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Valtoco Nasal Spray

Generic Name: diazepam nasal (dye AZ e pam)
Brand Name: Valtoco

Medically reviewed by Judith Stewart, BPharm. Last updated on April 23, 2020.

What is Valtoco?

Valtoco nasal spray (diazepam) is a benzodiazepine (ben-zoe-dye-AZE-eh-peen) that is used to treat seizure clusters (also known as "acute repetitive seizures") in adults and children at least 6 years old.

Valtoco is a federal controlled substance (C-IV) because it can be abused or lead to dependence. Keep this medicine in a safe place to prevent misuse and abuse. Selling or giving away Valtoco may harm others and is against the law. Tell your healthcare provider if you have abused or been dependent on alcohol, prescription drugs, or street drugs.

It is not known if Valtoco is safe and effective in children under 6 years of age.

Important Information

You should not use Valtoco if you have narrow-angle glaucoma.

MISUSE OF THIS MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription.

Fatal side effects can occur if you use this medicine with opioid medicines, alcohol, or other central nervous system depressants (including street drugs). Combined use can cause severe drowsiness, breathing problems (respiratory depression), coma, and death.

Like other antiepileptic drugs, Valtoco nasal spray may cause suicidal thoughts or actions in a small number of people, about 1 in 500. Call a healthcare provider right away if you have any of these symptoms, especially if they are new, worse, or worry you:

  • thoughts about suicide or dying

  • feeling agitated or restless

  • acting aggressive, being angry, or violent

  • attempts to commit suicide

  • panic attacks

  • acting on dangerous impulses

  • trouble sleeping (insomnia)

  • an extreme increase in activity and talking (mania)

  • new or worse anxiety

  • new or worse irritability

  • other unusual changes in behavior or mood

  • new or worse depression

Before taking this medicine

You should not use Valtoco if you are allergic to diazepam (Valium), or if you have:

  • narrow-angle glaucoma.

Valtoco is not approved for use by anyone younger than 6 years old.

To make sure Valtoco is safe for you, tell your doctor if you have:

Some people have thoughts about suicide while using seizure medicine. Your doctor will need to check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

If you use diazepam while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on habit-forming medicine may need medical treatment for several weeks.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of diazepam on the baby.

It may not be safe to breastfeed while using Valtoco. Ask your doctor about any risk.

How should I use Valtoco?

Use Valtoco nasal spray exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Diazepam may be habit-forming. Misuse can cause addiction, overdose, or death. Keep the medication in a place where others cannot get to it. Selling or giving away Valtoco is against the law.

Valtoco is a nasal spray that comes in a ready-to-use bottle. Each bottle is for one use only. Use only the number of sprays your doctor has prescribed.

Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.

Be sure a responsible family member or caregiver knows where you keep this medicine and how to give it to you.

After giving Valtoco to another person:

  • note the time the diazepam dose was given;

  • keep the person lying on his or her side;

  • stay with the person and watch for changes in his or her seizures.

Seek emergency medical help if the person's seizure seems different or last longer than other seizures, or if the person has slow breathing, blue colored lips, or is hard to wake up.

If needed, a second dose of Valtoco may be given at least 4 hours after the first dose. Do not give a second dose if the person has extreme drowsiness or very slow breathing.

Do not use more than 2 doses to treat a single seizure cluster episode.

Do not use Valtoco for more than 1 seizure cluster every 5 days. Do not use for more than 5 seizure clusters in 1 month.

Diazepam doses are based on weight. Your dose needs may change if you gain or lose weight.

Store at room temperature away from moisture, heat, and light. Do not freeze.

What happens if I miss a dose?

Since Valtoco is used when needed, it does not have a daily dosing schedule. Call your doctor if your symptoms do not improve after using this medicine.

Keep this medicine with you at all times in case you need it to control seizure clusters.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include drowsiness, confusion, severe weakness, or loss of consciousness.

What should I avoid while using Valtoco?

Avoid drinking alcohol. Dangerous side effects could occur.

Avoid driving or hazardous activity until you know how Valtoco will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.

Valtoco side effects

Get emergency medical help if you have signs of an allergic reaction to Valtoco: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if the person receiving this medication has:

  • extreme weakness or drowsiness;

  • pale or discolored skin; or

  • worsening seizures, or seizures that seem different from the patient's other seizures.

The sedative effects of diazepam may last longer in older adults. Accidental falls are common in elderly patients who use benzodiazepines. Use caution to avoid falling or accidental injury while you are using Valtoco.

Common Valtoco side effects may include:

  • drowsiness;

  • headache; or

  • discomfort in your nose.

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.

What other drugs will affect Valtoco?

Using Valtoco with other drugs that make you sleepy or slow your breathing can cause dangerous side effects or death. Ask your doctor before taking a sleeping pill, narcotic pain medicine, prescription cough medicine, a muscle relaxer, or medicine for anxiety, depression, or seizures.

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

Other drugs may interact with diazepam nasal, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Further information

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

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