Consumer Drug Information

diazepam

Generic Name: diazepam (dye AZ e pam)
Brand names: Valium, ...show all 7 brand names.

What is diazepam?

Diazepam is in a group of drugs called benzodiazepines (ben-zoe-dye-AZE-eh-peens). Diazepam affects chemicals in the brain that may become unbalanced and cause anxiety.

Diazepam is used to treat anxiety disorders, alcohol withdrawal symptoms, or muscle spasms. Diazepam is sometimes used with other medications to treat seizures.

Diazepam may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about diazepam?

You should not use this medication if you are allergic to diazepam, or if you have myasthenia gravis, severe liver disease, narrow-angle glaucoma, a severe breathing problem, or sleep apnea. This medication can cause birth defects in an unborn baby. Do not use diazepam if you are pregnant.

Before taking diazepam, tell your doctor if you have glaucoma, asthma or other breathing problems, kidney or liver disease, seizures, or a history of drug or alcohol addiction, mental illness, depression, or suicidal thoughts.

Do not drink alcohol while taking diazepam. This medication can increase the effects of alcohol.

Never take more of this medication than your doctor has prescribed. An overdose of diazepam can be fatal.

Diazepam may be habit-forming and should be used only by the person it was prescribed for. Diazepam should never be shared with another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.

What should I discuss with my healthcare provider before taking diazepam?

myasthenia gravis (a muscle weakness disorder);
severe liver disease;
narrow-angle glaucoma;
a severe breathing problem; or
sleep apnea (breathing stops during sleep).

If you have certain conditions, you may need a dose adjustment or special tests to safely take diazepam. Before taking diazepam, tell your doctor if you are allergic to any drugs, or if you have:

glaucoma;
asthma, emphysema, bronchitis, chronic obstructive pulmonary disorder (COPD), or other breathing problems;
kidney or liver disease;
epilepsy or other seizure disorder;
a history of mental illness, depression, or suicidal thoughts or behavior; or
a history of drug or alcohol addiction.

FDA pregnancy category D. Diazepam can cause birth defects in an unborn baby. Do not use diazepam while you are pregnant. Tell your doctor if you become pregnant during treatment. Use an effective form of birth control while you are using this medication. Diazepam can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. The sedative effects of diazepam may last longer in older adults. Accidental falls are common in elderly patients who take benzodiazepines. Use caution to avoid falling or accidental injury while you are taking diazepam. Do not give this medication to a child younger than 6 months old.

How should I take diazepam?

Take this medication exactly as it was prescribed for you. Never take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results from this medication.

Measure the liquid form of diazepam with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

Diazepam should be used for only a short time. Do not take this medication for longer than 4 months without your doctor's advice. Do not stop using diazepam suddenly without first talking to your doctor. You may have increased seizures or withdrawal symptoms when you stop taking diazepam. Withdrawal symptoms include tremor, sweating, trouble sleeping, muscle cramps, stomach pain, vomiting, and unusual thoughts or behavior. You may need to use less and less before you stop the medication completely. Contact your doctor if this medicine seems to stop working as well in treating your symptoms.

To be sure this medication is not causing harmful effects, your blood and liver function may need to be tested on a regular basis. Do not miss any scheduled visits to your doctor.

Store diazepam at room temperature away from moisture, heat, and light.

Keep track of how many pills have been used from each new bottle of this medicine. Benzodiazepines are drugs of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of diazepam can be fatal.

Overdose symptoms may include extreme drowsiness, confusion, limp or weak muscles, fainting, shallow breathing, or breathing that stops.

What should I avoid while taking diazepam?

Do not drink alcohol while taking diazepam. This medication can increase the effects of alcohol. Diazepam can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Diazepam side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:

confusion, unusual thoughts or behavior;
unusual risk-taking behavior, decreased inhibitions, no fear of danger;
depressed mood, thoughts of suicide or hurting yourself;
hyperactivity, anxiety, agitation, hostility;
double vision, hallucinations;
weak or shallow breathing;
feeling like you might pass out;
muscle twitching, tremor;
fever, chills, body aches, flu symptoms;
jaundice (yellowing of the skin or eyes); or
urinating less than usual or not at all.

Less serious side effects may include:

drowsiness, tired feeling;
dizziness, spinning sensation;
blurred vision;
sleep problems (insomnia), nightmares;
muscle weakness, lack of balance or coordination;
slurred speech;
nausea, vomiting, constipation;
headache, memory problems;
drooling or dry mouth;
skin rash; or
loss of interest in sex.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Diazepam Dosing Information

Usual Adult Dose for Anxiety:

Oral: 2 to 10 mg 2 to 4 times a day.
IM or IV: 2 to 5 mg (moderate anxiety) or 5 to 10 mg (severe anxiety) for one dose. May repeat in 3 to 4 hours, if necessary.

Usual Adult Dose for Alcohol Withdrawal:

Oral: 10 mg 3 to 4 times during the first 24 hours, then 5 mg 3 to 4 times a day as needed.
IM or IV: 5 to 10 mg one time. May repeat in 3 to 4 hours, if necessary.

Usual Adult Dose for ICU Agitation:

Initial dose: 0.02 to 0.08 mg/kg IV over 2 to 5 minutes every 0.5 to 2 hours to control acute agitation.
Maintenance dose: 0.4 to 0.2 mg/kg/hr by continuous IV infusion.

Usual Adult Dose for Muscle Spasm:

Oral: 2 to 10 mg 3 to 4 times a day.
IM or IV: 5 to 10 mg initially, then 5 to 10 mg in 3 to 4 hours, if necessary. For tetanus, larger doses may be required.

Usual Adult Dose for Seizures:

Oral: 2 to 10 mg 2 to 4 times a day.
Rectal gel: 0.2 mg/kg, rounded up to the nearest available unit dose. A supplemental dose of 2.5 mg may be added for more precise titration or if a portion of the first dose is expelled. May repeat in 4 to 12 hours. Maximum of 1 episode every 5 days, or 5 episodes per month.

Usual Adult Dose for Endoscopy or Radiology Premedication:

IV: 10 mg or less is usually adequate; however up to 20 mg may be necessary to produce the desired sedation in some patients.
IM: If IV cannot be used, 5 to 10 mg 30 minutes prior to the procedure.
Dosage of narcotics should be reduced by at least a third and in some cases may be omitted.

Usual Adult Dose for Status Epilepticus:

IV or IM: 5 to 10 mg initially (IV preferred).
May be repeated at 10 to 15 minute intervals up to a maximum dose of 30 mg.
If necessary, may be repeated again in 2 to 4 hours.

Usual Adult Dose for Light Anesthesia:

Premedication for Anesthesia:
10 mg, IM (preferred route), 1 to 2 hours before surgery.

Usual Pediatric Dose for Seizures:

Rectal gel:
<6 months: Use is not recommended.
<2 years: Safety and efficacy have not been established.
2 to 5 years: 0.5 mg/kg, rounded up to the nearest available unit dose.
6 to 11 years: 0.3 mg/kg, rounded up to the nearest available unit dose.
>12 years: 0.2 mg/kg, rounded up to the nearest available unit dose.
A supplemental dose of 2.5 mg may be added in 10 minutes for more precise titration or if a portion of the first dose is expelled. May repeat in 4 to 12 hours. Maximum of 1 episode every 5 days, or 5 episodes per month.

Usual Pediatric Dose for Status Epilepticus:

<1 month: 0.1 to 0.75 mg/kg IV over 3 to 5 minutes, may repeat every 15 to 30 minutes up to a maximum of 2.25 mg/kg. Diazepam injection is not recommended as the drug of choice in neonates due to its benzyl alcohol and propylene glycol.

1 month to 5 years: 0.2 to 0.5 mg IV or IM (IV preferred), slowly, every 2 to 5 minutes up to a maximum of 5 mg. May repeat in 2 to 4 hours if necessary.

>5 years: 1 mg IV or IM (IV preferred), slowly, every 2 to 5 minutes up to a maximum of 10 mg. May repeat in 2 to 4 hours if necessary.

Usual Pediatric Dose for Anxiety:

1 to 12 years:
Oral: 0.02 to 0.3 mg/kg (maximum 10 mg/dose) every 6 to 8 hours as needed.

IM: 0.04 to 0.3 mg/kg every 2 to 4 hours as needed, up to a maximum of 0.6 mg/kg in 8 hours.

Usual Pediatric Dose for Muscle Spasm:

1 to 12 years:
Oral: 0.02 to 0.3 mg/kg (maximum 10 mg/dose) every 6 to 8 hours as needed.

IM: 0.04 to 0.3 mg/kg every 2 to 4 hours as needed, up to a maximum of 0.6 mg/kg in 8 hours.

Usual Pediatric Dose for Seizure Prophylaxis:

1 to 12 years:
Oral: 0.02 to 0.3 mg/kg (maximum 10 mg/dose) every 6 to 8 hours as needed.

IM: 0.04 to 0.3 mg/kg every 2 to 4 hours as needed, up to a maximum of 0.6 mg/kg in 8 hours.

Usual Pediatric Dose for Light Sedation:

Conscious sedation for procedures:
Oral:
1 to 12 years: 0.2 to 0.3 mg/kg orally 45 to 60 minutes before procedure, up to a maximum of 10 mg
13 to 18 years: 5 mg orally 45 to 60 minutes before procedure, may repeat with 2.5 mg dose.

Sedation:
1 to 12 years:
Oral: 0.02 to 0.3 mg/kg every 6 to 8 hours as needed.
IM: 0.04 to 0.3 mg/kg IM every 2 to 4 hours as needed, up to a maximum of 0.6 mg/kg in 8 hours.

13 to 18 years:
Oral: 2 to 10 mg 2 to 4 times a day as needed.
IM or IV: 2 to 10 mg 2 to 4 times a day as needed.

Usual Pediatric Dose for Tetanus:

<1 month: 0.83 to 1.67 mg/kg/hour by continuous IV infusion, or 1.67 to 3.33 mg/kg IV, slowly, every 2 hours (20 to 40 mg/kg/day). Diazepam injection is not recommended as the drug of choice for neonates due to its benzyl alcohol and propylene glycol content.

1 month to 5 years: 1 to 2 mg IM or IV, slowly, repeated every 3 to 4 hours as necessary, or 15 mg/kg/day in divided doses every 2 hours.

>5 years: 5 to 10 mg IM or IV, slowly, repeated every 3 to 4 hours as necessary.

What other drugs will affect diazepam?

Before taking diazepam, tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, other sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to sleepiness caused by diazepam.

Before taking diazepam, tell your doctor if you take any other seizure medications, or if you are using any of the following drugs:

cimetidine (Tagamet);
ketoconazole (Nizoral);
omeprazole (Prilosec);
phenytoin (Dilantin);
a barbiturate such as amobarbital (Amytal), butabarbital (Butisol), mephobarbital (Mebaral), secobarbital (Seconal), or phenobarbital (Luminal, Solfoton);
an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate);
medicines to treat psychiatric disorders, such as aripiprazole (Abilify), chlorpromazine (Thorazine), haloperidol (Haldol), mesoridazine (Serentil), prochlorperazine (Compazine, Compro), promethazine (Pentazine, Phenergan, Phenadoz, Promethegan), and others;
narcotic medications such as fentanyl (Duragesic, Actiq), hydrocodone (Lortab, Vicodin), hydromorphone (Dilaudid), methadone (Dolophine, Methadose), morphine (Kadian, MS Contin, Oramorph), oxycodone (OxyContin), and others; or
an antidepressant such as amitriptyline (Elavil, Etrafon), citalopram (Celexa), doxepin (Sinequan), fluoxetine (Prozac, Sarafem), imipramine (Janimine, Tofranil), nortriptyline (Pamelor), paroxetine (Paxil), sertraline (Zoloft), and others.

This list is not complete and there may be other drugs that can interact with diazepam. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

Your pharmacist can provide more information about diazepam.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.