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Diastat®
(diazepam) Rectal Gel

Read first before using

To the caregiver using Diastat® (diazepam rectal gel) :

Please do not give DIASTAT® (diazepam rectal gel) until:

1. You have thoroughly read these instructions
2. Reviewed administration steps with the doctor
3. Understand the directions

To the caregiver using Diastat® (diazepam rectal gel) AcuDial™:

Please do not give DIASTAT® (diazepam rectal gel) AcuDial™ until:

1. You have confirmed:
   • Prescribed dose is visible and if known, is correct
   • green "ready" band is visible
2. You have thoroughly read these instructions
3. Reviewed administration steps with the doctor
4. Understand the directions

Please do not administer DIASTAT (diazepam rectal gel) until you feel comfortable with how to use DIASTAT (diazepam rectal gel) . The doctor will tell you exactly when to use DIASTAT (diazepam rectal gel) . When you use DIASTAT (diazepam rectal gel) correctly and safely you will help bring seizures under control. Be sure to discuss every aspect of your role with the doctor. If you are not comfortable, then discuss your role with the doctor again.

To help the person with seizures:

• You must be able to tell the difference between cluster and ordinary seizures.
• You must be comfortable and satisfied that you are able to give DIASTAT (diazepam rectal gel)
• You need to agree with the doctor on the exact conditions when to treat with DIASTAT (diazepam rectal gel) .
• You must know how and for how long you should check the person after giving DIASTAT (diazepam rectal gel) .

To know what responses to expect:

• You need to know how soon seizures should stop or decrease in frequency after giving DIASTAT (diazepam rectal gel) .
• You need to know what you should do if the seizures do not stop or there is a change in the person's breathing, behavior or condition that alarms you.

If you have any questions or feel unsure about using the treatment, CALL THE DOCTOR before using DIASTAT (diazepam rectal gel) .

When to treat. Based on the doctor's directions or prescription

Special considerations.

DIASTAT (diazepam rectal gel) should be used with caution:

•  In people with respiratory (breathing) difficulties (e.g., asthma or pneumonia)
•  In the elderly
•  In women of child bearing potential, pregnancy and nursing mothers

Discuss beforehand with the doctor any additional steps you may need to take if there is leakage of DIASTAT (diazepam rectal gel) or a bowel movement.

Patient's DIASTAT (diazepam rectal gel) dosage is: __ mg

Patient's resting breathing rate _            Patient's current weight _

Confirm current weight is still the same as when DIASTAT (diazepam rectal gel) was prescribed __

Check expiration date and always remove cap before using. Be sure seal pin is removed with the cap.

Treatment 1
Important things to tell the doctor.

Things to do after treatment with DIASTAT (diazepam rectal gel) .

Stay with the person for 4 hours and make notes on the following:

•  Changes in resting breathing rate ___
•  Changes in color _
•  Possible side effects from treatment _

Treatment 2
Important things to tell the doctor.

Things to do after treatment with DIASTAT (diazepam rectal gel) .

Stay with the person for 4 hours and make notes on the following:

•  Changes in resting breathing rate _
•  Changes in color _
•  Possible side effects from treatment _

Diastat (diazepam rectal gel) ®AcuDial™

INSTRUCTIONS FOR CAREGIVERS UPON RECEIPT FROM PHARMACY

•  Remove the syringe from the case.
•  Confirm the dose prescribed by your doctor is visible and if known, is correct.

FOR EACH SYRINGE:

•  Confirm that the prescribed dose is visible in the dose display window.
•  Confirm that the green "READY" band is visible.
•  Return the syringe to the case.

SEE PHARMACIST IF YOU HAVE ANY QUESTIONS ABOUT THESE INSTRUCTIONS.

The instructions are also available on the bottom of each drug product package.

Put person on their side where they can't fall.

Get medicine.

Get syringe.
Note: Seal Pin is attached to the cap.

Push up with thumb and pull to remove cap from syringe. Be sure Seal Pin is removed with the cap.

Lubricate rectal tip with lubricating jelly.

Turn person on side facing you.

Bend upper leg forward to expose rectum.

Separate buttocks to expose rectum.

Gently insert syringe tip into rectum.
Note: Rim should be snug against rectal opening.

Slowly count to 3 while gently pushing plunger in until it stops.

Slowly count to 3 before removing syringe from rectum.

Slowly count to 3 while holding buttocks together to prevent leakage.

Keep person on side facing you, note time given and continue to observe.

This step is for Diastaf AcuDial™ users only At the completion of step 14a:

•  Discard all used materials in the garbage can.
•  Do not reuse.
•  Discard in a safe place away from children.
•  Pull on plunger until it is completely removed from the syringe body.
•  Point tip over sink or toilet.
•  Replace plunger into syringe body, gently pushing plunger until it stops.
•  Flush toilet or rinse sink with water until gel is no longer visible.

At the completion of step 13:

•  Discard all used materials in the garbage can.
•  Do not reuse.
•  Discard in a safe place away from children.

CALL FOR HELP IF ANY OF THE FOLLOWING OCCUR

•  Seizure(s) continues 15 minutes after giving DIASTAT (diazepam rectal gel) or per the doctor's instructions: _
•  Seizure behavior is different from other episodes.
•  You are alarmed by the frequency or severity of the seizure(s).
•  You are alarmed by the color or breathing of the person.
•  The person is having unusual or serious problems.

Local Emergency Number:
(please be sure to note if your area has 911)

Doctor's Number:

Information for Emergency Squad:

Time DIASTAT (diazepam rectal gel) given: _

Dose :_

Last reviewed on RxList: 1/12/2009
This monograph has been modified to include the generic and brand name in many instances.