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Diazepam (Valium), rectal gel

How does this medicine work?

Diazepam (dy-aze-eh-pam, also known as Valium®) is a rescue medication given to control seizure activity. It usually works in 2 to 10 minutes.

What are the side effects?

Diazepam typically causes sleepiness. It can also cause children to be confused, dizzy, or slur their speech. Rarely, diazepam causes a child's breathing to be slow or shallow.

How should I give it?

While diazepam is available in many forms, this sheet gives instructions on the rectal ready-to-use gel.

Follow your health care practitioner’s orders for how much diazepam to give, when to give the diazepam and if the diazepam dose can be repeated.

This medication must be with the child wherever he/she goes. Keep all of your supplies together and in a safe place that is easy to get to.

Supplies include:

  • diazepam
  • lubricant (such as K-Y® jelly)

Giving the medicine rectally

  1. Place the child in a side-lying position facing you. Make sure it is where he or she cannot fall.
  2. Obtain the medication, remove cap and lubricate the syringe tip.
  3. Bend the upper leg forward and separate buttocks to expose rectum.
  4. Gently insert the syringe tip into the rectum about 1 inch.
  5. Slowly count to three while pushing the plunger all the way down. Slowly count to three before removing the syringe. As you remove the syringe, hold the child's buttocks together to prevent any leakage of medication. Hold the buttocks together for 10 minutes.
  6. Note the time the medication was given and time the length of the seizure
  7. Keep the child on his side and continue to observe for seizure activity, breathing and/or color changes.

If breathing stops, begin rescue breathing and call 911 for an ambulance.

If seizure activity has not decreased after prescribed amount of time, you may administer a second dose if directed to do so by your doctor.

When should I call the doctor?

  • if your child has multiple seizures and does not return to usual level of function
  • if you have concerns or questions about your child’s color, breathing or severity of seizure
  • if the seizure activity looks different from other episodes
  • if your child has signs of allergic reaction:
    - rash or hives
    - wheezing
    - trouble breathing (call 911)

Call 911:

  • if your child has trouble breathing
  • if your child does not respond to you after the seizure stops
  • if a second dose of rectal diazepam was given and the seizures do not stop
  • if diazepam does not stop the seizure in 10 minutes or the amount of time instructed by your doctor

What else do I need to know?

Your child’s stool will have a distinct odor (very smelly) the first few stools after receiving the rectal medication. 

You and your child should know the names and doses of all the medicines he or she is taking. Share this information with anyone involved in your child's health care. Please bring the medicine container when your child comes to the clinic or emergency department.

Always make sure you have enough medicine on hand. Each time you refill your prescriptions, check to see how many refills are left. If no refills are left, the pharmacist will need 2 or 3 days to contact the clinic to renew the prescription.

When you get the prescription refilled, check the expiration date on the label to be sure the medicine will be good for at least 6 months. Check the expiration date monthly.

Small amounts of left over diazepam may be disposed of in the sink or trash. Dispose of in a safe place away from children. Do not reuse the syringe.

Store all medicines in their original container, and away from direct sunlight or heat. Do not store them in humid places such as the bathroom. Keep them out of children's reach, locked up if possible.

If you are traveling on an airplane, carry the medication in the original package with the prescription label attached since it is a controlled substance. 

If too much diazepam is given, call the Poison Control Center at 1-800-222-1222.


If you have any questions, please call your clinic or pharmacy.

Last reviewed 12/2015

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This page is not specific to your child, but provides general information on the topic above. If you have any questions, please call your clinic. For more reading material about this and other health topics, please call or visit Children's Family Resource Center library, or visit

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