Diazepam: uses, side effects and short-term use

The NHS describes diazepam as a treatment for symptoms such as anxiety, seizures and muscle spasms, and notes it can be used to sedate before treatment or surgery. The same medicine is therefore prescribed in very different settings, from a short course for severe anxiety to emergency seizure control.

For anxiety, the NHS describes severe anxiety with symptoms such as sweating, shaking and not sleeping. It is a medicine for that kind of acute distress, not for everyday worry, and it sits alongside talking therapies and other treatments rather than replacing them.

Tablets come in 2 mg, 5 mg and 10 mg strengths and are swallowed whole with water. A rectal tube is used where tablets are not suitable, for example during seizures. The dose depends on the reason for prescribing. For children the NHS says it is typically taken twice daily, 10 to 12 hours apart.

If you miss a dose, skip it and take the next dose as scheduled. Do not take two doses together.

Doses can be spread through the day. The NHS gives the example of a 6 mg daily dose that might be divided into three 2 mg doses. For the rectal tube, the tip is inserted into the rectum and the tube squeezed to release the medicine, then thrown away after one use. If a seizure continues, another dose can usually be given after 10 minutes.

If you or a child take more than the prescribed amount, call NHS 111. Do not drive yourself to A&E; ask someone to take you or call 999 for an ambulance, and bring the packaging and any remaining medicine.

The NHS says diazepam should only be used short term, up to 4 weeks. Longer use can lead to dependence, and stopping suddenly causes withdrawal symptoms, so the dose is reduced gradually. If you have been taking it for a while, do not stop it without speaking to your prescriber.

Common effects centre on alertness and mood.

• Feeling less alert, drowsiness and tiredness.

• Increased anxiety or depression, and low blood pressure.

• Avoid driving or cycling until you feel better.

• Call NHS 111 for an allergic reaction, difficulty breathing or yellowing of the eyes or skin (jaundice, which can be harder to see on darker skin).

The NHS says diazepam may be unsuitable if you have long-term kidney, liver, heart or breathing problems, certain mental health conditions, a history of alcohol or drug misuse, an allergy to diazepam, or are pregnant. Tell your prescriber about any of these.

Do not drink alcohol, since it increases the risk of side effects. The NHS says to avoid or check combinations with antidepressants such as fluvoxamine and fluoxetine, antipsychotics, sedating antihistamines and general anaesthetics. Tell any dentist or surgeon that you take it. The NHS also says that grapefruit juice and alcohol both make side effects more likely, and that caffeine in tea, coffee or cola may make diazepam less effective.

Avoid it in pregnancy unless a doctor advises otherwise. It may pass into breast milk, and is used only short term at a low dose if the benefits outweigh the risks. Talk to your doctor or pharmacist before feeding. Suspected side effects can be reported to the MHRA Yellow Card scheme.