Diazepam

Diazepam is used to treat anxiety, muscle spasms and fits (seizures), such as epilepsy.

It belongs to a group of medicines called benzodiazepines. It is available only on prescription.

Diazepam is also used to treat alcohol withdrawal symptoms, such as sweating or difficulty sleeping.

It is sometimes used to help you relax before a medical operation. This is known as a 'pre-med.'

Types of diazepam

Diazepam comes in tablets or a rectal tube (medicine that's squeezed into your bottom).

It can also be given as an injection in hospital.

Brand names include:

  • Anxicalm
  • Diazemuls
  • Stesolid Rectal tubes
  • Diazepam Rectubes
  • Diazepam Desitin

It's also known as valium.

Get emergency help

You might need emergency help if you get serious side effects, take too much or have a serious allergic reaction (anaphylaxis).

Serious side effects

Serious side effects from taking diazepam are rare.

Urgent advice: Contact your GP straight away if:

  • your breathing becomes very slow or shallow
  • your skin or the whites of your eyes turn yellow
  • you find it difficult to remember things
  • you see or hear things that are not there
  • you think things that are not true
  • you keep falling over
  • you talk too much or feel over excited
  • you feel agitated or restless
  • you feel irritable or aggressive

If you take too much

The amount of diazepam that can lead to an overdose varies from person to person. You may need to go to the emergency department (ED).

Immediate action required: Phone 999 or 112, or go to your nearest ED if:

  • you've taken more than your dose of diazepam, even if you feel OK

Immediate action required: It's especially important to get emergency help if you've taken more than your dose and:

  • have poor coordination
  • feel confused
  • have slurred speech
  • have trouble speaking
  • feel sleepy
  • have a slow or irregular heartbeat
  • have uncontrolled eye movements
  • feel your muscles are weak
  • feel over excited

Do not drive yourself to the ED. Get someone else to drive or call for an ambulance.

Take your remaining medication and any leaflets with you.

Serious allergic reaction

It's rare that diazepam causes a serious allergic reaction (anaphylaxis).

Immediate action required: Call 112 or 999 or go to an ED if:

  • you get a rash that's itchy, red, swollen or blistered
  • you're wheezing
  • you get tightness in your chest or throat
  • you have trouble breathing or talking
  • your mouth, face, lips, tongue or throat start swelling

When you start taking diazepam

Diazepam is usually taken 1 to 3 times a day. It's important to take your dose exactly as your GP says.

If you are unsure, read the patient information leaflet that comes with your medicine or ask your GP or pharmacist.

You should take diazepam tablets for as short a period of time as possible. It is usually only recommended for use up to 4 weeks.

The amount of time it takes before diazepam starts to work will depend on your conditions. Your GP will prescribe the best dose for you.

Fits

Rectal tubes should start to work within 10 minutes.

Anxiety

You should start to feel a bit better in a few hours, but it may take up to 2 weeks to feel the full effect.

Muscle spasms

You should begin to feel less pain after 15 minutes, but it may take longer to feel the full effect.

Check if you can take diazepam

Diazepam is suitable for adults aged 18 years and over.

If prescribed by a doctor, it can also be taken by children aged 1 month or older for muscle spasms.

It may not be suitable if you:

  • have had an allergic reaction to diazepam or other medicines
  • have liver or kidney problems
  • are breathless or have difficulty breathing
  • suffer from obsessions or phobias (a fear of a particular object or situation)
  • are over 65
  • have a condition that causes muscle weakness (myasthenia gravis)
  • have a condition that causes breathing problems during sleep (sleep apnoea)
  • have depression or thoughts of harming yourself
  • have a personality disorder
  • have current or past problems with alcohol or drugs
  • have recently had a loss or bereavement
  • have a condition that affects the blood flow to your brain (arteriosclerosis)
  • have low levels of protein called albumin
  • are going to be put to sleep for an operation

Pregnancy

If you are pregnant, think you might be pregnant or are planning to have a baby, ask your GP or pharmacist for advice before taking diazepam. You may need to keep taking it to remain well.

We don't know if diazepam is safe to use in pregnancy. It can give your newborn baby withdrawal symptoms.

Your GP can explain the risks and benefits and will help you choose the best treatment for you and your baby.

Breastfeeding

Usually, you should not breastfeed while using diazepam, but your GP or nurse will let you know if it is safe for your baby.

If your baby is healthy it can be used in a low dose for a short time. Larger amounts can build up in your breast milk and make your baby too tired to feed.

If you take diazepam while breastfeeding, make sure your baby is feeding, sleeping and breathing normally.

Talk to your GP or public health nurse as soon as possible if you have concerns.

Contraception and fertility

Diazepam does not affect contraception including the combined pill or emergency contraception.

Some contraceptive pills can keep diazepam in your body for longer and increase its effect. You can also get bleeding in between your periods if you take diazepam and contraceptive pills together.

There is currently no evidence to suggest that taking diazepam will reduce fertility in either men or women.

How and when to take it

Rectal tube

Diazepam rectal tubes can be used if you or your child is having a fit.

If it's for you, a family member, friend or caregiver must know how to give this medicine.

Make sure your GP or pharmacist shows them how to use it.

Tablets

Take diazepam tablets with water. You can take them with or without food.

If you forget to take it

If you're taking diazepam regularly take the missed dose as soon as you remember, unless it's time for the next one.

In this case skip the missed dose and take your next one as normal.

Never take 2 doses at the same time or an extra dose to make up for a forgotten one.

Side effects

Keep taking the medicine but talk to your GP if side effects get worse or do not go away after a few days.

Side effects may include:

  • feeling sleepy or drowsy
  • confusion
  • problems with coordination or controlling your movements
  • shaky hands (tremors)
Information:

See the patient information leaflet that comes with your medicine for a full list of side effects.

You can report any suspected side effects to the Health Products Regulatory Authority (HPRA).

Long term use

Usually, you should not take diazepam for longer than 4 weeks. Do not stop taking your medicine without talking to your GP.

If you're prescribed diazepam for longer, your dose may be reduced gradually when coming off it to prevent withdrawal symptoms.

Addiction

There is a risk you might become addicted to diazepam, but the risk is small if you take a low dose for 2-4 weeks.

Addiction is more likely if you have past or current problems with alcohol or drugs.

Coming off diazepam

If you have been taking a high dose or have been taking diazepam for a long time, your GP will probably recommend reducing your dose gradually.

If you suddenly stop taking it, you may experience some side effects such as:

  • confusion
  • anxiety
  • panic attacks
  • palpitations
  • loss of appetite
  • insomnia
  • fits
  • depression
  • feeling nervous or irritable
  • sweating
  • diarrhoea

Read a guide on coming off benzodiazepines

Food and drink

Avoid grapefruit juice as it may increase the amount of diazepam in your blood.

Also avoid caffeine as it is a stimulant and may reduce the calming effects of diazepam.

Driving and operating machinery

Do not drive a car, ride a bike or operate machinery if taking diazepam:

  • makes you sleepy
  • gives you blurred vision
  • makes it difficult to concentrate or make decisions

These effects may continue for several days even after you stop taking diazepam.

Taking diazepam with other medicines

Tell your GP or pharmacist that you are on diazepam before you take any new medicines.

Before you take diazepam for the first time, tell your GP or pharmacist if you:

  • are taking any other medication
  • have recently taken any medication
  • might take any other medicines in the near future

This includes medicines you can get without a prescription.

Non-urgent advice: Check with your GP if you're already taking:

  • antipsychotics for mental health problems
  • anticonvulsants or other medicines for epilepsy
  • antidepressants
  • oral contraceptives (the pill)
  • corticosteroids
  • levodopa - used to treat Parkinson’s disease
  • medicines used to treat stomach problems
  • hypnotics for anxiety or sleep problems
  • drowsy or sedating antihistamines such as chlorphenamine or promethazine
  • strong painkillers such as codeine, methadone, morphine, oxycodone, pethidine or tramadol
  • HIV medicines such as ritonavir, atazanavir, efavirenz or saquinavir
  • antifungal medicines such as fluconazole
  • muscle relaxants such as baclofen and tizanidine
  • rifampicin for bacterial infections
  • theophylline for asthma or other breathing problems

Herbal remedies or supplements

Do not take herbal medicines for anxiety or insomnia, such as valerian or passionflower.

They can increase the drowsy effects of diazepam and may have other side effects.

Similar medicines

If diazepam does not work or gives you side effects, your GP may suggest you try different medicines for treating anxiety or fits.

For anxiety your GP may recommend a type of antidepressants called selective serotonin reuptake inhibitors (SSRI). Brand names include sertraline, paroxetine or escitalopram.

For fits, a medicine called midazolam can be used. It comes as a pre-filled syringe and is given inside the mouth between the cheek and the gum.

This can be used instead of rectal diazepam.

Alcohol

Do not drink alcohol while you're on diazepam - it can make you go into a very deep sleep.

There's a risk you will not be able to breathe properly and may have difficulty waking up.

Recreational drugs

Using cannabis, heroin or methadone with diazepam will increase the drowsy effects. It can make you go into a very deep sleep and may cause your breathing to stop. This could lead to death.

There's a risk you will not be able to breathe properly or have difficulty waking up.

Using cocaine or other stimulants like MDMA (ecstasy) and amphetamines with diazepam can also lead to drowsiness.

Talk to your GP if you think you might use recreational drugs while taking diazepam.

Finding your patient information leaflet online

Your patient information leaflet (PIL) is the leaflet that comes in the package of your medicine. 

Information:

To find your PIL online, visit the Health Products Regulatory Authority (HPRA) website

  1. In the ‘Find a medicine’ search box, enter the brand name of your medicine. A list of matching medicines appears.
  2. To the right of your medicine, select ‘PIL’. A PDF of the PIL opens in a new window. 

You can also:

  1. Select the brand name of your medicine.
  2. Scroll down to the Documents section.
  3. From the Package Leaflet line, select PDF version. A PDF of the PIL opens in a new window. 

If your PIL is not on the HPRA website, the European Medicines Agency (EMA) website opens in a new window when you select ‘PIL’.

You can find your PIL on the EMA website.

Finding your PIL on the EMA website

If your PIL is not on the HPRA website, you will be sent to the European Medicines Agency (EMA) website.

To find your PIL on the EMA website:

  1. In the Medicines search box, enter the brand name of your medicine and the word ‘epar’. For example: ‘Zoely epar’. A list of matching medicines appears.
  2. Select the ‘Human medicine European public assessment report (EPAR)’ for your medicine
  3. From the table of contents, select Product information.
  4. Select the EPAR – Product Information link for your medicine. A PDF opens in a new window. The PIL information is in Annex III of the PDF under ‘labelling and package leaflet’

This content was fact checked by a pharmacist, a GP, the National Medication Safety Programme (Safermeds) and the Health Products Regulatory Authority (HPRA).

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This project has received funding from the Government of Ireland’s Sláintecare Integration Fund 2019 under Grant Agreement Number 123.

Page last reviewed: 24 September 2021
Next review due: 24 September 2024

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