Diazepam ("Die-AZ-e-pam")
Valium ("VAL-ee-um")
Benzodiazepine
Tablets: 2mg, 5mg or 10mg tablets
Liquids: 2mg in 5ml
Injections: 10mg in 2ml (emergency hospital use only)
Diazepam should always be prescribed at the lowest effect dose for the shortest possible time.
If you are 18 or over, the doctor can prescribe diazepam for you as a licensed medicine for anxiety or insomnia (sleep problems), to help if you are giving up alcohol, or to relax you before an operation like dental surgery.
Diazepam also has anticonvulsant properties and may be part of treatment to help with seizures.
If you are under 18, a specialist doctor may still consider this as a treatment option.
For some medical conditions (like muscle spasms or epilepsy), it may be appropriate to continue diazepam for longer. In these situations, prescribed medication will be reviewed regularly to check it is still appropriate.
Diazepam belongs to a group of medicines called benzodiazepines. It helps to calm people if they are anxious or finding it difficult to sleep. It can also be called an anxiolytic medicine. Anxiolytic is a word used to refer to any medicine that treats anxiety.
Diazepam works by improving the effect of a chemical in the brain called gamma-aminobutyric acid (GABA). GABA is a chemical whose transmission across nerves in the brain is known to produce a ‘calming effect’. When diazepam locks on to the GABA receptors in the brain, it changes shape. The GABA binds to it better and the calming effect of GABA is increased.
This is because it has the potential to be misused as a street drug.
A prescription for diazepam must be dispensed by the pharmacy and collected within 28 days of the prescription being written. Other prescriptions, for medication that isn’t a controlled drug, are valid for up to six months.
If you need to take it to school, check your school policy on how your medicine should be stored safely.
Diazepam starts to work very quickly in your body. You should get calming effects within two hours of taking it.
Diazepam does not usually affect your weight. It can affect your appetite but this is rare.
Talk to your doctor or pharmacist if you are concerned about your weight, or changes to your weight, while taking diazepam.
You may want to let your family and friends know you are taking diazepam so they can support you and help you look out for side effects.
For guidance on this, check out our page on getting support with your medication.
Diazepam may make you feel very sleepy, and this can carry on into the next day.
Some people find it more difficult to get to sleep when taking diazepam or experience nightmares or strange dreams when taking it.
If your sleep is negatively affected by diazepam, you should discuss this with your doctor.
When you stop taking diazepam, you may experience ‘rebound insomnia’. This means your sleep might be worse and you might get more vivid dreams immediately after stopping it, but this should improve again. If it doesn’t, discuss this with your doctor.
Alcohol
Drinking alcohol if you are taking diazepam is not recommended as this is likely to make you very sleepy. Diazepam may lower your tolerance to alcohol and you may experience more side effects.
Sometimes diazepam is prescribed to help manage the withdrawal symptoms people experience if they stop drinking alcohol. If you have been prescribed diazepam to help you stop drinking, you should not drink any alcohol with this medicine.
Taking large amounts of alcohol and diazepam together could affect your breathing, especially if you have an existing lung problem.
If you need to drive a car or ride a bike, or use machines at work, taking alcohol and diazepam together could impair your ability to do this safely and be dangerous to yourself and others.
Drinking alcohol every day, or in large amounts, can make your symptoms worse and may mean you won’t get the maximum benefit from your medication.
Street drugs
Diazepam does not mix well with street drugs. It is very easy, and serious, to overdose with any combination of diazepam and drugs.
Using cannabis with diazepam will make its sedative effect worse. You could go into a very deep sleep where you do not breathe properly and have difficulty waking up.
Cannabis and other drugs may have their own side effects on your mental health, like anxiety or psychosis.
Using heroin or methadone with diazepam will also increase their combined sedative effects. You could go into a very deep sleep where you do not breathe properly and have difficulty waking up. This combination could be very dangerous.
Using cocaine or other stimulants (like ecstasy, amfetamines, MDA, 6-APB etc.) with diazepam is likely to lead to a reduced stimulant effect. This could lead you to increase the dose of the stimulant to make up for it, which could be very dangerous.
There are many other street drugs, but we don’t know what effect taking them with diazepam will have, so it’s best to be cautious. There is no regulation of street drugs or ‘legal highs’, so even if there are no known issues with the medication you take, the supply you receive might be mixed with other substances that could be dangerous.
Smoking
If you start or stop smoking while you are taking diazepam, you may have to change your dose. This is because cigarette smoke affects the amount of diazepam in your body.
If you already smoke when you begin taking this medication, you may need a higher dose than somebody who does not smoke. You should tell your doctor if you smoke and how much, so that they can prescribe the correct dose for you.
If you stop smoking, the level of diazepam in the body could rise, and you might need to reduce your dose of diazepam slowly over one week.
If you start or restart smoking, you might need to increase it again.
Go to your doctor for advice if you stop or start smoking, or if you switch from smoking cigarettes to using a nicotine replacement product or vaping.
Diazepam does not mix well with some other medicines, including herbal remedies. It may affect the way in which they work or could cause more side effects.
You should be very careful if you take diazepam with other medicines that can cause sedation, especially medicines for pain relief that contain opioids (for example dihydrocodeine or morphine). When combined, these medicines may make you extremely sedated or could affect your breathing. Your doctor will monitor this carefully if you are prescribed these medicines together.
Always tell the pharmacist that you are taking diazepam if you buy any medicines from a pharmacy.
Look at the leaflet inside your medicine box for more information about other medicines that can interact with diazepam. With some medicines your doctor may need to adjust the dose of your medicines if you take them together. Ask a doctor or pharmacist for more information if you have any questions.
Watch your caffeine intake while you are taking diazepam as caffeine has the opposite effect of diazepam in your body and interferes with it working.
Try not to drink caffeine drinks like coffee, cola or energy drinks while you are taking diazepam. These may reduce the effect of diazepam.
Caffeine can cause anxiety and sleep loss. Stopping these drinks might help to improve your symptoms.
Avoid drinking grapefruit juice with diazepam. This can increase the amount of diazepam in your blood and could make you very sleepy or mean that you get more side effects.
If you use oral contraceptives (combined oral contraceptives), break through bleeding has been reported if you take diazepam together with these. No failure in contraception has been reported. Discuss this with your doctor if you experience this and are concerned.
There are multiple companies that manufacture diazepam.
The non-active ingredients vary between products and manufacturers, so if you have any food allergies or intolerances always let your pharmacist know and always check with them if you’re concerned about any of the ingredients in your medication.
The tablets contain lactose and may not be suitable for you if you have problems eating some sugars or dairy products.
The yellow (5mg) tablets may also contain sunset yellow (E110) or similar colourants, a food additive that can cause allergic reactions. Check with your pharmacist if this is important.
Diazepam oral solution contains sorbitol and is not suitable if you have hereditary fructose intolerance.
If you need to avoid animal products, please note that non-active ingredients used in the production of medicines may sometimes be of animal origin. Ask your pharmacist if you have any questions about the ingredients.
Further information about practical considerations for medicines if you need to avoid animal products can be found on the Vegan Society website.
Diazepam can make you feel sleepy, dizzy and forgetful when you first start taking it. You might also find it difficult to concentrate during the first few days of treatment and may experience blurred vision and muscle weakness. For these reasons, you should not ride a bike or drive a car until you know how you will be affected.
You should also be very careful when doing anything else that requires concentration, such as operating machinery or exercising.
The effects of diazepam can last a while after taking it, so even if you only take one dose, you may feel them the next day. It’s important not to drive, ride a bike or operate machinery if you feel that your ability to concentrate has been compromised by taking diazepam.
It is illegal to drive with medication in your body if it impairs your driving. It is important to stick to the dose on the prescription, and to check that you can drive safely while taking it. Ask your doctor if you’re not sure if your condition or your medicine will affect your driving.
You may also have to prove that you have been prescribed diazepam by your doctor, so you should keep your repeat prescription slip with you in case you are asked.
The Department of Transport website has more details.
Pregnancy
If you become pregnant while you are on diazepam, you should carry on taking it and make an appointment to see your doctor as soon as possible. They can discuss the benefits and risks of continuing diazepam and help you to make a decision that is best for you and your baby. They may refer you to a specialist perinatal mental health team to support you with this decision.
If you are planning to get pregnant, it is recommended that you take folic acid while you are trying for a baby and during pregnancy. It is safe to take this together with diazepam.
You can find out more information about taking diazepam during pregnancy at Bumps (Best Use of Medicines in Pregnancy).
Untreated anxiety can also be harmful to you and your developing baby, so decisions about stopping or avoiding medication when you are pregnant need to be discussed carefully with your doctor.
If you and your doctor agree that carrying on with diazepam has more benefits than risks, you should tell your midwife that you are continuing to take this at your next appointment.
It will be important to take the lowest dose that works for you for the shortest period of time that is necessary. This is to minimise the amount of diazepam that the developing baby is exposed to.
Post-natal
Taking diazepam during the last few months of pregnancy can cause withdrawal symptoms in a new born baby that include:
If this does occur, you will need help from your midwife, so it is important they are looking out for symptoms.
Breastfeeding
Please talk to your midwife, doctor or pharmacist if you want to breastfeed while taking diazepam. They can discuss the pros and cons of taking diazepam during breastfeeding and help you consider other options for medication or feeding if you are concerned.
It is important that you remain well while you are bonding with your newborn baby. For this reason, you may need to keep taking some medicines on your doctor’s advice.
If you start or continue to take diazepam when breastfeeding, use the lowest dose of medicine for the shortest length of time possible.
Diazepam is passed to the baby in breast milk. This may mean your baby is very sleepy or doesn’t feed well. You should seek urgent advice from your midwife, health visitor or doctor if this happens.
If you are taking this medication, you may be more sedated and not as rousable overnight. Bed-sharing with the baby is not recommended if this medicine is being taken due to increased risk of suffocation or sudden infant death.
Sex
Diazepam can have side effects that might affect your sex life. These include:
Most side effects occur when you first start medication and improve over time.
Diazepam is only recommended for short-term use. If you take it for longer and these symptoms don’t pass within a couple of weeks, discuss this with your doctor if this is a problem for you.
Untreated anxiety can have a negative effect on your sex life, so if diazepam helps you to recover, positive effects can include improving your desire, experience and enjoyment of sex as your mood lifts and you become interested in life and relationships again.
Fertility
There is currently no evidence to suggest that diazepam affects fertility.
Talk to your doctor about your diazepam if you are trying to get pregnant.
Diazepam is not a banned substance in sport.
Diazepam has many side effects that might make you less able to take part in sports that need a lot of focus. These include feeling sleepy, blurred eyesight, being forgetful, muscle weakness and finding it difficult to concentrate. It might be best to stop such sports for the first few days until you know how it affects you.
The good effects of diazepam may have a positive impact on your sporting performance as your symptoms settle and you sleep better.
Ideally it is best not to take diazepam for the first time just before your exams. It is not possible to predict how the medication will make you feel, and if you do get any side effects, these are more likely to occur when you first start taking diazepam.
You may feel forgetful, very sleepy, and find it difficult to concentrate which may interfere with your preparation for exams or performance during exams.
You should talk to your doctor about any future exams if you are starting diazepam. You might decide together to delay starting it until you have done them.
If they are more than a few days away, however, you might find that it is better to start diazepam to reduce anxiety, improve your sleep and your ability to study. After the first few days you will know how it affects you.
Try not to drink caffeine drinks to stay awake for exam revision – they stop the diazepam working. Sleep is important to improve memory, and logical reasoning is important when revising and to help you perform better in exams.
If you are worried that taking diazepam might make studying for or taking your exams harder, discuss this with your doctor.
Your doctor will consider any other medical conditions or symptoms you have before recommending a medicine for you.
Your medicine will come with a ‘patient information leaflet’. It’s important that you read this information. Speak to your pharmacist if:
The information leaflet also includes a list of warnings and precautions to consider before you take the medicine. If you think that any of these apply to you and are concerned that your doctor is not already aware of them, check with your doctor or pharmacist before you start to take your medication (or as soon as possible if you are already taking it).
It is not recommended to take diazepam for more than four weeks at a time. You should take the lowest effective dose for the shortest possible time. If you take it longer than this, your body can become dependent on it. It might be hard to stop taking it and you might need a bigger dose to get the same benefit. You may also get withdrawal symptoms when you stop taking it.
If you take diazepam for anxiety or sleep problems, you will probably take it for two to four weeks to get you into a new routine and find other ways to improve your sleep.
You will get the best effect from diazepam if you take it at the dose prescribed by your doctor.
Some people may need to take it regularly every day, but for some, just taking it when you need it will be enough to help. Your doctor will be able to discuss this with you to decide what’s best.
Some people are prescribed diazepam to be taken a few times a day. If this is the case, choose times you can always remember to take the medication, such as mealtimes or when you brush your teeth.
Some people may only have to take diazepam for one day, for instance before they have an operation.
You should not normally be prescribed diazepam for more than four weeks.
If you are taking diazepam to help you sleep, you should take it just before bedtime.
Diazepam can be taken before or after food. Swallow tablets whole with a drink of water – if chewed, they taste bitter.
If you remember later during the day, take it as soon as possible.
If you forget to take it and you are four hours away or less from your next dose, just take the next dose. Do not try and catch up by taking a double dose.
If you take it for sleeping, you must allow yourself seven to eight hours’ sleep after taking it.
If you forget to take your medicine for a few days, you could get your old symptoms back.
If you have missed doses, this may mean your anxiety has improved, so this could be a good thing. If you have been taking diazepam for more than two to four weeks, you may experience some withdrawal symptoms.
If you have taken diazepam regularly, or just when needed, for less than four weeks, you should be able to stop it straight away, although your doctor may recommend you reduce the dose gradually over a few days or a week.
If you have taken diazepam regularly for longer than four weeks, it is likely you will experience withdrawal symptoms if you stop it suddenly.
Some of the symptoms you get may be the same or similar to symptoms you had when you were unwell, so understandably, you might feel anxious or upset that your illness could be returning.
You can stop taking diazepam safely with your doctor’s help. Planning a gradual withdrawal together can help to minimise or prevent the withdrawal symptoms you experience. This will consider the dose and how long you have been taking it for. Your doctor may recommend you switch to a different type so that the dose can be reduced more gradually.
If you stop diazepam suddenly or reduce the dose too quickly, you can get withdrawal symptoms. These include:
Depending how long you have been taking diazepam, your doctor will help you to reduce the medication slowly over the course of several days or even weeks at the end of your treatment. Even when you do this, you may get some symptoms, including:
If you suffer from any of these symptoms, go back to your doctor for advice.
If you have taken more than the dose prescribed by your doctor, contact NHS 111 immediately to ask for advice, or ask a family member or friend to do this for you. This is important even if you don’t feel any different.
NHS 111 can give you advice and direct you to the best place to get more help if you need it.
If you have taken too much medication on purpose, or if after taking this you quickly feel unwell, call 999 or get someone to take you to A&E straight away. This includes any of the following signs:
If you need to go to A&E, do not travel alone or drive yourself there. Get your parent, family member or friend to go with you to support you and keep you safe on the way. If someone is not able to drive you there, call for an ambulance. Take your medication with you and tell doctors how much you have taken.
While uncommon, diazepam can cause you to have thoughts about hurting yourself or taking your own life. If you have any thoughts like this, it is important you get urgent help. Contact your doctor immediately for advice and support. This could be your GP or specialist mental health team. If you are able, share how you are feeling with family member or friend as well so they can support you to get help.
If you discussed with your doctor what to do if you get these thoughts and created a safety plan, read this to remind you who to contact for support and what you can do to help you cope.
Diazepam can cause serious side effects, including allergic reactions. If you have taken diazepam with street drugs or alcohol, you could get very serious side effects. Go to hospital immediately and tell doctors everything you have taken so they can help you.
Stop taking diazepam and go to a hospital straight away if you get any of the following symptoms:
Contact your doctor immediately but don't stop taking diazepam, if you get any of the following symptoms:
If you are unable to contact your doctor, call NHS 111 for urgent advice.
Side effects are more common when you first start taking a new medicine. Many go away as you continue your medicine. If they don’t get better, or if you are worried by them and they are causing you distress, speak to your doctor, specialist team or pharmacist about them.
Very common side effects of diazepam (affecting more than one in ten people) include:
There are other side effects that you can get when taking this medicine. We have only included the most common ones here.
This list of side effects can look scary. You may not experience any of them, but it’s important to be aware of them so you know what to do if they do happen.
Unless your side effects are very severe or distressing, try to continue taking your medication until you can talk to your doctor. Your doctor can make changes to your medication to help if needed.
There is no additional monitoring routinely recommended with diazepam.
Your doctor may recommend additional checks depending on any other medical conditions you have or if you get any side effects. These may require a blood test.
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