Valium and Xanax are both benzodiazepines doctors prescribe to treat anxiety. However, there are key differences in side effects and drug interactions.

Valium and Xanax are brand names for two types of medication for anxiety. The generic name for Valium is diazepam. The generic name for Xanax is alprazolam.

Many anxiety symptoms result, to some extent, from a chemical imbalance in the brain. Medication can help change this imbalance.

Sedatives slow down certain functions in the body. This can help a person sleep or make them feel calmer.

The best choice of medication and the dosage and duration of treatment will be different for each individual.

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Valium and Xanax are different medications. A doctor should help a person decide which is most suitable.

People can take either medication as tablets or liquid, but adults usually only receive a prescription for pills.

An individual tends to take Valium or Xanax one to four times per day, but the dosage will depend on the person’s needs and on the medication, due to the differing lengths of action.

The following are some key facts about each:

used to treat severe anxiety and panic disordersused to treat less severe anxiety disorders, alcohol and drug withdrawal, muscle spasms, and seizures
intermediate onset (15–30 minutes)rapid onset (within 15 minutes)
can cause dependencycan cause dependency
causes withdrawal symptomscauses withdrawal symptoms
withdrawal does not last longer if a person takes the drug for a longer periodwithdrawal does not last longer if a person takes the drug for a longer period

Both medications work with a chemical in the brain called gamma-Aminobutyric acid (GABA).

GABA reduces activity in parts of the brain that control memory, emotions, logical thought, and functions such as breathing.

Valium and Xanax increase the effects of GABA. This makes the muscles relax, reduces anxiety, and causes drowsiness.

Valium and Xanax have similar side effects. Seek medical advice if any of these symptoms are severe or last for a long time.

FDA black box warning

  • Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death.
  • Reserve concomitant prescribing of these drugs for use in patients for whom alternative treatment options are inadequate.
  • Limit dosages and durations to the minimum required.
  • Follow patients for signs and symptoms of respiratory depression and sedation.
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Common side effects of these drugs include:

Side effectValiumXanax
dry mouthXX
appetite changesXX
difficulty concentratingX
weight changesX
blurred visionX
sex drive changesXX
difficulty urinatingXX
joint painX
increased salivationX

Some side effects can be serious. A person should seek urgent medical attention if they experience any of the following:

Side effectValiumXanax
shuffling walkX
lasting tremorX
difficulty breathingXX
difficulty swallowingX
serious skin rashXX
yellow skin or eyesXX
irregular heartbeatX
memory problemsX
speech problemsX
thoughts of suicideX
balance problemsX
behavior or mood changesX

These are partial lists of side effects. Effects may vary between individuals. People should talk to their doctor about side effects before using these drugs.

If anyone experiences these adverse effects, they should contact 911 or the nearest emergency line in their area.

A person who has taken Valium or Xanax regularly for a long time may experience withdrawal if they stop taking the medication. These symptoms may be physical or mental.

Withdrawal symptoms are similar for both, but Xanax may cause more symptoms than Valium.

Some examples of these withdrawal symptoms include:

  • stomach cramps
  • increased feeling of anxiety
  • headaches
  • dizziness
  • problems sleeping

A person should not stop either medication without talking with their doctor and establishing a plan. This is very important due to the potential for withdrawal symptoms.

It is possible for withdrawal symptoms to last for weeks or months. Support from friends, family, a group, or an organization can help a person coping with these effects. A doctor may be able to prescribe medication to help with withdrawal symptoms.

If a person does not have certain underlying health conditions, Valium and Xanax are safe to take as long as a person follows a doctor’s instructions.

Both medications can cause dependency because they trigger significant changes in the brain, and withdrawal can be difficult.

For this reason, doctors tend to recommend Valium and Xanax for short-term use.

People may not be able to take certain medications alongside Valium or Xanax. A person should talk with their doctor or pharmacist and review current medications to decide what they can or cannot take.

The list below covers some of the drugs that may interact with Valium or Xanax, but there may be more. People should talk with their doctor about all possible interactions that may occur.


Treatments that can interact with Valium include:

  • opioids
  • alcohol
  • antacids
  • cimetidine, ketoconazole, fluvoxamine, fluoxetine, and omeprazole, which inhibit certain hepatic enzymes, such as cytochrome P450 3A and 2C19
  • phenytoin
  • centrally acting agents

Examples of centrally acting agents include: phenothiazines, antipsychotics, anxiolytics and sedatives, hypnotics, anticonvulsants, narcotic analgesics, anesthetics, sedative antihistamines, narcotics, barbiturates, MAO inhibitors, and other antidepressants.

This is a partial list of interactions. Before starting treatment the individual should talk with their doctor or pharmacist about all medications, herbs, and supplements they are taking to ensure they are safe.


Drugs and drug types that may interact with Xanax include:

  • opioids
  • alcohol
  • other central nervous system (CNS) depressants
  • digoxin
  • imipramine
  • desipramine
  • drugs that inhibit CYP450 3A (examples include fluoxetine, propoxyphene and oral contraceptives)

A doctor may advise a person with a prescription for Valium or Xanax to stop taking other medications, or change the dosage of that person’s medications. The doctor may also monitor the person regularly for side effects.

This is a partial list of interactions. Before starting treatment the individual should talk with their doctor or pharmacist about all medications, herbs, and supplements they are taking to ensure they are safe.

These medications are not suitable for everyone. A doctor will ask about existing conditions before prescribing Valium or Xanax.

People with the following medical conditions usually cannot take Valium or Xanax:

  • breathing problems or lung disease
  • severe kidney or liver disease
  • sleep apnea
  • muscle weakness
  • previous or current drug or alcohol addiction or misuse
  • depression
  • glaucoma

Children generally cannot take Valium or Xanax. Older adults can, but they usually receive a reduced dosage. There is very little data showing the use of either Valium or Xanax in children.

People should speak to their doctor if they are pregnant, are planning to become pregnant, or might become pregnant. There is no data in humans to show that either of these medications is safe or harmful during pregnancy or breastfeeding.

Both drugs can cause drowsiness. A person should usually not drive or operate machinery while taking either medication.

Valium and Xanax are different, though they can treat similar issues. A doctor considers a range of factors before recommending either.