Diazepam belongs to a group of medicines called benzodiazepines.

It's used to treat anxiety, muscle spasms and fits (seizures). 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".

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 anus). It can also be given as an injection in hospital.

• The most common side effect is feeling drowsy.
• You're not recommended to use diazepam for longer than 4 weeks.
• If you take diazepam and feel sleepy, do not drive or use tools or machines.
• Do not drink alcohol while taking diazepam. It can make you sleep very deeply. You may have breathing problems and difficulty waking up.
• Diazepam is known by the brand names Diazemuls, Stesolid Rectal tubes, Diazepam Rectubes and Diazepam Desitin. It's also known as Valium, but this brand is not available in the UK anymore.

Diazepam tablets and liquid can be taken by adults aged 18 years and over.

It can also be taken by children aged 1 month or older for muscle spasms.

Diazepam rectal tubes can be used by adults and children.

It's not suitable for everyone. To make sure it's safe for you, tell your doctor before starting diazepam if you:

• have had an allergic reaction to diazepam or any other medicine in the past
• 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 personality disorder
• have (or have 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

Rectal tube

Diazepam rectal tubes (or rectal diazepam) can be used if you or your child is having a 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.

If you're having a fit, they also need to know how long to wait before giving you rectal diazepam.

Your doctor will decide the right dose for you or your child according to your weight, age and general health.

Tablets and liquid

Take diazepam tablets or liquid with a drink of water. You can take them with or without food.

You'll usually take your medicine 1 to 3 times a day.

Your doctor will decide the right dose for you. It's important to take diazepam exactly as your doctor tells you to.

The usual dose for:

• anxiety - is 2mg taken 3 times a day. This can be increased to 5mg to 10mg 3 times a day.
• sleep problems (related to anxiety) - is 5mg to 15mg taken once a day at bedtime.
• muscle spasms in adults - is 2mg to 15 mg a day. This can be given as 1mg twice a day and go up to 5mg 3 times a day. The dose can be increased up to 20mg 3 times a day if needed.
• muscle spasm in children (aged 1 month to 17 years) - varies depending on age. It's usually given twice a day, with 10 to 12 hours between each dose.

Your dose might be lower if you're over 65 or have kidney, liver or severe breathing problems.

What if I 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 as normal.

Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.

What if I take too much?

The amount of diazepam that can lead to an overdose varies from person to person.

Like all medicines, diazepam can cause side effects in some people, but many people have no side effects or only minor ones.

Common side effects

These common side effects happen in more than 1 in 100 people.

If you get these side effects, keep taking the medicine and speak to your doctor:

• feeling sleepy or drowsy
• confusion
• problems with your co-ordination or controlling your movements
• shaky hands (tremors)

Serious side effects

It happens rarely, but some people have serious side effects when taking diazepam.

Tell a doctor straight away if:

• your breathing becomes very slow or shallow
• your skin or the whites of your eyes turn yellow
• you find it difficult to remember things (amnesia)
• you see or hear things that are not there (hallucinations)
• you think things that are not true (delusions)
• you keep falling over

On very rare occasions, some people may experience unusual mood changes. These can become serious and are more likely to happen in children or if you're over 65.

Tell your doctor if you notice any of these side effects:

• talking too much or feeling overexcited
• feeling agitated or restless
• feeling irritable or aggressive

Serious allergic reaction

In rare cases, diazepam may cause a serious allergic reaction (anaphylaxis).

These are not all the side effects of diazepam. For a full list, see the leaflet inside your medicine packet.

If you feel sleepy or drowsy, do not drive or use tools or machinery until you feel better. Do not drink any alcohol.

This side effect should get better as your body gets used to the medicine.

If your symptoms do not improve after a week, speak to a doctor as you may need a lower dose.

If you experience any other side effect, speak to your doctor.

There's not enough information to know if diazepam is safe to use in pregnancy. But it can give your newborn baby withdrawal symptoms.

If you become pregnant while taking diazepam, speak to your doctor.

You may need to keep taking diazepam during pregnancy as it's important for you to remain well.

Your doctor 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, diazepam can be used during breastfeeding as long as you're only taking a low dose of diazepam occasionally or for a very short time.

Diazepam passes into breast milk. If you take diazepam for a long time or in high doses, it can build up in your milk. This can make your baby drowsy or tired and can make it difficult for them to feed.

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 the diazepam is being used for.

If you do take diazepam while you're breastfeeding and you notice that your baby's not feeding as well as usual, seems unusually sleepy, has unusual breathing, or you have any other concerns about them, talk to your health visitor or doctor as soon as possible.

Some medicines interfere with 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 :

• antipsychotics used to treat mental health problems
• antidepressants used to treat depression
• anticonvulsants used to treat epilepsy
• 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 and tizanidine
• disulfiram, a medicine for alcohol addiction
• isoniazid, a medicine for tuberculosis
• rifampicin, a medicine for bacterial infections
• theophylline, a medicine for asthma and other breathing problems

Mixing diazepam with herbal remedies or supplements

There's very little information about taking herbal remedies and supplements with diazepam.

Do not take herbal medicines 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.