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Diazepam, Oral Tablet

Highlights for diazepam

  1. Diazepam oral tablet is available as both a generic and brand-name drug. Brand name: Valium.
  2. It is also available as an oral solution and a rectal gel.
  3. Diazepam is used to treat anxiety, alcohol withdrawal, muscle spasms, and certain types of seizures.
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Important warnings

Important warnings

FDA warning: Dangerous effects with opioid use.
  • This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients about drug effects that may be dangerous.
  • Using diazepam with opioid drugs can cause dangerous effects. These can include severe drowsiness, slowed breathing, coma, and death. If your doctor prescribes diazepam with an opioid, they will monitor you closely. Examples of opioids include hydrocodone, codeine, and tramadol.
  • Sedation warning: This drug can slow down your brain’s activity and interfere with your judgment, thinking, and motor skills. You shouldn’t drink alcohol or use other drugs that can also slow down your brain’s activity while you’re on diazepam. You also shouldn’t drive, operate machinery, or do other tasks that require alertness until you know how this drug affects you.
  • Increased seizures warning: If you are on diazepam as an add-on therapy for treating seizures, you may need a higher dose of your other seizure medications. This drug may cause more frequent and more severe seizures. If you suddenly stop taking diazepam, you may temporarily have more seizures.

About

What is diazepam?

Diazepam oral tablet is a controlled substance drug that’s available as the brand-name drug Valium. It’s also available as a generic drug. Generic drugs usually cost less. In some cases, they may not be available in every strength or form as the brand-name version.

Diazepam is also available as an oral solution and a rectal gel.

Why it's used

Diazepam oral tablet is used to treat the following conditions:

  • anxiety
  • symptoms caused by alcohol withdrawal, such as agitation or tremors
  • add-on treatment for skeletal muscle spasms
  • add-on treatment for certain types of seizures

It may be used as part of a combination therapy. That means you need to take it with other drugs.

How it works

Diazepam belongs to a class of drugs called benzodiazepines. A class of drugs refers to medications that work similarly. They have a similar chemical structure and are often used to treat similar conditions.

Diazepam increases the activity of gamma aminobutyric acid (GABA), a special chemical that can send signals throughout your nervous system. If you don’t have enough GABA, your body may be in an excited state and cause you to have anxiety, get muscle spasms, or have seizures. When you take this drug, you’ll have more GABA in your body. This will help decrease your anxiety, muscle spasms, and seizures.

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Side effects

Diazepam side effects

Diazepam oral tablet can slow down your brain’s activity and interfere with your judgment, thinking, and motor skills. You shouldn’t drink alcohol or use other drugs that can also slow down your brain’s activity while you’re on diazepam. You also shouldn’t drive, operate machinery, or do other tasks that require alertness until you know how this drug affects you. There are additional effects that you should also be aware of.

More common side effects

The more common side effects that occur with diazepam include:

  • drowsiness
  • tiredness or fatigue
  • muscle weakness
  • inability to control muscle movements (ataxia)
  • headache
  • tremor
  • dizziness
  • dry mouth or excessive saliva
  • nausea
  • constipation

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Worsening of seizures. Symptoms can include:
    • increase in frequency
    • increase in severity
  • Changes in the brain or how you think. Symptoms can include:
    • depression
    • confusion
    • feelings of the room spinning (vertigo)
    • slowed or slurred speech
    • double or blurred vision
    • thoughts of suicide
    • memory loss
  • Unexpected reactions. Symptoms can include:
    • extreme excitement
    • anxiety
    • hallucinations
    • increased muscle spasms
    • trouble sleeping
    • agitation
  • Liver problems. Symptoms can include:
    • yellowing of your skin or whites of your eyes (jaundice)
  • Bladder problems. Symptoms can include:
    • inability to urinate
    • inability to hold urine
  • Increase or decrease in sex drive.
  • Withdrawal. Symptoms can include:
    • tremor
    • abdominal or muscle cramps
    • sweating
    • convulsions

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Interactions

Diazepam may interact with other medications

Diazepam oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Examples of drugs that can cause interactions with diazepam are listed below.

Acid-suppressing drugs

These drugs make it harder for the body to absorb diazepam. If you take them together, you may not get the full dose of diazepam and it may not work as well. These drugs include:

  • famotidine
  • omeprazole
  • pantoprazole
  • ranitidine

Allergy or cold drugs

Taking certain drugs that treat allergies or colds along with diazepam can increase your risk of drowsiness or sleepiness. It can also cause your breathing to slow down or stop. These drugs include:

  • diphenhydramine
  • chlorpheniramine
  • promethazine
  • hydroxyzine

Antidepressants

Taking certain antidepressants with diazepam can increase your risk of drowsiness or sleepiness. It can also cause your breathing to slow down or stop. These drugs include:

  • amitriptyline
  • nortriptyline
  • doxepin
  • mirtazapine
  • trazodone

Antifungal drugs

These drugs block the enzyme that breaks down diazepam. This can increase the levels of diazepam in your body, putting you at higher risk for side effects such as drowsiness. These drugs include:

  • ketoconazole
  • fluconazole
  • itraconazole

Antipsychotic drugs

Taking certain antipsychotic drugs with diazepam can increase your risk of drowsiness or sleepiness. It can also cause your breathing to slow down or stop. These drugs include:

  • haloperidol
  • chlorpromazine
  • quetiapine
  • risperidone
  • olanzapine
  • clozapine

Anxiety drugs

Taking certain anxiety drugs with diazepam can increase your risk of drowsiness or sleepiness. It can also cause your breathing to slow down or stop. These drugs include:

  • lorazepam
  • clonazepam
  • alprazolam

Motion sickness drugs

Taking certain motion sickness drugs with diazepam can increase your risk of drowsiness or sleepiness. It can also cause your breathing to slow down or stop. These drugs include:

  • meclizine
  • dimenhydrinate

Other anti-seizure drugs

Taking certain anti-seizure drugs with diazepam can increase your risk of drowsiness or sleepiness. It can also cause your breathing to slow down or stop. These drugs include:

  • phenobarbital
  • phenytoin
  • levetiracetam
  • carbamazepine
  • topiramate
  • divalproex
  • valproate

Phenytoin, phenobarbital, and carbamazepine also affect the enzyme that breaks down diazepam. This can increase the levels of diazepam in your body, putting you at higher risk for these side effects.

Pain drugs

Taking certain pain drugs with diazepam can increase your risk of drowsiness or sleepiness. It can also cause your breathing to slow down or stop. These drugs include:

  • oxycodone
  • hydrocodone
  • morphine
  • hydromorphone
  • codeine

Sleep drugs

Taking certain sleep drugs with diazepam can increase your risk of drowsiness or sleepiness. It can also cause your breathing to slow down or stop. These drugs include:

  • zolpidem
  • eszopiclone
  • suvorexant
  • temazepam
  • triazolam

Tuberculosis drugs

These drugs make your body process diazepam faster, so there will be lower levels of the drug in your body. If you take them with diazepam, it may not work as well. These drugs include:

  • rifampin
  • rifabutin
  • rifapentine

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

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Other warnings

Diazepam warnings

Diazepam oral tablet comes with several warnings.

Allergy warning

Diazepam can cause a severe allergic reaction. Symptoms include:

  • trouble breathing
  • swelling of your throat or tongue
  • hives
  • rash

Don’t take this drug again if you’ve ever had an allergic reaction to it before. Taking it a second time after an allergic reaction could be fatal.

Food interactions

You shouldn’t drink grapefruit juice while taking diazepam. It will stop your liver from processing this drug correctly, causing more of it to stay in your body longer. This may increase your risk for side effects.

Alcohol interaction

You shouldn’t drink alcohol while taking diazepam. This drug can interfere with your judgment, thinking, and motor skills. It can also make you drowsy and cause your breathing to slow down or stop.

Also, your body also processes alcohol and this drug in similar ways. That means that if you drink alcohol, this drug might take longer to leave your body. This may cause worse side effects.

Warnings for people with certain health conditions

For people with kidney disease: Diazepam is removed from your body by your kidneys. If you have kidney problems, more of the drug may stay in your body longer, putting you at risk for side effects. Your doctor may adjust your dose and monitor you more closely.

For people with acute narrow angle glaucoma: Talk to your doctor if you have glaucoma. Diazepam may be used in people with open angle glaucoma, but it shouldn’t be used in people with acute narrow angle glaucoma.

For people with a history of drug or alcohol abuse: Let your doctor know if you’ve had problems with drug or alcohol abuse. You may have a higher risk for becoming addicted, dependent, or tolerant to diazepam.

For people with liver disease: Diazepam is processed by your liver. If you have liver problems, more of this drug may stay in your body, putting you at risk for side effects. Your doctor may adjust your dose of diazepam and monitor you more closely. If you have severe liver disease, you shouldn’t take this drug.

For people with mental health issues: Let your doctor know if you have a history of severe depression, or if you’ve ever thought about or tried to commit suicide. Diazepam may make these problems worse. Your doctor will monitor you more closely.

For people with myasthenia gravis: If you have myasthenia gravis, you shouldn’t take diazepam. Myasthenia gravis is a disease that causes extreme muscle weakness and tiredness.

For people with breathing problems: Let your doctor know if you have breathing problems. Diazepam affects your central nervous system and may make it more difficult for you to breathe or cause you to stop breathing. Your doctor may start you on a lower dose and monitor you more closely. If your breathing problems are severe or if you have sleep apnea, your doctor may prescribe a different medication for you instead.

Warnings for other groups

For pregnant women: Diazepam is a category D pregnancy drug. That means two things:

  1. Studies show a risk of adverse effects to the fetus when the mother takes the drug.
  2. The benefits of taking the drug during pregnancy may outweigh the potential risks in certain cases.

Taking this drug during pregnancy may cause babies to be born with deformities, muscle weakness, breathing and eating problems, low body temperatures, and withdrawal symptoms.

Tell your doctor if you’re pregnant or plan to become pregnant. Diazepam should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

For women who are breastfeeding: Diazepam passes into breast milk and can cause serious effects in a child who is breastfed. You and your doctor may need to decide if you’ll take diazepam or breastfeed.

For seniors: Seniors may have a higher risk of side effects, such as motor ataxia (loss of muscle coordination while you move). This drug may also have more of a sedative effect in seniors. You may experience more dizziness, sleepiness, confusion, or a slowing or stopping of breathing. Your doctor will prescribe the lowest dose possible to control your symptoms.

For children: Keep this drug out of the reach of children. The safety and effectiveness of diazepam in children under the age of 6 months hasn’t been established.

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Dosage

How to take diazepam

This dosage information is for diazepam oral tablet. All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

Forms and strengths

Generic: diazepam

  • Form: Oral tablet
  • Strengths: 2 mg, 5 mg, and 10 mg

Brand: Valium

  • Form: Oral tablet
  • Strengths: 2 mg, 5 mg, and 10 mg

Dosage for anxiety

Adult dosage (ages 18–64 years)

The standard dose is 2–10 mg taken by mouth 2–4 times per day.

Child dosage (ages 0–5 months)

This medicine hasn’t been studied in children and shouldn’t be used in children under the age of 6 months.

Child dosage (ages 6 months–17 years)

  • The usual starting dose is 1–2.5 mg taken by mouth 3–4 times per day.
  • Your doctor will start you at the lowest dose and increase it as based on how you’re responding to and tolerating this medication.

Senior dosage (ages 65 years and older)

  • The usual starting dose is 2–2.5 mg taken by mouth 1–2 times per day.
  • Your doctor will slowly increase your dose as needed based on how you are responding to and tolerating this medication.
  • Your body processes this drug more slowly. Your doctor may start you on a lowered dose so that too much of this drug doesn’t build up in your body. Too much of the drug in your body can be toxic

Special considerations

People with debilitating disease:

  • The usual starting dose is 2–2.5 mg, given 1–2 times per day.
  • Your doctor will slowly increase your dose as needed based on how you’re responding to and tolerating this medication.

Dosage for acute alcohol withdrawal

Adult dosage (ages 18–64 years)

The standard dose is 10 mg taken by mouth 3–4 times during the first 24 hours. This will be reduced to 5 mg taken 3–4 times per day as needed.

Child dosage (ages 0–5 months)

This medicine hasn’t been studied in children and shouldn’t be used in children under the age of 6 months.

Child dosage (ages 6 months–17 years)

  • The usual starting dose is 1–2.5 mg taken by mouth 3–4 times per day.
  • Your doctor will start you at the lowest dose and increase it as based on how you’re responding to and tolerating this medication.

Senior dosage (ages 65 years and older)

  • The usual starting dose is 2–2.5 mg taken by mouth 1–2 times per day.
  • Your doctor will slowly increase your dose as needed based on how you are responding to and tolerating this medication.
  • Your body processes this drug more slowly. Your doctor may start you on a lowered dose so that too much of this drug doesn’t build up in your body. Too much of the drug in your body can be toxic

Special considerations

People with debilitating disease:

  • The usual starting dose is 2–2.5 mg, given 1–2 times per day.
  • Your doctor will slowly increase your dose as needed based on how you’re responding to and tolerating this medication.

Dosage for add-on treatment of muscle spasms

Adult dosage (ages 18–64 years)

The standard dose is 2–10 mg taken by mouth 3–4 times per day.

Child dosage (ages 0–5 months)

This medicine hasn’t been studied in children and shouldn’t be used in children under the age of 6 months.

Child dosage (ages 6 months–17 years)

  • The usual starting dose is 1–2.5 mg taken by mouth 3–4 times per day.
  • Your doctor will start you at the lowest dose and increase it as based on how you’re responding to and tolerating this medication.

Senior dosage (ages 65 years and older)

  • The usual starting dose is 2–2.5 mg taken by mouth 1–2 times per day.
  • Your doctor will slowly increase your dose as needed based on how you are responding to and tolerating this medication.
  • Your body processes this drug more slowly. Your doctor may start you on a lowered dose so that too much of this drug doesn’t build up in your body. Too much of the drug in your body can be toxic

Special considerations

People with debilitating disease:

  • The usual starting dose is 2–2.5 mg, given 1–2 times per day.
  • Your doctor will slowly increase your dose as needed based on how you’re responding to and tolerating this medication.

Dosage for add-on treatment for seizures in people with epilepsy

Adult dosage (ages 18–64 years)

The standard dose is 2–10 mg taken by mouth 2–4 times per day.

Your doctor will start you at the lowest dose and increase it based on how you’re responding to and tolerating this medication.

Child dosage (ages 0–5 months)

This medicine hasn’t been studied in children and shouldn’t be used in children under the age of 6 months.

Child dosage (ages 6 months–17 years)

  • The usual starting dose is 1–2.5 mg taken by mouth 3–4 times per day.
  • Your doctor will start you at the lowest dose and increase it as based on how you’re responding to and tolerating this medication.

Senior dosage (ages 65 years and older)

  • The usual starting dose is 2–2.5 mg taken by mouth 1–2 times per day.
  • Your doctor will slowly increase your dose as needed based on how you are responding to and tolerating this medication.
  • Your body processes this drug more slowly. Your doctor may start you on a lowered dose so that too much of this drug doesn’t build up in your body. Too much of the drug in your body can be toxic

Special considerations

People with debilitating disease:

  • The usual starting dose is 2–2.5 mg, given 1–2 times per day.
  • Your doctor will slowly increase your dose as needed based on how you’re responding to and tolerating this medication.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.

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Take as directed

Take as directed

Diazepam oral tablet is used for short-term treatment. It comes with serious risks if you don’t take it as prescribed.

If you miss a dose: Take it when you remember, but don’t take more than one dose per day.Never try to catch up by taking two doses at once. This could cause toxic side effects.

If you don’t take it: Your symptoms (anxiety, tremors or agitation from alcohol withdrawal, muscle spasms, or seizures) won’t get better.

If you suddenly stop taking it: You may have withdrawal symptoms, such as:

  • tremors
  • stomach and muscle cramps or pain
  • vomiting
  • sweating
  • headache
  • extreme anxiety
  • tension
  • restlessness
  • confusion
  • irritability
  • hallucinations
  • seizures

The risks for withdrawal are greater if you’ve been taking diazepam for a long time.

If you take too much: Taking too much of this drug can cause depression of your central nervous system (CNS). Symptoms include:

  • drowsiness
  • confusion
  • tiredness
  • poor reflexes
  • slowing or stopping of your breathing
  • dangerously low blood pressure
  • coma

This may even be fatal. If you think that you’ve taken too much, call your doctor or go to the emergency room right away. You may be given the drug flumazenil to reverse a benzodiazepine overdose. This drug may increase your risk of seizures.

How to tell the drug is working: Depending on what you’re using diazepam for, you will notice your symptoms (such as anxiety, agitation and tremors from alcohol withdrawal, muscle spasms, or seizures) decrease or stop.

It is not known if diazepam is effective for long-term use (specifically longer than 4 months). Your doctor will regularly reassess your condition to see if diazepam is still appropriate for you to take.

Important considerations

Important considerations for taking diazepam

Keep these considerations in mind if your doctor prescribes diazepam oral tablet for you.

General

  • Diazepam tablets can be crushed

Storage

Store diazepam at room temperature between 68°F (20°C) and 77°F (25°C).

  • Protect it from light.
  • Keep it away from high temperature.
  • Keep your drugs away from areas where they could get wet, such as bathrooms. Store this drug away from moisture and damp locations.

Refills

This drug may be refilled if your doctor authorizes it on the prescription. It may only be refilled up to five times within 6 months after the prescription was given. After five refills or 6 months, whichever occurs first, you’ll need a new prescription from your doctor.

Travel

When traveling with your medication:

  • Always carry your medication with you in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t hurt your medication.
  • You may need to show airport staff your pharmacy’s label to clearly identify the medication. Keep the original prescription label with you when traveling.
  • Don’t leave this medication in the car, especially when the temperature is hot or freezing.
  • Since this is a controlled substance, it might be difficult to get refills. Make sure that you have enough medication before you leave on your trip.

Clinical monitoring

Before starting and during your treatment with diazepam, your doctor will check the following:

  • Liver function: These tests will help your doctor decide if diazepam is safe for you and if you need a lower dose.
  • Kidney function: These tests will help your doctor decide if diazepam is safe for you if you need a lower dose.
  • Breathing rate: Your doctor will monitor your breathing rate during treatment to make sure it is not too low.
  • Mental status: Your doctor will monitor you to make sure you don’t have changes in thinking or memory.
  • Relief of symptoms: Your doctor will check if your symptoms have improved.
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Alternatives

Are there any alternatives?

Your doctor will decide the right dose for you. If needed, your doctor will slowly and carefully increase your dose to avoid side effects.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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