Diazepam (rectal) for stopping seizures

Name of medicine

Diazepam for rectal administration 

Why is it important for my child to take Diazepam?

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:

• Note the time when the seizure starts.
• Wait 5 minutes. The fit may stop on its own.
• If the seizure has not slowed down or stopped, give one dose of diazepam.
• Wait 5 minutes.
• If the seizure has not slowed down or stopped, call for an ambulance.

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.

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 fi rst 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 fi rmly 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 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; 111 or 0845 4647 in parts of Wales) or take your child to hospital. Take the medicine container or packet with you, even if it is empty. This will be useful to the doctor. Have the packet 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).

Side effects you must do something about

Other side-effects you need to know about

• 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

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 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. 
• 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 I 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.

• Keep the medicine in the container it came in.

Who to contact for more information?

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

Copyright disclaimer

Version [2]. © NPPG, RCPCH and WellChild, all rights reserved. Review by May 2018.

The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk.

We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.