From the Guidelines
Diazepam should be administered at a dose of 0.1 to 0.8 mg per kg of body weight in a single oral dose for conscious sedation, as recommended by the most recent and relevant study 1. The dose of diazepam can vary depending on the indication and patient population.
- For conscious sedation in renal failure patients, the recommended dose is 0.1 to 0.8 mg per kg of body weight in a single oral dose 1.
- It is essential to note that diazepam is metabolized in the liver, and no dose adjustment is required for renal failure patients 1.
- However, it is crucial to consult with a nephrologist to determine the type and dose of anxiolytic agents to use before surgery, especially in patients with renal failure 1.
- Other studies, such as the one published in 2020 1, provide guidance on managing COVID-19 symptoms, including anxiety or agitation, but the dose of lorazepam recommended in this study is not directly applicable to diazepam dosing.
- The mechanism of action of diazepam involves enhancing the effect of GABA, an inhibitory neurotransmitter in the brain, producing sedative, anxiolytic, anticonvulsant, and muscle relaxant effects.
- Patients should be aware of the potential side effects, including drowsiness, dizziness, and coordination problems, and avoid alcohol and be aware of the potential for dependence with prolonged use 1.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION Dosage should be individualized for maximum beneficial effect. While the usual daily dosages given below will meet the needs of most patients, there will be some who may require higher doses. In such cases dosage should be increased cautiously to avoid adverse effects. ADULTS: USUAL DAILY DOSE: Management of Anxiety Disorders and Relief of Symptoms of Anxiety Depending upon severity of symptoms—2 mg to 10 mg, 2 to 4 times daily Symptomatic Relief in Acute Alcohol Withdrawal. 10 mg, 3 or 4 times during the first 24 hours, reducing to 5 mg, 3 or 4 times daily as needed Adjunctively for Relief of Skeletal Muscle Spasm. 2 mg to 10 mg, 3 or 4 times daily Adjunctively in Convulsive Disorders 2 mg to 10 mg, 2 to 4 times daily Geriatric Patients, or in the presence of debilitating disease. 2 mg to 2.5 mg, 1 or 2 times daily initially; increase gradually as needed and tolerated 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 recommended diazepam dose is:
- For adults: 2 mg to 10 mg, 2 to 4 times daily for anxiety disorders, 10 mg, 3 or 4 times during the first 24 hours for acute alcohol withdrawal, 2 mg to 10 mg, 3 or 4 times daily for skeletal muscle spasm, and 2 mg to 10 mg, 2 to 4 times daily for convulsive disorders.
- For geriatric patients: 2 mg to 2.5 mg, 1 or 2 times daily initially, increasing gradually as needed and tolerated.
- For pediatric patients: 1 mg to 2.5 mg, 3 or 4 times daily initially, increasing gradually as needed and tolerated 2.
From the Research
Diazepam Dose Information
- The provided studies do not directly mention the dose of diazepam, but they discuss its use and pharmacokinetics in various contexts 3, 4.
- In the management of status epilepticus, diazepam has been used, but its effective duration of action is only 20 to 30 minutes due to its high lipid solubility and protein binding 4.
- Continuous intravenous infusion of diazepam has been used successfully in some patients with status epilepticus refractory to initial treatment, but the dose is not specified 4.
- The studies primarily focus on the comparison of different benzodiazepines, such as clonazepam, lorazepam, and midazolam, in terms of efficacy and safety in various conditions, including anxiety disorders and status epilepticus 5, 6.
- There is no direct information on the recommended dose of diazepam in the provided studies, suggesting that further research or consultation of other sources may be necessary to determine the appropriate dosage.