diazepam
Diazepam (Valium) is a benzodiazepine. It's used to treat symptoms of anxiety and alcohol withdrawal. It can also treat certain types of muscle spasms and seizures. Diazepam (Valium) comes as a tablet and liquid solution. It's taken by mouth, typically 2 to 4 times daily. Some common side effects of diazepam (Valium) include sleepiness, dizziness, and weakness. Additionally, this medication carries a risk for misuse and dependence, so it's classified as a controlled substance.
What is Diazepam (Valium)?
What is Diazepam (Valium) used for?
- Anxiety disorders and short-term anxiety symptoms
- Alcohol withdrawal symptoms
- Muscle spasms or spasticity from certain conditions, such as cerebral palsy and stiff-person syndrome (SPS)
- Add-on to other medications for seizures
How Diazepam (Valium) works
Diazepam (Valium) is a benzodiazepine. It works by raising the levels of gamma-aminobutyric acid (GABA), a chemical that slows down activity in your brain. This helps control symptoms of anxiety, muscle spasms, and seizures.
Drug facts
Risks and warnings for Diazepam (Valium)
Diazepam (Valium) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Extreme sleepiness and difficulty breathing
- Risk factors: Taking diazepam (Valium) with opioids or alcohol | Taking diazepam (Valium) at higher doses than prescribed
Taking diazepam (Valium) with opioid medications can cause severe drowsiness, trouble breathing, and can even result in death. Some people with long-term pain might be already taking opioids when their healthcare professional (HCP) prescribes diazepam (Valium). If this applies to you, have a discussion with your HCP to see if there are safer options for your condition. In the case there aren't safer alternatives, your prescriber will most likely ask you to take the lowest effective doses of both medications for the shortest period of time to minimize your risk of extreme sleepiness and breathing problems. If you develop difficulty breathing or have trouble waking up easily, get medical help right away.
Misuse and dependence
- Risk factors: Taking with alcohol or illicit drugs | Taking diazepam (Valium) for a long time | Taking higher doses of diazepam (Valium) than prescribed | Stopping diazepam (Valium) suddenly
It's possible to misuse medications like diazepam (Valium). This means taking the medication differently than how it's prescribed by your HCP. Misusing a medication, especially if you're taking it with alcohol or other medications, can lead to serious side effects such as dangerous breathing problems, overdose, and even death. Take diazepam (Valium) exactly as prescribed by your HCP and don't start any new medications without first checking with them to see if it's safe.
Taking diazepam (Valium) for longer periods of time can lead to dependence. Only take this medication as directed by your HCP, and only for the shortest period of time and the lowest dose needed to treat your condition. Ask your HCP if you're not sure about how long you should continue taking this medication.
Withdrawal
- Risk factors: Stopping diazepam (Valium) suddenly
If you've been taking diazepam (Valium) for a long period of time or at higher doses, suddenly stopping this medication can lead to withdrawal. Symptoms of withdrawals include nausea, vomiting, diarrhea, and shaking. In very serious cases, it can also include seizures, which can be life-threatening.
Typically, withdrawal symptoms show up within the week after you stop taking diazepam (Valium). But in some cases, people still experience withdrawal symptoms weeks or more than a year after they stop this medication. Don't suddenly stop taking diazepam (Valium) without first talking to your HCP. If you want to stop, your prescriber will help you do so safely by lowering your dose slowly over time.
Harm to babies during pregnancy and after delivery
- Risk factors: Taking diazepam (Valium) while pregnant or breastfeeding
Let your HCP know if you're pregnant, thinking of becoming pregnant, or breastfeeding. The CDC found that babies born to mothers who took diazepam (Valium) or other benzodiazepines during pregnancy are at a slightly higher risk of developing birth defects. But they're also in danger of having a benzodiazepine withdrawal at or within the first month of birth. There is a North American Antiepileptic Drug (NAAED) Pregnancy Registry to monitor the safety of anti-seizure medications during pregnancy. If you're currently pregnant and taking diazepam (Valium), it's encouraged that you enroll in the registry to help researchers learn more about the risks.
In addition, diazepam (Valium) can pass into breastmilk, so it isn't recommended to use it while breastfeeding.
Interactions with other medications
Diazepam (Valium) can interact with other medications. For example, certain medications can cause diazepam (Valium) to reach dangerously high levels in the body, which raises your risk for serious side effects. These include some antifungal medications and some mental health medications, like fluvoxamine (Luvox). Talk to your care team about all the medications you're taking or plan to take, including over-the-counter medications and supplements. They might need to make adjustments to the dose of certain medications or recommend safer alternatives.
Use with caution in people with depression
- Risk factors: History of depression
Diazepam (Valium) can make depression worse. Sometimes, manic episodes have occurred when people with depression took diazepam (Valium). Watch for new or worsening signs of depression, suicidal thoughts or behavior, or any unusual changes in mood or behavior while taking diazepam (Valium). Get medical help right away if you or a loved one notices any of these changes.
Side effects of Diazepam (Valium)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Sleepiness
- Dizziness
- Muscle weakness
- Problems with balance or coordination
- Memory problems
Less Common Side Effects
- Confusion
- Depression
- Trouble speaking
- Nausea
- Headache
- Blurred vision
- Feeling very excited or nervous
- Changes in behavior and sleep
Diazepam (Valium) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Dangerously slow breathing: shortness of breath, bluish-colored lips, fingers, or toes
- Severe sedation: drowsiness, slowed breathing, confusion, memory problems, slurred speech, loss of consciousness
- Withdrawal symptoms: uncontrolled movements, blurred vision, trouble with sleep or memory, muscle pain and stiffness, anxiety, panic attacks, depression, irritability, hallucinations, convulsions or seizures, suicidal thoughts
More on Diazepam (Valium) side effects
The following Diazepam (Valium) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Shakiness and unsteady walk
unsteadiness, trembling, or other problems with muscle control or coordination
Incidence not known
Abdominal or stomach pain
agitation
black, tarry stools
blistering, flaking, or peeling of the skin
blurred vision
changes in patterns and rhythms of speech
chills
confusion
dark urine
decrease in the frequency of urination
decrease in urine volume
difficulty in passing urine (dribbling)
discouragement
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
false beliefs that cannot be changed by facts
fast heartbeat
fast or irregular breathing
feeling sad or empty
feeling that others are watching you or controlling your behavior
feeling that others can hear your thoughts
feeling, seeing, or hearing things that are not there
headache
hyperexcitability
increased muscle spasms or tone
irritability
itching or rash
lack of memory of what takes place after a certain event
loss of appetite
loss of bladder control
loss of interest or pleasure
lower back or side pain
nightmares
outbursts of anger
painful or difficult urination
pale skin
restlessness
seizures
slurred speech
sweating
trouble concentrating
trouble sleeping
trouble speaking
ulcers, sores, or white spots in the mouth
unpleasant breath odor
unusual behavior
unusual bleeding or bruising
unusual feeling of excitement
unusual tiredness or weakness
vomiting of blood
yellow eyes or skin
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
Change in consciousness
difficult or troubled breathing
irregular, fast or slow, or shallow breathing
lack of coordination
loss of consciousness
loss of strength or energy
muscle pain or weakness
pale or blue lips, fingernails, or skin
sleepiness
unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Incidence not known
decreased interest in sexual intercourse
difficulty with swallowing
double vision
feeling of constant movement of self or surroundings
inability to have or keep an erection
increase in sexual ability, desire, drive, or performance
increased interest in sexual intercourse
increased watering of the mouth
indigestion
loss of sexual ability, desire, drive, or performance
passing of gas
seeing double
sensation of spinning
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Diazepam (Valium)
Pros
- Taken by mouth
- Available as tablets and liquid
- Works within 30 minutes
Cons
- Might need to take multiple times a day
- Short-term use only because risk for dependence
- Generally not recommended during pregnancy or breastfeeding
Pharmacist tips for Diazepam (Valium)
- You can take diazepam (Valium) with or without a meal. Taking it with food can help if it upsets your stomach.
- Diazepam (Valium) can make you sleepy and dizzy. Don't drive or do anything that requires concentration until you know how this medication affects you.
- Don't drink alcohol when you're taking diazepam (Valium). Taking this medication with alcohol can cause serious side effects, such as slowed breathing and extreme sleepiness.
- Diazepam (Valium) can have serious interactions with certain medications. Examples include opioids, antipsychotics, and seizure medications. Make sure to tell your healthcare professional (HCP) and pharmacist about all of the medications you're taking before starting diazepam (Valium).
- Don't change your dose or stop taking diazepam (Valium) without talking to your HCP first. Doing so can cause withdrawal symptoms like hallucinations (seeing or hearing things that aren't real), anxiety, and sleeping problems. Follow your HCP's instructions to lower your dose slowly over a period of time to stop the medication completely.
- Diazepam (Valium) isn't recommended if you're pregnant because it might not be safe for your baby. If you're pregnant or thinking of becoming pregnant, talk to your HCP about the risks and benefits of using diazepam (Valium), or ask about alternative treatment options.
- Diazepam (Valium) can pass into breastmilk and cause side effects in a breastfed baby. Your healthcare team might ask you to avoid taking diazepam (Valium) if you're breastfeeding and recommend that you feed your baby with formula or previously stored breastmilk during treatment.
For the diazepam (Valium) 1 mg/mL oral solution:
- The diazepam (Valium) oral solution contains 1 mg of diazepam in each 1 mL of solution. There's also a more concentrated diazepam solution, called diazepam (Diazepam Intensol), that contains 5 mg of diazepam in each 1 mL of solution. Double check the strength of your product to make sure you're using the right product and taking the right dose.
- Measure your dose with an oral syringe or medication dosing cup. Don't use household spoons because they aren't accurate and might cause you to take the wrong dose.
- Store diazepam (Valium) liquid at room temperature. After opening a brand new bottle, the medication is good for up to 3 months (90 days). Make sure to write the expiration date on the bottle when you open it.
Common questions about Diazepam (Valium)
You might notice your symptoms improve about 15 to 30 minutes after a dose of diazepam (Valium). The effects of this medication might last 12 hours or more, and even longer for people with kidney or liver problems. Typically, healthcare professionals will monitor people with kidney or liver problems more closely for side effects and adjust the dose as needed.
Yes, diazepam (Valium) can be considered a muscle relaxer. But it's only approved to treat muscle spasms or spasticity from certain conditions, such as cerebral palsy and stiff-person syndrome (SPS). Diazepam (Valium) isn't a first-choice option as a muscle relaxer because it can be habit-forming.
No, diazepam (Valium) isn't a narcotic. Narcotics typically refer to opioid medications. Diazepam (Valium) isn't an opioid pain medication; it's a benzodiazepine.
Yes, diazepam (Valium) has a risk of misuse and dependence, which can lead to addiction. For this reason, diazepam (Valium) is a schedule IV controlled substance. To help lower the risk for addiction, only take diazepam (Valium) as prescribed. Typically, your healthcare professional will prescribe the lowest dose of diazepam (Valium) for the shortest period of time needed to treat your symptoms.
Benzodiazepines, like diazepam (Valium), can make you sleepy. Let your prescriber and care team know if you're taking other medications that make you sleepy, such as diphenhydramine (Benadryl) or beta blockers. Taking diazepam (Valium) with these types of medications can worsen sleepiness. Make sure to avoid driving or doing anything that requires concentration until you know how diazepam (Valium) affects you.
Some of the most common side effects of diazepam (Valium) include sleepiness, weakness, or dizziness. The medication can also potentially affect your balance and coordination or your memory. These side effects can raise your risk for falls, especially for older adults. Don't drive or do anything that needs a lot of focus until you know how diazepam (Valium) makes you feel. Let your healthcare team know if you're noticing any of these side effects, especially if they're affecting your ability to go about your day. They might need to lower your dose of diazepam (Valium) or recommend an alternative medication for your condition.
Low blood pressure isn't a common side effect of diazepam (Valium). But, a study showed that older adults who take benzodiazepines regularly are more likely to experience low blood pressure than younger adults. If you feel lightheaded or faint after taking diazepam (Valium), sit down and call your healthcare professional. They might recommend a lower dose and regular blood pressure checks at home.
Diazepam (Valium) isn't FDA-approved for pain. If you have pain, it's best to contact your healthcare professional so they can examine you and come up with a treatment plan that works best for you.
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Diazepam (Valium) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 5mg | 30 tablets | $7.33 | $0.24 |
| 10mg | 30 tablets | $7.37 | $0.25 |
| 2mg | 30 tablets | $5.61 | $0.19 |
Typical dosage for Diazepam (Valium)
Your healthcare professional (HCP) will monitor you closely and will adjust your diazepam (Valium) dose based on how well it's helping the symptoms of your condition and if you're having side effects.
Diazepam (Valium) tablet and diazepam 1 mg/mL oral solution
-
Children ages 6 months to under 18 years old:
- The typical starting dose is 1 mg by mouth 3 to 4 times daily.
-
Adults ages 18 to 64 years old:
- Anxiety: The typical starting dose is 2 mg by mouth 2 to 4 times daily.
- Alcohol withdrawal: The typical dose is 10 mg by mouth 3 or 4 times during the first 24 hours, then 5 mg by mouth 3 to 4 times daily as needed.
- Muscle spasms: The typical starting dose is 2 mg by mouth 3 to 4 times daily.
- Seizures: The typical starting dose is 2 mg by mouth 2 to 4 times daily.
-
Age 65 years and older:
- The typical starting dose is 2 mg by mouth 1 or 2 times daily.
Diazepam also comes as an injection that's used for people in the hospital.
More on Diazepam (Valium) dosage
Interactions between Diazepam (Valium) and other drugs
More on Diazepam (Valium) interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Flumazenil
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Abametapir
- Alfentanil
- Alprazolam
- Amobarbital
- Benzhydrocodone
- Bromazepam
- Bromopride
- Buprenorphine
- Butabarbital
- Butalbital
- Butorphanol
- Calcifediol
- Calcium Oxybate
- Cannabidiol
- Carbinoxamine
- Carisoprodol
- Cetirizine
- Chloral Hydrate
- Chlorzoxazone
- Clobazam
- Cobicistat
- Codeine
- Conivaptan
- Dantrolene
- Dihydrocodeine
- Doxylamine
- Esketamine
- Eslicarbazepine Acetate
- Ethchlorvynol
- Etravirine
- Fentanyl
- Flibanserin
- Fosnetupitant
- Fosphenytoin
- Fospropofol
- Gabapentin
- Gabapentin Enacarbil
- Hydrocodone
- Hydromorphone
- Ketamine
- Lemborexant
- Levocetirizine
- Levorphanol
- Lofexidine
- Loxapine
- Magnesium Oxybate
- Meclizine
- Meperidine
- Mephenesin
- Mephobarbital
- Meprobamate
- Metaxalone
- Methadone
- Methocarbamol
- Methohexital
- Metoclopramide
- Midazolam
- Mirtazapine
- Morphine
- Morphine Sulfate Liposome
- Nalbuphine
- Netupitant
- Orlistat
- Oxycodone
- Oxymorphone
- Pentazocine
- Pentobarbital
- Periciazine
- Phenobarbital
- Phenytoin
- Potassium Oxybate
- Pregabalin
- Primidone
- Propofol
- Remimazolam
- Scopolamine
- Secobarbital
- Sodium Oxybate
- Sufentanil
- Tapentadol
- Thiopental
- Tramadol
- Trazodone
- Zolpidem
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Amitriptyline
- Amprenavir
- Clarithromycin
- Dalfopristin
- Desogestrel
- Dienogest
- Disulfiram
- Drospirenone
- Erythromycin
- Estradiol
- Ethinyl Estradiol
- Ethynodiol
- Fluvoxamine
- Gestodene
- Ginkgo
- Isoniazid
- Levonorgestrel
- Mestranol
- Nomegestrol
- Norethindrone
- Norgestimate
- Norgestrel
- Quinupristin
- Rifapentine
- Roxithromycin
- St John's Wort
- Theophylline
- Troleandomycin
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Diazepam (Valium) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Diazepam (Valium) will not be safe for you to take.
- Under 6 months of age
- Myasthenia gravis
- Severe breathing problems
- Severe liver problems
- Sleep apnea
- Acute narrow-angle glaucoma (open-angle glaucoma is OK if treated)
What are alternatives to Diazepam (Valium)?
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