Diazepam Gel: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Diazepam Gel is a prescription benzodiazepine anticonvulsant used rectally in emergency situations to control certain seizures. It is given to treat acute repetitive seizures or seizure clusters in people with epilepsy age 2 years and older. The gel works by calming overactive electrical activity in the brain and can be given by a trained caregiver outside a hospital setting.

What is Diazepam Gel

Diazepam rectal gel is a prescription medicine used in emergency situations to control certain seizures. It is a benzodiazepine that calms overactive electrical activity in the brain.

Diazepam Gel uses

• Acute treatment of intermittent, distinct episodes of frequent seizure activity (seizure clusters, acute repetitive seizures) that are different from a person's usual seizure pattern, in people with epilepsy age 2 years and older

Benefits of Diazepam Gel

• Helps rapidly control acute seizure episodes or seizure clusters
• Is commonly used as a rescue treatment in people with epilepsy who have intermittent breakthrough seizures
• Helps shorten prolonged seizure activity and may reduce the risk of seizure-related complications
• Can often be administered outside a hospital by a trained caregiver when prescribed
• Provides an alternative when taking medicine by mouth is not practical during a seizure

How Diazepam Gel works

Diazepam works by boosting the effect of a natural calming chemical in the brain called GABA. This helps quiet down overactive brain activity that causes seizures.

Diazepam Gel dosage

Use diazepam gel exactly as directed by your doctor. Do not use more or less of it, or use it more often than prescribed.

This medicine is given rectally using a prefilled syringe with a special plastic tip; your caregiver will be trained on how to give it.

Diazepam rectal gel should not be used more than 5 times a month or more often than every 5 days without talking to your doctor.

Put the person having seizures on their side in a safe place where they cannot fall, then follow the steps your doctor and caregiver instructions describe for giving the rectal gel.

After giving the dose, keep the person on their side, note the time the medicine was given, and continue to watch them.

Seek immediate medical help if seizures continue 15 minutes after the gel was given, seem different or worse than usual, or if you are worried about the person's breathing or skin color.

Available forms and strengths

• Rectal gel in a prefilled syringe (rectal delivery system)

Side effects of Diazepam Gel

Common

• Drowsiness
• Headache
• Stomach pain
• Nervousness
• Flushing
• Diarrhea
• Dizziness, unsteadiness, lack of coordination
• Abnormal 'high' mood
• Somnolence (sleepiness)
• Vasodilatation (widening of blood vessels)
• Ataxia (loss of coordination)
• Euphoria
• Rash

Serious

• Rash, hives; swelling of the eyes, face, lips, tongue, or throat; hoarseness; difficulty breathing or swallowing
• Unusual dizziness, lightheadedness, extreme sleepiness, slowed or difficult breathing, or unresponsiveness
• Unusual movements; ringing in the ears; anxiety; memory problems; difficulty concentrating; sleep problems; seizures; shaking; muscle twitching; changes in mental health; depression; burning or prickling feeling in hands, arms, legs, or feet; seeing or hearing things that others do not see or hear; thoughts of harming or killing yourself or others; overexcitement; or losing touch with reality
• Hypoventilation (very slow, shallow breathing)

Warnings and precautions

• This medicine may cause serious or life-threatening breathing problems, extreme drowsiness, or coma if used together with certain medications, especially opioid pain or cough medicines
• This medicine can be habit-forming. Never use more of it, use it more often, or for longer than your doctor tells you to
• Do not stop using this medicine or take fewer doses without talking to your doctor first, as stopping suddenly can cause serious withdrawal reactions
• Combining benzodiazepines with opioids can cause profound sleepiness, breathing problems, coma, and death
• This medicine carries a risk of abuse, misuse, and addiction, which can lead to overdose or death, especially when combined with alcohol or other drugs
• This medicine is not recommended for children under 6 months of age because of the risk of prolonged sleepiness and slowed breathing in very young infants
• Older adults should generally avoid this medicine because it is not as safe for them as other treatment options for the same condition
• Tell your doctor if you are pregnant, plan to become pregnant, or become pregnant while using this medicine. Using it late in pregnancy can cause sedation or withdrawal symptoms in the newborn.
• Diazepam passes into breast milk and can cause sleepiness, poor feeding, or poor weight gain in a nursing infant. Tell your doctor if you are breastfeeding or plan to breastfeed.
• This medicine should be used carefully in people with kidney problems, since the breakdown products of diazepam are removed by the kidneys.
• Liver disease can slow down how quickly the body clears diazepam, so this medicine should be used carefully in people with liver problems.
• Talk to your doctor about drinking alcohol while using this medicine, since alcohol can make side effects like drowsiness worse and increase the risk of dangerous breathing problems.
• This medicine may make you drowsy and affect coordination. Do not drive, operate machinery, or ride a bicycle until you know how it affects you.

Storage

• Keep this medication in the container it came in, tightly closed, and out of reach of children
• Store it at room temperature and away from excess heat and moisture (not in the bathroom)
• Talk to your pharmacist about the proper disposal of your medication
• To dispose of remaining diazepam gel, remove the plunger from the syringe body, point the tip over a sink or toilet, reinsert the plunger and gently push to release the medication into the toilet or sink, then flush the toilet or rinse the sink with water until the gel is no longer visible
• Discard all used materials in the trash away from children and pets
• Store at 25°C (77°F); brief exposure to temperatures between 15°C and 30°C (59°F to 86°F) is permitted

When to see a doctor

• Get emergency care right away if you have unusual dizziness, extreme sleepiness, slowed or difficult breathing, or become unresponsive
• Get medical help right away for swelling of the face, lips, tongue, or throat, hoarseness, or trouble breathing or swallowing, which could be a serious allergic reaction
• Contact your doctor or get emergency care if seizures continue 15 minutes after the gel was given, or if seizures seem different or worse than usual
• Seek help right away if you notice changes in mood or behavior, or thoughts of harming yourself or others
• If breastfeeding, seek medical care right away if your baby has slow or noisy breathing, is unusually sleepy or hard to wake, or seems limp
• If you think too much medicine has been taken, contact a poison control center or emergency room right away

Alternatives

• Levetiracetam
• Clonazepam
• Lorazepam
• Diazepam Nasal Spray
• Midazolam Nasal Spray