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Diazepam (dye AZ e pam) has been approved by the FDA to treat:

  • Short-term treatment of seizure clusters (also known as “acute repetitive seizures”)
    • in patients with epilepsy 2 years of age and older for the rectal formulation.
    • in patients with epilepsy 6 years of age and older for the nasal formulation.
  • The oral form may be used along with other drugs in convulsive disorders.

Diazepam is a member of a group of drugs known as benzodiazepines. Benzodiazepines are commonly used in epilepsy as a rescue medicine on an “as needed” basis. These treatments are meant to rapidly stop seizures, whether to prevent an emergency or during one while under the care of healthcare providers. These medications do not replace your daily seizure medication and should not be taken daily. Talk to your healthcare provider about how your rescue medication should be used.

Your epilepsy treatment should always be discussed with your healthcare provider before use. Based on their judgment and knowledge, a drug may be prescribed for other epilepsy types not included in the indications. For more information, please see the prescribing information.

How can you take diazepam? (Available formulations)

Diazepam is available as a nasal spray, a rectal gel with an applicator, and an oral tablet which can be taken by mouth with or without food.

Who should not take diazepam?

If you are allergic to diazepam or any of the inactive ingredients, then you should not take it. Diazepam should not be taken by babies under 6 months old. If you have myasthenia gravis (an autoimmune neuron/muscle affecting disease), sleep apnea syndrome (temporarily stopped breathing during sleep), or acute narrow-angle glaucoma, or severe lung or liver problems, then you should not take diazepam.

Other considerations may influence whether you should take diazepam. Tell your healthcare provider if you:

  • have asthma, emphysema, bronchitis, chronic obstructive pulmonary disease, or other breathing problems.
  • have a history of alcohol or drug abuse.
  • have a history of depression, mood problems, or suicidal thoughts or behaviors.
  • have liver or kidney problems.
  • are pregnant or plan to become pregnant.
  • are breastfeeding or plan to breastfeed.

Talk to your healthcare provider about the risks and benefits of using diazepam if you are 65 years of age or older. Older adults should not usually use diazepam because it is not as safe as other medications that can be used to treat the same condition.

What is important to know about taking diazepam?

Do not stop taking diazepam suddenly unless directed to do so by your healthcare provider.

As with all antiseizure medications, diazepam should be withdrawn gradually to minimize the risk of causing or worsening seizures or status epilepticus. You should not stop using diazepam suddenly unless your healthcare provider tells you to stop the medicine because of a serious side effect.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Taking diazepam with certain other medicines may cause side effects or affect how well they work. Do not start or stop other medicines without talking to your healthcare provider. Especially tell your healthcare provider if you take: opioids.

While diazepam is occasionally prescribed as a daily seizure medicine, it is most often used for acute treatment of seizures in a hospital setting or as a rescue medicine given to stop seizure clusters and prevent seizure emergencies. Your healthcare provider will talk to you and your caregiver about how to recognize signs of the type of seizure activity that should be treated with this medication, and how to administer the rectal gel or nasal spray. Be sure that your caregiver or family members know which symptoms may be serious so they can call the healthcare provider or emergency medical care if you are unable to seek treatment on your own.

Call for emergency help if any of the following happen:

  • seizures continue for 15 minutes after diazepam was given (or follow your healthcare provider’s instructions)
  • the seizures seem different or worse than usual
  • you are worried about how often seizures are happening
  • you are worried about the skin color or breathing of the person with seizures
  • the person is having unusual or serious problems
Abuse, misuse, and addiction

Diazepam is a federally controlled substance (C-IV) because it can be abused or lead to dependence. Do not use a larger dose, use it more often, or for a longer time than your healthcare provider tells you to. Tell your healthcare provider if you have ever drunk large amounts of alcohol, if you use or have ever used street drugs, or have overused prescription medications. Do not drink alcohol or use street drugs during your treatment. Drinking alcohol or using street drugs during your treatment with diazepam also increases the risk that you will experience serious, life-threatening side effects. Talk to your healthcare provider about the signs and symptoms of diazepam addiction.

Boxed warnings

Diazepam is approved by the FDA because it is safe and effective for the majority of people who take it. However, there are risks associated with all medicines. Some side effects caused by diazepam can be very serious, and even life-threatening. It is important to be informed about these serious reactions and to be aware of their symptoms.

Use with opioids or other central nervous system depressants

Get emergency help right away if you experience shallow or slowed breathing, breathing stops (which may lead to the heart stopping), or excessive sleepiness (sedation).

Diazepam can slow or stop your breathing, especially if you have recently used an opiate medication, alcohol, or other central nervous system depressants as they also may slow your breathing. Opiates can be found in medications such as those for cough that contain codeine or hydrocodone, or those for pain that contain codeine, fentanyl, hydromorphone, meperidine, methadone, morphine, oxycodone, and tramadol. Tell your healthcare provider if you take these medications as they may need to change the dosages of your medications and will monitor you carefully. If you take diazepam and you develop any of the following symptoms, call your healthcare provider or seek emergency medical care immediately:

  • weak or shallow breathing
  • severe drowsiness
  • restlessness or you feel agitated or irritable
  • unusual thoughts, hallucinations
  • a light-headed feeling, like you might pass out
Women or those who are/plan to become pregnant

Diazepam may hurt your baby if taken while pregnant.

Use in pregnancy

Ordinarily, diazepam should not be used during pregnancy except in serious or life-threatening conditions where safer drugs cannot be used or are ineffective. Studies have also shown in humans that diazepam and some metabolites are transferred to the placenta. However, having a seizure during pregnancy could harm both the pregnant individual and the baby. Tell your healthcare provider right away if you become pregnant. Do not start or stop taking seizure medication during pregnancy without your healthcare provider’s advice.

If you become pregnant while taking diazepam, talk to your healthcare provider about registering with the North American Antiepileptic Drug (NAAED) Pregnancy Registry. The purpose of this registry is to collect information about the safety of antiseizure medicine during pregnancy. You can enroll in this registry by calling 1-888-233-2334.

Use during breastfeeding

Diazepam passes into breast milk. Breastfeeding is therefore not recommended, as, the possibility exists that diazepam, like other benzodiazepines, may sedate or otherwise adversely affect the infant. It is also unknown if diazepam impacts milk production. Talk to your healthcare provider about the best way to feed your baby while taking diazepam. Your healthcare provider will consider the developmental and health benefits of breastfeeding along with your need for diazepam and the potential effect on the infant from diazepam or from your epilepsy.

Effect on birth control and fertility

The effect of diazepam on fertility in humans is unknown. There is some evidence in animal studies to suggest impairment of fertility.

What are the side effects of diazepam?

Common side effects

The most common side effects that were reported in studies of diazepam are drowsiness, fatigue, muscle weakness, and problems with movement and balance (ataxia).

Rare, but serious side effects
Nervous system depressant effect

Since diazepam has a central nervous system depressant effect, patients should be advised against the simultaneous ingestion of alcohol and other CNS-depressant drugs during diazepam therapy.

Status epilepticus

When diazepam is used as an adjunct in treating convulsive disorders, the possibility of an increase in the frequency and/or severity of grand mal seizures may require an increase in the dosage of standard anticonvulsant medication. Abrupt withdrawal of diazepam in such cases may also be associated with a temporary increase in the frequency and/or severity of seizures.