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Valtoco
diazepam nasal
Black Box Warnings .
Risks from Concomitant Opioid Use
concomitant benzodiazepine use w/ opioids may result in profound sedation, resp. depression, coma, and death; reserve concomitant use for pts w/ inadequate alternative tx options; limit to minimum required dosage and duration; monitor pts for s/sx of resp. depression and sedation
Addiction, Abuse, and Misuse
benzodiazepines expose users to risk of abuse, misuse, and addiction, can lead to overdose or death; commonly involves concomitant use w/ other meds, alcohol, and/or illicit substances, which is assoc. w/ incr. frequency of serious adverse outcomes; assess risk for abuse, misuse, and addiction before prescribing and throughout tx
Dependence and Withdrawal Reactions
cont. benzodiazepine use may lead to clinically significant physical dependence; risk of dependence and withdrawal incr. w/ longer tx duration and higher daily dose; if used more frequently than recommended, use gradual taper to D/C as abrupt D/C or rapid dose reduction may cause acute withdrawal reactions, potentially life-threatening
Adult Dosing .
Dosage forms: 5 mg convenience pack, 10 mg convenience pack, 15 mg convenience pack, 20 mg convenience pack
Special Note
- [5 mg convenience pack]
- Info: single-dose pack contains 5 mg nasal spray device x1
- [10 mg convenience pack]
- Info: single-dose pack contains 10 mg nasal spray device x1
- [15 mg convenience pack]
- Info: single-dose pack contains 7.5 mg nasal spray device x2
- [20 mg convenience pack]
- Info: single-dose pack contains 10 mg nasal spray device x2
- [dosing clarification]
- Info: each device delivers 1 spray
seizures, acute repetitive
- [14-27 kg]
- Dose: 5 mg intranasally x1 given as 1 spray in one nostril (use one 5 mg device), then may repeat dose x1 after at least 4h; Max: 2 doses/single episode; 1 episode q5 days for up to 5 episodes/mo; Info: alternate nostrils w/ each spray
- [28-50 kg]
- Dose: 10 mg intranasally x1 given as 1 spray in one nostril (use one 10 mg device), then may repeat dose x1 after at least 4h; Max: 2 doses/single episode; 1 episode q5 days for up to 5 episodes/mo; Info: alternate nostrils w/ each spray
- [51-75 kg]
- Dose: 15 mg intranasally x1 given as 1 spray in each nostril (use two 7.5 mg devices), then may repeat dose x1 after at least 4h; Max: 2 doses/single episode; 1 episode q5 days for up to 5 episodes/mo; Info: alternate nostrils w/ each spray
- [>76 kg]
- Dose: 20 mg intranasally x1 given as 1 spray in each nostril (use two 10 mg devices), then may repeat dose x1 after at least 4h; Max: 2 doses/single episode; 1 episode q5 days for up to 5 episodes/mo; Info: alternate nostrils w/ each spray
renal dosing
- [not defined]
- renal impairment: not defined
- HD/PD: not defined
hepatic dosing
- [see below]
- hepatic impairment: not defined, caution advised
Peds Dosing .
- Dosage forms: 5 mg convenience pack, 10 mg convenience pack, 15 mg convenience pack, 20 mg convenience pack
Special Note
- [5 mg convenience pack]
- Info: single-dose pack contains 5 mg nasal spray device x1
- [10 mg convenience pack]
- Info: single-dose pack contains 10 mg nasal spray device x1
- [15 mg convenience pack]
- Info: single-dose pack contains 7.5 mg nasal spray device x2
- [20 mg convenience pack]
- Info: single-dose pack contains 10 mg nasal spray device x2
- [dosing clarification]
- Info: each device delivers 1 spray
seizures, acute repetitive
- [6-11 yo, 10-18 kg]
- Dose: 5 mg intranasally x1 given as 1 spray in one nostril (use one 5 mg device), then may repeat dose x1 after at least 4h; Max: 2 doses/single episode; 1 episode q5 days for up to 5 episodes/mo; Info: alternate nostrils w/ each spray
- [6-11 yo, 19-37 kg]
- Dose: 10 mg intranasally x1 given as 1 spray in one nostril (use one 10 mg device), then may repeat dose x1 after at least 4h; Max: 2 doses/single episode; 1 episode q5 days for up to 5 episodes/mo; Info: alternate nostrils w/ each spray
- [6-11 yo, 38-55 kg]
- Dose: 15 mg intranasally x1 given as 1 spray in each nostril (use two 7.5 mg devices), then may repeat dose x1 after at least 4h; Max: 2 doses/single episode; 1 episode q5 days for up to 5 episodes/mo; Info: alternate nostrils w/ each spray
- [6-11 yo, 56-74 kg]
- Dose: 20 mg intranasally x1 given as 1 spray in each nostril (use two 10 mg devices), then may repeat dose x1 after at least 4h; Max: 2 doses/single episode; 1 episode q5 days for up to 5 episodes/mo; Info: alternate nostrils w/ each spray
- [12 yo and older, 14-27 kg]
- Dose: 5 mg intranasally x1 given as 1 spray in one nostril (use one 5 mg device), then may repeat dose x1 after at least 4h; Max: 2 doses/single episode; 1 episode q5 days for up to 5 episodes/mo; Info: alternate nostrils w/ each spray
- [12 yo and older, 28-50 kg]
- Dose: 10 mg intranasally x1 given as 1 spray in one nostril (use one 10 mg device), then may repeat dose x1 after at least 4h; Max: 2 doses/single episode; 1 episode q5 days for up to 5 episodes/mo; Info: alternate nostrils w/ each spray
- [12 yo and older, 51-75 kg]
- Dose: 15 mg intranasally x1 given as 1 spray in each nostril (use two 7.5 mg devices), then may repeat dose x1 after at least 4h; Max: 2 doses/single episode; 1 episode q5 days for up to 5 episodes/mo; Info: alternate nostrils w/ each spray
- [12 yo and older, >76 kg]
- Dose: 20 mg intranasally x1 given as 1 spray in each nostril (use two 10 mg devices), then may repeat dose x1 after at least 4h; Max: 2 doses/single episode; 1 episode q5 days for up to 5 episodes/mo; Info: alternate nostrils w/ each spray
renal dosing
- [not defined]
- renal impairment: not defined
- HD/PD: not defined
hepatic dosing
- [see below]
- hepatic impairment: not defined, caution advised