"The U.S. Food and Drug Administration today approved a device to help reduce the frequency of seizures in epilepsy patients who have not responded well to medications.
The RNS Stimulator consists of a small neurostimulator implanted within "...
Diastat Side Effects Center
Medical Editor: John P. Cunha, DO, FACOEP
Diastat (diazepam) Rectal Gel is used to treat occasionally increased seizures in people with epilepsy who also routinely take other anti-convulsants. Diastat rectal is not for long-term daily use to prevent seizures. It is a benzodiazepine. Common side effects include drowsiness, dizziness, diarrhea, and unsteadiness.
The recommended dose of Diastat rectal gel is 0.2-0.5 mg/kg depending on age. Diastat may interact with cimetidine, valproate, barbiturates, MAO inhibitors, medicines to treat psychiatric disorders, narcotics, or antidepressants. Tell your doctor all medications you use. Diastat is not recommended for use during pregnancy. It may harm a fetus. Since untreated seizures are a serious condition that can harm both a pregnant woman and the fetus, do not stop taking this medication unless directed by your doctor. Consult your doctor about using this medication during pregnancy. This drug may pass into breast milk. Because of the possible harm to the infant, breast-feeding while using this drug is not recommended. Withdrawal symptoms may occur if you suddenly stop using this medication.
Our Diastat (diazepam) Rectal Gel Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What is Patient Information in Detail?
Easy-to-read and understand detailed drug information and pill images for the patient or caregiver from Cerner Multum.
Diastat in Detail - Patient Information: Side Effects
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if the person receiving this medication has a serious side effect such as:
- worsening seizures, or seizures that seem different from the patient's other seizures;
- pale or discolored skin;
- confusion, hallucinations, unusual thoughts or behavior, unusual risk-taking behavior, decreased inhibitions, no fear of danger;
- hyperactivity, agitation, hostility, depressed mood, thoughts of suicide or hurting yourself;
- feeling like you might pass out; or
- pain or burning when you urinate.
Less serious side effects may include:
- headache, blurred vision, dizziness, drowsiness, tiredness;
- sleep problems (insomnia);
- slurred speech, loss of balance or coordination; or
- nausea, vomiting, stomach pain, diarrhea.
This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.
Read the entire detailed patient monograph for Diastat (Diazepam Rectal Gel) »
What is Patient Information Overview?
A concise overview of the drug for the patient or caregiver from First DataBank.
Diastat Overview - Patient Information: Side Effects
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. This medication stays in the body for a long time. Be sure to watch for reactions for at least 4 hours after giving the medication.
Seek immediate medical attention if any of these unlikely but very serious side effects occur: slow/shallow/difficult breathing, mental/mood changes (e.g., anxiety, restlessness, hallucinations, sleep problems), slurred speech, trouble walking.
A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching/swelling (especially of the face/tongue/throat), dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US -
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
Read the entire patient information overview for Diastat (Diazepam Rectal Gel)»
What is Prescribing information?
The FDA package insert formatted in easy-to-find categories for health professionals and clinicians.
Diastat FDA Prescribing Information: Side Effects
Diazepam rectal gel adverse event data were collected from double-blind, placebo-controlled studies and open-label studies. The majority of adverse events were mild to moderate in severity and transient in nature.
Two patients who received Diazepam rectal gel died seven to 15 weeks following treatment; neither of these deaths was deemed related to Diazepam rectal gel.
The most frequent adverse event reported to be related to Diazepam rectal gel in the two double-blind, placebo-controlled studies was somnolence (23%). Less frequent adverse events were dizziness, headache, pain, abdominal pain, nervousness, vasodilatation, diarrhea, ataxia, euphoria, incoordination, asthma, rhinitis, and rash, which occurred in approximately 2-5% of patients.
Approximately 1.4% of the 573 patients who received Diazepam rectal gel in clinical trials of epilepsy discontinued treatment because of an adverse event. The adverse event most frequently associated with discontinuation (occurring in three patients) was somnolence. Other adverse events most commonly associated with discontinuation and occurring in two patients were hypoventilation and rash. Adverse events occurring in one patient were asthenia, hyperkinesia, incoordination, vasodilatation and urticaria. These events were judged to be related to diazepam rectal gel.
In the two domestic double-blind, placebo-controlled, parallel-group studies, the proportion of patients who discontinued treatment because of adverse events was 2% for the group treated with Diazepam rectal gel, versus 2% for the placebo group. In the Diazepam rectal gel group, the adverse events considered the primary reason for discontinuation were different in the two patients who discontinued treatment; one discontinued due to rash and one discontinued due to lethargy. The primary reason for discontinuation in the patients treated with placebo was lack of effect.
Adverse Event Incidence in Controlled Clinical Trials
Table 1 lists treatment-emergent signs and symptoms that occurred in > 1 % of patients enrolled in parallel-group, placebo-controlled trials and were numerically more common in the Diazepam rectal gel group. Adverse events were usually mild or moderate in intensity.
The prescriber should be aware that these figures, obtained when Diazepam rectal gel was added to concurrent antiepileptic drug therapy, cannot be used to predict the frequency of adverse events in the course of usual medical practice when patient characteristics and other factors may differ from those prevailing during clinical studies. Similarly, the cited frequencies cannot be directly compared with figures obtained from other clinical investigations involving different treatments, uses, or investigators. An inspection of these frequencies, however, does provide the prescribing physician with one basis to estimate the relative contribution of drug and non-drug factors to the adverse event incidences in the population studied.
TABLE 1: Treatment-Emergent Signs And Symptoms That Occurred
In > 1 % Of Patients Enrolled In Parallel-Group, Placebo-Controlled Trials
And Were Numerically More Common In The Diazepam rectal gel Group
|Body System||COSTART Term||Diastat||Placebo|
|N = 101||N = 104|
|Body As A Whole||Headache||5%||4%|
|Skin and Appendages||Rash||3%||0%|
Other events reported by 1% or more of patients treated in controlled trials but equally or more frequent in the placebo group than in the Diazepam rectal gel group were abdominal pain, pain, nervousness, and rhinitis. Other events reported by fewer than 1 % of patients were infection, anorexia, vomiting, anemia, lymphadenopathy, grand mal convulsion, hyperkinesia, cough increased, pruritus, sweating, mydriasis, and urinary tract infection.
The pattern of adverse events was similar for different age, race and gender groups.
Other Adverse Events Observed During All Clinical Trials:
Diazepam rectal gel has been administered to 573 patients with epilepsy during all clinical trials, only some of which were placebo-controlled. During these trials, all adverse events were recorded by the clinical investigators using terminology of their own choosing. To provide a meaningful estimate of the proportion of individuals having adverse events, similar types of events were grouped into a smaller number of standardized categories using modified COSTART dictionary terminology. These categories are used in the listing below. All of the events listed below occurred in at least 1 % of the 573 individuals exposed to Diazepam rectal gel.
All reported events are included except those already listed above, events unlikely to be drug-related, and those too general to be informative. Events are included without regard to determination of a causal relationship to diazepam.
BODY AS A WHOLE: Asthenia
CARDIOVASCULAR: Hypotension, vasodilatation
The following infrequent adverse events were not seen with Diazepam rectal gel but have been reported previously with diazepam use: depression, slurred speech, syncope, constipation, changes in libido, urinary retention, bradycardia, cardiovascular collapse, nystagmus, urticaria, neutropenia and jaundice.
Paradoxical reactions such as acute hyperexcited states, anxiety, hallucinations, increased muscle spasticity, insomnia, rage, sleep disturbances and stimulation have been reported with diazepam; should these occur, use of Diazepam rectal gel should be discontinued.
Drug Abuse and Dependence
Diazepam is a Schedule IV controlled substance and can produce drug dependence. It is recommended that patients be treated with Diazepam rectal gel no more frequently than every five days and no more than five times per month.
Addiction-prone individuals (such as drug addicts or alcoholics) should be under careful surveillance when receiving diazepam or other psychotropic agents because of the predisposition of such patients to habituation and dependence.
Abrupt discontinuation of diazepam following chronic regular use has resulted in withdrawal symptoms, similar in character to those noted with barbiturates and alcohol (convulsions, tremor, abdominal and muscle cramps, vomiting and sweating). The more severe withdrawal symptoms have usually been limited to those patients who had received excessive doses over an extended period of time. Generally milder withdrawal symptoms (e.g., dysphoria and insomnia) have been reported following abrupt discontinuation of benzodiazepines taken continuously at therapeutic levels for several months.
Read the entire FDA prescribing information for Diastat (Diazepam Rectal Gel) »
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