• If you are allergic to anything, including medicines, dyes, additives, or foods.

• If you have any medical conditions such as kidney disease, liver disease (including hepatitis), heart disease, congestive heart failure, seizures, or brain disease. These conditions may require that your medicine dose, regimen, or timing be changed.

• If you have asthma, emphysema, bronchitis, sleep apnea, or other breathing problems. This medicine can worsen breathing.

• If you have depression, myasthenia gravis, or porphyria. This medicine may make the symptoms worse.

• If you have glaucoma. People with acute narrow-angle glaucoma should not use this drug.

• If you are taking any medicine (sedative) that makes you calmer or drowsy, or if you drink alcohol. The combination may produce serious side effects.

• If you have ever had a problem with alcohol or addiction in the past. This drug can be habit forming, and those who have had other addictions are more at risk.

• If you are pregnant, trying to get pregnant, or if there is any chance of pregnancy. There seems to be an increased risk of harm to the fetus if a woman takes this drug during pregnancy. In addition, newborns whose mothers take the drug regularly in late pregnancy may have withdrawal symptoms after birth.

• If you are breast-feeding. The drug passes into breast milk and may harm the baby.

• About any other prescription or over-the-counter medicines you are taking, including vitamins and herbs. In fact, keeping a written list of each of these medicines (including the doses of each and when you take them) with you in case of emergency may help prevent complications if you get sick.

The following drugs can also cause diazepam to build up in the body, raising the risk of serious side effects. If you need one of these medicines while you are taking diazepam, your doctor may be able to adjust your diazepam dose:

• antidepressant drugs nefazodone (Serzone), fluvoxamine (Luvox), fluoxetine (Prozac, Serafem)
• antibiotics erythromycin, clarithromycin, and similar drugs
• acid blocking drugs cimetidine (Tagamet) and omeprazole (Prilosec)
• certain blood pressure medicines such as diltiazem and verapamil
• HIV drugs such as indinavir, ritonavir, and nelfinavir

Diazepam can add to the effects of other medicines and substances that make you sleepy or less alert, such as:

• antihistamines
• tranquilizers (sedatives)
• sleeping pills
• muscle relaxers
• barbiturates
• anti-seizure medicines
• opioid pain medicines
• anesthetics
• antidepressants
• anti-psychotic drugs
• certain anti-nausea medicines
• alcohol

Using these kinds of substances while taking diazepam can result in losing consciousness (passing out) and possibly death.

Certain medicines, supplements, and other substances can reduce the amount of diazepam in the body, so that it does not work as well:

• anti-seizure medicines such as carbamazepine, phenobarbital, phenytoin
• pioglitazone (Actos), for diabetes
• St. John's wort
• TB medicines rifampin and rifabutin
• smoking cigarettes

Check with your doctor, nurse, or pharmacist about whether other medicines, vitamins, herbs, and supplements can cause problems with this medicine.

In addition, it comes in a liquid concentrate form that is measured with a special dropper and mixed with water, juice, or other liquid.

A gel form of diazepam is given in the rectum, which requires special instructions for the caregiver who gives it. If you must give the rectal gel, be sure you get the full instructions on how to do it, including how to observe the patient afterward.

The dose and how often it is given depends on the reason it is being given and your size. Take this drug exactly as your doctor tells you to. If you do not understand the instructions, your doctor or nurse can explain them to you. Store the medicine in a tightly closed container away from heat and moisture and away from children and pets. Do not let anyone else share your medicine.

Diazepam may cause you to feel drowsy or dizzy. This is more likely if you are taking other drugs that depress the nervous system such as opioids, anti-anxiety drugs, muscle relaxers, or some anti-nausea medicines. Do not drive or operate heavy machinery until you know the effect the drug will have on you. Usually, drowsiness and dizziness go away after a few days of taking diazepam. Talk to your doctor or nurse if you feel too drowsy or have dizziness that does not go away.

This is a controlled substance, and may be habit-forming. Take diazepam only as directed by your doctor. Diazepam may cause physical dependence (your body goes into withdrawal if drug is suddenly stopped). Signs of physical dependence are common when the drug is taken for more than a few weeks. Physical dependence can be managed by stopping the medicine gradually over time. A few people also become psychologically dependent on diazepam (which can lead to addiction). Some signs of psychological dependence are a strong desire to keep taking the medicine and wanting larger doses of the medicine. Talk with your doctor if you think this is happening to you.

Do not stop taking this drug without talking with your doctor. If you have been taking this drug for more than a few weeks, you may experience withdrawal symptoms for several days if you stop it suddenly. Most often this appears as irritability, nervousness, trouble sleeping, stomach cramps or upset stomach, trembling or shaking, and even hallucinations and seizures in those who have taken high doses for a long time. Talk with your doctor or nurse about how to lower your dose gradually until it is stopped.

Tell anyone who is planning surgery on you, including dentists, that you are taking this medicine.

If you notice any strange or unusual thoughts or behavior while on this medicine, discuss it with your doctor. Rarely, people get confused, agitated, or start seeing or hearing things that are not there.

Call your doctor if you have seizures, confusion, shuffling walk, restlessness or tremor, fever, irregular heart rate, yellow skin or eyes.

Older people are more likely to be sleepy, dizzy, or fall while taking diazepam. Have another responsible adult with you for a few days after you start this medicine and any time you change doses. The drug also stays in the body longer in older people.

Rather than getting calmer, a few people respond to the drug in the opposite way, and become irritable, nervous, excited, anxious, hostile, and less sleepy. If this happens, call your doctor or nurse.

Rarely, allergic reactions happen with this medicine. Call your doctor if you notice severe rash, swelling in the mouth, face, or throat, or trouble breathing or swallowing.

If you think that you or someone else may have taken an overdose of this medicine, get emergency help right away. Taking too much diazepam, or taking it with alcohol or any other medicine that slows the nervous system can cause confusion, severe drowsiness or weakness, trouble walking or talking, coma or unconsciousness, and sometimes death.

• drowsiness (mostly when first starting the drug)
• tiredness ( usually when first starting the drug)
• confusion
• headache (when first starting the drug)

• feeling "hung over" the next day
• decreased coordination
• decreased mental alertness
• low blood pressure, which can make you feel dizzy or faint
• slower heart rate
• trouble with memory and concentration

• vivid dreams
• slurred speech
• bizarre behavior*
• blurred vision or seeing double
• nausea
• vomiting
• abdominal discomfort, upset stomach
• slowed breathing
• rash
• hives
• pain at place of injection
• paradoxical (opposite) reaction in which the person gets "hyper" and excited rather than calmer*
• withdrawal symptoms if drug is stopped suddenly, such as anxiety, irritation, nausea, trouble sleeping*
• allergic reaction*

*See Precautions section for more detailed information