How Long Does Valium Take to Work?
Medically reviewed by Alex Yampolsky, PharmD
Valium (diazepam) belongs to the benzodiazepine class of medication. It's approved by the Food and Drug Administration (FDA) to manage anxiety symptoms, treat alcohol withdrawal symptoms, and as add-on therapy for skeletal muscle spasms and convulsive disorders.
Diazepam is the single active ingredient in Valium. Valium is available as an oral tablet, suspension, intramuscular and intravenous injection, and rectal gel.
Diazepam can take anywhere from a few minutes to one hour to begin working, depending on the route of administration. Injectable, nasal, or rectal formulations have a quicker onset of action than oral.
This article will provide an overview of how quickly Valium begins working, along with other important information regarding the safe use of this benzodiazepine.
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How Long Does It Take for Valium to Work?
Valium should work similarly whether it is taken for anxiety or agitation. However, individual responses to it can vary.
In general, Valium’s onset of action can vary but is relatively quick, typically occurring within 30 to 60 minutes after taking the medication by mouth. The medication can last up to several hours in the body before another dose is needed. For most indications, Valium can be taken every six to eight hours.
The peak concentration of Valium in the bloodstream typically occurs within one hour after oral administration.
Valium is metabolized in the liver and expelled from the body through the urine.
How long it takes Valium to work can vary depending on how it is administered and several factors specific to individuals such as:
Liver function
Body weight
Age
Metabolism
Liver Function
Because Valium is processed in the liver, liver function can impact the drug’s metabolism. If the drug’s metabolism is affected by poor liver function, the drug may take longer to leave the body, resulting in prolonged effects.
Body Weight
Body weight can impact how Valium is distributed in the body. Individuals with more body fat may experience a slower onset of action. Therefore, Valium may take longer to work.
Age
Age can play a role in older individuals due to age-related changes in metabolism that may exist. These changes may result in a slower onset of Valium.
Metabolism
An individual's metabolism can impact how Valium is broken down in the body. A faster metabolism may result in a quicker onset of action. Those with slower metabolisms may take longer to feel the drug’s effects.
Drug Tolerance
If Valium is taken excessively, drug tolerance may develop over time. If Valium tolerance occurs, higher doses of the drug may be needed. This may also influence how quickly the drug works.
What Is Valium?
Diazepam is the active ingredient found in Valium. It belongs to a class of medications called benzodiazepines. Valium is FDA-approved for the short-term relief of anxiety symptoms, symptoms associated with alcohol withdrawal, and muscle spasms.
It should not be used in children under 6 months of age. Adults 65 and older should take precautions while using it or avoid it altogether.
Brand-name Valium is available as tablets only. Generic diazepam is available as a tablet, oral solution, injection, and rectal gel.
Off-label uses of Valium include:
Sedation in the hospital setting
The treatment of muscle symptoms in children with cerebral palsy
Valium carries boxed warnings—the FDA's strictest safety warning added to a prescription drug label—regarding the potential for abuse, misuse, addiction, dependence, and withdrawal reactions.
Controlled Substance
Valium is a federally controlled substance (C-IV) due to its risk of abuse or dependence. Schedule IV drugs are considered to have a low potential for abuse and dependence.
How It Works
Valium works by enhancing the activity of a chemical messenger found in the brain called gamma-aminobutyric acid (GABA), making it more effective.
By attaching to GABA receptors, Valium produces a calming effect on the brain and reduces nervous system activity. This calming effect helps lessen symptoms associated with anxiety, alcohol withdrawal, and muscle spasms.
When compared to other benzodiazepines, Valium works similarly. However, it is considered to be one of the longer-acting benzodiazepines and has a medium potency (strength).
Dosing Valium
The usual daily dose of Valium for anxiety in adults is 2–10 milligrams (mg), taken every six to 12 hours, depending on symptom severity.
The usual dose of Valium, when used as add-on therapy for relieving muscle spasms in adults, is 2–10 mg, taken every six to eight hours.
These are common doses, but there may be instances in which higher doses are required. Follow the instructions of the healthcare provider treating the condition when considering Valium dosing.
Side Effects
The most common side effects of Valium are:
Severe side effects of Valium include:
Long-term side effects may occur if physical dependence on Valium develops and may include withdrawal if stopped suddenly. Withdrawal symptoms include:
Anxiety
Cognitive difficulties such as trouble remembering or concentrating
Depression
Difficulty sleeping
Muscle twitching
Avoid taking Valium before or while engaging in activities that require you to be alert and attentive. Ensure Valium is only taken as instructed by a healthcare provider.
Boxed Warnings
Valium carries boxed warnings regarding the potential for abuse, misuse, addiction, dependence, and withdrawal reactions.
Taking Valium at the same time as opioid medicines, alcohol, or other medications that affect the central nervous system can be harmful and cause severe side effects such as drowsiness, breathing problems, coma, and death.
Valium carries a risk of abuse, misuse, and potentially addiction even if taken as prescribed. This can lead to overdose and serious side effects, including coma and death.
Valium can also cause physical dependence and withdrawal reactions.
Safely Taking Valium
The following preexisting health conditions would disqualify someone from taking Valium:
Myasthenia gravis (an autoimmune condition)
Severe breathing problems
Severe liver problems
Long-term use of Valium should be avoided unless instructed by a healthcare provider. Clinical trials have not evaluated the effectiveness of Valium used longer than four months.
Use in Specific Populations
The following circumstances should be considered before taking Valium:
Pregnancy: Valium should be avoided during pregnancy if possible. The drug has shown evidence of human risk in clinical trials. However, the benefits of using the medication may outweigh the risks.
Breastfeeding: Breastfeeding is not recommended for those taking Valium. Valium passes through breast milk.
Age: Valium should be used cautiously or avoided entirely in adults 65 years and older. Its half-life increases by one hour each year over the age of 40. This can put older people at risk of serious and long-lasting side effects such as cognitive impairment, falls, and fractures. It is recommended that the smallest effective dose be used to prevent side effects.
Potential for Interaction
Avoid taking Valium with the following medications due to their potential effect on drug absorption and effectiveness:
Some seizure medications, such as Lamictal (lamotrigine) and carbamazepine
Antifungals such as ketoconazole
Antidepressants such as Prozac (fluoxetine)
Prilosec (omeprazole), a drug for heartburn relief
Dilantin (phenytoin), a drug to prevent and treat seizures
Opioids and other medications that act on the central nervous system, such as anxiety medications, muscle relaxers, narcotic pain medications, and some antidepressants, should be avoided due to the potential harm that may occur as a result of taking these medications together.
Alcohol should be avoided while taking Valium.
How Effective Is Valium?
Studies have compared the effectiveness of Valium with other benzodiazepines. In general, they have similar effectiveness in managing anxiety and muscle spasms.
One study compared the efficacy and tolerability of diazepam and alprazolam, the active ingredient in Xanax, for the treatment of panic disorder. The results showed that diazepam was an effective alternative to alprazolam.
Overall, studies show that Valium is an effective treatment option for both anxiety and muscle soreness.
Alternative Treatment Options
Cognitive behavioral therapy (CBT) has been proven to be an effective nondrug treatment option for anxiety.
Some other nondrug treatment options for anxiety include:
Nondrug treatment options for muscle pain and spasms include:
Acupuncture
Massage therapy
Relaxation therapy
Physical therapy
Alcohol withdrawal should be appropriately treated by a healthcare professional. In minor alcohol withdrawal, medication may not be needed, but evaluation and observation by a healthcare provider are still recommended.
Summary
Diazepam is a benzodiazepine that is FDA-approved for anxiety, symptoms associated with alcohol withdrawal, and muscle spasms. It is available as an oral tablet, suspension, intramuscular and intravenous injection, and rectal gel.
Valium generally begins working within 30 to 60 minutes after taking the medication by mouth. The medication can last anywhere from a few hours to several hours in the body before another dose is needed. For most indications, Valium can be taken every six to eight hours.
Valium carries boxed warnings regarding the potential for abuse, misuse, addiction, dependence, and withdrawal reactions. Before starting treatment, talk to your healthcare provider about how to safely take it.
Read the original article on Verywell Health.
