Before using rectal diazepam

Before using rectal diazepam make sure your doctor or pharmacist knows:

• If you are pregnant, trying for a baby or breast-feeding.
• If you suffer from any respiratory (breathing) problems.
• If you suffer from liver or kidney problems.
• If you suffer from myasthenia gravis (a muscle weakening disease).
• If you suffer from porphyria (a blood disorder).
• If you suffer from a personality disorder.
• If you have ever had a problem with drug or alcohol addiction.
• If you suffer from sleep apnoea (temporary stopping of breathing during sleep).
• If you suffer from phobias or obsessional conditions.
• If you are taking other medicines, including those available to buy without a prescription, herbal or complementary medicines.
• If you have ever had an allergic reaction to this or any other medicine.

How to give rectal diazepam

• Before beginning treatment, read the manufacturer's printed information leaflet.
• Try to lie the patient on their side with their knees drawn up towards their chest and with one leg drawn up more than the other.

1. Remove the cap from the rectal tube.
2. Insert the tube into the rectum (back passage) as far as the mark on the nozzle. NOTE: If this medicine is for a child under 3 years of age, the tube should be inserted only half way between the mark and the tip of the nozzle.
3. Empty the contents completely by squeezing the tube between the index finger and thumb.
4. When the tube is empty, keeping it squeezed, remove it from the back passage and then throw it away.
5. After giving the dose, hold the patients buttocks together for a few minutes to prevent any seepage and then lower the patient's legs to a comfortable position. The patient may feel an immediate urge to go to the toilet. Encourage them to ignore this.
6. Your doctor will have told you what to do if no effect is seen after 5-10 minutes. If you are unsure, contact your doctor for assistance.

1. Remove the wrapping from the suppository.
2. Gently insert the suppository into the rectum (back passage), pointed end first, as far as it will go.
3. If the suppository comes out immediately, it was not inserted far enough, and it should be reinserted.
4. After giving the dose, lower the patient's legs to a comfortable position to help hold the medicine in place. The patient may feel an immediate urge to go to the toilet. Encourage them to ignore this.

Getting the most from this treatment

• Suppositories are usually easier to insert if they have been stored in the fridge.
• Keep regular appointments with the your doctor so that your progress can be checked.
• After using rectal tubes many people feel drowsy, dizzy, light-headed, clumsy, unsteady or less alert than normal - feelings which can can last for several hours. The patient should be allowed to sleep after receiving this treatment and must not do any jobs that require them to be fully alert, like driving or operating machinery, until any drowsiness has disappeared. Drinking alcohol will increase these feelings of drowsiness so do not drink alcohol while you are taking diazepam.
• If given continuously for too long, there is a risk of becoming dependent on diazepam which will cause problems when the treatment is stopped. If you are concerned about this, discuss it with your doctor.
• If you buy any medicines, check with a pharmacist that they are safe to take with diazepam.

Can rectal diazepam cause problems?

Along with their useful effects all medicines can cause unwanted side-effects which usually improve as your body adjusts to the new medicine. Speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

How to store rectal diazepam

• Keep all medicines out of the reach and sight of children.
• Store in a cool, dry place, away from direct heat and light.

Important information about all medicines

References

• Manufacturer's PIL, Diazepam Rectal Tubes, Wockhardt UK Ltd, electronic Medicines Compendium. Revised February 2004, accessed May 2009.
• British National Formulary; 57th Edition (March 2009) British Medical Association and Royal Pharmaceutical Society of Great Britain, London.