From the FDA Drug Label
DOSAGE AND ADMINISTRATION ... PEDIATRIC PATIENTS: Because of varied responses to CNS-acting drugs, initiate therapy with lowest dose and increase as required. Not for use in pediatric patients under 6 months. 1 mg to 2. 5 mg, 3 or 4 times daily initially; increase gradually as needed and tolerated
The appropriate dose of Valium (Diazepam) for anxiolysis in a 4-year-old child is 1 mg to 2.5 mg, 3 or 4 times daily initially, and may be increased gradually as needed and tolerated 1.
From the Research
Diazepam Dosage for Anxiolysis in Children
The appropriate dose of Valium (Diazepam) for anxiolysis in a 4-year-old child is not explicitly stated in the provided studies. However, some studies provide information on the dosage of diazepam used in children for anxiolysis and sedation:
- A study published in 1985 2 used oral diazepam 0.25 mg/kg or 0.5 mg/kg as premedication in children undergoing elective surgery.
- The study found that 0.25 mg/kg diazepam produced less sedation in children under 5 years old, compared with those 5 years and older.
- Another study published in 1994 3 mentions that diazepam is usually the drug of choice for anxiolysis, given in single doses, very short (1 to 7 days) or short (2 to 4 weeks) courses.
Considerations for Diazepam Use in Children
When using diazepam in children, it is essential to consider the following:
- The elimination half-life of diazepam is prolonged in newborns and the elderly, and in some cases of liver disease 4.
- Accumulation of the active N-desmethylated metabolite during long-term treatment can occur 4.
- Daily handling or intraperitoneal administration did not alter the behavioral response to acute challenge with 2 mg/kg diazepam in all the three behavioral paradigms studied 5.
Dosing Considerations
The dosing of diazepam for anxiolysis in children should take into account the individual patient's requirements and the potential for adverse effects:
- A study published in 2012 5 found that tolerance to the sedative effect of 2 mg/kg diazepam ensued after 14 days of protracted treatment with 2 and 10 mg/kg of diazepam.
- The study also found that treatment with the lowest dose (0.5 mg/kg) of diazepam resulted in potentiation of the sedative effect of acute challenge with 2 mg/kg diazepam.