8 Diazepam Side Effects You Should Know About

Diazepam treats many medical conditions including anxiety, muscle spasms, and alcohol withdrawal symptoms. It can also be used with other medications to treat seizures. It’s in the benzodiazepine medication class, which are commonly called “benzos.”

Diazepam comes in several different dosage forms. Not all forms are approved to treat the same conditions. Oral forms include tablets (Valium) and liquid (Diazepam Intensol). It also comes as a nasal spray (Valtoco), intravenous (IV) injection, and rectal gel (Diastat, Diastat Acudial).

Although diazepam can be effective, it also has risks. Here, we’ll cover eight important diazepam side effects to be aware of.

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1. Drowsiness

Drowsiness (or sleepiness) is a common diazepam side effect. This is because diazepam works by calming down the brain, which can cause sleepiness. Because diazepam is often taken in multiple doses, you may end up feeling sleepy throughout the day.

You might also experience prolonged drowsiness. That’s because Diazepam is considered a long-lasting benzo. After you take a dose, it may stay in your system for days — and even longer if you’re an older adult or have liver problems. This means you may experience drowsiness for longer than you’d think.

If you’re just starting diazepam or if your provider has increased your dose, avoid activities like driving or operating machinery. Once you see whether diazepam makes you drowsy, you can determine which activities are safe to do. 

If drowsiness continues for more than a few days or you’re having a hard time functioning normally, let your healthcare provider know. They may need to adjust your diazepam dose or consider a different medication.

Keep in mind: It’s a good idea to avoid combining other medications and substances that can cause drowsiness with diazepam. This includes opioids, muscle relaxers, and alcohol. Even over-the-counter antihistamines like diphenhydramine (Benadryl) can cause drowsiness. Before starting diazepam, ask your provider and pharmacist to review all the medications you take. They can let you know if you’re taking medications that interact with diazepam.

2. Weakness

Besides feeling sleepy after taking diazepam, you may also experience muscle weakness and a lack of energy (fatigue). Your body may adjust after you’ve been taking diazepam for a few days or weeks. In the meantime, getting enough rest, physical activity, and energy-boosting foods may help increase your energy. 

But if weakness continues, let your healthcare provider know. They can help determine if it’s from diazepam or another cause. 

3. Problems with coordination

Benzos can cause problems with coordination (ataxia). Sometimes, ataxia is caused by medical conditions. But other times it can be caused by medications. 

These coordination problems are part of the reason why benzos like diazepam may cause falls. This can be dangerous and lead to fractures, especially in older adults. So it may be best for older adults to avoid diazepam altogether. But if diazepam is needed, it’s usually started at a lower dose.

Remember that diazepam lasts for a long time in the body. So you could experience trouble with coordination for hours, or even days, after taking it. If this occurs, talk to your healthcare provider. If you have a fall or a fracture, let them know right away.

4. Dizziness

Dizziness is another possible diazepam side effect and a common side effect of many medications. And it can also occur due to other reasons, like certain medical conditions. If you’re feeling dizzy, it may be helpful to sit or lie down until the symptoms go away.

When you first start diazepam, avoid activities like driving and operating heavy machinery. If diazepam makes you feel dizzy for an extended period of time, it’s likely unsafe to do these activities. Let your healthcare provider know if this is the case. They can help you decide if you need a lower diazepam dose or if you should switch to another medication.

5. Memory problems

Short-term memory loss can occur with benzos. Research has shown that it usually only happens while your blood levels of benzos are high. But since diazepam lasts so long in the body, this may mean that memory problems can last a while.

So far, the research isn’t clear whether benzos cause long-term or permanent forms of memory loss, like dementia. But if you’re taking diazepam and having trouble remembering conversations or recent events, talk to your healthcare provider.

6. Dependence and misuse

Like other benzos, diazepam is considered a controlled substance by the FDA. This means it can cause physical or psychological dependence and misuse. There are also strict limitations on prescribing and filling controlled substances. 

Diazepam isn’t usually meant to be taken for a long time because the risk of dependence increases with long-term use. Your body may feel like it needs diazepam to function normally. Dependence can happen even if you take diazepam exactly as prescribed. But if you take higher doses or take it for longer than intended, you may also be showing signs of substance use disorder.

A substance use disorder may be diagnosed when someone continues to take a substance even though it’s causing significant problems. This may include relationship problems or trouble completing your responsibilities at work or home. All benzos are labeled with a strong warning (called a boxed warning) from the FDA about misuse. This warning indicates that benzos can lead to misuse, which often involves other medications like opioids or alcohol.

Misusing benzos can lead to benzo overdose, which we’ll discuss below. To lower your risk of benzo misuse, take diazepam exactly as prescribed and be honest with your prescriber if you’re experiencing problems from diazepam.

If you or someone you know struggles with substance use, help is available. Call SAMHSA’s National Helpline at 1-800-662-4357 to learn about resources in your area.

7. Withdrawal symptoms

If you’ve been taking diazepam regularly, stopping it abruptly (or decreasing the dose too quickly) can lead to withdrawal symptoms. Benzo withdrawal symptoms may be mild, like nausea, diarrhea, or sweating. But they can also be more severe, like psychosis, panic attacks, and seizures.

To reduce the risk of benzo withdrawal, you’ll want to slowly lower your dose if you and your healthcare provider decide it's safe to stop diazepam. Your provider can help you come up with a plan to gradually reduce your dose.

8. Benzo overdose

Diazepam misuse can lead to a benzo overdose. This risk is higher if you combine diazepam with other medications or substances that can also slow breathing — including opioids, sleep medications like zolpidem (Ambien), and alcohol.

Symptoms of benzo overdose include extreme tiredness, confusion, or passing out. Coma and death are also possible. Regardless of your symptoms, a benzo overdose requires emergency medical care. If you or a loved one has taken too much diazepam, call 911 and get help immediately.

When should I contact my healthcare provider about diazepam side effects?

Contact your healthcare provider about any diazepam side effects you experience. Even if they’re mild, it’s better to be on the safe side and talk with them.

More serious diazepam side effects that raise your risk for falls may require you to stop diazepam. But don’t do this without talking to your provider first. Stopping diazepam abruptly can lead to withdrawal symptoms.

If you’re experiencing signs of a substance use disorder, like using diazepam in non-prescribed ways or continuing to take it despite problems it's causing in your personal life, immediately contact your provider. They can help you navigate ways to seek additional support and treatment. 

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Written by:

Austin Ulrich, PharmD, BCACP

Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

Edited by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed by:

Daphne Berryhill, RPh

Daphne Berryhill, RPh, has two decades of experience as a clinical pharmacist. She spent most of her career in the Chicago area practicing in-home infusion.

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