Valtoco (diazepam nasal spray) is a brand-name prescription medication. It’s FDA-approved as a “rescue” (short-term) treatment for seizure clusters. The drug is prescribed for adults and children ages 6 years and older with epilepsy.

Epilepsy is a brain disorder that causes seizures. During a seizure, your brain cells send signals much faster than usual.

With seizure clusters, you have two or more seizures within a 24-hour period. Seizure clusters are unpredictable, and they’re different from your usual seizure pattern.

Drug details

Valtoco contains the active drug diazepam. It belongs to a drug class called benzodiazepines. Valtoco is called a “rescue” treatment because it works quickly to stop seizure symptoms.

Valtoco comes as a solution inside a nasal spray device. The device delivers one dose of the drug into a person’s nostril.

Valtoco comes in three strengths. These contain either 5 milligrams (mg), 7.5 mg, or 10 mg of diazepam per 0.1 milliliter (ml) of solution.

Is Valtoco a controlled substance?

Yes, Valtoco is a Schedule IV controlled substance. It contains the drug diazepam, which has accepted medical uses. However, diazepam also carries risks for physical dependence and misuse.* (With physical dependence, your body relies on having a drug to function. With misuse, a drug is used differently than in the way it was prescribed.)

To help minimize these risks, healthcare professionals must follow special rules for prescribing and dispensing controlled substances.

* Valtoco has a boxed warning about the risk of this side effect. A boxed warning is the strongest warning required by the FDA. Boxed warnings alert doctors and patients about drug effects that may be dangerous. For more information, see the “Valtoco side effects” section below.

Effectiveness

For information about the effectiveness of Valtoco, see the “Valtoco uses” section below.

Valtoco contains the active drug diazepam. It’s available only as a brand-name medication. Valtoco isn’t currently available in generic form.

A generic drug is an exact copy of the active drug in a brand-name medication. Generics usually cost less than brand-name drugs.

The information below describes the usual Valtoco nasal spray dosing. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug form and strengths

Valtoco comes as a solution inside a nasal spray device.

The device contains one dose of the drug in 0.1 milliliters (ml) of solution. It delivers a dose of the drug into your nostril. After a single use, the device is discarded. Depending on your situation, you or your caregiver will administer Valtoco doses.

Valtoco comes in three strengths. These contain either 5 milligrams (mg), 7.5 mg, or 10 mg of diazepam per 0.1 ml of solution.

Depending on your age and weight, your doctor will prescribe a certain treatment dose for you. Valtoco doses are administered as needed, according to your doctor’s instruction. For certain treatment doses, you’ll use just one nasal spray device. However, for other treatment doses, you’ll use two Valtoco devices.

Dosages for seizure clusters

Valtoco is taken as a “rescue” (short-term) treatment for seizure clusters in people with epilepsy. To learn more about seizure clusters, see the “Valtoco uses” section below.

Your doctor will determine your dosage of Valtoco based on your age and body weight. Recommended dosages for adults and children are described below.

Valtoco dosing chart for adults

For adults, the recommended dosage of Valtoco is about 0.2 mg per kilogram (kg) of body weight. One kg is equal to about 2.2 pounds (lb).

The dosing chart below shows the usual dosage of Valtoco for adults.

Weight of adult:Treatment dose:Given as:
14 to 27 kg (about 30.9 to 59.5 lb)5 mgone 5-mg nasal spray device into one nostril
28 to 50 kg (about 61.7 to 110.2 lb)10 mgone 10-mg nasal spray device into one nostril
51 to 75 kg (about 112.4 to 165.3 lb)15 mgtwo 7.5-mg nasal spray devices, one into each nostril
76 kg and up (about 167.6 lb and up)20 mgtwo 10-mg nasal spray devices, one into each nostril

It’s important to note that 5-mg and 10-mg treatment doses are given using one Valtoco nasal spray device into one nostril. In contrast, 15-mg and 20-mg treatment doses are given using two Valtoco nasal spray devices, one into each nostril.

For more details, see Valtoco’s dosing card and instructions for use. You can also learn more in the “How to take Valtoco” section below.

Valtoco second doses

If seizure cluster symptoms continue, a second treatment dose of Valtoco may be given in certain situations. However, a second dose should not be given if the person affected isn’t breathing as usual or they’re extremely drowsy.

If you’re not sure if a second dose is needed, call your doctor. A second dose should be given at least 4 hours after the first dose, using a new package of Valtoco.

If the seizure cluster episode continues after the second dose, call 911 or seek emergency medical care. Also, call 911 or get emergency medical help if the person isn’t breathing as usual or is extremely drowsy.

Valtoco maximum dosage

Valtoco’s manufacturer provides recommendations on how much of this drug you should take.

The maximum dosage of Valtoco is two treatment doses for each seizure cluster episode.

You should not treat more than one seizure cluster once every 5 days. And you should not treat more than five episodes per month.

Taking Valtoco more often than this can increase the risk of physical dependence or misuse.* (With physical dependence, your body relies on having a drug to function. With misuse, a drug is used differently than in the way it was prescribed.) However, be sure to take the dosage your doctor prescribes for you.

* Valtoco has a boxed warning about the risk of this side effect. A boxed warning is the strongest warning required by the FDA. Boxed warnings alert doctors and patients about drug effects that may be dangerous. For more information, see the “Valtoco side effects” section below.

Children’s dosage

A doctor will determine your child’s dosage of Valtoco based on the child’s age and body weight. Typical dosages for children are shown below.

Valtoco dosing chart for children ages 12 years and older

For children ages 12 years and older, the recommended dosage of Valtoco is about 0.2 mg of drug per kg of body weight. One kg is equal to about 2.2 lb.

The dosing chart below shows the usual dosage of Valtoco for children ages 12 years and older.

Weight of child ages 12 years and older:Treatment dose:Given as:
14 to 27 kg (about 30.9 to 59.5 lb)5 mgone 5-mg nasal spray device into one nostril
28 to 50 kg (about 61.7 to 110.2 lb)10 mgone 10-mg nasal spray device into one nostril
51 to 75 kg (about 112.4 to 165.3 lb)15 mgtwo 7.5-mg nasal spray devices, one into each nostril
76 kg and up (about 167.6 lb and up)20 mgtwo 10-mg nasal spray devices, one into each nostril

Valtoco dosing chart for children ages 6 to 11 years

For children ages 6 to 11 years, the recommended dosage of Valtoco is approximately 0.3 mg of drug per kg of body weight.

The dosing chart below shows Valtoco’s usual dosage for children ages 6 to 11 years.

Weight of child ages 6 to 11 years:Treatment dose:Given as:
10 to 18 kg (about 22 to 39.7 lb)5 mgone 5-mg nasal spray device into one nostril
19 to 37 kg (about 41.9 to 81.6 lb)10 mgone 10-mg nasal spray device into one nostril
38 to 55 kg (about 83.8 to 121.3 lb)15 mgtwo 7.5-mg nasal spray devices, one into each nostril
56 to 74 kg (about 123.5 to 163.1 lb)20 mgtwo 10-mg nasal spray devices, one into each nostril

For questions about your child’s Valtoco dosage, talk with your child’s doctor.

What if I miss a dose?

Valtoco is a rescue treatment that’s only taken as needed for seizure clusters. (A rescue treatment is taken to quickly stop symptoms after they’ve started.) So, Valtoco isn’t taken on a regular schedule.

To help make sure that you don’t miss a dose when you need it, you should take Valtoco with you wherever you go. Depending on your symptoms during a seizure cluster episode, you may be unable to give yourself Valtoco. It’s important for your household members, coworkers, or others around you to be aware of your condition so they can give Valtoco to you if necessary.

Will I need to take this drug long term?

No, Valtoco isn’t meant to be taken as a long-term treatment. Valtoco is taken as a rescue treatment for seizure cluster episodes. Your doctor will likely prescribe Valtoco for you to keep on hand, just in case you need it.

As with all medications, the cost of Valtoco can vary. To find current prices for Valtoco in your area, check out GoodRx.com.


The cost you find on GoodRx.com is what you may pay without insurance. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Keep in mind that you may be able to get a 90-day supply of Valtoco. If approved by your insurance company, getting a 90-day supply of the drug could reduce your number of trips to the pharmacy and help lower the cost. If you’re interested in this option, check with your doctor, pharmacist, or insurance company.

Before approving coverage for Valtoco, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure if you’ll need to get prior authorization for Valtoco, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Valtoco, or if you need help understanding your insurance coverage, help is available.

Neurelis Inc., the manufacturer of Valtoco, offers a savings card that can lower the cost of its drug. For more information and to find out if you’re eligible for support, visit the drug’s website.

To learn more about saving money on prescriptions, check out this article.

Mail-order pharmacies

Valtoco may be available through a mail-order pharmacy. Using this service may help lower the drug’s cost and allow you to get your medication without leaving home.

If recommended by your doctor, you may be able to receive a 90-day supply of Valtoco, so there’s less concern about running out of the medication. If you’re interested in this option, check with your doctor, pharmacist, or insurance company. Some Medicare plans may help cover the cost of mail-order medications.

If you don’t have insurance, you can ask your doctor or pharmacist about online pharmacy options.

Generic version

Valtoco is not available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Generics tend to cost less than brand-name drugs.

Valtoco can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Valtoco. These lists do not include all possible side effects.

For more information about the possible side effects of Valtoco, talk with your doctor or pharmacist. They can give you tips on how to manage any side effects that may be concerning or bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Valtoco, you can do so through MedWatch.

Mild side effects

Mild side effects* of Valtoco can include:

Most of these side effects may go away within a few days or a couple of weeks. However, if they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Valtoco. To learn about other mild side effects, talk with your doctor or pharmacist, or view Valtoco’s prescribing information.

Serious side effects

Serious side effects from Valtoco are rare, but they can happen. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

* For more information about this side effect, see the “Valtoco withdrawal and dependence” section below.
Valtoco has a boxed warning about the risk of this side effect. A boxed warning is the strongest warning required by the FDA. Boxed warnings alert doctors and patients about drug effects that may be dangerous.
‡ For more information about this side effect, see “Side effect details” below.

Side effects in children

Valtoco is approved to be taken by adults and children ages 6 years and older. In clinical trials, side effects in children who received the drug were similar to those seen in adults.

Side effect details

Here’s some detail on certain side effects this drug may cause.

Misuse and addiction

Taking Valtoco more often than recommended may lead to addiction.* And drug addiction can lead to misuse (also called abuse).*

With addiction, a person continues to take a substance, even though doing so is harmful. With misuse, a drug is taken differently than the way it was prescribed. For example, Valtoco is misused when a person takes a drug in an attempt to get “high” but doesn’t need it for a medical reason.

Misuse may increase the risk of overdose, which can be life threatening. (For more information about overdose, see the “Valtoco overdose” section below.)

Misuse of Valtoco, especially if it’s misused with alcohol or illegal substances, can lead to harmful effects. These may include respiratory depression (slowed, shallow breathing), coma, and, in rare cases, death.

If you’ve ever misused substances in the past, it’s important to tell your doctor about this before taking Valtoco. They can work with you to find a treatment plan that’s best for you.

* Valtoco has a boxed warning about the risk of this side effect. A boxed warning is the strongest warning required by the FDA. Boxed warnings alert doctors and patients about drug effects that may be dangerous.

Risks if taken with opioids

Valtoco may cause harmful effects if taken with opioids.*

Diazepam (the active drug of Valtoco) belongs to a drug class called benzodiazepines. Taking a benzodiazepine with an opioid drug, such as certain pain medications, may cause dangerous side effects. This is because both benzodiazepines and opioids are CNS depressants.

CNS depressants can slow down the activity of your brain and spinal cord. This can lead to serious side effects such as:

Due to these risks, doctors typically will not prescribe Valtoco to someone who’s taking an opioid.

Your doctor will only prescribe Valtoco with an opioid if there aren’t any other treatment options available. In this case, your doctor will discuss the risks of this drug combination with you.

If your doctor prescribes Valtoco with an opioid, they’ll likely prescribe the lowest effective dose for the shortest possible time. And they’ll monitor you very closely during treatment.

If you have questions about the risks of taking opioids with Valtoco, talk with your doctor. For a list of common opioids, see the “Valtoco interactions” section below.

* Valtoco has a boxed warning about the risk of this side effect. A boxed warning is the strongest warning required by the FDA. Boxed warnings alert doctors and patients about drug effects that may be dangerous.

Excessive sleepiness

In clinical trials of diazepam (the active drug in Valtoco), sleepiness was commonly reported. However, most people described this side effect as mild to moderate.

The drug may cause severe or excessive sleepiness in some people. However, this side effect is less common.

Because Valtoco may make you sleepy, it’s best to avoid activities that could be dangerous. You should do this until you know how your body responds to Valtoco. This includes activities that require mental alertness and quick reactions, such as driving a car or operating machinery.

If you drink alcohol or take other medications that cause drowsiness, Valtoco may interact with those substances. And this can increase your risk of excessive sleepiness. (See the “Valtoco and alcohol” and “Valtoco interactions” sections below for more details.)

To find out how often sleepiness occurred in clinical trials, see Valtoco’s prescribing information. And, if you have questions about excessive sleepiness while taking Valtoco, talk with your doctor or pharmacist.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Valtoco. It isn’t known how often this occurred in clinical trials.

Symptoms of a mild allergic reaction can include:

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have an allergic reaction to Valtoco, as the reaction could become severe. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Valtoco has a boxed warning about the risk of physical dependence and withdrawal. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). The warning alerts healthcare professionals and patients about drug effects that may be dangerous.

With physical dependence, your body relies on having a drug to function. If you suddenly stop taking the drug, you can have withdrawal, and you may experience certain physical symptoms.

Valtoco contains the active drug diazepam, which belongs to a drug class called benzodiazepines. If you take a benzodiazepine regularly, especially in high or frequent doses, you can develop physical dependence.

Withdrawal symptoms from benzodiazepines can last for a long time, and they can include:

If untreated, severe withdrawal symptoms can occur. These may include convulsions or seizures that may be life threatening.

Valtoco isn’t intended to be taken daily or frequently. If you take it more often than prescribed, the risk of physical dependence and withdrawal symptoms can increase. Valtoco can typically be taken to treat up to five seizure cluster episodes a month. However, it isn’t recommended to treat more than one seizure cluster episode once every 5 days.

If you’re taking Valtoco more often than prescribed, tell your doctor. If necessary, they can guide you on a supportive treatment plan that will safely and slowly end your dependence on the drug. They may also recommend changes to your other seizure medications.

You should take Valtoco according to the instructions your doctor gives you.

Instructions

Valtoco comes as a solution inside a nasal spray device. The device delivers a dose of the drug into a person’s nostril.

Your doctor will show you and your caregiver how to take Valtoco nasal spray. Depending on your symptoms during a seizure cluster episode, you may be unable to give Valtoco doses to yourself. However, it’s important for your household members, coworkers, or others around you to be aware of your condition so they can give doses to you if necessary.

Also, it’s important to note that each treatment dose of Valtoco comes packaged with the number of devices that you’ll need to administer a complete dose. The 5-mg and 10-mg treatment doses are given using one Valtoco nasal spray device into one nostril. In contrast, the 15-mg and 20-mg treatment doses are given using two Valtoco nasal spray devices, one into each nostril.

For more details about how to take Valtoco, see the drug’s dosing card and instructions for use. You can also read more about typical doses in the “Valtoco dosage” section above.

Step-by-step instructions for taking Valtoco are included in the product packaging. The manufacturer’s website also features helpful videos.

The Food and Drug Administration (FDA) approves prescription drugs such as Valtoco to treat certain conditions.

Valtoco for seizure clusters

Valtoco (diazepam nasal spray) is FDA-approved as a “rescue” (short-term) treatment for seizure clusters. The drug is prescribed to adults and to children ages 6 years and older who have epilepsy.

Epilepsy is a brain disorder that causes seizures. With seizure clusters, you have two or more seizures within a 24-hour period. Seizure clusters are unpredictable, and they’re different from your usual typical seizure pattern.

There are several types of seizures. A person may or may not be conscious during a seizure or remember it after it happens. Symptoms can vary significantly between seizure types. People with the same type of seizure may also experience different symptoms.

Some examples of seizure symptoms can include:

  • repeated jerking movements
  • rhythmic twitching of the body
  • brief twitches of a one body area, such as the eyelids
  • muscles may become limp and weak or tense and rigid
  • staring spells with no movements

For most people with epilepsy, using daily seizure medications helps prevent or manage seizures. However, additional treatment with a rescue medication, such as Valtoco, is sometimes needed for seizure clusters.

The goal of rescue treatment is to stop seizure clusters quickly to help prevent status epilepticus. This is a rare but severe seizure that won’t stop and can be life threatening.

Effectiveness for seizure clusters

Diazepam (the active drug in Valtoco) has been shown to be effective in treating seizure clusters. For information on how the drug performed in clinical trials, see Valtoco’s prescribing information.

Valtoco and children

Valtoco is FDA-approved to be taken by adults and children ages 6 years and older. In clinical trials, Valtoco was shown to be a safe and effective rescue treatment for seizure clusters in people with epilepsy.

Doctors prescribe Valtoco for people with epilepsy. This drug is taken as a “rescue” (short-term) treatment for seizure clusters. (With seizure clusters, you have two or more seizures within a 24-hour period.)

Epilepsy is a brain disorder that causes seizures. People with this condition usually take other medications to help manage and prevent seizures. These medications are called antiepileptic drugs (AEDs), and they’re typically taken every day.

Examples of AEDs that may be prescribed along with Valtoco include:

If you have questions about taking AEDs with Valtoco, talk with your doctor or pharmacist.

Drinking alcohol and taking Valtoco can increase your risk of serious side effects. These include dizziness, excessive sleepiness, and central nervous system (CNS) depression. (CNS depression occurs when the activity of your brain and spinal cord slows down too much.)

For more information about some of these side effects, see “Valtoco side effects” above.

Alcohol can also make these side effects of the drug worse.

However, Valtoco isn’t a medication that you’ll take every day. So, it may be safe for you to drink alcohol in moderation on days you haven’t taken Valtoco. But this depends on your medical condition and medical history.

Also, keep in mind that alcohol may not be safe to drink with seizure medications that you may be taking.

If your doctor prescribes you Valtoco, it’s important to talk with them about how much, if any, alcohol is safe for you to drink.

Valtoco can interact with several other medications. It may also interact with herbal supplements.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Valtoco and other medications

Below are medications that can interact with Valtoco. These are not all the drugs that may interact with Valtoco.

Before taking Valtoco, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Opioid drugs and other central nervous system (CNS) depressants

Taking Valtoco with opioids or other CNS depressants can lead to serious side effects.

Examples of opioids include:

Examples of other CNS depressants include:

CYP2C19 and CYP3A4 inhibitors

Drugs that are CYP2C19 and CYP3A4 inhibitors may increase the risk of side effects from Valtoco.

Examples of CYP2C19 and CYP3A4 inhibitors include:

CYP2C19 and CYP3A4 inducers

Drugs that are CYP2C19 and CYP3A4 inducers may decrease the effectiveness of Valtoco.

Examples of CYP2C19 and CYP3A4 inducers include:

Valtoco and herbs and supplements

There aren’t any herbs or supplements that have been specifically reported to interact with Valtoco.

However, it’s possible the herbal supplement St. John’s wort could interact with Valtoco. This herb can reduce how well Valtoco works. If you are taking St. John’s wort, tell your doctor or pharmacist before taking Valtoco.

Valtoco and foods

There aren’t any foods that have been specifically reported to interact with Valtoco. If you have any questions about eating certain foods with Valtoco, talk with your doctor.

Valtoco is given as a “rescue” (short-term) treatment for seizure clusters. The drug is prescribed to adults and to children ages 6 years and older who have epilepsy.

Epilepsy is a brain disorder that causes seizures. During a seizure, your brain cells send signals much faster than usual. This causes your brain to experience a rush of electrical stimulation, which leads to seizure symptoms.

With seizure clusters, you have two or more seizures within a 24-hour period.

Valtoco contains the active drug diazepam, which belongs to a drug class called benzodiazepines. Diazepam and other benzodiazepines work by increasing the levels of a neurotransmitter called gamma-aminobutyric acid. (A neurotransmitter is a chemical that sends signals between brain cells.)

It isn’t exactly known how benzodiazepines work to stop seizures. However, they’re thought to slow down brain cell signals. This makes your brain less sensitive to stimulation, helping to stop your seizure symptoms.

How long does it take to work?

Valtoco starts working as soon as a dose is given.

In clinical trials, one treatment dose of the drug helped to stop seizure clusters within 1.5 to 4 hours in some people.

However, some people may need a second treatment dose. (For more information on a second treatment dose, see “Valtoco dosage” above).

Valtoco may cause harmful effects if it’s taken during pregnancy. This is because Valtoco contains the active drug diazepam, which belongs to a drug class called benzodiazepines.

Based on past studies, taking benzodiazepines during pregnancy may cause harmful effects in a developing fetus. This includes cleft palate.

Also, children born to females* who’ve received benzodiazepines in late pregnancy have an increased risk of side effects. These include withdrawal symptoms, low body temperature, and breathing or feeding problems. (Withdrawal symptoms are side effects that can happen when you stop taking a drug that your body has become dependent on.)

For these reasons, Valtoco is not usually prescribed during pregnancy.

Before taking Valtoco, talk with your doctor if you’re pregnant or planning to become pregnant. They can discuss the risks and benefits with you. And if you become pregnant while taking Valtoco, tell your doctor right away.

* Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.

It’s not known if Valtoco is safe to take during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re taking Valtoco.

For more information about taking Valtoco during pregnancy, see the “Valtoco and pregnancy” section above.

It’s not known if Valtoco is safe to take while breastfeeding. The drug wasn’t studied in people who were breastfeeding.

However, Valtoco contains the active drug diazepam, which is known to pass into breast milk. And there have been reports of side effects in children who were breastfed whose mothers took diazepam. These side effects include excessive sleepiness, sluggish behavior, and feeding problems.

Before taking Valtoco, talk with your doctor if you’re breastfeeding or planning to breastfeed. They can discuss the risks and benefits with you.

Here are answers to some frequently asked questions about Valtoco.

Does Valtoco prevent seizures?

No, Valtoco doesn’t prevent seizures. Instead, it’s taken as a “rescue” (short-term) treatment for seizure clusters in people with epilepsy. Epilepsy is a brain disorder that causes seizures.

With seizure clusters, you have two or more seizures within a 24-hour period.

Because seizure clusters are unpredictable, Valtoco isn’t taken to prevent them. Instead, it’s taken during a seizure or seizure cluster. It works quickly to stop or slow down seizure symptoms.

How often can you take Valtoco?

Valtoco is taken as needed to treat seizure clusters. Valtoco’s manufacturer provides recommendations on how much of this drug you should take.

The maximum dosage of Valtoco is two treatment doses per seizure cluster episode. And the second dose should be given at least 4 hours after the first dose.

Valtoco can be taken to treat up to five seizure cluster episodes a month. However, it isn’t recommended to treat more than one seizure cluster episode once every 5 days with the drug.

Taking Valtoco more often can increase the risk of physical dependence or misuse. (With physical dependence, your body relies on having a drug to function. With misuse, a drug is used differently than in the way it was prescribed.)

If you are having frequent seizure cluster episodes, talk with your doctor. They may adjust your daily seizure medication regimen.

How is Valtoco different from the seizure medication I take every day?

Valtoco is different from other seizure medications that are taken every day. It’s a rescue treatment that’s only taken as needed for occasional seizure clusters.

It’s given during a seizure or seizure cluster. Valtoco works to quickly stop or slow seizure symptoms.

When your doctor prescribes Valtoco, be sure to continue taking your daily seizure medication regimen. These drugs are taken every day to manage epilepsy. They are taken to help prevent seizures and reduce the number or severity of seizures you have.

This drug comes with several precautions.

FDA warnings

This drug has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.

Risks if taken with opioids. Taking opioids with benzodiazepines, such as Valtoco, can cause harmful effects. These include excessive sleepiness, central nervous system depression, coma, and, in rare cases, death. Due to these risks, doctors won’t typically prescribe Valtoco if you’re taking an opioid drug. If they do prescribe this medication, they’ll monitor you very closely during treatment. (For more information, see the “Valtoco side effects” section above.)

Risk of misuse and addiction. Taking a benzodiazepine, such as Valtoco, may lead to drug misuse (also called abuse). With misuse, a drug is used differently than the way it was prescribed. Misuse of a medication may increase your risk of addiction. With addiction, a person continues to take a substance, even though doing so is harmful. Misuse can also lead to overdose, which may be life threatening. (To learn more, see the “Valtoco side effects” section above.)

Risk of dependence and withdrawal. Taking Valtoco more often than recommended can increase the risk of developing physical dependence on the drug. With physical dependence, your body relies on having a drug to function. This can lead to serious withdrawal symptoms if you suddenly stop taking Valtoco. Withdrawal symptoms can happen when you stop taking a drug that your body has become dependent on. If you’ve been taking Valtoco frequently, your doctor will likely decrease your dosage slowly, if you need to stop the medication. (For more information, see the “Valtoco dependence and withdrawal” section above.)

Other precautions

Before taking Valtoco, talk with your doctor about your health history. Valtoco may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Glaucoma. If you have glaucoma, Valtoco can increase intraocular pressure (the pressure inside your eye). If you have a type of glaucoma called acute narrow-angle glaucoma, your doctor will not prescribe Valtoco because the drug could worsen your condition. If you have open-angle glaucoma that’s currently being treated and is well-managed, your doctor may consider prescribing Valtoco. They’ll likely recommend frequent eye exams to monitor your intraocular pressure.
  • Depression or suicidal thoughts. Suicidal thoughts or behaviors can occur as a rare side effect of taking Valtoco. If you already have depression or a history of suicidal behavior, it’s possible that taking Valtoco could worsen your condition. Before taking Valtoco, be sure to talk with your doctor about your depression or past suicidal behavior. If your doctor prescribes Valtoco for you, they may monitor you more carefully.
  • Allergic reaction. If you’ve had an allergic reaction to Valtoco or any of its ingredients, your doctor will likely not prescribe Valtoco. Ask your doctor what other medications are better options for you.
  • Pregnancy. Valtoco may cause harmful effects if it’s taken during pregnancy. Due to this risk, doctors typically will not prescribe Valtoco during pregnancy unless the benefits outweigh the risks. For more information, see the “Valtoco and pregnancy” section above.
  • Breastfeeding. It’s not known if Valtoco is safe to take while breastfeeding. Valtoco contains the drug diazepam, which passes into breast milk and may cause side effects in a child who is breastfed. For more information, see the “Valtoco and breastfeeding” section above.

Note: For more information about the potential negative effects of Valtoco, see the “Valtoco side effects” section above.

Taking more than the recommended dosage of Valtoco can lead to serious side effects. Do not take more Valtoco than your doctor recommends.

Overdose symptoms

Symptoms of an overdose can include:

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use its online tool. However, if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.

When you get Valtoco from the pharmacy, the pharmacist will add an expiration date to the label on the container. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid taking expired medications. If you have unused medication that has gone past the expiration date, talk with your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good to use can depend on many factors, including how and where you store the medication.

Valtoco should be stored at room temperature, 68°F to 77°F (20°C to 25°C), in a tightly sealed container away from light. Avoid storing this medication in areas where it could get damp or wet, such as bathrooms.

Disposal

If you no longer need to take Valtoco and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information about how to dispose of your medication.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.