How does this medication work? What will it do for me?

Diazepam belongs to the class of medications called benzodiazepines. It is used for the short-term relief of symptoms of mild to moderate anxiety or alcohol withdrawal (such as agitation). It is also used for the reduction of muscle spasms. It works by slowing down the nerves in the brain (i.e., central nervous system).

The injectable form of this medication is used to control prolonged seizures.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are being given this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Each pale yellow cylindrical, biplane bevelled-edged tablet, engraved "ROCHE" over "5" on one side, single scored on both sides, contains diazepam 5 mg. Nonmedicinal ingredients: cornstarch, iron oxide yellow, lactose, and magnesium stearate. Gluten-, paraben-, sodium-, sulfite-, and tartrazine-free.

How should I use this medication?

The recommended dose of diazepam for adults ranges from 2 mg to 10 mg, taken 2 to 4 times daily. For children older than 6 months, the initial dose usually ranges from 1 mg to 2.5 mg, taken 3 or 4 times daily.

It is important that the dose be individualized to your specific needs to avoid excessive sedation or motor impairment.

Diazepam is normally used for a short period of time or as required. It may be habit-forming when taken for long periods of time. If you have been using this medication regularly for a long period of time (i.e., more than 1 month), do not stop using the medication without speaking with your doctor. To avoid withdrawal effects, a gradual reduction in dose is usually recommended when stopping this medication.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

It is important to use this medication exactly as prescribed by your doctor. If you miss a dose, administer it as soon as you remember and continue with your regular schedule. If your next dose is in less than 6 hours, skip the missed dose and continue with your regular dosing schedule. Do not administer a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store at room temperature in a dry place. Keep out of reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take diazepam if you:

  • are allergic to diazepam or any ingredients of the medication
  • are allergic to any other benzodiazepines
  • have acute narrow-angle glaucoma
  • have liver disease
  • have myasthenia gravis
  • have severe breathing problems
  • have sleep apnea

Do not give this medication to infants under 6 months of age.

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • blurred vision
  • clumsiness or unsteadiness
  • constipation
  • dizziness or lightheadedness
  • drowsiness
  • headache
  • muscle weakness
  • slurred speech

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • anxiety or agitation
  • confusion
  • falls and fractures
  • fast, pounding, or irregular heartbeat
  • hallucinations (seeing or hearing things not there)
  • memory loss
  • mood or behaviour changes (e.g., aggression, rage, anxiety or excitation)
  • nightmares
  • signs of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Alcohol use: Alcohol should be avoided when you are taking diazepam. Combining alcohol with this medication can cause an increase in the side effects of the diazepam, including slowing down your breathing or causing heart failure. People who have an addiction to alcohol or other medications should not take diazepam, except in rare situations under medical supervision.

Dependence and withdrawal: Physical dependence (a need to take regular doses to prevent physical symptoms) has been associated with benzodiazepines such as diazepam. Severe withdrawal symptoms may occur if the dose is significantly reduced or suddenly discontinued. These symptoms include seizures, irritability, nervousness, sleep problems, agitation, tremors, diarrhea, abdominal cramps, vomiting, memory impairment, headache, muscle pain, extreme anxiety, tension, restlessness, and confusion. Reducing the dose gradually under medical supervision can help prevent or decrease these withdrawal symptoms.

Rebound anxiety may also occur if treatment with diazepam is stopped abruptly. Rebound anxiety is a transient syndrome where the symptoms that led to use of diazepam recur in an enhanced form.

Depression: Benzodiazepine medications such as diazepam have been known to cause mood swings and symptoms of depression. If you have depression or a history of depression, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. If you experience symptoms of depression such as poor concentration, changes in weight, changes in sleep, decreased interest in activities, or notice them in a family member who is taking this medication contact your doctor as soon as possible.

Drowsiness/reduced alertness: Because diazepam causes drowsiness and sedation, do not engage in activities requiring mental alertness, judgment, and physical coordination (such as driving or operating machinery) while taking it. This is particularly true when first taking the medication and until you establish that diazepam does not affect you this way. Alcohol can increase the drowsiness effects and should be avoided.

Suicidal or agitated behaviour: People taking this medication sometimes feel agitated (restless, anxious, aggressive, emotional, and feeling not like themselves), or they may want to hurt themselves or others. This behaviour is more likely to occur in children or seniors, however it can occur in other adults, particularly those with mental or emotional disorders. These symptoms may occur within several weeks after starting this medication. If you experience these side effects or notice them in a family member who is taking this medication, contact your doctor immediately. You should be closely monitored by your doctor for emotional and behaviour changes while taking this medication.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately. Babies born to mothers who have used diazepam regularly during late pregnancy may have breathing difficulties and show signs of withdrawal when they are first born.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking diazepam, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of this medication have not been determined for use by children less than 6 months of age.

Seniors: Seniors may be at increased risk for the sedative and impaired coordination effects of this medication. They need to use extra caution, for example, when getting up during the night.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Alcohol use: Alcohol should be avoided when you are taking diazepam. Combining alcohol with this medication can cause an increase in the side effects of the diazepam, including slowing down your breathing or causing heart failure. People who have an addiction to alcohol or other medications should not take diazepam, except in rare situations under medical supervision.

Dependence and withdrawal: Physical dependence (a need to take regular doses to prevent physical symptoms) has been associated with benzodiazepines such as diazepam. Severe withdrawal symptoms may occur if the dose is significantly reduced or suddenly discontinued. These symptoms include seizures, irritability, nervousness, sleep problems, agitation, tremors, diarrhea, abdominal cramps, vomiting, memory impairment, headache, muscle pain, extreme anxiety, tension, restlessness, and confusion. Reducing the dose gradually under medical supervision can help prevent or decrease these withdrawal symptoms.

Rebound anxiety may also occur if treatment with diazepam is stopped abruptly. Rebound anxiety is a transient syndrome where the symptoms that led to use of diazepam recur in an enhanced form.

Depression: Benzodiazepine medications such as diazepam have been known to cause mood swings and symptoms of depression. If you have depression or a history of depression, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. If you experience symptoms of depression such as poor concentration, changes in weight, changes in sleep, decreased interest in activities, or notice them in a family member who is taking this medication contact your doctor as soon as possible.

Drowsiness/reduced alertness: Because diazepam causes drowsiness and sedation, do not engage in activities requiring mental alertness, judgment, and physical coordination (such as driving or operating machinery) while taking it. This is particularly true when first taking the medication and until you establish that diazepam does not affect you this way. Alcohol can increase the drowsiness effects and should be avoided.

Suicidal or agitated behaviour: People taking this medication sometimes feel agitated (restless, anxious, aggressive, emotional, and feeling not like themselves), or they may want to hurt themselves or others. This behaviour is more likely to occur in children or seniors, however it can occur in other adults, particularly those with mental or emotional disorders. These symptoms may occur within several weeks after starting this medication. If you experience these side effects or notice them in a family member who is taking this medication, contact your doctor immediately. You should be closely monitored by your doctor for emotional and behaviour changes while taking this medication.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately. Babies born to mothers who have used diazepam regularly during late pregnancy may have breathing difficulties and show signs of withdrawal when they are first born.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking diazepam, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of this medication have not been determined for use by children less than 6 months of age.

Seniors: Seniors may be at increased risk for the sedative and impaired coordination effects of this medication. They need to use extra caution, for example, when getting up during the night.

What other drugs could interact with this medication?

There may be an interaction between diazepam and any of the following:

  • alcohol
  • antihistamines (e.g., cetirizine, doxylamine, diphenhydramine, hydroxyzine, loratadine)
  • antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
  • aprepitant
  • aripiprazole
  • azelastine
  • "azole" antifungals (e.g., itraconazole, ketoconazole, voriconazole)
  • baclofen
  • barbiturates (e.g., butalbital, phenobarbital)
  • benzodiazepines (e.g., alprazolam, diazepam, lorazepam)
  • birth control pills
  • bosentan
  • bocepravir
  • brimonidine
  • buprenorphine
  • buspirone
  • calcium channel blockers (e.g., amlodipine, diltiazem, nifedipine, verapamil)
  • carbamazepine
  • chloral hydrate
  • chloramphenicol
  • clozapine
  • conivaptan
  • dasatinib
  • deferasirox
  • desvenlafaxine
  • dexamethasone
  • droperidol
  • fusidic acid
  • gabapentin
  • gemfibrozil
  • grapefruit juice
  • HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., delaviridine, efavirenz, etravirine, nevirapine)
  • HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
  • imatinib
  • isoniazid
  • lamotrigine
  • levetiracetam
  • macrolide antibiotics (e.g., clarithromycin, erythromycin)
  • metyrosine
  • mifepristone
  • mirtazapine
  • moclobemide
  • modafinil
  • muscle relaxants (e.g., cyclobenzaprine, methocarbamol, orphenadrine)
  • narcotic pain relievers (e.g., codeine, fentanyl, morphine, oxycodone)
  • norfloxacin
  • olopatadine
  • oxcarbazepine
  • paraldehyde
  • phenytoin
  • pramipexole
  • proton pump inhibitors (e.g., lansoprazole, omeprazole)
  • rifabutin
  • rifampin
  • ropinirole
  • selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, duloxetine, fluoxetine, paroxetine, sertraline)
  • scopolamine
  • sodium oxybate
  • St. John's wort
  • tapentadol
  • tetracycline
  • theophylline
  • ticlopidine
  • topiramate
  • tramadol
  • tranylcypromine
  • yohimbine
  • zolpidem
  • zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. In many cases, interactions are intended or are managed by close monitoring. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.