What is the maximum rectal dose of diazepam?

From the Guidelines

The maximum rectal dose of diazepam is 20 mg.

Rectal Diazepam Dosage

• The dosage for rectal administration of diazepam is 0.5 mg/kg up to a maximum of 20 mg 1.
• This route may be useful when IV access is unavailable, but absorption may be erratic.
• Diazepam should be followed immediately by a long-acting anticonvulsant, such as phenytoin/fosphenytoin, because it is rapidly redistributed and seizures often recur within 15–20 min.
• It is essential to note that the rectal dose is part of the treatment for status epilepticus, and the medication should be administered with caution and under medical supervision.

From the Research

Maximum Rectal Dose of Diazepam

The maximum rectal dose of diazepam is not explicitly stated in the provided studies. However, the following information can be gathered:

• A study published in 2004 2 mentions that overdoses of up to 330% of the maximum recommended dosage have been reported without any respiratory or cardiac depression.
• A study published in 1992 3 evaluated the efficacy of intrarectal diazepam solution at doses of 20 and 30 mg in the treatment of serial seizures in adult patients with refractory partial epilepsy.
• Key points about the maximum rectal dose of diazepam include:
  • The maximum recommended dosage is not explicitly stated in the provided studies.
  • Doses of up to 30 mg have been evaluated in clinical studies 3.
  • Overdoses of up to 330% of the maximum recommended dosage have been reported without serious clinical consequences 2.

Rectal Administration of Diazepam

Some key points about rectal administration of diazepam include:

• Rectal administration can be difficult, inconvenient, and objectionable 4.
• The bioavailability of diazepam after rectal administration has been evaluated in several studies 5, 4, 6.
• The efficacy and safety of rectal diazepam have been established in several clinical studies 2, 3.