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diazepam rectal
generic
Black Box Warnings .
Risks from Concomitant Opioid Use
concomitant benzodiazepine use w/ opioids may result in profound sedation, resp. depression, coma, and death; reserve concomitant use for pts w/ inadequate alternative tx options; limit to minimum required dosage and duration; monitor pts for s/sx of resp. depression and sedation
Addiction, Abuse, and Misuse
benzodiazepines expose users to risk of abuse, misuse, and addiction, can lead to overdose or death; commonly involves concomitant use w/ other meds, alcohol, and/or illicit substances, which is assoc. w/ incr. frequency of serious adverse outcomes; assess risk for abuse, misuse, and addiction before prescribing and throughout tx
Dependence and Withdrawal Reactions
cont. benzodiazepine use may lead to clinically significant physical dependence; risk of dependence and withdrawal incr. w/ longer tx duration and higher daily dose; if used more frequently than recommended, use gradual taper to D/C as abrupt D/C or rapid dose reduction may cause acute withdrawal reactions, potentially life-threatening
Adult Dosing .
Dosage forms: GEL: 2.5 mg per applicatorful, 10 mg per applicatorful, 20 mg per applicatorful
seizures, acute repetitive
- [0.2 mg/kg/dose PR x1]
- Max: 1 tx/5 days up to 5 tx/mo; Info: may repeat dose x1 in 4-12h; 10 mg and 20 mg applicators deliver doses in 2.5 mg increments; use 10 mg per applicatorful for 5 mg, 7.5 mg, or 10 mg doses; use 20 mg per applicatorful for 12.5 mg, 15 mg, 17.5 mg, or 20 mg doses; use 2.5 mg per applicatorful for partial replacement or supplement
renal dosing
- [see below]
- renal impairment: no adjustment; Info: metabolite accumulation possible
- HD/PD: no adjustment; no supplement; Info: metabolite accumulation possible
hepatic dosing
- [see below]
- hepatic impairment: not defined, caution advised
Peds Dosing .
- Dosage forms: GEL: 2.5 mg per applicatorful, 10 mg per applicatorful, 20 mg per applicatorful
seizures, acute repetitive
- [2-5 yo]
- Dose: 0.5 mg/kg/dose PR x1; Max: 1 tx/5 days up to 5 tx/mo; Info: may repeat dose x1 in 4-12h; 10 mg and 20 mg applicators deliver doses in 2.5 mg increments; use 10 mg per applicatorful for 5 mg, 7.5 mg, or 10 mg doses; use 20 mg per applicatorful for 12.5 mg, 15 mg, 17.5 mg, or 20 mg doses; use 2.5 mg per applicatorful for partial replacement or supplement
- [6-11 yo]
- Dose: 0.3 mg/kg/dose PR x1; Max: 1 tx/5 days up to 5 tx/mo; Info: may repeat dose x1 in 4-12h; 10 mg and 20 mg applicators deliver doses in 2.5 mg increments; use 10 mg per applicatorful for 5 mg, 7.5 mg, or 10 mg doses; use 20 mg per applicatorful for 12.5 mg, 15 mg, 17.5 mg, or 20 mg doses; use 2.5 mg per applicatorful for partial replacement or supplement
- [12 yo and older]
- Dose: 0.2 mg/kg/dose PR x1; Max: 1 tx/5 days up to 5 tx/mo; Info: may repeat dose x1 in 4-12h; 10 mg and 20 mg applicators deliver doses in 2.5 mg increments; use 10 mg per applicatorful for 5 mg, 7.5 mg, or 10 mg doses; use 20 mg per applicatorful for 12.5 mg, 15 mg, 17.5 mg, or 20 mg doses; use 2.5 mg per applicatorful for partial replacement or supplement
renal dosing
- [see below]
- renal impairment: no adjustment; Info: metabolite accumulation possible
- HD/PD: no adjustment; no supplement; Info: metabolite accumulation possible
hepatic dosing
- [see below]
- hepatic impairment: not defined, caution advised