Diazepam

Diazepam starts to work very quickly in your body. You should get calming effects within two hours of taking it.

Diazepam does not usually affect your weight. It can affect your appetite but this is rare.

Talk to your doctor or pharmacist if you are concerned about your weight, or changes to your weight, while taking diazepam.

You may want to let your family and friends know you are taking diazepam so they can support you and help you look out for side effects.

Diazepam may make you feel very sleepy, and this can carry on into the next day.

Some people find it more difficult to get to sleep when taking diazepam or experience nightmares or strange dreams when taking it.

If your sleep is negatively affected by diazepam, you should discuss this with your doctor.

When you stop taking diazepam, you may experience ‘rebound insomnia’. This means your sleep might be worse and you might get more vivid dreams immediately after stopping it, but this should improve again. If it doesn’t, discuss this with your doctor.

Alcohol

Drinking alcohol if you are taking diazepam is not recommended as this is likely to make you very sleepy. Diazepam may lower your tolerance to alcohol and you may experience more side effects.

Sometimes diazepam is prescribed to help manage the withdrawal symptoms people experience if they stop drinking alcohol. If you have been prescribed diazepam to help you stop drinking, you should not drink any alcohol with this medicine.

Taking large amounts of alcohol and diazepam together could affect your breathing, especially if you have an existing lung problem.

If you need to drive a car or ride a bike, or use machines at work, taking alcohol and diazepam together could impair your ability to do this safely and be dangerous to yourself and others.

Drinking alcohol every day, or in large amounts, can make your symptoms worse and may mean you won’t get the maximum benefit from your medication.

Street drugs

Diazepam does not mix well with street drugs. It is very easy, and serious, to overdose with any combination of diazepam and drugs.

Using cannabis with diazepam will make its sedative effect worse. You could go into a very deep sleep where you do not breathe properly and have difficulty waking up.

Cannabis and other drugs may have their own side effects on your mental health, like anxiety or psychosis.

Using heroin or methadone with diazepam will also increase their combined sedative effects. You could go into a very deep sleep where you do not breathe properly and have difficulty waking up. This combination could be very dangerous.

Using cocaine or other stimulants (like ecstasy, amfetamines, MDA, 6-APB etc.) with diazepam is likely to lead to a reduced stimulant effect. This could lead you to increase the dose of the stimulant to make up for it, which could be very dangerous.

There are many other street drugs, but we don’t know what effect taking them with diazepam will have, so it’s best to be cautious. There is no regulation of street drugs or ‘legal highs’, so even if there are no known issues with the medication you take, the supply you receive might be mixed with other substances that could be dangerous.

Smoking

If you start or stop smoking while you are taking diazepam, you may have to change your dose. This is because cigarette smoke affects the amount of diazepam in your body.

If you already smoke when you begin taking this medication, you may need a higher dose than somebody who does not smoke. You should tell your doctor if you smoke and how much, so that they can prescribe the correct dose for you.

If you stop smoking, the level of diazepam in the body could rise, and you might need to reduce your dose of diazepam slowly over one week.

If you start or restart smoking, you might need to increase it again.

Go to your doctor for advice if you stop or start smoking, or if you switch from smoking cigarettes to using a nicotine replacement product or vaping.

Get more advice on drugs and alcohol.

Diazepam does not mix well with some other medicines, including herbal remedies. It may affect the way in which they work or could cause more side effects.

You should be very careful if you take diazepam with other medicines that can cause sedation, especially medicines for pain relief that contain opioids (for example dihydrocodeine or morphine). When combined, these medicines may make you extremely sedated or could affect your breathing. Your doctor will monitor this carefully if you are prescribed these medicines together.

Always tell the pharmacist that you are taking diazepam if you buy any medicines from a pharmacy.

Look at the leaflet inside your medicine box for more information about other medicines that can interact with diazepam. With some medicines your doctor may need to adjust the dose of your medicines if you take them together. Ask a doctor or pharmacist for more information if you have any questions.

Watch your caffeine intake while you are taking diazepam as caffeine has the opposite effect of diazepam in your body and interferes with it working.

Try not to drink caffeine drinks like coffee, cola or energy drinks while you are taking diazepam. These may reduce the effect of diazepam.

Caffeine can cause anxiety and sleep loss. Stopping these drinks might help to improve your symptoms.

Avoid drinking grapefruit juice with diazepam. This can increase the amount of diazepam in your blood and could make you very sleepy or mean that you get more side effects.

If you use oral contraceptives (combined oral contraceptives), break through bleeding has been reported if you take diazepam together with these. No failure in contraception has been reported. Discuss this with your doctor if you experience this and are concerned.

There are multiple companies that manufacture diazepam.

The non-active ingredients vary between products and manufacturers, so if you have any food allergies or intolerances always let your pharmacist know and always check with them if you’re concerned about any of the ingredients in your medication.

The tablets contain lactose and may not be suitable for you if you have problems eating some sugars or dairy products.

The yellow (5mg) tablets may also contain sunset yellow (E110) or similar colourants, a food additive that can cause allergic reactions. Check with your pharmacist if this is important.

Diazepam oral solution contains sorbitol and is not suitable if you have hereditary fructose intolerance.

If you need to avoid animal products, please note that non-active ingredients used in the production of medicines may sometimes be of animal origin. Ask your pharmacist if you have any questions about the ingredients.

Further information about practical considerations for medicines if you need to avoid animal products can be found on the Vegan Society website.

Diazepam can make you feel sleepy, dizzy and forgetful when you first start taking it. You might also find it difficult to concentrate during the first few days of treatment and may experience blurred vision and muscle weakness. For these reasons, you should not ride a bike or drive a car until you know how you will be affected.

You should also be very careful when doing anything else that requires concentration, such as operating machinery or exercising.

The effects of diazepam can last a while after taking it, so even if you only take one dose, you may feel them the next day. It’s important not to drive, ride a bike or operate machinery if you feel that your ability to concentrate has been compromised by taking diazepam.

It is illegal to drive with medication in your body if it impairs your driving. It is important to stick to the dose on the prescription, and to check that you can drive safely while taking it. Ask your doctor if you’re not sure if your condition or your medicine will affect your driving.
You may also have to prove that you have been prescribed diazepam by your doctor, so you should keep your repeat prescription slip with you in case you are asked.

The Department of Transport website has more details.

Pregnancy

If you become pregnant while you are on diazepam, you should carry on taking it and make an appointment to see your doctor as soon as possible. They can discuss the benefits and risks of continuing diazepam and help you to make a decision that is best for you and your baby. They may refer you to a specialist perinatal mental health team to support you with this decision.

If you are planning to get pregnant, it is recommended that you take folic acid while you are trying for a baby and during pregnancy. It is safe to take this together with diazepam.

You can find out more information about taking diazepam during pregnancy at Bumps (Best Use of Medicines in Pregnancy).

Untreated anxiety can also be harmful to you and your developing baby, so decisions about stopping or avoiding medication when you are pregnant need to be discussed carefully with your doctor.
If you and your doctor agree that carrying on with diazepam has more benefits than risks, you should tell your midwife that you are continuing to take this at your next appointment.

It will be important to take the lowest dose that works for you for the shortest period of time that is necessary. This is to minimise the amount of diazepam that the developing baby is exposed to.

Post-natal

Taking diazepam during the last few months of pregnancy can cause withdrawal symptoms in a new born baby that include:

• weakness and breathing difficulties
• being jittery, irritable or constant crying
• being too cold
• suckling/ feeding difficulties or being sick
• floppy muscles, or tremors
• being very sleepy or finding it difficult to sleep

If this does occur, you will need help from your midwife, so it is important they are looking out for symptoms.

Breastfeeding

Please talk to your midwife, doctor or pharmacist if you want to breastfeed while taking diazepam. They can discuss the pros and cons of taking diazepam during breastfeeding and help you consider other options for medication or feeding if you are concerned.

It is important that you remain well while you are bonding with your newborn baby. For this reason, you may need to keep taking some medicines on your doctor’s advice.

If you start or continue to take diazepam when breastfeeding, use the lowest dose of medicine for the shortest length of time possible.
Diazepam is passed to the baby in breast milk. This may mean your baby is very sleepy or doesn’t feed well. You should seek urgent advice from your midwife, health visitor or doctor if this happens.

If you are taking this medication, you may be more sedated and not as rousable overnight. Bed-sharing with the baby is not recommended if this medicine is being taken due to increased risk of suffocation or sudden infant death.

Sex

Diazepam can have side effects that might affect your sex life. These include:

• losing interest in sex or sometimes feeling more like having sex
• feeling ‘numb’ to your normal emotions
• finding it difficult to get an erection (get hard)

Most side effects occur when you first start medication and improve over time.

Diazepam is only recommended for short-term use. If you take it for longer and these symptoms don’t pass within a couple of weeks, discuss this with your doctor if this is a problem for you.

Untreated anxiety can have a negative effect on your sex life, so if diazepam helps you to recover, positive effects can include improving your desire, experience and enjoyment of sex as your mood lifts and you become interested in life and relationships again.

Fertility

There is currently no evidence to suggest that diazepam affects fertility.

Talk to your doctor about your diazepam if you are trying to get pregnant.

Diazepam is not a banned substance in sport.

Diazepam has many side effects that might make you less able to take part in sports that need a lot of focus. These include feeling sleepy, blurred eyesight, being forgetful, muscle weakness and finding it difficult to concentrate. It might be best to stop such sports for the first few days until you know how it affects you.

The good effects of diazepam may have a positive impact on your sporting performance as your symptoms settle and you sleep better.

Ideally it is best not to take diazepam for the first time just before your exams. It is not possible to predict how the medication will make you feel, and if you do get any side effects, these are more likely to occur when you first start taking diazepam.

You may feel forgetful, very sleepy, and find it difficult to concentrate which may interfere with your preparation for exams or performance during exams.

You should talk to your doctor about any future exams if you are starting diazepam. You might decide together to delay starting it until you have done them.

If they are more than a few days away, however, you might find that it is better to start diazepam to reduce anxiety, improve your sleep and your ability to study. After the first few days you will know how it affects you.

Try not to drink caffeine drinks to stay awake for exam revision – they stop the diazepam working. Sleep is important to improve memory, and logical reasoning is important when revising and to help you perform better in exams.

If you are worried that taking diazepam might make studying for or taking your exams harder, discuss this with your doctor.