What is the typical IV dose of diazepam for acute seizures?

• A. 0.15–0.2 mg/kg IV (often about 10 mg)
• B. 0.5 mg/kg IV
• C. 0.05 mg/kg IV
• D. 1 mg/kg IV

Answer: (A)

In acute seizures, the goal is to rapidly achieve seizure control with a dose that is powerful enough but still safe. Diazepam given by IV acts quickly because it is highly lipid soluble and reaches the brain rapidly, enhancing GABA-A receptor activity to stop the convulsing activity. The standard approach uses a weight-based dose: 0.15 to 0.2 mg per kilogram of body weight, with a practical maximum around 10 mg in adults. This range provides quick anticonvulsant effect while minimizing the risk of profound sedation or respiratory depression that can accompany larger doses. In many cases, a single dose around 10 mg is enough; if seizures persist, a second dose can be given after a short interval, or another benzodiazepine or escalation to other anticonvulsants can be considered with airway and vitals monitored. Remember to adjust for patient factors such as age, liver function, and concurrent CNS depressants, since these can increase sedation and respiratory risk.