Usually the benefits of Diastat far outweigh its mild to moderate side effects, which generally go away within hours, and with no lasting harm. Serious problems are very rare.
Breathing Problems: These are very rare when Diastat is used. The greatest risk of slowed breathing is when a second dose is used, specially if the first dose was near the upper limit of what the person can tolerate.
- Caregivers should be alert for signs of breathing problems, such as slower breathing or a change in the color of the skin (skin may look bluish).
- The risk of breathing problems may be greater in older adults or people with other breathing problems.
- If the seizure has stopped but no breathing can be seen for more than 8 to 10 seconds, call emergency medical personnel (911, if available).
Use in older adults or people with liver or kidney disease: Extra caution is needed when using Diastat for seniors or those with liver or kidney disease. The drug may last longer in the body. If the drug is given to them too often, the amount in their body may be too high. This can cause more side effects.
Central nervous system (CNS) depression: In general, drugs like diazepam affect the CNS (the brain and spinal cord) and can cause sleepiness, dizziness, or poor coordination for a time after Diastat has been used.
- People should avoid doing things that could be dangerous, like riding a bicycle, after using diazepam if they are having any side effects.
- Some other medicines can increase side effects of diazepam - talk to your health care provider and pharmacist about any drug interactions.
- Alcohol or other substances that affect the brain, such as opioids used to treat severe pain, can worsen side effects of diazepam and should not be used at the same time.
Suicidal thoughts and behavior: Since 2008, the Food and Drug Administration (FDA) has placed a warning on seizure medicines (called AEDs) used for any reason. The FDA alert states that some seizure medicines may increase a person's risk for suicidal thoughts or behavior. Together these thoughts are called suicidality. According to the FDA’s Alert, among the patients with epilepsy in these drug studies, more had symptoms of suicidality than people taking a placebo or inactive substance - 3.5 of 1,000 people taking a seizure medicine had symptoms of suicidality compared to 1 of 1,000 people taking a placebo.
- Since diazepam rectal gel is being used intermittently for cluster seizures, the risk for suicidality would likely be rare.
- People taking any seizure medicine should talk to their provider about the following recommendations.
- Taking seizure medicines may increase the risk of suicidal thoughts or actions.
- Do not make any changes to the medicines without first talking to the prescribing health care provider.
- Stopping any seizure medicine suddensent could lead to worsening of seizures and mood.
- Pay close attention to any day-to-day changes in mood, behavior and actions. These changes can happen very quickly so it is important to be mindful of any sudden differences.
- Know common warning signs that might be a signal for risk of suicide,
- Talking or thinking about wanting to hurt yourself or end your life
- Withdrawing from friends and family
- Becoming depressed or having your depression get worse
- Becoming preoccupied with death and dying
- Giving away prized possessions
Allergic reactions: Allergic reactions happen rarely, but can cause symptoms such as low blood pressure, hives, rash, breathing difficulties, and swelling. It can happen after the first dose or any time when taking the medicine. Since this can be life-threatening, get immedicate medical help if these symptoms occur.