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Diazepam (rectal) for stopping seizures

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Diazepam (rectal) for stopping seizures

This leaflet is about the use of rectal diazepam to stop seizures. 
(Seizures may also be called convulsions or fits.)

This leaflet has been written for parents and carers about how to use this medicine in children. Our information sometimes differs from that provided by the manufacturers, because their information is usually aimed at adult patients. Please read this leaflet carefully. Keep it somewhere safe so that you can read it again.

Never give your child more than one dose of diazepam during one seizure unless you have been told to do this by the hospital doctor.

Name of drug

Diazepam for rectal administration (rectal diazepam)

Why is it important for my child to take this medicine?

Rectal diazepam is used to stop a seizure

What is diazepam available as?

  • Diazepam RecTubes®: prefilled white rectal tube with nozzle, containing 2.5 mg, 5 mg or 10 mg diazepam as a liquid. Each RecTube® is wrapped in foil.
  • Stesolid®: prefilled yellow rectal tube with nozzle, containing 5 mg or 10 mg diazepam as a liquid. Each foil package contains four Stesolid® tubes.
  • Desitin®:prefilled white rectal tube with nozzle, containing 5 mg or 10 mg of diazepam as a liquid. Each Desitin® tube is wrapped in foil. There are five Desitin® tubes in a package.

These contain alcohol, speak to your doctor, epilepsy nurse or pharmacy if you are concerned

When should I give diazepam?

You should give rectal diazepam if your child’s seizure lasts more than 5 minutes. Follow these steps.

Timeline-diazepam
 

How much should I give?

Your doctor will work out the amount of diazepam (the dose) that is right for your child. The dose will be shown on the medicine label.
Make sure you know which dose your child has, and check that you have the right dose of rectal tube.

It is important that you follow your doctor’s instructions about how much to give.

How should I give diazepam?

Your epilepsy nurse should have given you the things you need to give the rectal diazepam. These should be kept together, somewhere close to hand. You will need:

  • the RecTubes®, Stesolid® or Desitin® tubes
  • disposable plastic gloves.

Although it can be upsetting to see your child having a seizure, it is important that you stay calm and follow the instructions.

Prepare the diazepam
  • Tear open the foil pack of a RecTube®, Stesolid® or Desitin® tube.
  • Take off the cap at the end of the RecTube®. Remove the cap of the Stesolid® or Desitin® tube by turning it two or three times, without pulling.
Give the diazepam
  • If you have time, put on the plastic gloves, or wash your hands with soap and hot water.
  • Put your child into the recovery position (as you would normally during a seizure), lying on their side (this will help the diazepam to be absorbed). With a small child it may be easier to lay the child on their front or across your knees.
  • Hold one buttock gently to one side so that you can see the back passage.
  • Gently inset the nozzle (neck of the tube) of the applicator into the back passage, pointing it slightly downwards. 
  • RecTube® nozzles and Desitin® tubes should be inserted halfway.
  • Stesolid® tubes have marks on the nozzle to guide you. For babies and children under 3 years old, the nozzle should be inserted up to the first mark. For children aged 3 years and older, the whole nozzle should be inserted.
  • Empty the contents of the RecTube®, Stesolid® or Desitin® by squeezing it firmly between your index finger and thumb.
  • Keep the RecTube®, Stesolid® or Desitin® tube squeezed while you remove the nozzle from your child’s back passage.
  • Hold your child’s buttocks together for about a minute to make sure the diazepam doesn’t leak out.
  • There may be a small amount of liquid left in the Stesolid® or Desitin® tube, but this does not matter.
    There should be no liquid left in the RecTube®.
  • Put the empty tube and gloves into your normal household waste.
  • When you get time, wash your hands thoroughly with soap and hot water.

What if my child is sick (vomits)?

You do not need to worry if your child is sick, as the medicine will still work.

What if I don’t give diazepam?

If you do not give the diazepam, or do not give the right dose, your child’s seizure may not stop, which could be dangerous.

What if I give too much?

If you think you may have given your child too much diazepam, contact your doctor or local NHS services (111 in England and Scotland; 0845 4647 in Wales) or take your child to hospital.

Take the medicine container or packaging with you, even if it is empty. This will be useful to the doctor. Have the medicine or packaging with you if you telephone for advice.

Are there any possible side-effects?

We use medicines to make our children better, but sometimes they have other effects that we don’t want (side-effects).

  • Your child may be sleepy after having diazepam. They should have a sleep if they want to.
  • Your child may be confused. They probably won’t remember having the seizure.

Your child’s breathing may become a little shallow for a while. You do not need to worry about this. However, if you think your child is not breathing or if your child’s lips get a blue tinge, call an ambulance straight away.

There may, sometimes, be other side-effects that are not listed above. If you notice anything unusual and are concerned, contact your doctor. You can report any suspected side-effects to a UK safety scheme at http://www.mhra.gov.uk/yellowcard.

Is there anything else I need to know about this medicine?

  • Your child should have their rectal diazepam with them at all times. Make sure that your child’s teachers and anyone else who looks after them know about their medicine and when it should be given. If they are not able or willing to give the rectal diazepam themselves and your child has a seizure, they must phone an ambulance or take your child to hospital straight away. For older children, make sure their friends also know what to do if your child has a seizure when they are out together.
  • When you collect a new prescription, make sure you have the right size/dose tube, as they come in different doses.
  • Only give diazepam to your child. Never give it to anyone else, even if their condition appears to be the same, as this could do harm.

If you think someone else may have taken the medicine by accident, contact your doctor straight away.

  • Make sure that the medicine you have at home has not reached the ‘best before’ or ‘use by’ date on the packaging.
  • RecTubes®, Stesolid® or Desitin® should not be kept for longer than 6 months once they have been taken out of the foil packaging.
  • Give old medicines to your pharmacist to dispose of.

Where should keep this medicine?

  • Keep the medicine in a cupboard, away from heat and direct sunlight. It does not need to be kept in the fridge.
  • Make sure that children cannot see or reach the medicine.

You must keep the medicine in the container it came in.

Who to contact for more information

Your child’s doctor, pharmacist or epilepsy nurse will be able to give you more information about diazepam and about other medicines used to treat seizures.

You can also get useful information from: 
Publication date: 
15/05/2015

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