Dosing and Administration of Diazepam Nasal Spray for Acute Seizure Treatment

Dosing Guidelines

For adults weighing 50-100 kg, the American Academy of Pediatrics recommends a dose of 5-10 mg of diazepam nasal spray 1
For adults weighing >100 kg, the American Academy of Pediatrics recommends a dose of 15-20 mg of diazepam nasal spray 2

When administering diazepam, be prepared to support ventilation as there is an increased incidence of apnea when given rapidly or when combined with other sedative agents 1, 2, 3

Diazepam should be followed immediately by a long-acting anticonvulsant for status epilepticus, as seizures often recur within 15-20 minutes due to rapid redistribution 1, 2, 3
Flumazenil may be administered to reverse life-threatening respiratory depression caused by diazepam, but it also counteracts the anticonvulsant effects and may precipitate seizures 1, 2, 3
Monitor oxygen saturation and respiratory effort during and after administration 1, 2, 3