Diazepam

What is diazepam?

Diazepam (brand names: Valium®, Diastat®, E Pam Tab®, Meva®l, Vivol®) is a benzodiazepine anticonvulsant and tranquilizer used as a muscle relaxant, anti-anxiety medication, appetite stimulant, and an anti-seizure medication. It is also used as a preanesthetic in hospital.

Its use in cats, dogs, small mammals, horses, birds, and exotic species to treat anxiety, seizures, lack of appetite, and tense muscles is off label (extra label). Many drugs are commonly prescribed for off-label use in veterinary medicine. 

“Off label” means the drug is being used in a way that has not been reviewed or approved by the U.S. Food and Drug Administration (FDA) or Health Canada. In these instances, follow your veterinarian’s directions and cautions carefully, as they may be significantly different from those on the label.

How is diazepam given?

• Diazepam is given by mouth in the form of a tablet or liquid solution. It may also be given as an injection in the hospital or given rectally, as a gel. Occasionally, your veterinarian may send home the injectable form to be used rectally to stop a seizure.
• Measure liquid forms carefully.
• Give the tablets or capsules with or without food.
• If your pet vomits when receiving this medication on an empty stomach, give future doses with food.
• If using this medication for anxiety, give it to your pet an hour before the triggering event.
• If you give this medication long-term, do not stop it abruptly, as this can cause withdrawal effects. Consult your veterinarian on how to stop giving this medication.

Monitor your pet closely the first time you use this medication until you know how your pet reacts to it. This medication should take effect within 1 to 2 hours, and improvements in clinical signs should follow.

What if I miss giving my pet the medication?

If you miss a dose, give it as soon as you remember, and then wait the recommended time for the next dose, as prescribed by your veterinarian. Do not give the pet two doses at once.

Are there any potential side effects?

Diazepam may cause the following side effects:

• Sleepiness
• Increased appetite
• Incoordination
• Weakness
• Changes in behavior
• Drooling

Serious adverse reactions may occur. If any of the following signs develop, stop giving diazepam and contact your veterinarian immediately:

• Yellowing of the skin, gums, or whites of the eyes
• Lack of appetite
• Severe lethargy
• Continued vomiting

If used long term, discontinuing this medication suddenly can cause withdrawal side effects; consult your veterinarian before stopping this medication.

Other side effects may occur. If you notice anything unusual, contact your veterinarian immediately. This short-acting medication should stop working within 24 hours, although effects can be longer in pets with liver or kidney disease.

Are there any risk factors for this medication?

DO NOT USE diazepam in:

• Pets that are allergic to it or other benzodiazepines
• Pets with severe liver disease
• Pets that are pregnant (particularly during the first trimester) or lactating, unless the benefits clearly outweigh the risks

DO NOT USE the oral form of diazepam in cats, as it can cause liver failure.

USE WITH CAUTION in:

• Pets with general liver or kidney disease
• Pets with breathing problems
• Pets with myasthenia gravis
• Pets with glaucoma
• Working animals
• Pets that are aggressive
• Pets that are debilitated, geriatric, obese, or in shock.

Are there any drug interactions I should be aware of?

Several medications should be used with caution when given with diazepam, including:

• Antacids
• Antidepressants
• Antihypertensive agents
• Central nervous system depressant agents
• Fluoxetine
• Hepatic enzyme inducers or inhibitors
• Melatonin
• Propranolol
• Theophylline

Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking before starting any new treatment.

Diazepam may also interact with urine glucose tests and cause false-negative results.

Is any monitoring needed with this medication?

• No specific monitoring is needed while your pet is taking this medication.
• Your veterinarian will let you know when and how they want to reassess your pet to ensure the medication is working and not causing side effects.
• At home, monitor for any side effects such as those noted above. If any occur, stop using the medication and contact your veterinarian.

How do I store diazepam?

• Store diazepam at room temperature between 59°F and 86°F (15°C and 30°C) and protect from direct sunlight.
• The injectable form of diazepam should not be stored in plastic bottles or syringes.

Diazepam is a controlled substance, which means that it has been designated by the Drug Enforcement Administration (DEA) as having a potential for diversion to people other than the patient it was prescribed for. Use of a controlled substance in any person or animal other than that for which it is prescribed is illegal. Therefore, this medication should be stored in a locked cabinet or safe that cannot be easily moved, with access limited to only those that need to administer the medication. Monitor the amount of medication remaining to ensure the expected amount is present.

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility. Be prepared to provide information about the product and your pet's weight and symptoms.