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Benzodiazepine — Status Epilepticus / Febrile Convulsions (Community)

Diazepam (Paediatric)

Brand names: Stesolid (rectal), Valium (oral/IV)

Diazepam is a benzodiazepine used in children for the acute treatment of prolonged or repeated seizures including status epilepticus, and for febrile convulsions, available by oral, rectal and parenteral routes.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It enhances the inhibitory action of GABA at GABA-A receptors, increasing chloride conductance and reducing neuronal excitability.

Prescribing in practice

  • The principal risk is respiratory depression and sedation, which is greater with intravenous use and when combined with other CNS depressants, so resuscitation facilities must be available.
  • Rectal solution provides a practical route for seizures in the community when intravenous access is unavailable; a defined maximum number of doses should not be exceeded before seeking emergency help.
  • Dose by weight using a children's formulary and reduce in hepatic impairment as accumulation can occur.

Monitoring

During and after administration monitor respiratory rate, oxygen saturation, conscious level and blood pressure.

Counselling the patient

  • Carers should be shown how to give rectal diazepam and when to call emergency services.
  • Expect drowsiness afterwards and ensure the child is supervised.
  • Seek immediate help if breathing becomes slow or the seizure does not stop.

Evidence & guidelines

Diazepam is an established option for terminating acute seizures in children, with buccal midazolam and intravenous lorazepam as alternatives per UK status epilepticus protocols.

Reference: APLS UK Algorithm 2021; NICE CG137 (Febrile Seizures); RCPCH Seizure Management Guidelines; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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