How is diazepam administered in the treatment of alcohol withdrawal syndrome?

Updated: Oct 18, 2020
  • Author: Nathanael J McKeown, DO; Chief Editor: David Vearrier, MD, MPH  more...
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Answer

Diazepam can be administered intravenously, orally, or per rectum. Diazepam rapidly controls agitation because of its rapid distribution secondary to its high lipid solubility. However, it has a long duration of action. Its active metabolites help smooth the course of withdrawal and limit breakthrough symptoms; however, prolonged sedation is a risk. Diazepam is initially given at a dose of 5 mg IV. The drug is repeated at 5-20 mg per dose every 5-15 minutes until adequate control of agitation is achieved. After agitation is controlled, an hourly dose is given as needed to maintain light somnolence.

Total dosing of intravenous diazepam should not routinely exceed 100 mg/h or 250 mg in 8 hours. Total dosing of intravenous lorazepam should not routinely exceed 20 mg/h or 50 mg in 8 hours.


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