Comprehensive medication guide to Valium including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$15 copay for generic diazepam on most commercial plans; typically Tier 1–2 (preferred generic) on most formularies. Medicare Part D and Medicaid also cover generic diazepam at low or no cost.
Estimated Cash Pricing
$15–$30 retail for a 30-day supply of generic diazepam 5 mg tablets; as low as $4 at Walmart's $4 generic program, or $7–$12 with a GoodRx or SingleCare coupon.
Medfinder Findability Score
72/100
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Valium is the brand name for diazepam, a long-acting benzodiazepine medication first introduced in 1963. It is FDA-approved to treat anxiety disorders, alcohol withdrawal symptoms, muscle spasms associated with upper motor neuron disorders, and as adjunctive therapy for seizure disorders and status epilepticus. It is also used for preoperative sedation and anxiety relief before medical procedures.
Diazepam is available as generic tablets in 2 mg, 5 mg, and 10 mg strengths, as well as oral solution, rectal gel (Diastat), and nasal spray (Valtoco). It is a DEA Schedule IV controlled substance due to its potential for dependence and misuse. Generic diazepam is widely available and is one of the most affordable prescription medications on the market.
Diazepam has a very long half-life of approximately 48 hours, with active metabolites lasting up to 100 hours. This makes it one of the longest-acting benzodiazepines, useful for tapering protocols and providing sustained anxiety relief, but requiring careful monitoring for accumulation — particularly in elderly patients and those with liver disease.
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Diazepam works by enhancing the activity of GABA (gamma-aminobutyric acid), the brain's primary inhibitory neurotransmitter. It binds to a specific site on the GABA-A receptor complex — the benzodiazepine receptor site — and acts as a positive allosteric modulator, increasing how frequently the chloride ion channel opens when GABA is present. This produces greater neuronal inhibition throughout the central nervous system.
This mechanism explains all of diazepam's clinical effects: increased GABA activity reduces anxiety by calming overactive neural circuits, raises the seizure threshold, relaxes skeletal muscles by acting on spinal cord interneurons, and produces sedation by depressing overall CNS activity.
Unlike barbiturates (which can directly open chloride channels), benzodiazepines require GABA to be present to work — this is part of why they have a wider therapeutic window. However, they remain dangerous in combination with other CNS depressants, particularly opioids and alcohol, which can produce fatal respiratory depression through additive mechanisms.
2 mg — tablet
Starting dose for elderly patients and mild anxiety
5 mg — tablet
Standard dose for anxiety and muscle spasms; most commonly prescribed strength
10 mg — tablet
Used for more severe anxiety, alcohol withdrawal, and muscle spasms
5 mg/mL — oral concentrate (Diazepam Intensol)
Oral liquid concentrate for dose flexibility
2.5 mg, 10 mg, 20 mg — rectal gel (Diastat)
Used for acute seizure rescue; not for daily use
5 mg/0.1 mL — nasal spray (Valtoco)
FDA-approved 2020 for cluster seizure management; brand-name only
Oral diazepam tablets are generally available across the United States in 2026. Generic diazepam is manufactured by multiple pharmaceutical companies and stocked at most major pharmacy chains and independent pharmacies. It is not currently on the FDA's official drug shortage list. However, patients do report intermittent localized stock-outs — where a specific pharmacy or region experiences temporary unavailability of certain strengths or manufacturers' products.
The DEA's annual production quotas for Schedule IV controlled substances, combined with post-pandemic demand increases and global supply chain variability, create periodic gaps at individual pharmacies. Injectable (parenteral) diazepam has historically faced more severe shortage periods, primarily affecting hospital and clinical settings rather than retail pharmacy dispensing.
If you're having difficulty locating Valium at your regular pharmacy, medfinder can check multiple pharmacies near you to find which ones have your prescription in stock. You provide your medication, dosage, and location, and medfinder handles the pharmacy calls — results are texted to you.
Because diazepam is a DEA Schedule IV controlled substance, it can only be prescribed by practitioners who hold a valid DEA registration. Prescriptions are subject to federal refill limits (up to 5 refills in 6 months) and state prescription monitoring program reporting requirements.
Telehealth prescribing of diazepam is available in many states for established patients. Federal and state rules for telehealth prescribing of Schedule IV substances have evolved since the COVID-19 pandemic. Patients seeking a new diazepam prescription for the first time should typically begin with an in-person evaluation with a PCP or psychiatrist.
Yes. Valium (diazepam) is a DEA Schedule IV controlled substance under the Controlled Substances Act. This classification reflects that it has accepted medical use but also carries a recognized potential for abuse, misuse, and physical or psychological dependence. The DEA lists diazepam alongside other Schedule IV benzodiazepines including alprazolam (Xanax), lorazepam (Ativan), and clonazepam (Klonopin).
As a Schedule IV controlled substance, diazepam prescriptions are subject to federal regulations: they may be refilled up to 5 times within 6 months of the original issue date. New prescriptions are required after 6 months or after 5 fills. Some states have stricter rules. All prescribers must hold a valid DEA registration to prescribe diazepam, and pharmacies must maintain strict records of all dispensing.
Diazepam is NOT a narcotic or opioid — it is a benzodiazepine, which works through a fundamentally different mechanism (GABA enhancement rather than opioid receptor activation). However, the combination of diazepam with opioids carries an FDA boxed warning for potentially fatal respiratory depression. The FDA requires a REMS (Risk Evaluation and Mitigation Strategy) education program for benzodiazepines.
Most common side effects (dose-dependent):
Serious side effects requiring medical attention:
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Lorazepam (Ativan)
Shorter-acting benzodiazepine with no active metabolites; preferred for elderly patients and those with liver disease. Approximate equivalence: Lorazepam 1 mg ≈ Diazepam 5 mg.
Clonazepam (Klonopin)
Long-acting benzodiazepine (half-life 18-50 hours); FDA-approved for panic disorder and seizure disorders; requires less frequent dosing. Equivalence: Clonazepam 0.5 mg ≈ Diazepam 5 mg.
Alprazolam (Xanax)
Shorter-acting benzodiazepine commonly used for panic disorder and anxiety; higher abuse potential than diazepam. Equivalence: Alprazolam 0.5 mg ≈ Diazepam 5-10 mg.
Hydroxyzine (Vistaril/Atarax)
Non-benzodiazepine anxiolytic antihistamine; no abuse potential, not a controlled substance; appropriate for mild-moderate anxiety but not for withdrawal management or seizures.
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Opioids (oxycodone, hydrocodone, fentanyl, etc.)
majorFDA boxed warning: combination can cause profound sedation, respiratory depression, coma, and death. Avoid unless no alternatives exist; use minimum doses with close monitoring.
Alcohol
majorAdditive CNS and respiratory depression. Can be fatal. Never combine with Valium.
Sodium oxybate (GHB/Xyrem)
majorContraindicated: profound sedation and respiratory depression risk.
Barbiturates (phenobarbital, butalbital)
majorAdditive CNS and respiratory depression; increased risk of respiratory arrest.
Fluoxetine (Prozac)
moderateCYP2C19 inhibitor; increases diazepam blood levels, worsening sedation and side effects.
Ketoconazole and other azole antifungals
moderateCYP3A4 inhibitors; can significantly increase diazepam concentrations.
Rifampin
moderatePotent CYP3A4/CYP2C19 inducer; can reduce diazepam levels by 50-90%, significantly reducing effectiveness.
Carbamazepine (Tegretol)
moderateCYP3A4 inducer; reduces diazepam effectiveness — relevant for epilepsy combination therapy.
St. John's Wort
moderateCYP3A4 inducer; herbal supplement that can significantly reduce diazepam blood levels.
Grapefruit juice
moderateCYP3A4 inhibitor in gut; may increase diazepam absorption and blood levels. Avoid grapefruit while taking diazepam.
Valium (diazepam) remains an important and widely used medication more than 60 years after its introduction. When used appropriately — for anxiety, alcohol withdrawal, muscle spasms, or seizure disorders — it is effective and, for most patients, affordable. Generic diazepam is one of the most cost-accessible prescription medications available, with Walmart's $4 generic program making it accessible to nearly anyone.
The most important things to know about diazepam: never stop it suddenly (withdrawal can be life-threatening), never combine it with alcohol or opioids (risk of respiratory depression and death), and be aware that its very long half-life means effects can accumulate with daily use. These risks are manageable with appropriate prescriber oversight and patient education.
If you're having difficulty finding Valium or diazepam at your local pharmacy, medfinder can help. medfinder calls pharmacies near you to find which ones have your prescription in stock, saving you time and reducing the risk of running out of your medication.
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Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
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