Diastat (dye-ah-stat) is the brand name used in the United States and Canada for the seizure medicine with the generic name diazepam (dye-az-eh-pam), in the form of a gel that is inserted into the patient's rectum to stop a cluster of repeated seizures. Similar products are available in the UK and elsewhere.

Diazepam was first used in the United States in 1968. The pill form (best known by the brand name Valium, but also available in many generic forms) is too slowly absorbed when taken by mouth to be used to stop a seizure, and is only moderately effective against epilepsy. If diazepam pills are used daily, they become less effective as tolerance develops, and dependence also becomes a problem. Emergency personnel sometimes give diazepam by injection to stop prolonged or repeated seizures. Diastat, the first at-home alternative, was approved by the United States Food and Drug Administration (FDA) in 1997.

Forms
Diastat is distributed in the United States by Valeant. The name or appearance may differ in other places. The dose (measured in milligrams, abbreviated "mg") will usually be the same. These descriptions apply to the U.S. versions:

"Quick-Dose" rectal delivery system (resembling a syringe with a flexible, molded tip): Pediatric: 2.5 mg, 5 mg "Universal": 10 mg Adult: 15 mg, 20 mg

How to use and store Diastat
Follow the doctor's directions. With the medication, you should have received written instructions with pictures showing how to give Diastat. If you are the caregiver, study these instructions carefully right away, so you are not trying to learn the steps during an emergency. If you have any questions, ask the doctor. Do not give Diastat until you are sure that you understand the procedure and are comfortable with your role in giving it.

The doctor or nurse should discuss with you the conditions that might require the use of Diastat, since the pattern of seizures differs between different people with epilepsy. You will be advised about exactly when to use the Diastat, what to look for after you have used it, and what to do if the person's condition does not improve as expected. Make sure you understand all of these aspects. Then keep the Diastat close at hand so it can be used anytime the situation calls for it, both at home and away from home.

As shown above, Diastat is packaged in plastic applicators of various sizes, which contain different doses of diazepam. The doctor will prescribe the correct one for the weight and age of the person with epilepsy. Each "Twin Pack" package contains devices for giving the medication two times.

Store Diastat at room temperature. If you don't need to use it right away, it should be good for up to 3 years.

You should check with the doctor every 6 months or so regarding the dosage, however. The dose may need to be adjusted because of changes in the patient's weight or age.

Reviewed February 2004 by Steven C. Schachter, MD, epilepsy.com Editorial Board.