Diazepam (Valium)

What diazepam is and how it works

Diazepam (brand name Valium) is a prescription benzodiazepine medicine used for short-term relief of anxiety, certain muscle spasms, some seizure disorders, acute alcohol withdrawal symptoms, and premedication before some procedures. (1)

Diazepam carries a genuine, current boxed warning -- the FDA's strongest safety warning -- covering three real risks: dangerous, potentially fatal breathing problems if combined with opioids; risk of abuse, misuse, and addiction; and risk of physical dependence with life-threatening withdrawal reactions if stopped abruptly or the dose is reduced too quickly. Because of these risks, diazepam is intended for short-term use, and any change in dose or plan to stop must always be made together with your prescriber -- never on your own.

Mechanism of action: how diazepam works

Diazepam is a benzodiazepine that enhances the effect of GABA (gamma-aminobutyric acid), the brain's main inhibitory neurotransmitter, at the GABA-A receptor, producing anxiolytic, sedative, muscle-relaxant, and anticonvulsant effects. (1) (2)

What diazepam is used for

Before taking diazepam

Do not take / not appropriate for

• Do not take diazepam if you have myasthenia gravis, severe breathing problems (severe respiratory insufficiency), severe liver problems (severe hepatic insufficiency), sleep apnea syndrome, or acute narrow-angle glaucoma. (all countries) (1)
• Do not give diazepam to infants under 6 months of age. (all countries) (1)
• Do not combine diazepam with opioid medicines unless your prescriber has specifically decided there is no adequate alternative, because of the real risk of profound sedation, dangerously slowed breathing, coma, and death. (all countries) (1)
• Do not stop diazepam abruptly or reduce your dose quickly on your own after regular use, because of the real risk of life-threatening withdrawal reactions, including seizures. (all countries) (1) (2)

Tell your clinician about

• Any personal or family history of alcohol or drug misuse, since this increases the risk of abuse, misuse, and addiction with diazepam.
• All other medicines you take, especially opioids, other sedatives, or anything affecting breathing.
• Any history of liver or kidney problems, breathing problems, or glaucoma.
• Whether you are pregnant, planning pregnancy, or breastfeeding.
• How long you have been taking diazepam before considering any dose change, since even short-term use can lead to some dependence.

How to take diazepam

• Take diazepam exactly as your prescriber directs, for the shortest time needed -- current UK/New Zealand guidance caps the anxiety-relief use at about 2-4 weeks.
• Before starting, your prescriber should discuss a plan for how treatment will eventually end, to help reduce the risk of dependence.
• Never change your own dose, stop abruptly, or take diazepam more often or in a larger amount than prescribed -- this is central to both the addiction/misuse risk and the withdrawal risk described in the boxed warning.
• If your prescriber decides it is time to stop diazepam after regular use, they will typically taper (gradually reduce) your dose over time rather than stopping it suddenly.

Procedures and treatment changes

Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3) (4) (5) (6) (7)

Missed dose

Contact your prescriber or pharmacist for guidance if you miss a dose. Do not take an extra dose to make up for a missed one, and do not change your overall dosing pattern on your own.

Overdose

Seek emergency medical help immediately for a suspected overdose, especially if diazepam has been combined with opioids, alcohol, or other sedatives, or if there are signs of severe drowsiness, confusion, slowed or stopped breathing, or loss of consciousness. Overdose risk and severity are substantially increased when diazepam is combined with opioids or alcohol. (1)

Side effects

Side effects and their urgency vary; report severe, persistent, or concerning symptoms.

Serious warnings

Interactions

• Opioid pain or cough medicines: combining with diazepam carries a genuine, boxed-warning-level risk of profound sedation, dangerously slowed breathing, coma, and death. (1)
• Alcohol: increases sedation and breathing-suppression risk, and increases the risk of misuse-related harm. (1)
• Other sedatives, sleep medicines, or muscle relaxants can add to diazepam's sedating and breathing-suppression effects. (2)
• Flumazenil (a benzodiazepine antagonist, sometimes used in overdose) may precipitate acute, potentially life-threatening withdrawal reactions, including seizures, in someone who is physically dependent on diazepam. (1)

Pregnancy, breastfeeding, kidney/liver function, age

Monitoring

Before starting

• Personal/family history of substance misuse
• Current use of opioids or other sedatives
• Liver function and breathing status
• A discussion of the treatment duration and end-of-treatment plan

During treatment

• Regular review of ongoing need, given the short-term intent of most indications.
• Watch for signs of tolerance, misuse, or dependence developing, even with short-term use.
• If stopping after regular use, dose is typically tapered gradually under your prescriber's direction rather than stopped abruptly.

Storage

Store at controlled room temperature, in the original container with a child-resistant closure, out of reach of children, and away from anyone who might misuse it. Dispose of unused diazepam through a medicine take-back program where available, given its abuse/misuse potential.

Frequently asked questions

References

1. VALIUM (diazepam) tablet -- full prescribing informationU.S. Food and Drug Administration / DailyMed (NIH), full prescribing information · United States · accessed 2026-07-30 · source 1
2. Diazepam Tablet (2 mg / 5 mg / 10 mg) -- Summary of Product Characteristicselectronic medicines compendium (emc), United Kingdom · United Kingdom · accessed 2026-07-30 · source 2
3. Diazepam -- list of nationally authorised medicinal products (PSUSA/00001029/202503)European Medicines Agency (EMA) -- Periodic Safety Update Report Single Assessment (PSUSA) list of nationally authorised medicinal products · European Union · accessed 2026-07-30 · source 3
4. VALIUM (diazepam) / generic diazepam tablets -- Health Canada Product MonographHealth Canada product monograph · Canada · accessed 2026-07-30 · source 4
5. VALIUM (diazepam) 5 mg tablet -- TGA-approved Product Information / ARTG entry 48566Therapeutic Goods Administration (TGA), Australia, via the Australian Commission on Safety and Quality in Health Care's Medicine Finder · Australia · accessed 2026-07-30 · source 5
6. Diazepam -- New Zealand Data Sheet(s) (Arrow-Diazepam, DBL Diazepam injection, and others)Medsafe (New Zealand Medicines and Medical Devices Safety Authority) · New Zealand · accessed 2026-07-30 · source 6
7. Reminder: Potential for abuse, dependence and withdrawal with benzodiazepines (June 2022)Medsafe (New Zealand Medicines and Medical Devices Safety Authority) -- Prescriber Update safety communication · New Zealand · accessed 2026-07-30 · source 7

Brand names by country

Single-ingredient diazepam names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.

Priority countries