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DIAZEPAM Lactation Yes (Unsafe) Trade Name: Valium
Class / Mechanism of Action
Benzodiazepine;
Acts as an Anxiolytic/Hypnotic, anticonvulsant and sedative – Long Half Life (25-100hr)
Onset of action: IV, Almost Immediate
Duration: IV, 20-30min
Indications
Labeled Indications:
• Anxiety Disorders
• Convulsive Disorders and Alcohol Withdrawal Symptoms
• Skeletal Muscle Relaxant
• Induce Sedation and Amnesia (Midazolam is primary medication)
Contraindications
• Hypersensitivity to diazepam or any component of the formulation or other benzodiazepines
• Acute narrow angle glaucoma , Acute Alcohol Intoxication
• Respiratory Insufficiency/Depression (Overdose Reversal: FLUMAZENIL can be used, however it
carries elevated risk. Respiratory support until the medication is metabolized is traditionally the best
care in Benzodiazepine overdose)
• Neurologic Depression (Head Trauma)
Adverse Reactions / Precautions
• No Analgesic properties (Narcotic pain control is needed for RSI’d/Intubated trauma patients)
• May Cause Respiratory depression: Do not give without stable IV line and BVM (airway control) ready
• Hypotension, vasodilation
• Amnesia, confusion, drowsiness, slurred speech (Paradoxical Reactions possible: aggressiveness,
agitation, anxiety, inappropriate behavior)
Dose and Administration: ADULT PEDIATRIC Always Reference BROSELOW Tape
Anxiety: Sedation / Muscle relaxation / Anxiety :
Oral, IV, IM: (Oral and IV doses more reliable) IV, IM (IV doses more reliable)
• 2-10mg bid/qid prn • Children: 0.04-0.3mg/kg/dose q2-4hr to a
Status Epilepticus: maximum of 0.6mg/kg within an 8-hour period
IV: (SLOW) if needed
• 5-10mg q5-10min given over 3 minutes
(maximum dose: 30mg) Status Epilepticus:
Sedation in ICU patient: IV:
IV: • Infants >30 days and Children <5 years:
• Loading dose: 5-10mg; Maintenance dose: 0.2-0.5mg given slowly q2-5min
0.03-0.1mg/kg q30min to 6hr (maximum total dose: 5mg); repeat in 2-4hr if
Muscle Spasm: needed
IV: • Children ≥5 years: 1mg given slowly q2-5min
• Initial: 5-10mg; then 5-10mg in 3-4hr, if (maximum total dose: 10mg); repeat in 2-4hr if
necessary. Larger doses may be required if needed
associated with tetanus.
Nerve Agent Exposure (CBRNE) Muscle spasm associated with tetanus:
IM: IV, IM
• 10mg for seizures associated with Nerve Agent • Infants >30 days and Children <5 years:
1-2mg/dose q3-4hr prn
exposure; or if 3 MARK 1 kits were used on a
casualty • Children ≥5 years: 5-10mg/dose q3-4hr prn

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