Diazepam

General

• Type: Benzodiazepines
• Dosage Forms:
• Common Trade Names: Valium

Adult Dosing

• Anxiety
  • PO: 2 - 10 mg 2-4 times daily

• Muscle spasm
  • PO: 2 - 10 mg 2-4 times daily

• Sedation in ICU
  • IV: Loading dose: 5 - 10 mg, Maintenance dose: 0.03 - 0.1 mg/kg every 30 minutes to 6 hours

Special Populations

• Pregnancy Rating: D
• Lactation: Diazepam and metabolites are present in breast milk
• Renal Dosing
  • Adult
    • Not defined
  • Pediatric
    • Not defined
• Hepatic Dosing
  • Adult
    • Not defined, use with caution, do not used oral tablets in severe hepatic impairment
  • Pediatric
    • Not defined, use with caution, do not used oral tablets in severe hepatic impairment

Contraindications

• Allergy to class/drug
• severe hepatic impairment

Adverse Reactions

Serious

• Respiratory/CNS depression
• Hypotension
• paradoxical CNS stimulation

Common

• drowsiness
• disinhibition
• ataxia

Pharmacology

• Half-life: 30-60 hours
• Metabolism: Liver
• Excretion: Urine
• Mechanism of Action: GABA agonist

Indications by Condition

The following table is automatically generated from disease/condition pages across WikEM.

Indication	Dose	Context	Route	Population
Carbamate poisoning	5-10mg IV	Seizure control	IV	Adult
Carbamate poisoning	0.2-0.5mg/kg IV	Seizure control	IV	Pediatric
Cocaine toxicity	5-10mg IV q5min PRN agitation	First-line for agitation, seizures, and sympathetic excess	IV	Adult
Delirium tremens	10mg x2, then 20mg x3, then 40mg x3 q5-10min (max 200mg)	First-line escalating dose protocol for DTs	IV	Adult
Ethanol withdrawal	5-10 mg IV q5-10min, increase by 10 mg increments until desired effect	1st line benzodiazepine (long-acting)	IV	Adult
Organophosphate toxicity	5-10 mg	Seizure control	IV	Adult
Organophosphate toxicity	0.2-0.5 mg/kg	Seizure control	IV	Pediatric
Vertigo	2.5-10 mg q6hr PRN	Benzodiazepine (vestibular suppressant)	PO	Adult

References

• Diazepam: Drug information. UpToDate. www.uptodate.com. Accessed April 2, 2019.