Diazepam (Valium): Approved Uses, Boxed Warning and Risks

What diazepam is

Diazepam is a benzodiazepine sold as a tablet under the brand Valium and as a generic. MedlinePlus also lists liquid forms taken by mouth. Other diazepam products, such as a nasal spray for seizure clusters in people with epilepsy, have their own labels, and this page does not cover them.

The FDA label states that diazepam is a Schedule IV controlled substance. Its label reaches into muscle and seizure care as well as anxiety.

What it is approved for, and what the label limits

The Valium label lists these uses, among others:

• Treatment of anxiety disorders.
• Short-term treatment of anxiety symptoms.
• Add-on treatment of skeletal muscle spasm from a local condition, spasticity from upper motor neuron disorders, athetosis, or stiff-person syndrome.
• Add-on treatment of seizure disorders.

Limits on those uses, and how it is thought to work

The label lists other uses, including some that are outside the care described here. The label also sets limits: effectiveness beyond 4 months has not been evaluated, and it is not recommended as the only long-term treatment for seizure disorders. It is not recommended for babies under 6 months.

MedlinePlus says diazepam is sometimes prescribed for other uses but names none, so we list no off-label uses. For trauma, the VA's clinician guide on PTSD medications says studies have not shown benefit for benzodiazepines in PTSD and that their use is recommended against.

The label says diazepam is thought to work by strengthening GABA, a calming brain messenger, through a benzodiazepine site on GABA-A receptors. MedlinePlus describes this as calming abnormal overactivity in the brain.

What taking it can be like

According to the label, blood levels peak on average 1 to 1.5 hours after a tablet, later when taken with food, and a moderate fat meal also lowers how much is absorbed. Levels then build with daily use: diazepam reaches a steady state within about 5 days, and its main active breakdown product within about 10 days.

That long-acting pattern is what stands out on this label. Diazepam's half-life can reach 48 hours and its active breakdown product's can reach 100 hours, so it stays in the body for a long time. Ask your prescriber how long its effects may last. The label reports extensive build-up in healthy older men, and MedlinePlus says people 65 or older should talk about risks and benefits with their doctor.

The label says to avoid alcohol and to avoid food or drink containing grapefruit juice. It also warns against hazardous activities that need full alertness, such as driving or using machinery. NIMH says benzodiazepines are usually prescribed for short periods and tapered slowly. Tell your prescriber if you are pregnant, may become pregnant or are breastfeeding.

Side effects and warnings

The boxed warning is the strongest warning the FDA puts on a label. It applies to anyone taking diazepam for any of its uses.

• Do not stop suddenly. Do not stop diazepam or take fewer doses without talking to your prescriber. Withdrawal can include seizures, and if you take it for seizures, MedlinePlus says stopping suddenly may make them worse. Some people have withdrawal symptoms lasting weeks to more than 12 months.
• Who should not take it: people with a known allergy to diazepam or its inactive ingredients, and people with acute narrow-angle glaucoma. With open-angle glaucoma, the label allows use only with appropriate therapy.
• Mood and suicide risk: the label warns of suicidal thoughts or behavior with antiseizure medicines, including diazepam, and says it may worsen existing depression. Call your prescriber right away about new or worse mood symptoms.
• Common side effects: drowsiness, fatigue, muscle weakness and poor coordination are the most common in the label. Others include blurred or double vision, dry mouth, nausea, constipation, dizziness, headache, slurred speech and memory loss for events after a dose.
• Falls and fractures: the label says this risk is higher in older adults and with other sedating medicines or alcohol.
• Paradoxical reactions and breathing: agitation, aggression, anger or hallucinations are more likely in children and older adults. Slowed or stopped breathing can be fatal, especially with lung disease or other sedating medicines. MedlinePlus also asks you to mention myasthenia gravis, sleep apnea, and lung or liver disease.
• Interactions: medicines that block the enzymes CYP3A4 or CYP2C19 can raise diazepam levels and prolong sedation, and medicines that induce them can lower levels. MedlinePlus names some allergy medicines, cimetidine and omeprazole. Share your full list.

Can it be managed online in Pennsylvania and New York

As of November 2026, a temporary federal rule (Federal Register, Fourth Temporary Extension) allows DEA-registered practitioners to prescribe Schedule II to V medicines by audio-video telemedicine without a prior in-person evaluation, under set conditions, through December 31, 2026. Rules may change after that date.

The rule permits telemedicine prescribing; it does not require it, and a visit may not end in a prescription for this or any medicine. Muscle and seizure care stay with the doctors managing those conditions. Our psychiatrist's care is for anxiety, depression and trauma.

A licensed psychiatrist on our team, a Doctor of Osteopathic Medicine (DO) with more than three decades of practice, sees people by secure video who are physically located in Pennsylvania or New York during each visit. Read about online anxiety treatment and medication management, with details for Pennsylvania and New York. Whether it is an option for you is a decision for you and your prescriber. Ask us whether our psychiatrist can help, and ask about fees, insurance and ages.

Our therapists do not prescribe. They see clients in Pennsylvania, West Virginia, Arizona, Colorado and Florida, not New York, so a New York reader can get psychiatry here but not anxiety therapy here. Our medication list covers other medicines.

If you are in crisis, call or text 988, or call 911. Locascio Wellness does not provide emergency services; crisis resources are on our site. MedlinePlus gives Poison Help at 1-800-222-1222 for an overdose, and 911 if the person has collapsed, had a seizure, has trouble breathing or cannot be awakened.