What is Diazepam Rectal: Uses, Dosage, Side Effects and More

Diazepam rectal is a medication that's inserted into the rectum to quickly stop seizures when they happen. It's the same active ingredient as the oral diazepam pills you might know, but this form works much faster because it bypasses the digestive system entirely.

This medication belongs to a group called benzodiazepines, which work by calming overactive brain signals. When someone is having a seizure, their brain is essentially firing too many electrical signals at once, and diazepam helps restore that balance quickly.

What is Diazepam Rectal Used For?

Diazepam rectal is primarily used as an emergency treatment for seizures that won't stop on their own. It's specifically designed for situations where someone needs immediate help, and taking a pill by mouth isn't practical or fast enough.

The most common use is for breakthrough seizures in people who already have epilepsy. These are seizures that happen despite someone taking their regular seizure medications. Sometimes, even with the best treatment plan, seizures can still occur unexpectedly.

Doctors also prescribe this medication for prolonged seizures, which are seizures lasting longer than five minutes. These situations require quick action because the longer a seizure continues, the more dangerous it becomes for the brain and body.

In some cases, healthcare providers use diazepam rectal for severe muscle spasms or extreme anxiety episodes, though this is less common. The rectal form is typically reserved for emergency situations rather than daily management of these conditions.

How Does Diazepam Rectal Work?

Diazepam rectal works by enhancing a natural calming chemical in your brain called GABA. Think of GABA as your brain's natural brake system that helps slow down overactive nerve signals.

When you insert the medication rectally, it's absorbed directly into your bloodstream through the rich network of blood vessels in the rectal area. This bypasses your stomach and liver, which means the medication reaches your brain much faster than if you took it by mouth.

The medication is considered moderately strong within the benzodiazepine family. It's powerful enough to stop most seizures effectively, but it's not the strongest option available. This balance makes it both effective and relatively safe for emergency use.

You can typically expect the medication to start working within 5 to 15 minutes after insertion. The effects usually last several hours, giving your body time to stabilize and hopefully preventing additional seizures.

How Should I Take Diazepam Rectal?

Diazepam rectal comes in pre-filled syringes or gel tubes that make insertion easier and more precise. Before using it, wash your hands thoroughly and make sure the person receiving the medication is lying on their side in a comfortable position.

You don't need to worry about timing this medication with meals since it doesn't go through the digestive system. However, it's helpful to have the person lie still for a few minutes after insertion to ensure the medication stays in place and gets properly absorbed.

The insertion process is straightforward but requires gentleness. Remove the protective cap from the syringe, insert the tip about one inch into the rectum, and slowly push the plunger to release the medication. The person should remain lying on their side for at least 15 minutes afterward.

If you're a caregiver, it's important to stay calm during this process. Your composed demeanor can help reassure the person experiencing the seizure, even if they're not fully conscious at the moment.

How Long Should I Take Diazepam Rectal For?

Diazepam rectal is designed for single-dose emergency use, not ongoing daily treatment. Most people will only use it once during a seizure episode, and then not need it again for weeks, months, or potentially much longer.

Your doctor will provide specific guidelines about when to use a second dose if the first one doesn't work. Generally, if seizures continue after 10 to 15 minutes, emergency medical services should be contacted rather than giving another dose at home.

The medication stays active in your system for several hours after use, so you won't need repeated doses throughout the day. This is different from daily seizure medications that need to be taken consistently to maintain protective levels in your blood.

Some people might have multiple rescue doses prescribed to keep at home, work, or school, but each individual episode should typically require only one dose. Your healthcare provider will help you understand your specific situation and usage plan.

What Are the Side Effects of Diazepam Rectal?

Like all medications, diazepam rectal can cause side effects, though many people tolerate it well, especially considering it's used during medical emergencies. The most common side effects are related to the medication's calming effects on the nervous system.

Here are the side effects you're most likely to experience after using this medication:

• Drowsiness or feeling very sleepy for several hours
• Dizziness or feeling unsteady when standing
• Confusion or feeling mentally foggy
• Muscle weakness or feeling physically tired
• Mild irritation around the rectal area
• Headache as the medication wears off

These effects are generally temporary and fade as your body processes the medication. It's completely normal to feel sleepy or confused after using diazepam rectal, especially after experiencing a seizure.

While less common, some people may experience more significant side effects that require medical attention. These more serious reactions happen in a small percentage of users but are important to recognize:

• Difficulty breathing or very slow breathing
• Severe confusion that doesn't improve after a few hours
• Unusual agitation or aggressive behavior
• Allergic reactions like rash, swelling, or difficulty swallowing
• Continued seizures despite medication use

If you notice any of these more serious side effects, seek medical help immediately. Remember, this medication is used during emergencies, so having medical professionals evaluate the situation afterward is often wise anyway.

Who Should Not Take Diazepam Rectal?

Diazepam rectal isn't safe for everyone, and there are certain health conditions that make using this medication risky. Your doctor will review your medical history carefully before prescribing it.

People with severe breathing problems, such as severe asthma or chronic obstructive pulmonary disease (COPD), may need to avoid this medication because it can slow down breathing even more. This is especially important if you already use oxygen therapy or have been hospitalized for breathing issues.

If you have severe liver disease, your body may not be able to process diazepam effectively, leading to stronger or longer-lasting effects than expected. Your doctor might choose a different emergency seizure medication or adjust dosing if liver function is a concern.

Certain other conditions also require careful consideration before using diazepam rectal:

• Severe kidney disease that affects how your body eliminates medications
• Sleep apnea or other conditions causing breathing interruptions during sleep
• Myasthenia gravis, a condition causing muscle weakness
• Severe depression or thoughts of self-harm
• History of drug or alcohol addiction
• Pregnancy, especially during the first trimester

Age can also be a factor, as very young children and older adults may be more sensitive to the medication's effects. However, this doesn't automatically rule out its use - your doctor will weigh the benefits against the risks for your specific situation.

Diazepam Rectal Brand Names

Diazepam rectal is available under several brand names, with Diastat being the most commonly prescribed version in the United States. This brand comes in pre-filled syringes that make emergency administration easier for caregivers.

Other brand names include Diazepam Intensol Rectal and various generic formulations. While the active ingredient is the same across brands, the delivery system and concentration might vary slightly.

Your pharmacy may substitute generic versions unless your doctor specifically requests the brand name. Generic versions work just as effectively as brand names and often cost less, which can be helpful since this is an emergency medication you hope to rarely use.

Regardless of the brand, the medication will come with detailed instructions for proper storage and administration. Keep these instructions easily accessible for caregivers who might need to help during an emergency.

Diazepam Rectal Alternatives

Several other medications can serve as alternatives to diazepam rectal for emergency seizure treatment. The choice depends on factors like your age, other health conditions, and how well you've responded to different medications in the past.

Midazolam nasal spray is becoming increasingly popular as an alternative because it's even easier to administer during a seizure. Instead of rectal insertion, caregivers simply spray the medication into the nostril, which many people find less invasive.

Lorazepam can also be given rectally and works similarly to diazepam, though it may have a slightly different duration of action. Some people respond better to one benzodiazepine over another, so your doctor might try different options if diazepam doesn't work well for you.

For people who experience frequent breakthrough seizures, doctors sometimes consider other approaches like adjusting daily seizure medications or adding new ones to prevent emergencies from occurring in the first place.

Is Diazepam Rectal Better Than Midazolam Nasal?

Both diazepam rectal and midazolam nasal are effective emergency seizure treatments, but they each have advantages depending on your situation. Neither is universally "better" - the best choice depends on your specific needs and circumstances.

Midazolam nasal spray is often easier for caregivers to use because it doesn't require positioning or insertion. During a seizure, when someone may be moving or difficult to position, the nasal spray can be administered more quickly and with less physical handling.

However, diazepam rectal may work longer once it's absorbed, potentially providing more extended protection against additional seizures. Some people also absorb rectal medications more consistently than nasal ones, especially if they have nasal congestion or sinus problems.

Your doctor will help you choose based on factors like your seizure pattern, who will be administering the medication, and your personal preferences. Some families even keep both options available for different situations.