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diazepam nasal (Valtoco)

Brand Names: Valtoco

Generic Name: diazepam nasal

What is diazepam nasal (Valtoco)?

Diazepam nasal is a benzodiazepine (ben-zoe-dye-AZE-eh-peen) that is used to treat seizure clusters in adults and children at least 6 years old.

Diazepam nasal may also be used for purposes not listed in this medication guide.

What are the possible side effects of diazepam nasal (Valtoco)?

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if the person receiving this medication has:

  • extreme weakness or drowsiness;
  • pale or discolored skin; or
  • worsening seizures, or seizures that seem different from the patient's other seizures.

The sedative effects of diazepam may last longer in older adults. Accidental falls are common in elderly patients who use benzodiazepines. Use caution to avoid falling or accidental injury while you are using diazepam nasal.

Common side effects may include:

  • drowsiness;
  • headache; or
  • discomfort in your nose.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What is the most important information I should know about diazepam nasal (Valtoco)?

You should not use this medicine if you have narrow-angle glaucoma.

MISUSE OF THIS MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription.

Fatal side effects can occur if you use this medicine with opioid medicine, alcohol, or other drugs that cause drowsiness or slow your breathing.

Some people have thoughts about suicide while using diazepam nasal. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

What should I discuss with my healthcare provider before using diazepam nasal (Valtoco)?

You should not use this medicine if you are allergic to diazepam (Valium), or if you have:

Diazepam nasal is not approved for use by anyone younger than 6 years old.

Tell your doctor if you have ever had:

Some people have thoughts about suicide while using seizure medicine. Your doctor will need to check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

If you use diazepam nasal while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on habit-forming medicine may need medical treatment for several weeks.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of diazepam nasal on the baby.

It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk.

How should I use diazepam nasal (Valtoco)?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Diazepam may be habit-forming. Misuse can cause addiction, overdose, or death. Keep the medication in a place where others cannot get to it. Selling or giving away this medicine is against the law.

Diazepam is a nasal spray that comes in a ready-to-use bottle. Each bottle is for one use only. Use only the number of sprays your doctor has prescribed.

Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.

Be sure a responsible family member or caregiver knows where you keep this medicine and how to give it to you.

After giving diazepam nasal to another person:

  • note the time the diazepam dose was given;
  • keep the person lying on his or her side;
  • stay with the person and watch for changes in his or her seizures.

Seek emergency medical help if the person's seizure seems different or last longer than other seizures, or if the person has slow breathing, blue colored lips, or is hard to wake up.

If needed, a second dose of diazepam nasal may be given at least 4 hours after the first dose. Do not give a second dose if the person has extreme drowsiness or very slow breathing.

Do not use more than 2 doses to treat a single seizure cluster episode.

Do not use diazepam nasal for more than 1 seizure cluster every 5 days. Do not use for more than 5 seizure clusters in 1 month.

Diazepam doses are based on weight. Your dose needs may change if you gain or lose weight.

Store at room temperature away from moisture, heat, and light. Do not freeze.

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What happens if I miss a dose (Valtoco)?

Since diazepam nasal is used when needed, it does not have a daily dosing schedule. Call your doctor if your symptoms do not improve after using this medicine.

Keep this medicine with you at all times in case you need it to control seizure clusters.

What happens if I overdose (Valtoco)?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include drowsiness, confusion, severe weakness, or loss of consciousness.

What should I avoid while using diazepam nasal (Valtoco)?

Avoid drinking alcohol. Dangerous side effects could occur.

Avoid driving or hazardous activity until you know how this medicine will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.

What other drugs will affect diazepam nasal (Valtoco)?

Using diazepam nasal with other drugs that make you sleepy or slow your breathing can cause dangerous side effects or death. Ask your doctor before taking a sleeping pill, narcotic pain medicine, prescription cough medicine, a muscle relaxer, or medicine for anxiety, depression, or seizures.

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

Other drugs may affect diazepam nasal, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Where can I get more information (Valtoco)?

Your pharmacist can provide more information about diazepam nasal.


Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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Reviewed on 9/9/2020

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