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Midazolam vs. Valium

Medical and Pharmacy Editor:

Are Midazolam and Valium the Same Thing?

Midazolam Injection and Syrup and Valium (diazepam) are benzodiazepines used for different purposes.

Midazolam Injection is used as a sedative before surgery or other medical procedures. Midazolam hydrochloride syrup is used in pediatric patients.

Valium is used for treatment of anxiety, seizures, muscle spasms, and symptoms of alcohol withdrawal.

Brand names for midazolam include Versed.

Side effects of midazolam and Valium that are similar include nausea, dizziness, drowsiness, tiredness/fatigue, or skin rash.

Side effects of midazolam that are different from Valium include vomiting, cough, headache, hiccups, trouble sleeping, breathing difficulties, chest congestion, agitation, slow heart rate, “oversedation,” or injection site reactions (pain, swelling, redness, stiffness, blood clots, and tenderness).

Side effects of Valium that are different from midazolam include spinning sensation, constipation, loss of balance, memory problems, restlessness, irritability, muscle weakness, drooling, dry mouth, slurred speech, blurred or double vision, itching, or loss of interest in sex.

Both midazolam and Valium may interact with alcohol or drugs that make you drowsy (narcotics, psychiatric medicines, anti-anxiety drugs, anti-seizure drugs, antihistamines, muscle relaxants, sleeping pills, or sedatives).

Midazolam may also interact with H2 blockers, theophylline, aminophylline, azole antifungals, protease inhibitors, calcium channel blockers, antibiotics, rifampin, or phenobarbital.

Withdrawal symptoms may occur if you suddenly stop taking midazolam or Valium.

What Are Possible Side Effects of Midazolam?

Common side effects of Midazolam include:

What Are Possible Side Effects of Valium?

Common side effects of Valium include:

  • drowsiness,
  • tired feeling,
  • dizziness,
  • spinning sensation,
  • fatigue,
  • constipation,
  • ataxia (loss of balance),
  • memory problems,
  • restlessness,
  • irritability,
  • muscle weakness,
  • nausea,
  • drooling,
  • dry mouth,
  • slurred speech,
  • blurred or double vision,
  • skin rash,
  • itching, or
  • loss of interest in sex.

What Is Midazolam?

Midazolam HCl Injection is a benzodiazepine used as a sedative before surgery or other medical procedures.

What Is Valium?

Valium is indicated for the management of anxiety disorders or for the short-term relief of the symptoms of anxiety. Anxiety or tension associated with the stress of everyday life usually does not require treatment with an anxiolytic.

What Drugs Interact With Midazolam?

Midazolam may interact with H2 blockers, fluconazole, theophylline, aminophylline, erythromycin, or drugs that make you drowsy, such as: narcotics, psychiatric medicines, anti-anxiety drugs, anti-seizure drugs, antihistamines, muscle relaxants, sleeping pills, or sedatives. Tell your doctor all medications and supplements you use. During pregnancy, Midazolam should be used only if prescribed. It may harm a fetus. Infants born to mothers who have used this drug during pregnancy may have withdrawal symptoms. This drug passes into breast milk. Consult your doctor before breastfeeding. Withdrawal symptoms may occur if you suddenly stop taking this medication.

What Drugs Interact With Valium?

Centrally Acting Agents

If Valium is to be combined with other centrally acting agents, careful consideration should be given to the pharmacology of the agents employed particularly with compounds that may potentiate or be potentiated by the action of Valium, such as phenothiazines, antipsychotics, anxiolytics/sedatives, hypnotics, anticonvulsants, narcotic analgesics, anesthetics, sedative antihistamines, narcotics, barbiturates, MAO inhibitors and other antidepressants.

Alcohol

Concomitant use with alcohol is not recommended due to enhancement of the sedative effect.

Antacids

Diazepam peak concentrations are 30% lower when antacids are administered concurrently. However, there is no effect on the extent of absorption. The lower peak concentrations appear due to a slower rate of absorption, with the time required to achieve peak concentrations on average 20 - 25 minutes greater in the presence of antacids. However, this difference was not statistically significant.

How Should Midazolam Be Taken?

Dosing of Midazolam is individualized. The recommended premedication dose of midazolam for low risk adult patients below the age of 60 years is 0.07 to 0.08 mg/kg IM (approximately 5 mg IM) administered up to 1 hour before surgery.

How Should Valium Be Taken?

Take Valium exactly as your healthcare provider tells you to take it. Your healthcare provider will tell you how much Valium to take and when to take it.

Talk to your healthcare provider about slowly stopping Valium to avoid withdrawal symptoms.

If you take too much Valium, call your healthcare provider or go to the nearest hospital emergency room right away.

Reviewed on 3/14/2019

References:
FDA. Midazolam (Versed) Prescribing Information.
https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/208878Orig1s000lbl.pdf
FDA. Valium Product Information.
https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/013263s094lbl.pdf

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