Diazepam Injectable: Dosing and Precautions
Injectable diazepam guidance for convulsive status epilepticus, tetanus-related muscle spasms, and severe adult agitation.
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Source reviewed
October 2024
Guide category
Injectable drugs
Safety boundary
Prescription medicine information for clinician-guided use.
Kenza Health Hub presents this medicine page as structured health education. Check dose, route, interactions, pregnancy or breast-feeding considerations, and local protocol with a qualified clinician or pharmacist. Read our medical editorial policy.
Therapeutic action
Antiseizure (anticonvulsant), muscle relaxant, sedative, anxiolytic.
Indications
- First-line treatment of convulsive status epilepticus.
- Muscle spasms due to tetanus.
- Severe agitation in adults.
Forms and strengths, route of administration
The injectable solution may be used rectally.
- 10 mg in 2 ml ampoule, 5 mg/ml, for IM injection, slow IV injection, or IV infusion in 0.9% sodium chloride or 5% glucose.
Dose and duration
During and after administration, have ventilation equipment and solutions for fluid replacement ready for use.
For seizures, preferably use the rectal route in children.
| Age | Weight | 10 mg/2 ml solution | |
|---|---|---|---|
| Rectal route | IV injection | ||
| 1 to < 4 months | 3 to < 6 kg | 0.4 ml | 0.25 ml |
| 4 to < 12 months | 6 to < 10 kg | 0.7 ml | 0.4 ml |
| 1 to < 3 years | 10 to < 15 kg | 1.2 ml | 0.6 ml |
| 3 to < 5 years | 15 to < 20 kg | 1.5 ml | 1 ml |
| 5 to < 9 years | 20 to < 30 kg | 2 ml | 1.2 ml |
| 9 to < 12 years | 30 to < 40 kg | 2 ml | 2 ml |
Convulsive status epilepticus
- Child 1 month to 11 years: rectal route, one dose of 0.5 mg/kg, maximum 10 mg; slow IV injection, one dose of 0.2 to 0.3 mg/kg, maximum 10 mg.
- Child 12 years and over and adult: rectal route, one dose of 10 to 20 mg; slow IV injection, one dose of 10 mg.
- If seizures do not stop 5 minutes after the first dose, readminister the same dose regardless of route. Do not administer more than 2 doses in total.
Muscle spasms due to tetanus
- Child 1 month and over and adult: 0.1 to 0.3 mg/kg by slow IV injection every 1 to 4 hours or 0.1 to 0.5 mg/kg/hour by IV infusion over 24 hours.
Severe agitation
- Adult: 10 mg by IM injection, to be repeated once after 30 to 60 minutes if necessary.
Contra-indications, adverse effects, precautions
- Do not administer to neonates because the formulation contains benzyl alcohol, nor to patients with severe respiratory insufficiency or severe hepatic impairment.
- Administer with caution to older patients, patients with renal or hepatic impairment, and patients with history of substance abuse or mental disorders.
- May cause pain at injection site, hypotension, muscle weakness, ataxia, hypotonia, drowsiness, lethargy, confusional state, respiratory depression, and coma in overdose.
- Avoid or monitor combination with opioid analgesics, antipsychotics, first-generation antihistamines, antidepressants, other antiseizure medications, enzyme inducers, omeprazole, macrolides, ritonavir, isoniazid, fluconazole, itraconazole, and phenytoin.
- Pregnancy and breast-feeding: avoid, except if vital.
- Diazepam is subject to international controls: follow national regulations.
- Do not mix with other drugs in the same syringe or infusion.
Source
MSF Essential drugs practical guidelines (January 2026)
This page combines source-derived medicine reference sections with Kenza editorial context, while leaving out the Storage and Remarks sections from the source batch.
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