dorsum of the hand or wrist should be avoided. Risk of venous thrombosis, phlebitis, local irritation, swelling and vascular spasm is increased.

> Extreme care must be taken to avoid intra-arterial injection or extravasation.

> Diazepam may cause prolonged CNS depression in the neonate - 30 days of age 

© Matt Dillard 2012