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Table 2 Information regarding each benzodiazepine’s recommended dose and target serum concentration as well as reported serum concentrations, time to peak serum concentration and time to seizure control achieved with each administration route in dogs

From: First-line management of canine status epilepticus at home and in hospital-opportunities and limitations of the various administration routes of benzodiazepines

  Midazolam Diazepam
Recommended dose 0.2–0.5 mg/kg intravenous, intranasal or intramuscular 0.5–2.0 mg/kg intravenous, intranasal or rectal
Recommended target serum concentration for seizure control (pharmakokinetic studies) <  0.04 μg/mL (value derived from humans) 0.15–0.5 μg/mL
Serum concentration achieved with each administration route (pharmakokinetic studies) Intravenous
NA NA
Intranasal
0.21 ± 0.02 μg/mL (solution) or 0.45 ± 0.09 μg/mL (gel) 0.44 ± 0.04 μg/mL (solution) or 0.31 +/− 0.17 (solution/atomised formulation)
Intramuscular
0.20 ± 0.06 μg/mL or 0.55 ± 0.12 μg/mL (solution) NA
Rectal
NA 0.5 μg/mL (solution) and or 0.01–0.1 μg/mL (suppository)
Buccal
0.1–0.2 μg/mL (gel) NA
Sublingual
NA NA
Time to peak serum concentration achieved with each administration route (pharmakokinetic studies) Intravenous
NA NA
Intranasal
12 min (gel) or 17 min (solution) 4.5–8.0 min (solution/atomised formulation)
Intramuscular
10–15 min (solution) NA
Rectal
NA 15 min (solution) or 80 min (suppository)
Buccal
15 min (gel) NA
Sublingual
NA NA
Time to seizure control achieved with each administration route (clinical studies) Intravenous
1.0–4.5 min NA
Intranasal
0.5–1.6 min NA
Intramuscular
NA NA
Buccal
NA NA
Sublingual
NA NA
Rectal
NA 2.5 min