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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 seizures by calming abnormal over activity in the brain. 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.

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 or she goes. Keep all of your supplies together and in a safe place that is easy to get to.

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 the usual level of function
  • if you have concerns or questions about your child’s color, breathing or severity of the 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

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.

What else do I need to know?

  • Your child will have very smelly stool after receiving the rectal medication. 
  • Know the names and doses of all the medicines your child takes. Share this information with anyone involved in your child's health care.
  • Bring the medicine container to clinic appointments or to the emergency department, if necessary.
  • Make sure you have enough medicine on hand.
    • Keep track of how many refills are left when you refill a prescription.
    • The pharmacist will need 2 or 3 days to renew the prescription if you run out of refills.
    • Check expiration dates monthly. Make sure new syringes will be good for at least 6 months.
  • Store all medicines in their original container, 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.

Questions?

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 www.childrensmn.org/educationmaterials.

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