Diastat (diazepam) is a brand-name drug that’s prescribed as a rescue treatment for refractory seizures, including seizure clusters, in adults and some children with epilepsy. Diastat comes as a rectal gel that’s typically given as needed by a trained caregiver. The dosage can vary depending on your age and weight.
Diastat belongs to a drug class called benzodiazepines. Diastat is available in a generic version.
Keep reading for specific information about the dosage of Diastat, including its strengths and how to use the medication. For a comprehensive look at Diastat, see this article.
Note: This article describes typical dosages for Diastat and Diastat AcuDial provided by the drug’s manufacturer. “AcuDial” refers to a special type of syringe used to give the drug. This article will use the term “Diastat” when referring to either brand-name version. Your doctor will prescribe the Diastat dosage that’s right for you.
The information below describes Diastat’s typical dosages and other details about the drug.
Diastat forms
Both Diastat and Diastat AcuDial come as a rectal gel. The gel comes inside a prefilled syringe with a flexible tip. A healthcare professional or a caregiver will inject the gel into your rectum. Other details include:
- Diastat comes as a pack of two prefilled, single-use syringes (twin pack) with a 4-centimeter (cm) tip.
- Diastat AcuDial comes as a twin pack of prefilled, single-use syringes with a 4-cm or 6-cm tip. The prefilled syringes have a special display window that shows the amount of medication being given. The Diastat AcuDial syringe also has a green “ready” band to show when you can give the dose.
Diastat strengths
Diastat comes in one strength: 2.5 milligrams (mg) per 0.5 milliliters (mL).
Diastat AcuDial comes in the following strengths:
- 10 mg/2 mL with a 4-cm tip for doses of:
- 5 mg
- 7.5 mg
- 10 mg
- 20 mg/4 mL with a 6-cm tip for doses of:
- 12.5 mg
- 15 mg
- 17.5 mg
- 20 mg
Typical dosages
The following information describes dosages that are commonly prescribed or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.
Dosage for seizures
Diastat rectal gel is a rescue treatment for refractory seizures in adults and some children with epilepsy. Refractory seizures are episodes of increased seizure activity, including seizure clusters, despite the use of seizure medications.
Diastat’s dosages are based on age and body weight in kilograms (kg). (For reference, 1 kg equals about 2.2 pounds [lb].) The recommended weight-based dosing for Diastat by age is as follows:
- ages 2 to 5 years: 0.5 mg per kg (mg/kg) of body weight
- ages 6 to 11 years: 0.3 mg/kg of body weight
- ages 12 years and older: 0.2 mg/kg of body weight
Your doctor will calculate your dose for you. They’ll prescribe Diastat or Diastat AcuDial, which comes in specific strengths. So after calculating your dose, your doctor will typically round up to the nearest available strength. For example, if your calculated dose is 14.5 mg, your doctor will round up to a 15-mg dose. To achieve this dose, your doctor will likely prescribe the 20 mg/4 mL strength of Diastat AcuDial.
Your doctor will continue to monitor you and make dose adjustments as needed, such as if your weight changes.
It’s important to note that there may be situations where a second dose is given 4 to 12 hours after the first dose. When your doctor prescribes the drug, they’ll explain when a second dose may be needed. They’ll also advise you about treatment frequency. Typically, this is no more than five treatments per month.
The following table shows typical weight-based doses of Diastat for children ages 2 to 5 years:
| Body weight | Dose based on 0.5 mg/kg of body weight |
| 6 kg to 10 kg | 5 mg |
| 11 kg to 15 kg | 7.5 mg |
| 16 kg to 20 kg | 10 mg |
| 21 kg to 25 kg | 12.5 mg |
| 26 kg to 30 kg | 15 mg |
| 31 kg to 35 kg | 17.5 mg |
| 36 kg to 44 kg | 20 mg |
The following table shows typical weight-based doses of Diastat for children ages 6 to 11 years:
| Body weight | Dose based on 0.3 mg/kg of body weight |
| 10 kg to 16 kg | 5 mg |
| 17 kg to 25 kg | 7.5 mg |
| 26 kg to 33 kg | 10 mg |
| 34 kg to 41 kg | 12.5 mg |
| 42 kg to 50 kg | 15 mg |
| 51 kg to 58 kg | 17.5 mg |
| 59 kg to 74 kg | 20 mg |
The following table shows typical weight-based doses of Diastat for children ages 12 years and older:
| Body weight | Dose based on 0.2 mg/kg of body weight |
| 14 kg to 25 kg | 5 mg |
| 26 kg to 37 kg | 7.5 mg |
| 38 kg to 50 kg | 10 mg |
| 51 kg to 62 kg | 12.5 mg |
| 63 kg to 75 kg | 15 mg |
| 76 kg to 87 kg | 17.5 mg |
| 88 kg to 111 kg | 20 mg |
Pediatric (children’s) dosage
Diastat rectal gel is prescribed as a rescue treatment for refractory seizures in children ages 2 years and older with epilepsy. Refractory seizures are episodes of increased seizure activity, including seizure clusters, despite the use of seizure medications.
Your child’s doctor will determine your child’s dosage based on their age and body weight. For more information on Diastat dosing in children, refer to the “Typical dosages” section just above.
Your child’s doctor will also show you how to give your child their dose. For guidance on giving Diastat, see the “How Diastat is given” section below.
Long-term treatment
Diastat isn’t meant to be used as a long-term treatment. It’s a rescue treatment for certain seizures. Rescue treatments are medications that work quickly to stop a seizure. However, your doctor may prescribe Diastat long term so that you always have the medication available.
Talk with your doctor if you have questions about your or your child’s Diastat treatment.
The Diastat dosage your doctor prescribes will depend on several factors. These include:
- your age
- your body weight
- how your body responds to Diastat
Other medical conditions you have can also affect your Diastat dosage.
Dosage adjustments
If you have kidney or liver disease, your doctor may monitor you more closely. In some cases, they may adjust your dosage.
Talk with your doctor to learn more about factors that may affect your Diastat dosage.
Diastat comes as a rectal gel inside a prefilled syringe. Diastat and Diastat AcuDial prefilled syringes have a flexible tip. Your doctor or another healthcare professional will show your caregiver how to give your dose rectally. Do not try to give yourself a dose of Diastat.
If your child’s doctor prescribes Diastat, they’ll show you how to give your child their dose.
When your doctor prescribes Diastat, they’ll tell you whether to give a second dose of the drug.
The specific instructions for using Diastat depend on whether your doctor prescribes Diastat or Diastat AcuDial prefilled syringes. For details about these two forms, see the “Diastat dosage” section above.
For a step-by-step guide on how to use Diastat and Diastat AcuDial, you can refer to these instructions.
ACCESSIBLE DRUG LABELS AND CONTAINERSSome pharmacies offer labels with large print, braille, or a code you scan with a smartphone to convert text to speech. If your local pharmacy doesn’t have these options, your doctor or pharmacist might be able to recommend a pharmacy that does.
Diastat has a
With misuse, a drug is taken or used in a way other than how it’s prescribed. With addiction, a drug is taken even though it’s causing harm.
Diastat has a risk of misuse and addiction because it’s a benzodiazepine. The use of medications in this drug class may lead to severe breathing problems, overdose, coma, and even death in rare cases. Using the drug more frequently than prescribed, at higher doses than prescribed, or with other drugs or alcohol increases the risk. To learn about Diastat’s recommended dosages, see the “Diastat dosage” section above.
Before prescribing Diastat, your doctor will determine whether it’s safe for you to take. They may not prescribe Diastat if you’ve ever had substance use disorder.
Talk with your doctor if you have questions about Diastat and misuse.
If you use more Diastat than your doctor prescribes, you may develop serious side effects. To learn about the side effects of Diastat, see this article.
It’s important that you do not use more Diastat than your doctor advises.
Symptoms of an overdose
Diastat overdose symptoms can include:
- drowsiness
- breathing problems
- confusion
- slower reflexes
- difficulty speaking
- trouble moving
- coma
If you take more than the recommended amount of Diastat
Call your doctor right away if you believe you’ve used too much Diastat. Another option is to call America’s Poison Centers at 800-222-1222 or use its online tool. If you have severe symptoms, immediately call 911 or your local emergency number, or go to the nearest emergency room.
Diastat has a
With physical dependence, your body needs the drug to function as usual. Withdrawal symptoms are side effects that can occur when you stop taking a drug that your body has become dependent on.
Some people who have taken benzodiazepines long term and suddenly stopped taking them have experienced life threatening withdrawal symptoms. (Diastat is a benzodiazepine.)
If Diastat is given as prescribed, there’s a lower risk of physical dependence. This is because the drug is used only in emergency situations to treat certain seizures. However, using Diastat more often or at higher doses than prescribed increases your risk of physical dependence. To learn about Diastat’s recommended dosages, see the “Diastat dosage” section above.
Physical dependence increases the risk of withdrawal. Signs and symptoms of Diastat withdrawal include:
- anxiety
- blurry vision
- nausea
- vomiting
- dizziness
- fatigue
- muscle stiffness
- tremors
- fast heart rate
- seizures
If you’ve been using Diastat for a long time, your doctor will recommend safe ways to stop treatment. For more information, talk with your doctor.
The dosages in this article are typical dosages provided by the drug’s manufacturer. If your doctor recommends Diastat for you, they’ll prescribe the dosage that’s right for you. Always follow the dosage that your doctor prescribes. Diastat can be given only by a caregiver with training on how to administer it. Do not try to give yourself a dose of Diastat.
As with any drug, never change your dosage of Diastat without your doctor’s recommendation. If you have questions about the dosage of Diastat that’s best for you, talk with your doctor.
Besides learning about dosage, you may want other information about Diastat. These additional articles might be helpful:
- More about Diastat. For information about other aspects of Diastat, refer to this article.
- Details about your condition. For details about epilepsy and seizures, see our epilepsy and seizures hub.
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
