Children metabolize benzodiazepine agonists more quickly than adults and adolescents.
dose recommendation of formulary compared to licensed use (on-label versus off-label)
No information is present at this moment.
Available formulations
No information is present at this moment.
Dosages
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Relaxation of the skeletal muscles
Intravenous
1 month
up to
18 years
Initial dose
0.05
- 0.2
mg/kg/dose,
once only.
Further dosing depending on the effect.
Administer intravenously with monitoring
1 month
up to
18 years
Initial dose
0.05
- 0.2
mg/kg/dose,
once only.
Further dosing depending on the effect.
Administer intravenously with monitoring
1 month
up to
18 years
Initial dose
0.05
- 0.2
mg/kg/dose,
once only.
Further dosing depending on the effect.
Administer intravenously with monitoring
Rectal
10
up to
15 kg
5
mg/dose,
as required.
If there is no effect after 10 minutes, repeat the dose and then repeat if necessary every 12 hours..
≥ 3 years
and
≥ 15 kg
10
mg/dose,
as required.
If there is no effect after 10 minutes, repeat the dose and then repeat if necessary every 12 hours..
Acute anxiety (short use)
Oral
6 years
up to
12 years
0.1
- 0.3
mg/kg/day
in 2
- 3
doses.
Start with a low initial dose and increase slowly, depending on the clinical picture
12 years
up to
18 years
3
- 10
mg/day
in 2
- 3
doses.
Start with a low initial dose and increase slowly, depending on the clinical picture
Rectal
≥ 6 years
10
mg/dose,
as required.
If there is no effect after 10 minutes, repeat the dose and then repeat if necessary every 12 hours..
Status epilepticus
Intravenous
1 month
up to
18 years
0.1
- 1
mg/kg/dose,
once only Dose may be repeated once after 10-15 minutes.. Max: 20 mg/dose.
Higher doses than the maximum dosage may be required depending on body weight and severity of symptoms.
Febrile convulsions
Rectal
1 month
up to
18 years
0.25
- 1
mg/kg/dose
repeat after 10 minutes if indicated.
Dose may be repeated once every 12 hours..
Renal impaiment in children > 3 months
GFR ≥10 ml/min/1.73m2: Dose adjustment not required.
GFR <10 ml/min/1.73m2: A general recommendation on dose adjustment cannot be provided.
The complete list of all undesirable drug reactions can be found in the national Summary of Product Characteristics (SmPC) – click here
Side effects in children
Can exacerbate respiratory depression by barbiturates. Paradoxical reactions can occur in children in particular, with acute agitation, confusion and changes in the mental condition. Increased secretion of saliva and bronchial secretions have been observed after rectal use, particularly in children (SmPC).
The complete list of all contra-indications can be found in the national Summary of Product Characteristics (SmPC) – click here
Contra-indications
No information available on specific contra indications in children.
The complete list of all warnings and precautions can be found in the national Summary of Product Characteristics (SmPC) – click here
Warnings & precautions in children
Administer intravenously with monitoring. The antagonist flumazenil (Anexate) must be present: 0.01 mg/kg; repeat after 1 min if needed.
Interactions
The complete list of all interactions can be found in the national Summary of Product Characteristics (SmPC) – click here
Nederlandse Vereniging voor Kindergeneeskunde, Richtlijn status epilepticus kinderen ouder dan één maand., Nederlandse Vereniging voor Kindergeneeskunde, Juni 2012