*An off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may offer a benefit to someone.
Valium can cause side effects like headache, drowsiness, poor coordination, and skin problems. Its doses, duration, and the person’s health conditions affect the severity of side effects. Common side effects are muscle weakness, tiredness, and difficulty controlling body movements. Less common but serious side effects breathing difficulties, allergic reactions, and hallucinations.
If you are considering Valium or want to discuss your current medication treatment with a provider, online psychiatry platforms can be a good place to start. Talkiatry is one of the few online psychiatry platforms that can and will prescribe benzodiazepines, like Valium, which are controlled substances. They offer assessments and prescription consultation, and can answer any questions you have about medication side effects.
Boxed Warning: Diazepam (Valium) – Risk of medication misuse or abuse
Diazepam, the active ingredient in Valium, has black box warnings. These are the most serious types of warnings from the Food and Drug Administration (FDA).
– Taking diazepam, a benzodiazepine, with other opioid medications increases your risk for serious side effects that include severe sedation, slower breathing, coma, and death. Diazepam should not be taken with an opioid unless there are no other options.
– Taking diazepam can lead to misuse (abuse) and addiction of the medication, which can increase your risk of overdose and death.
– Using diazepam can lead to physical dependence and this risk increases the longer you take diazepam. If you suddenly stop taking diazepam, you can expereince withdrawal. Withdrawal can be life threatening. Diazepam should only be discontinued by gradual tapering of the dose.
Valium is a controlled substance, which means that it’s more likely to be misused or cause dependence. There are federal and state laws that limit the amount of medication that can be prescribed or dispensed within a certain period of time.
What Is Valium?
Valium contains the active ingredient diazepam and is a benzodiazepine medicine that doctors prescribe to treat certain conditions. Its long-lasting effects are well-known. The medication works by increasing the production of a brain chemical called gamma-aminobutyric acid (GABA), which slows down the transmission of information from the brain to the nerves. This leads to relaxation in the mind and body.
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Valium is used as an FDA-approved medication to treat disorders such as:2
- Anxiety disorders and symptoms
- Alcohol withdrawal
- Muscle stiffness (spasticity) or contraction
- With other medications to treat seizures
Valium has non-FDA approved (off-label) uses such as:
- Sedation in ICU or before surgery
- Short-term treatment of spasticity in children with cerebral palsy
- Restless leg syndrome/Willis-Ekbom disease (RLS/WED), violent leg movements
- Psychosis
Off-label uses of medication are not FDA-approved. Doctors can decide to use a medication off-label because, in their clinical judgment, they believe it may benefit people.
Common Side Effects of Valium
Valium use may cause side effects that vary depending on the drug dose and its impact on the brain. The most frequent side effect is drowsiness, but other common side effects may include tiredness, dizziness, blurry vision, unsteadiness, and muscle weakness. However, some side effects, such as sudden agitation or anger, hallucinations, and sleep disturbances, can be severe and require immediate medical attention.
People allergic to Valium or other benzodiazepines and with a family history of drug allergies to benzodiazepines may experience symptoms like skin rash, itching, swelling of the face, tongue, and throat, severe dizziness, and breathlessness. If you develop severe headaches and difficulty speaking or breathing, immediately seek medical attention by calling 911. Do not take Valium until you consult your doctor, who may adjust the drug dose or help you safely discontinue the medication.
The most common side effects of Valium include:2
- Drowsiness
- Fatigue
- Muscle weakness
- Ataxia, poor muscle control that causes clumsy voluntary movements
This is not a comprehensive list of possible side effects. You should talk with your doctor about the potential benefits and risks of taking Valium before starting the medication.
Severe Side Effects of Valium
Valium can be helpful when used as directed. However, if misused over a long period of time, it can cause severe side effects that affect brain and body coordination. It’s important to note that certain health conditions and the use of other drugs can intensify these side effects, leading to agitation, confusion, depression, difficulty with walking, urinating, and speaking, muscle weakness, shaking or tremors, yellowing of the skin and eyes, and infection (fever, chills, or a sore throat). Some people can develop Valium addiction.
Although rare, it is important to be aware of these potential side effects that could cause serious problems if left unchecked. Seek immediate medical attention when you experience fainting, chest tightness, slow or shallow breathing.
Severe side effects of Valium include:2
- Respiratory depression
- Suicidality
- Dependency and abuse
- Withdrawal symptoms
- Cardiovascular collapse
- Bradycardia
- Hypotension
- Syncope
- Paradoxical CNS stimulation
This is not a comprehensive list of possible side effects. You should talk with your doctor about the potential benefits and risks of taking Valium before starting the medication
Long-term Side Effects of Valium
When Valium is used more than needed, it may interfere with normal functions of the brain and body and cause long-term side effects including seizures, extreme anxiety, agitation, memory loss, and exhaustion. These effects can be harmful and cause social isolation, job loss, financial difficulties, and increase the risk of a car accident. Uncomfortable and harmful withdrawal effects may occur when people stop taking Valium suddenly after using it for a long time.
Seek immediate medical care for serious side effects, including slow or shallow breathing, chest pain, and serious allergic reactions, including rash, itching, swelling (face, tongue, and throat), severe dizziness, and trouble breathing.
Long-term side effects of Valium may include:3
- Memory problems
- Confusion
- Drowsiness
- Depression
- Elevated heart rate
- Worsening of seizures with epilepsy
- Worsening of anxiety with anxiety disorders
Side effects can vary from person to person, again the list provided may not be complete. While some side effects may go away on their own, others may require a change in medication. If you experience side effects while taking Valium, inform your doctor and discuss any new symptoms you may notice.
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Allergic Reactions
Although allergic reactions to Valium are not common, during treatment some people may develop hives or rash, swelling of the face, lips, tongue, or other parts of the body, wheezing or difficulty breathing, anxiety, sweating, and confusion. Make sure that your health care providers, including your pharmacist, are aware of your allergy.
Some people may experience anaphylaxis, a potentially life-threatening reaction with multiple symptoms (rash, difficulty breathing, shock) occurring together affecting two or more organ systems. Allergic reactions may occur in any part of your body.
Allergic reactions to Valium include:4
- Swelling of the face, lips, tongue, or throat (angioedema)
- Trouble breathing and wheezing (bronchospasm)
- Dizziness
- Skin rash and hives
- Itching
- Blistered or peeling skin
- Rapid heart rate (tachycardia > 100 beats per minute)
- Hypotension
Call 911 if you notice swelling, difficulty breathing, vomiting and hives. Tell the emergency care team when the drug was taken and what the dose was.
Interactions With Valium
Tell your doctor about any prescription medicine or over-the-counter products, vitamins, herbs, or dietary supplements you are taking before starting Valium. By sharing this information, you can avoid potential interactions that may occur.
Valium can interact with various drugs that may increase or decrease its levels. It is mainly due to the effect of two liver substances (CYP2C19 and CYP3A4 enzymes) on Valium. Some drugs (may prevent these enzyme activities, thus boosting the effects of Valium, while others increase their activity, thereby lowering the Valium effect.
Using Valium with opioids is risky due to an increased risk of sedation and respiratory depression. If Valium is taken with psychotropic or anticonvulsant drugs, careful consideration should be given to phenothiazines, narcotics, barbiturates, MAO inhibitors, and other antidepressants as they also boost the sedative effects of Valium. Combining Valium with narcotics, barbiturates, or alcohol may result in hypotension and muscular weakness.
The following substances you should avoid while taking Valium include:5
- Antipsychotics: Using antipsychotics with Valium may increase Valium levels and cause drowsiness, sleepiness, and breathing difficulties.
- Opioids: Using Valium with opioid medications used for pain may increase the risk of dangerous side effects including respiratory depression and sedation..
- Anxiolytics: Anxiety medications include benzodiazepines, such as Ativan, Xanax, and Klonopin. Using Valium with these medications may increase Valium levels and cause drowsiness, sleepiness, and breathing difficulties.
- Sedatives or hypnotics: These medications treat anxiety or sleep problems. Using Valium with these medications may increase Valium levels and cause drowsiness, sleepiness, and breathing difficulties.
- Antidepressants: Using antidepressants with Valium may increase the Valium levels and cause drowsiness, sleepiness, and breathing difficulties.
- Narcotic analgesics: Using strong pain medication such as narcotic analgesics with Valium may cause drowsiness, sleepiness, and breathing difficulties.
- Anesthetics: Using Valium with anesthetics may increase Valium levels and cause drowsiness, sleepiness, and breathing difficulties.
- Antiepileptics: Medications such as Tegretol and Carbatrol treat seizures, and using them with Valium may decrease the level or effect of Valium.
- Antihistamines with sedation: Certain antihistamines, such as Benadryl (diphenhydramine) can cause a sedative effect. They are used for allergies like hay fever, hives, conjunctivitis, and insect bites or stings. Using sedative antihistamines with Valium use may increase Valium levels and cause drowsiness, sleepiness, and breathing difficulties.
- Antifungals: Using antifungals with Valium may increase Valium levels and cause drowsiness, sleepiness, and breathing difficulties.
- HIV protease inhibitors: Using Valium with HIV protease inhibitors may increase Valium levels and cause drowsiness, sleepiness, and breathing difficulties.
- Tuberculosis drugs: Their (rifampin, rifabutin, rifapentine, Isoniazid) use with Valium may decrease the level or effect of Valium.
- Disulfiram: Treats alcohol addiction. Using disulfiram with Valium may increase Valium levels and cause drowsiness, sleepiness, and breathing difficulties.
- Antacids: Proton pump inhibitors (PPIs) for reducing stomach acids, such as omeprazole or esomeprazole. They may increase the Valium levels and prolong its sedative effect.
- Oral contraceptives: Contraception is not affected. But combined will increase the level and effect of Valium.
- Muscle relaxants: Using muscle relaxants with Valium may increase Valium levels and cause drowsiness, sleepiness, and breathing difficulties.
- Rifampicin: It is an antibiotic to treat bacterial infections, including tuberculosis (TB), Mycobacterium avium complex, leprosy, and Legionnaires’ disease. Using this antibiotic with Valium may decrease the level or effect of Valium.
- Sodium oxybate: This medication is a treatment for narcolepsy. Using Valium with sodium oxybate may increase Valium levels and cause profound sedation, respiratory depression, coma, and death.
- St. John’s wort: It treats depression and may lower the effects of Valium.
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Who Experiences the Most Side Effects on Valium?
Older adults and those with liver, lung, and kidney problems using Valium experience the most side effects. This risk is higher in older people who take Valium for a long time as it may lead to falls and fractures. Older individuals must take the lowest effective dose with caution to avoid falls at night. Children are also sensitive to Valium because it can cause gasping breathing due to its sedative effect. As a result, Valium is typically not recommended for children under six months old.
Before taking Valium, it is essential to let your doctor know if you have any medical conditions such as kidney, liver, lung, or breathing problems (sleep apnea), glaucoma, mental (psychosis), or muscle weakness disorders (myasthenia gravis). The doctor might prescribe the lowest possible dose of the drug that is still effective. It’s important to note that Valium can cause birth problems and developmental abnormalities during pregnancy, so it’s best to avoid it if you’re nursing.1
Valium Frequently Asked Questions (FAQ) About Side Effects
Typically, Valium is prescribed for the short term so most side effects do not need medical attention. They may go away during treatment as your body adjusts to the medicine. However, if used over time people become tolerant of its effects, and higher doses are needed to get the same effect. So, it is possible one may develop a physical or psychological dependence. The risk of dependence increases with the dose and duration of treatment. The risk may also be increased for those taking Valium with sedatives, including alcohol, more frequently than prescribed.
If you believe you have taken too much Valium, seek medical care right away. If a dose is missed, take it as soon as you can. However, if it is almost time for the next dose, take only that dose. Never take double or extra doses. Take your doses regularly and do not take drugs more often than directed. If you have been taking this drug for some time and want to stop it, gradually reduce the dose to avoid side effects. Take advice from your care team.
How Long Do Valium Side Effects Tend to Last?
The duration of Valium side effects varies from person to person depending on factors, such as level of support, exposure to stress, or past trauma. While mild discomfort, sleep issues, and pain may subside within a few days, psychological symptoms like muscle spasms, tremors, and weakness could persist for up to 4 to 6 weeks or longer. Without treatment, depression, suicidal thoughts, and difficulty sleeping may continue for over a year.
Do Valium Side Effects Vary Based on the Dosage?
Yes, Valium side effects and their severity depend on the drug doses. Other factors, such as how often and how long it is taken for, the presence of medical problems, and the use of other drugs or substances, may also increase the likelihood of side effects due to higher drug levels. It is important to stick to the recommended dosage of Valium and avoid using other medications, alcohol, or illicit substances, as doing so can increase the risk of serious side effects, like respiratory depression, overdose, and even death.
Does Valium Cause Anger or Other Emotional Side Effects?
Yes, Valium may cause anger or other emotional side effects. Sometimes individuals may have used Valium for a significant length of time and then discontinue its use developing a rebound effect. The rebound effect occurs when discontinuation of the drug results in symptoms that the drug is originally controlling like increased anxiety, vivid dreams, hyperactivity, sexual disinhibition, hostility, and rage.
Mood and environment influence these paradoxical or disinhibition reactions. Young and elderly people above 65 with personality and neurological disorders. Those with a history of aggression and poor impulse control may be more susceptible to experiencing paradoxical reactions.6
Valium Withdrawal
Withdrawal symptoms associated with sudden Valium discontinuation can be potentially unpleasant and may include anxiety, cognitive impairment, depression, and insomnia. Serious life-threatening reactions like breathing difficulties, severe depression, and seizures require emergency medical services to stabilize the person and control the symptoms.
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Valium dependence may develop after using it for a long time or taking higher doses more frequently than recommended. Therefore, these individuals should be under careful supervision as the risk of developing withdrawal symptoms increases. The risk is more pronounced in individuals on long-term valium therapy.
The determination of how soon after stopping Valium the symptoms will appear depends on how much and how often the person took Valium, the length of time Valium was used, whether or not other drugs were also used, and individual differences in metabolism and emotional and psychological stability. While initial withdrawal symptoms may appear 1 to 4 days after the last dose of Valium, a lengthy withdrawal phase may continue for 10 to 14 days in most people.1
Other Warnings & Precautions For Taking Valium
Individuals with heart, liver, kidney, and psychological problems like depression and anxiety are more vulnerable to adverse reactions to Valium. Valium is a sedative medicine that may cause drowsiness, decreased level of consciousness, and risk of falls in the elderly, with the potential for subsequent severe fractures.
Additionally, the use of alcohol and other sedatives during Valium therapy may increase the likelihood of serious side effects like breathing difficulties, coma, and death. This combination may reduce brain functions and impair judgment, and thinking. It is important to avoid activities like driving a vehicle, operating machinery, or jobs that require mental alertness.
Precautions for taking Valium include:1
People with Liver Problems
Valium must be used with caution in individuals with serious liver disease. Because it may cause jaundice, periodic liver function tests are advisable during long-term drug therapy. The doctor may adjust the drug dose based on the severity of your liver condition due to the slower removal of the medicine from your body.
Allergies
Avoid Valium or other benzodiazepines (oxazepam, temazepam) if they produce serious allergic reactions or other problems.
Medical history
Use the drug cautiously if you have medical conditions like muscle disease (myasthenia gravis), lungs or breathing problems (COPD, sleep apnea), liver, kidney, heart (arteriosclerosis), and brain problems (decreased consciousness, head injury), including mood changes or personality issues (agitation, hallucinations, restlessness, depression, suicidal thoughts).
Substance use
During Valium treatment, alcohol, and marijuana use may cause dizziness and reduced mental alertness. Engaging in activities requiring mental alertness should be discouraged. One should not drive or use machinery that needs alertness or clear vision until one can do it safely.
Abrupt Discontinuation
After long-term use, sudden Valium discontinuation may also be associated with a serious seizure disorder (tonic status epilepticus). Doctors should slowly taper the drug dose to avoid the risk of seizures.
Pregnancy
Generally, Valium is not advised during pregnancy due to the risk of passing the drug into breast milk and producing side effects on a nursing baby. Newborn babies of mothers who receive this medication late in pregnancy may develop shallow breathing, nonstop crying, shaking, or trouble feeding. The doctor’s advice is a must before planning a pregnancy to adjust the drug dose or use an alternative method.
Children, Infants, and Neonates
Typically, kids are more sensitive to the sedative effects of Valium. Side effects like sluggishness, heavy breathing, and acidity in the blood (gasping syndrome) are likely to occur in newborns and low birth weight babies.
Older Adults
People over 65 should take extra care using Valium as they are more vulnerable to the impact of side effects like drowsiness, lack of coordination, cognitive impairment, falls, fractures, and motor vehicle accidents. Some people may even experience the opposite effect like agitation, hallucinations, or sleeping problems, instead of having a calming effect.
Questions to Ask Your Healthcare Provider About Valium Side Effects
When someone wants to consider Valium as a treatment, they must consult a healthcare provider about the expected side effects and the associated risks of the drug. It may help you to know what to experience if you start, stop or don’t consider taking it at all. It is crucial to ask your doctor if you can continue your current treatment with the new anxiety drug, Valium.
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Questions to ask your care team when considering the side effects of Valium may include:
- Can I use Valium along with therapy to treat anxiety?
- How long will it take for me to adjust to taking Valium?
- Am I at risk for more severe symptoms if I am already taking medication for anxiety, depression, or other mental health conditions?
- Will a previous history of addiction make me more susceptible to dependency?
- What is the best dosage to ensure fewer side effects?
- What happens if I miss a dose?
- What happens if I overdose?
- What should I avoid while taking Valium?
- What other drugs will affect Valium?
- Will it affect my contraceptive pills?
- Can I drive or operate heavy machines during the treatment?
- Is it OK to reduce the dose or stop taking medicine if I feel better?
In My Experience
In my experience when taken as directed, Valium is typically more helpful than it is harmful for anxiety. Only a doctor can prescribe the right dose and tell you the specific precautions you need to take. It helps people to stop drinking alcohol and treats withdrawal symptoms, such as trembling, confusion, and anxiety. Some people may feel better almost immediately, but with others, it may be hours before they notice a difference.
Though people prefer Valium for its pleasurable effects, be mindful of some short-term and long-term side effects also due to its frequent excessive use.
Valium interaction with other drugs does not always mean that you must stop taking one of them. In many cases, interactions are managed by close monitoring. Speak to your doctor about how the drug interactions should be managed. Driving and operating machinery must be strictly restricted during the treatment to avoid serious accidents. Don’t be disturbed by the list of side effects, you may not experience any of them. Your healthcare team needs to assess your symptoms and determine the best way for you to take Valium.
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