Diazepam Dosage and Administration

Adult Dosing by Indication

For acute alcohol withdrawal, the American Gastroenterological Association recommends a dose of 10 mg, 3 or 4 times during the first 24 hours 1
For relief of skeletal muscle spasm, the American Academy of Pediatrics suggests a dose of 2 mg to 10 mg, 3 or 4 times daily 2
For status epilepticus, the American Academy of Pediatrics recommends an IV dose of 0.1-0.3 mg/kg every 5-10 minutes (maximum: 10 mg per dose) 2, 3
For conscious sedation for endoscopic procedures, the American Gastroenterological Association recommends an initial induction dose of 5 to 10 mg over 1 minute, with additional doses at 5-minute intervals if required 1, 4

For geriatric patients or debilitating disease, the American Gastroenterological Association recommends starting with 2 mg to 2.5 mg, 1 or 2 times daily initially, with a dose reduction of 50% or more indicated in the elderly 1, 4
For pediatric patients, the American Academy of Pediatrics recommends a dose of 1 mg to 2.5 mg, 3 or 4 times daily initially, with no use in children under 6 months 1, 2, 3
For renal failure patients, the International Journal of Oral Science states that no dose adjustment is required as diazepam is metabolized in the liver, with recommended doses varying from 0.1 to 0.8 mg per kg of body weight in a single oral dose for conscious sedation 1, 5

The American Academy of Pediatrics and the International Journal of Oral Science recommend respiratory monitoring due to the increased risk of apnea when diazepam is given rapidly or combined with other sedative agents, with preparation to support ventilation if necessary 2, 3, 5
The American Gastroenterological Association recommends a gradual taper to discontinue diazepam or reduce dosage to minimize withdrawal reactions, with consideration to pause the taper or increase to previous dosage level if withdrawal reactions develop 4
The American Gastroenterological Association advises that long-term prescription should be avoided when possible, with limitation of prescriptions to a few days, occasional use, or courses not exceeding 2 weeks for insomnia, and use in single doses, very short (1-7 days) or short (2-4 weeks) courses for anxiety 4
The American Gastroenterological Association warns of a synergistic effect on respiratory depression when combined with opioids, with a higher risk of adverse effects when combined with other CNS depressants 1, 4