Evidence map›Paper›PMID 36413125›Full record

Trial reportEpilepsia2023

A randomized, open-label, two-treatment crossover study to evaluate the effect of food on the pharmacokinetics of diazepam nasal spray in healthy adults.

Michael A Rogawski, Gary Slatko

Open access · greenAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Epilepsia, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.8field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 7 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Prehospital rescue treatment of cluster epileptic seizures and status epilepticus.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
    Review
  4. Seizure Rescue Therapies: Comparing Approved and Commonly Used Benzodiazepine Formulations.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2023
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors at 2 institutions in 1 country.

Michael A RogawskiDepartments of Neurology and Pharmacology, School of Medicine, University of California, Davis, Sacramento, California, USA.ORCID 0000-0002-3296-8193
Gary SlatkoAquestive Therapeutics, Warren, New Jersey, USA.ORCID 0000-0003-2680-6304
Aquestive (United States) · USUniversity of California, Davis · US

Funding

Aquestive Therapeutics
6 · The paper itself

Abstract

objectiveThe pharmacokinetics of oral diazepam are affected by food, but food-effect studies have not been conducted for diazepam nasal spray because it is believed that most absorption occurs via the nasal mucosa. However, gastrointestinal side effects reported with nasal diazepam suggest that at least a portion of the drug may be absorbed enterally and thus subject to food effects. The objective of this study was to evaluate the possible effects of food on the pharmacokinetics of diazepam nasal spray in healthy adults.

methodsThis randomized, open-label crossover study compared equal doses of diazepam nasal spray after an overnight fast and after a standardized high-fat, high-calorie breakfast. Each participant served as their own control, and there was a washout period of at least 21 days between treatments.

resultsTwenty-four healthy adults enrolled in this study. Two participants withdrew consent, and two had pre-dose diazepam concentrations that exceeded the protocol-defined minimum after the washout period and were excluded from the final analysis population of 20 participants. Under fed conditions, the mean maximum plasma diazepam concentration was decreased by 48% (p < .0001) and the overall diazepam exposure during the first 4 h was reduced by 57% (p < .0001) compared with fasted conditions. The time to maximum plasma concentration was 4.0 h in the fed state compared with 2.0 h in the fasted state (p < .0001). At 2 h post-dose, diazepam concentrations were ≥150 ng/mL for 100% of the participants when in the fasted state and 30% when in the fed state. Significantly more participants experienced adverse events under fasted conditions (83.3%) than under fed conditions (54.5%; p = .0340). SIGNIFICANCE: This study in healthy volunteers demonstrated that food significantly decreases and delays the absorption of diazepam dosed via nasal spray. Patients using diazepam nasal spray after eating may obtain diazepam concentrations that are below those needed for seizure control.

Indexed as

DiazepamNasal SpraysAdministration, OralAdultArea Under CurveBiological AvailabilityCross-Over StudiesHumansSeizuresDiazepamNasal Spraysabsorptionenteralfastedfed

Identifiers

PMID36413125
PMCPMC10107174
OpenAlexW4309593282

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.