The use of benzodiazepines, including diazepam, could expose you to the possibility of dependence or abuse, which could lead to severe events like overdose or even death. Using other medications, alcohol, and/or illicit substances can increase your risk for misuse. Talk to your healthcare provider about your risk of dependence when starting and while taking Valium.
Further, extended use can cause you to need higher doses to get the same effect (due to tolerance), which can lead to dependence. Longer use and increasing tolerance can result in withdrawal reactions (such as trouble focusing or sleeping, numbness, tingling, weakness, or shaking) if you suddenly stop taking it. Withdrawal reactions can last several weeks to months and can be dangerous. To lower your risk of withdrawal, talk to your healthcare provider when tapering (lowering your dosage slowly) if you are planning to stop taking Valium.
This medication is classified as a benzodiazepine. Benzodiazepines work in the central nervous system (CNS) in the brain to increase the activity of certain chemicals called gamma-aminobutyric acid (GABA). GABA produces a calming effect.
Valium is classified by the Drug Enforcement Agency (DEA) as a schedule IV controlled substance, meaning it has a risk for dependence or abuse, but less so than drugs classified as schedule I, II, or III substances.
Valium is available for oral use in tablet form.
What Is Valium Used For?
Valium is used for anxiety, alcohol withdrawal syndrome, seizure disorders, and muscle spasms. Anxiety or tension associated with the stress of everyday life usually does not require treatment with Valium.
Brand Name(s): Valium
Drug Availability: Prescription
Therapeutic Classification: Benzodiazepine
Available Generically: Yes
Controlled Substance: Schedule IV
Administration Route: Oral
Active Ingredient: Diazepam
Dosage Form(s): Tablet
In anxiety, Valium helps manage symptoms such as:
TensionExcitationAgitationFearAggressiveness
It can also reduce agitation, tremor, and severe, life-threatening symptoms associated with alcohol withdrawal.
How to Take Valium
Valium should be taken by mouth as prescribed by your healthcare provider. You may need to start on a lower dosage if you also use other drugs known to cause respiratory depression (slowed breathing), have liver problems, or, depending on your age.
You can take Valium with or without food; however, it may take longer to work if you consume a high-fat meal with it.
If taking it for an extended period, the risk of dependency increases. You should never stop taking your medication abruptly, as you may experience withdrawal symptoms. Always talk to your healthcare provider before stopping.
Storage
Store Valium in a cool, dry place at room temperature (between 68 F and 77 F). Make sure you keep it out of reach from children and pets, and always store it in a secure area.
Off-Label Uses
Valium can be used off-label to help with the symptoms of other benzodiazepine withdrawals. In off-label use, drugs are prescribed to treat health conditions they are not FDA-approved to treat but for which they may be beneficial.
What Are the Side Effects of Valium?
This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at www.fda.gov/medwatch or 800-FDA-1088.
Common Side Effects
The most common side effects of Valium are:
Drowsiness Fatigue Muscle weakness Ataxia (impaired balance or coordination)
Other side effects that have been reported with Valium include:
Confusion Headache Slurred speech Tremor Vertigo (dizzy spells) Diplopia (double vision) Blurred vision Hypotension (low blood pressure)
Severe Side Effects
Call your healthcare provider immediately if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.
Like other benzodiazepines, Valium carries multiple boxed warnings. Be aware of the following risks:
Using Valium together with an opioid (e. g. , oxycodone, hydrocodone, morphine) can cause serious unwanted side effects, such as sedation, troubled breathing, coma, and even death. The use of benzodiazepines, including diazepam, could expose you to the possibility of dependence or abuse. Extended use can cause you to need higher doses to get the same effect, which can lead to dependence. More prolonged use and increasing tolerance can result in withdrawal reactions (such as trouble focusing or sleeping, numbness, tingling, weakness, or shaking) if you suddenly stop taking it. Withdrawal reactions can last several weeks to months and can be dangerous. To lower your risk of withdrawal, talk to your healthcare provider when tapering (lowering your dosage slowly) if you are planning to stop taking Valium.
Other serious side effects and their symptoms can include the following:
Central nervous system depression, which can cause extreme confusion or memory loss, sudden mood swings, slow reflexes, and extreme fatigue Suicidal thoughts Neutropenia (abnormally low neutrophils, the most common white blood cells, present in the blood) Jaundice (yellowing of the skin and whites of the eyes) Anterograde amnesia (struggling to create new memories)
Long-Term Side Effects
Valium and benzodiazepines, as a whole, are not recommended to be used for more than a few weeks due to withdrawal side effects and their possibility of dependence. Additionally, if you have insomnia, long-term use of benzodiazepines could lead to adverse changes in your sleep structure.
Dosage: How Much Valium Should I Take?
Modifications
Your initial dosage of Valium may vary if you:
If you experience a serious side effect, you or your healthcare provider may send a report to the FDA’s MedWatch Adverse Event Reporting Program or by phone (800-332-1088).
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
For oral dosage forms (solution or tablets): For anxiety: Adults—2 to 10 milligrams (mg) 2 to 4 times a day. Older adults—At first, 2 to 2. 5 mg 1 or 2 times a day. Your doctor may increase your dose if needed. Children 6 months of age and older—At first, 1 to 2. 5 mg 3 or 4 times per day. Your child’s doctor may increase the dose if needed. Children up to 6 months of age—Use is not recommended. For alcohol withdrawal: Adults—10 milligrams (mg) 3 or 4 times for the first 24 hours, then 5 mg 3 to 4 times per day as needed. Older adults—At first, 2 to 2. 5 mg 1 or 2 times a day. Your doctor will gradually increase your dose as needed. Children—Use and dose must be determined by your doctor. For muscle spasm: Adults—2 to 10 milligrams (mg) 3 or 4 times a day. Older adults—At first, 2 to 2. 5 mg 1 or 2 times a day. Your doctor may increase your dose if needed. Children 6 months of age and older—At first, 1 to 2. 5 mg 3 or 4 times per day. Your child’s doctor may increase the dose if needed. Children up to 6 months of age—Use is not recommended. For seizures: Adults—2 to 10 milligrams (mg) 2 to 4 times a day. Older adults—At first, 2 to 2. 5 mg 1 or 2 times a day. Your doctor may increase your dose if needed. Children 6 months of age and older—At first, 1 to 2. 5 mg 3 or 4 times per day. Your child’s doctor may increase the dose if needed. Children up to 6 months of age—Use is not recommended.
Are over the age of 65Have severe liver damageHave chronic respiratory insufficiencyAre debilitated (in a weakened state)
Children may also require an adjusted dosage.
Missed Dose
Always ask your healthcare provider how to take your medication. If you miss a dose of Valium, take it as soon as you remember. However, if it is almost time for your next dose, do not take the missed one. Instead, wait for your next dose as scheduled.
Overdose: What Happens If I Take Too Much Valium?
If you accidentally take too much Valium, you may feel symptoms of central nervous system depression, such as:
DrowsinessConfusionLethargy (lack of energy or sluggishness)
Serious symptoms of central nervous system depression can include:
Low blood pressure Ataxia Coma or death (rarely)
In the case of an overdose, vomiting must be forced within one hour of swallowing the medication, but only if the individual is conscious. The healthcare provider treating you may also give activated charcoal. Charcoal achieves an effect called decontamination to slow down or prevent drug absorption.
Other treatments can include flumazenil, a medication that can help reverse the effects of a benzodiazepine overdose.
Precautions
What Are Reasons I Shouldn’t Take Valium?
Do not take Valium if any of the following apply to you:
If someone collapses or isn’t breathing after taking Valium, call 911 immediately.
Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.
This medicine may cause some people, especially older persons, to become drowsy, dizzy, lightheaded, clumsy, unsteady, or less alert than they are normally. Also, this medicine may cause double vision or other vision problems. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert or able to think or see well.
This medicine will add to the effects of alcohol and other central nervous system (CNS) depressants. Some examples of CNS depressants are antihistamines or medicine for hay fever, allergies, or colds, sedatives, tranquilizers, or sleeping medicine, prescription pain medicine or narcotics, barbiturates or seizure medicines, muscle relaxants, or anesthetics (numbing medicines), including some dental anesthetics. This effect may last for a few days after you or your child stop using this medicine. Check with your doctor before taking any of the above while you or your child are using this medicine.
If you or your child develop any unusual or strange thoughts and behavior while taking diazepam, be sure to discuss it with your doctor. Some changes that have occurred in people taking this medicine are like those seen in people who drink too much alcohol. Other changes might be confusion, worsening of depression, hallucinations (seeing, hearing, or feeling things that are not there), suicidal thoughts, and unusual excitement, nervousness, or irritability.
Do not stop taking this medicine without checking first with your doctor. Your doctor may want you or your child to gradually reduce the amount you are using before stopping it completely. This may help prevent a worsening of your condition and reduce the possibility of withdrawal symptoms, including hallucinations, seizures, stomach or muscle cramps, sweating, tremors, or unusual behavior.
Symptoms of an overdose include: change or loss of consciousness, confusion, dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position, irregular, fast or slow, or shallow breathing, lack of coordination, loss of strength or energy, muscle pain or weakness, pale or blue lips, fingernails, or skin, shakiness and unsteady walk, unsteadiness, trembling, or other problems with muscle control or coordination, sweating, trouble breathing, unusual drowsiness, dullness, tiredness, weakness or feeling of sluggishness, or unusual weak feeling. Call your doctor right away if you notice these symptoms.
This medicine may be habit-forming. If you feel that the medicine is not working as well, do not use more than your prescribed dose. Call your doctor for instructions.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
Previous allergic reaction to Valium, diazepam, or any of its ingredients Myasthenia gravis, a chronic autoimmune, neuromuscular disease Severe respiratory insufficiency (severe breathing problems) Severe hepatic insufficiency (severe liver damage) Sleep apnea syndrome Narrow-angle glaucoma Psychosis Breastfeeding
It should also not be used in children under six months old.
What Other Medications Interact with Valium?
Several interactions can occur with Valium, such as:
Opioids: Since opioids also work on the central nervous system, when taken with Valium, they can increase the risk of central nervous system depression and respiratory depression. Examples of opioids can include morphine, hydrocodone, oxycodone, tramadol, methadone, and codeine. Alcohol: Valium and alcohol combined can cause increased sedation (sleepiness). Antacids: When Valium is taken at the same time as an antacid, it can decrease the amount of Valium absorbed into your body. Dilantin (phenytoin): Valium can increase the effects of phenytoin when they are taken together.
Other drug interactions can occur. Before taking Valium, tell your healthcare provider about all prescription and over-the-counter (OTC) medications and vitamins or herbal supplements you take. Ask them for a complete list of interactions.
What Medications Are Similar?
Valium belongs to the benzodiazepine class of medications. Other benzodiazepines with similar uses include:
Xanax (alprazolam), also used for anxiety Klonopin (clonazepam), used for seizure disorders and panic disorders Ativan (lorazepam), used to treat anxiety and epilepsy
This is a list of drugs that are similar to Valium. It is not necessarily a list of alternative drugs. It is not recommended to take these medications together. Discuss any questions with your healthcare provider.
How Can I Stay Healthy While Taking Valium?
When taken correctly, Valium is an effective medication for treating anxiety, alcohol withdrawal, or muscle spasms.
Anxiety or tension associated with the stress of everyday life usually does not require treatment with Valium.
While taking any benzodiazepine, it is especially important to take your medication exactly as prescribed. Notify your healthcare provider if you feel you need to take more of it to feel the effects, as this could be a sign of increased dependence. However, you shouldn’t stop taking it without consulting your healthcare provider first. They will need to devise a plan to safely wean you off the medication to prevent withdrawal.
Always tell your healthcare provider if you are taking other medications, OTC products, vitamins, or herbal supplements.
The author would like to recognize and thank Jon Candelaria for contributing to this article.
