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Valium: 7 things you should know

Medically reviewed by Carmen Fookes, BPharm. Last updated on Feb 9, 2021.

1. How it works

  • Valium is a brand (trade) name for diazepam, a medication that has anxiety-relieving, seizure-relieving, muscle relaxant, anticonvulsant, and amnestic effects.
  • Valium (diazepam) is used for the short-term treatment of anxiety and seizure disorders. Diazepam is thought to work by enhancing the effects of GABA, which is an inhibitory neurotransmitter in the central nervous system.
  • Valium belongs to the class of medicines known as benzodiazepines.

2. Upsides

  • May be used for the short-term relief of anxiety.
  • May also be used to relieve symptoms associated with alcohol withdrawal. Valium can help relieve alcohol withdrawal symptoms such as agitation, tremor, delirium tremens, or hallucinations.
  • May be used in addition to other treatments to relieve muscle spasm due to inflammation, trauma, or conditions such as cerebral palsy or paraplegia.
  • Can also be used in the treatment of prolonged seizures in conjunction with other anti-seizure medications. Valium has not proved useful as sole therapy.
  • May be used in adults and children over the age of 6 months.
  • Taken orally (by mouth).
  • Available as 2mg, 5mg, and 10mg tablets.
  • Valium is available as a generic under the name diazepam.

3. Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

  • Drowsiness, muscle weakness, fatigue, and unsteadiness when standing; all of which may contribute to an increased risk of falls.
  • May also cause confusion, depression, headache, nausea, incontinence, urinary retention, skin reactions, gastrointestinal disturbances, blurred vision, slurred speech, and low blood pressure.
  • Amnesia (loss of short-term memory) is more likely to occur at higher dosages and has been associated with antisocial behavior.
  • May impair reaction skills and affect a person's ability to drive or operate machinery. Alcohol should be avoided because it can enhance the sedative effect.
  • Valium is addictive and may cause emotional and physical dependence. It also carries a high potential for abuse. The use of Valium for longer than four months has not been assessed in clinical studies. Periodically reassess the need for this drug. A lower dosage may be needed in elderly patients.
  • Withdrawal symptoms (including convulsions, tremor, cramps, vomiting, sweating, or insomnia) may occur with abrupt discontinuation of extended therapy; taper off slowly under a doctor's supervision.
  • Valium should not be used during pregnancy unless the benefits outweigh the risks because it has been associated with an increased risk of birth defects. Valium is incompatible with breastfeeding.
  • Paradoxical reactions (the opposite of what is expected), such as worsening of insomnia, aggressiveness, hallucinations, extroversion, and rage have been reported, mainly in people with other mental health concerns.
  • May interact with several other medicines, including other drugs that have sedation as a side effect, such as benzodiazepines (interaction may cause profound sedation, respiratory depression, coma, and death). See prescribing information for a full list of interactions.
  • May not be suitable for some people including those with respiratory disease, kidney or liver disease, psychiatric illness, myasthenia gravis, sleep apnea syndrome, or those with a history of substance abuse or addictive disorders. Should not be used by those with a history of allergy to diazepam, Valium, or other benzodiazepines. May be used by people with open-angle glaucoma receiving appropriate therapy but not by those with narrow-angle glaucoma.

Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects

4. Bottom Line

Valium may be used occasionally to relieve anxiety and some other conditions such as acute muscle spasms and alcohol withdrawal. However, it is addictive and withdrawal symptoms can be severe.

5. Tips

  • Avoid operating machinery, driving, or performing tasks that require mental alertness while taking this medicine.
  • Valium may be given as split doses, with the largest dose just before bedtime.
  • Grapefruit juice or grapefruit products may increase blood levels of Valium; avoid concurrent use.
  • Valium can increase your risk of falls, particularly if you need to get up in the middle of the night to go to the toilet. Remove any fall hazards from your house (such as loose rugs) and slowly get out of bed when getting up in the middle of the night.
  • Avoid alcohol while taking this medicine.
  • Use the lowest effective dose of Valium that has been prescribed for you. Do not increase the dosage without your doctor's advice.
  • Withdrawal symptoms (blurred vision, insomnia, sweating, rarely seizures) may occur if long-term Valium is stopped abruptly; discontinue slowly on a doctor's advice.
  • Paradoxical reactions (the opposite of what is expected), such as over-excitation, anxiety, hallucinations, insomnia, and rage have been reported. Seek medical advice if these occur.
  • Talk to your doctor or pharmacist before buying other medications over the counter to check that they are compatible with Valium.

6. Response and effectiveness

  • 90% of Valium is absorbed and the peak effect of Valium is seen within 1 to 1.5 hours in most people. Diazepam is 98% bound to plasma proteins.
  • Food delays the time to peak to about 2.5 hours.
  • Valium is metabolized into active metabolites so its effects may last for more than 24 hours and extend with repeated dosing as the drug and its metabolites accumulate in the body.
  • The half-life of diazepam in children aged three to eight yesrs is 18 hours. In newborns, half-lives of 30 hours have been reported, and in prem infants 28 to 24 weeks gestation half-lives of 54 hours have been documented. Half-lives increase by approximately one hour for each year of age beginning at age 20 with a half-life of 20. Half-lives may increase 2 fold to 5 fold in those with mild to moderate cirrhosis.

7. Interactions

Medicines that interact with Valium may either decrease its effect, affect how long it works for, increase side effects, or have less of an effect when taken with Valium. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.

Common medications that may interact with Valium include:

  • antacids
  • anti-anxiety medications, including other benzodiazepines, such as lorazepam and oxazepam
  • anticonvulsants such as valproate
  • antidepressants, such as amitriptyline, imipramine, nortriptyline
  • antihistamines that cause sedation, such as diphenhydramine
  • barbiturates
  • duloxetine
  • monoamine oxidase inhibitors, such as selegiline, isocarboxazid, or phenelzine
  • opioid analgesics such as codeine, oxycodone, and morphine
  • oral contraceptives
  • medications that inhibit hepatic enzymes CYP P450 3A and 2C19.
  • muscle relaxants such as cyclobenzaprine
  • probenecid
  • scopolamine
  • sleeping pills, such as zolpidem
  • some medications used to treat mental illness, such as clozapine and thioridazine
  • theophylline.

Alcohol may worsen the side effects of Valium such as drowsiness and dizziness and should be avoided.

Note that this list is not all-inclusive and includes only common medications that may interact with Valium. You should refer to the prescribing information for Valium for a complete list of interactions.

References

Valium (diazepam) [Package Insert] Revised 11/2019. Roche Laboratories Inc. https://www.drugs.com/pro/valium.html

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Valium only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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