By Rania Gollakner, BS, DVM, MPH

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 the hospital setting.

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’ or ‘extra label’. Many drugs are commonly prescribed for off-label use in veterinary medicine. In these instances, follow your veterinarian’s directions and cautions very carefully as their directions 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 setting or given rectally in the form of a rectal gel. Occasionally, your veterinarian may send home the injectable form to be used rectally to stop a seizure.

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. Measure liquid forms carefully. If using this medication as an anti-anxiety medication, administer to your pet an hour prior to the triggering event.

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.

Do not abruptly stop this medication if it has been given long-term, as this can cause withdrawal effects. Consult with your veterinarian on how to best stop giving this medication.

What if I miss giving my pet the medication?

Give the missed dose as soon as you remember, and then wait the recommended amount of time between doses. Never give your pet two doses at once or give extra doses.

Are there any potential side effects?

Side effects include sleepiness, increased appetite, incoordination, weakness, agitation, drooling, and aggression. Side effects in cats include irritability, depression, and general changes in behavior. In horses, side effects include muscle twitches, weakness, and incoordination. Serious side effects include a yellowing of the skin, gums, or whites of the eyes, lack of appetite, severe lethargy, or continued vomiting

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

Diazepam should not be used in pets that are allergic to it or other benzodiazepines, or in pets with severe liver disease. Do not use the oral form in cats as it can cause liver failure. It should be used cautiously in pets that have general liver or kidney disease, breathing problems, myasthenia gravis, or glaucoma, or pets that are working animals, aggressive, debilitated, geriatric, obese, or in shock. Diazepam should not use in pets that are pregnant (particularly during the first trimester) or lactating unless necessary and the benefits clearly outweigh the risks.

Are there any drug interactions I should be aware of?

The following medications should be used with caution when given with diazepam: amiodarone, antacids, antidepressants, antihypertensive agents, carbonic anhydrase inhibitors, central nervous system depressant agents, digoxin, fluoxetine, fluvoxamine, hepatic enzyme inducers or inhibitors, ifosfamide, lithium, melatonin, neuromuscular blockers, phenytoin, propranolol, theophylline/aminophylline, valproic acid/divalproex, or yohimbine.

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

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

Is there any monitoring that needs to be done with this medication?

There is no specific monitoring that needs to be done while your pet is taking this medication. Your veterinarian may monitor your pet to be sure that the medication is working. Monitor your pet at home for serious side effects.

How do I store diazepam?

Store this medication at room temperature between 59°F and 86°F (15°C and 30°C) and protect from direct sunlight. The injectable form 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.

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