Diazepam belongs to a group of medicines called benzodiazepines.
It's used to treat anxiety, muscle spasms and seizures or fits. It's also used in hospital to reduce alcohol withdrawal symptoms, such as sweating or difficulty sleeping.
It can also be taken to help you relax before an operation or other medical or dental treatments. This is known as a pre-med.
It works by increasing the levels of a calming chemical in your brain called gamma-aminobutyric acid (GABA).
Diazepam is available on prescription only.
It comes as tablets, a liquid that you swallow, or in a rectal tube – medicine that's squeezed into your bottom (anus). It can also be given as an injection in hospital.
Who can take diazepam
Most adults aged 18 years and over can take diazepam tablets and liquid. People aged over 65 might need to take a lower dose.
Children aged 1 month and older can take it for muscle spasms.
Diazepam rectal tubes can be used by adults and children.
Who may not be able to take diazepam
Diazepam is not suitable for some people. To make sure it's safe for you, tell your doctor before starting to take diazepam if you:
- have ever had an allergic reaction to diazepam or any other medicine
- have liver or kidney problems
- have myasthenia gravis, a condition that causes muscle weakness
- have sleep apnoea, a condition that causes breathing problems when you're asleep
- have depression or thoughts of harming yourself or suicide
- have been diagnosed with a personality disorder
- have ever had problems with alcohol or drugs
- have recently had a loss or bereavement
- have arteriosclerosis, a condition that affects the blood flow to your brain
- have low levels of a protein called albumin in your blood
- are trying to get pregnant, are already pregnant or breastfeeding
- are over 65
- are going to be put to sleep (have a general anaesthetic) for an operation or other medical treatment
Your doctor will decide the right dose of diazepam for you. It's important to take diazepam exactly as your doctor tells you to.
Dosage for tablets and liquid
The usual dose is:
- anxiety – 2mg, taken 3 times a day, this can be increased to 5mg to 10mg, taken 3 times a day
- sleep problems (related to anxiety) – 5mg to 15mg, taken once a day at bedtime
- muscle spasms in adults – 2mg to 15 mg a day. This can be taken as 1mg twice a day and can go up to 5mg taken 3 times a day. The dose can be increased to up to 20mg, taken 3 times a day if needed
- muscle spasms in children (aged 1 month to 17 years) – the dose varies depending on age. It's usually taken twice a day, with 10 to 12 hours between each dose
Your dose might be lower if you're over 65 or have kidney or liver problems or severe breathing problems.
Dosage for rectal tubes
Your doctor will decide the right dose of diazepam rectal tubes for you or your child according to your weight, age and general health.
How to take or use it
How to take tablets and liquid
Take diazepam tablets or liquid with a drink of water. You can take them with or without food.
If you're taking diazepam as a liquid, the medicine will come with a plastic syringe or spoon to help you measure out the right dose. If you do not have a syringe or spoon, ask your pharmacist for one. Do not use a kitchen teaspoon as it will not measure the right amount.
How to use rectal tubes
Diazepam rectal tubes (or rectal diazepam) can be used if you or your child is having a seizure or fit.
If you have been prescribed rectal tubes, it's important that a family member, friend or carer knows how to give you this medicine. This may vary between different brands. Read the instructions that come with the medicine carefully.
If you're having a seizure, they also need to know how long to wait before giving you rectal diazepam. This depends on the type of seizure and how long it lasts.
Before prescribing diazepam rectal tubes your doctor will talk to you and your family member or carer about how to recognise the type of seizure that should be treated with this medicine. They will also teach your family member or carer how to give the medicine.
How long to take it for
How long you'll need to take diazepam for depends on why you're taking it. It is usually only recommended for a short period of time of up to 4 weeks.
If you're prescribed diazepam for more than 4 weeks, your dose may be reduced gradually to prevent withdrawal symptoms.
If you forget to take it
If you're taking diazepam regularly and forget to take a dose, take the missed dose as soon as you remember, unless it's nearly time for your next dose. In this case, just leave out the missed dose and take your next dose at the usual time.
Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.
If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to remember to take your medicine.
If you take too much
If you take more than your prescribed dose of diazepam you may get symptoms including:
- poor co-ordination or trouble speaking
- feeling sleepy
- a slow or irregular heartbeat
- uncontrolled eye movements
- muscle weakness
- feeling overexcited
The amount of diazepam that can lead to an overdose varies from person to person.
- you take more than your prescribed dose of diazepam
Go to 111.nhs.uk or call 111
If you need to go to A&E, do not drive yourself. Get someone else to drive you or call for an ambulance.
Take the diazepam packet, or the leaflet inside it, plus any remaining medicine with you.
Common side effects
These common side effects of diazepam happen in more than 1 in 100 people. There are things you can do to help cope with them:
It happens rarely, but some people have serious side effects when taking diazepam.
Talk to a doctor or contact 111 straight away if:
- your skin turns yellow, or the whites of your eyes turn yellow although this may be less obvious on brown or black skin
- you see or hear things that are not there (hallucinations)
- you think things that are not true (delusions)
- you keep falling over
- you have unusual mood changes such as talking more than usual or feeling overexcited, agitated, restless, irritable or aggressive – these side effects are more likely in children or if you're over 65
Go to 111.nhs.uk or call 111.
Make an appointment to see your doctor if you have memory loss (amnesia).
- your breathing becomes very slow or shallow
In rare cases, diazepam may cause a serious allergic reaction (anaphylaxis).
Diazepam can cause withdrawal symptoms if you take it for a long time.
If you're prescribed diazepam for more than 4 weeks, your dose may be reduced gradually when you stop taking it to prevent withdrawal symptoms.
Other side effects
These are not all the side effects of diazepam. For a full list, see the leaflet inside your medicine packet.
Diazepam and pregnancy
You can take diazepam during pregnancy, but taking it for a long time, particularly towards the end of pregnancy, may make your baby drowsy after they're born.
You may need to keep taking diazepam during pregnancy as it's important for you to remain well.
If you become pregnant while taking diazepam, speak to your doctor. They can explain the risks and the benefits of taking diazepam, and will help you choose the best treatment for you and your baby.
Diazepam and breastfeeding
If your doctor or health visitor says your baby is healthy, you can take diazepam while breastfeeding as long as you're only taking a low dose occasionally or for a very short time.
Diazepam passes into breast milk, usually in small amounts. If you take it for a long time or in high doses, it can build up in your milk. This can make your baby sleepy and can make it difficult for them to feed. It is important not to share a bed with your baby until you have finished taking diazepam.
If you're breastfeeding or planning to breastfeed, talk to your doctor or pharmacist, as other medicines might be better while breastfeeding, although this will depend on what you're using the diazepam for.
If you do take diazepam while you're breastfeeding and you notice that your baby is not feeding as well as usual, seems unusually sleepy, or has unusual breathing, or you have any other concerns about your baby, talk to your doctor, pharmacist, midwife or health visitor as soon as possible.
Diazepam and fertility
There's no clear evidence to suggest that taking diazepam reduces fertility in either men or women.
If you're trying to get pregnant, or you're having problems getting pregnant while on diazepam, speak to your doctor.
Cautions with other medicines
Some medicines affect the way diazepam works and increase the chances of you having side effects.
Before you start taking diazepam, tell your doctor if you're taking any of these medicines:
- antipsychotics, used to treat mental health problems
- antidepressants, used to treat depression
- anticonvulsants, used to treat seizures
- hypnotics, used to treat 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
- proton pump inhibitors (PPIs) – medicines for reducing stomach acid, such as omeprazole or esomeprazole
- muscle relaxants, such as baclofen or tizanidine
- disulfiram, a medicine for alcohol addiction
- isoniazid, a medicine for tuberculosis (TB)
- rifampicin, a medicine for bacterial infections
- theophylline, a medicine for asthma and other breathing problems
Mixing diazepam with herbal remedies or supplements
Do not take herbal remedies for anxiety or insomnia, such as valerian or passionflower, with diazepam. They can increase the drowsy effects of diazepam and may also have other side effects.
There's not enough information to say that other herbal remedies and complementary medicines are safe to take with diazepam. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.
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