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Concomitant use of benzodiazepiones, including Valium, and opioids may result in profound sedation, respiratory depression, coma, and death. Because of these risks, reserve concomitant prescribing of these drugs for use in patients for whom alternative treatment options are inadequate.
Observational studies have demonstrated that concomitant use of opioid analgesics and benzodiazepines increases the risk of drug-elated mortality compared to use of opioids alone. If a decision is made to prescribe Valium concomitantly with opioids, prescribe the lowest effective dosages and minimum durations of concomitant use, and follow patients closely for signs and symptoms of respiratory depression and sedation. In patients already receiving an opioid analgesic, prescribe a lower initial dose of Valium than indicated in the absence of an opioid and titrate based on clinical response. If an opioid is initiated in a patient already taking Valium, prescribe a lower initial dose of the opioid and titrate based upon clinical response.

Valium (Generic) Diazepam
Diazepam is used to treat anxiety, alcohol withdrawal, and seizures. It is also used to relieve muscle spasms and to provide sedation before medical procedures. This medication works by calming the brain and nerves. Diazepam belongs to a class of drugs known as benzodiazepines.

How Does Diazepam Work?
Benzodiazepines including diazepam work by increasing certain chemicals in the brain. These chemicals have a calming effect on the brain which can help to reduce anxiety, help your muscles to relax, or make you feel relaxed or drowsy. It can even stop seizure activity. Sometimes diazepam is prescribed as a sleeping aid.
Because diazepam can have lots of different effects, it is prescribed for a range of different medical conditions. These might include anxiety, difficulty falling asleep or as an emergency medication to be given during seizures. Because diazepam can make you sleep heavily, it is advisable not to consume alcohol when taking diazepam. The combined effect of alcohol and diazepam may lead to changes in your breathing and make it more difficult to wake up.

Use of the drug
When taken orally, blood levels of the drug reach maximum in about one hour. Intravenous or intramuscular injection is more effective. Diazepam is metabolized into different metabolites in the liver, main of which are nordiazepam and oxazepam. These metabolites affect the body for a long time. It takes several days (not hours) for the release of all active compounds from the body. Therefore, patients experience lethargy for 1-2 days after taking the medicine. They feel weak in the morning. Those who keep feeling this way for a long time usually switch to Xanax (another benzodiazepine). This substance has a much shorter half-life and is excreted from the body faster.

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