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Uses

What is Valtoco used for?

Valtoco (diazepam)  is commonly used to treat a certain type of seizure disorder (epilepsy) called seizure clusters, also known as acute repetitive seizures.

Learn more about Valtoco Nasal Spray for Seizure Clusters.

Valtoco may also be used for other conditions as determined by your healthcare provider.

Diazepam is also available in other dosage forms. See Diazepam rectal and Diazepam for information about other dosage forms. 

How does Valtoco work (mechanism of action)?

Valtoco produces a calming effect on the brain and nerves, which helps to prevent seizures.

How is Valtoco supplied (dosage forms)?

Valtoco is available as a 5 mg, 7.5 mg, or 10 mg nasal spray.

How should I store Valtoco?

Valtoco should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.

Side Effects

What are the most common side effects of Valtoco?

The most common side effects of Valtoco are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

  • Drowsiness (or sleepiness)
  • Headache
  • Nose discomfort

There may be other side effects of Valtoco that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Valtoco?

While less common, the most serious side effects of Valtoco are described below, along with what to do if they happen.

Severe Allergic Reactions. Valtoco may cause allergic reactions, which can be serious. Stop using Valtoco and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Suicidal Thoughts and Actions. Valtoco may cause suicidal thoughts or actions in a small number of people. If you are about to harm yourself, call 911 or call or text 988, the Suicide & Crisis Lifeline. Call your healthcare provider right away if you have any of the following symptoms.

  • New or increased thoughts of suicide or death
  • Suicide attempt
  • New or increased feelings of anxiety, depression, or other unusual changes in mood or behavior 

Risk of Misuse and Addiction. Misusing Valtoco can lead to serious side effects like coma or death. Misuse means taking a medicine in a way other than how it was prescribed. Use Valtoco exactly as prescribed. Tell your healthcare provider if you feel that Valtoco is not working. Call your healthcare provider right away or go to the nearest emergency room if you experience any of the following serious symptoms.

  • Sudden confusion or feeling disoriented
  • Feeling paranoid
  • Suicidal thoughts or actions
  • Seizures
  • Trouble breathing

Dependence and Withdrawal Reactions. Valtoco can cause physical dependence, which means your body relies on the medicine to function properly. If you stop Valtoco suddenly, it could lead to withdrawal symptoms, which may be life-threatening. Do not stop using Valtoco without talking with your healthcare provider. Your healthcare provider will tell you how to stop Valtoco to reduce the risk of withdrawal reactions. Call your healthcare provider right away or go to the nearest emergency room if you experience any of the following serious symptoms.

  • Unusual movements, responses, or expressions
  • Seizures
  • Sudden and severe mental or nervous system changes
  • Seeing or hearing things that others do not see or hear, also called hallucinations
  • An extreme increase in activity or talking
  • Losing touch with reality

Some people may experience the following symptoms of a withdrawal reaction that can last for several weeks to more than 12 months.

  • Anxiety
  • Trouble remembering, learning, or concentrating
  • Depression
  • Problems sleeping
  • Feeling like insects are crawling under the skin
  • Weakness
  • Shaking
  • Muscle twitching
  • Burning or prickling feeling in the hands, arms, legs, or feet
  • Ringing in the ears

Risk With Opioid Medicines. Using Valtoco with an opioid medicine, such as codeine, morphine, and oxycodone, may lead to severe drowsiness, breathing problems, coma, and death. Get emergency help right away if you experience the following symptoms.

  • Slow or shallow breathing
  • Breathing stops (which may lead to the heart stopping)
  • Excessive sleepiness or trouble staying awake 

Decreased Alertness or Coordination. Valtoco can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how Valtoco affects you.

Warnings & Precautions

Who should not use Valtoco?

Allergies to Ingredients. People who are allergic to any of the following should not use/take Valtoco.

  • Diazepam
  • Valtoco
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in Valtoco.

Acute Narrow Angle Glaucoma. Valtoco should not be used if you have a specific eye condition called acute narrow angle glaucoma. Tell your healthcare provider if you have glaucoma.

What should I know about Valtoco before using it?

Do not use Valtoco unless it has been prescribed to you by a healthcare provider. Use it as prescribed.

Do not share Valtoco with other people, even if they have the same condition as you. It may harm them.

Keep Valtoco out of the reach of children. Valtoco is a controlled substance because it can be misused or lead to dependence. Store Valtoco in a safe place to protect it from theft. It is illegal to sell or give away this medicine.

Valtoco can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how Valtoco affects you.

Valtoco is given by a spray into the nostril. Each spray only contains one dose and cannot be reused. Do not test or prime the nasal spray before using it.  

What should I tell my healthcare provider before using Valtoco?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if Valtoco is right for you.

In particular, make sure that you discuss any of the following.

Mental Health Problems. Tell your healthcare provider about your recent and current mental health problems, especially if you have had depression, thoughts of suicide or dying, or have ever attempted suicide.

Substance Use Disorder. Valtoco is a controlled substance and may be misused or lead to dependence. Tell your healthcare provider if you have a history of a drug or alcohol disorder. 

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

  • Liver problems
  • Kidney problems
  • Lung disease or breathing problems, which includes asthma, emphysema, bronchitis, or chronic obstructive pulmonary disease

Other Medicines and Supplements. Valtoco may interact with other medicines and supplements. Before using Valtoco, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how Valtoco could affect pregnancy or harm an unborn baby. Taking Valtoco during the later stages of pregnancy can cause withdrawal and the following symptoms in newborns.

  • Breathing problems
  • Sluggish
  • Low muscle tone
  • Jittery
  • Fussiness or irritability
  • Restlessness
  • Shaking
  • Excessive crying
  • Feeding problems

Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should take Valtoco while you are pregnant or trying to get pregnant. If you become pregnant while using Valtoco, talk to your healthcare provider about registering with the North American Antiepileptic Drug Pregnancy Registry. This registry collects information about the safety of antiepileptic medicines during pregnancy. You can register by calling 888-233-2334 or online at www.aedpregnancyregistry.org. 

Breastfeeding. Valtoco passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should take Valtoco while breastfeeding.

How can I get more information about Valtoco?

For more information about Valtoco, you can visit the manufacturer’s website at www.valtoco.com or call them at 866-696-3873.

Interactions

Does Valtoco interact with foods or drinks?

Eating grapefruit or drinking grapefruit juice may increase Valtoco levels and side effects.

Do not drink alcohol while taking Valtoco. The risk of serious problems such as severe dizziness, sleepiness, and trouble breathing may be increased if you drink alcohol while taking Valtoco.

Does Valtoco interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using Valtoco.

  • An opioid, such as oxycodone, morphine, codeine, or fentanyl, which is a medicine used for certain types of pain
  • Any other medicine that causes dizziness and sleepiness, such as prescription pain medicines, sleep medicines, and medicines for anxiety
  • Flumazenil (Romazicon), which is a medicine used to manage benzodiazepine overdose

Some other medicines may alter the blood levels of Valtoco. Tell your healthcare provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with Valtoco. Always check with your healthcare provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much Valtoco?

If you or someone else has used too much Valtoco, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of Valtoco?

Valtoco is meant to be used only when needed. Use it as your healthcare provider recommends. Do not take double or extra doses.