Valtoco (diazepam) is a brand-name nasal spray that’s prescribed for seizure clusters. As with other drugs, Valtoco can cause side effects. These include misuse, addiction, dependence, and withdrawal.

Valtoco can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

These are just a few of the more common side effects of Valtoco reported by people in clinical trials:

* For more information about this side effect, see “Side effect specifics” below.

Mild side effects can occur with Valtoco. This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to Valtoco’s prescribing information.

Mild side effects that have been reported with Valtoco include:

These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you develop a side effect during Valtoco treatment and want to tell the FDA about it, visit MedWatch.

* For more information about this side effect, see “Side effect specifics” below.
† An allergic reaction is possible after administering Valtoco. However, this side effect wasn’t reported in clinical trials. To learn more, see the “Side effect specifics” section below.

Valtoco may cause serious side effects. The list below may not include all possible serious side effects of the drug. For more information, you can refer to Valtoco’s prescribing information.

If you develop serious side effects while receiving Valtoco, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Serious side effects that have been reported and their symptoms include:

* Valtoco has a boxed warning for this side effect. This is a serious warning from the Food and Drug Administration (FDA). To learn more, see the “Side effect specifics” section below.
† An allergic reaction is possible after administering Valtoco. However, this side effect wasn’t reported in clinical trials. To learn more, see the “Side effect specifics” section below.

Valtoco may cause several side effects. Here are some frequently asked questions about the drug’s side effects and their answers.

How do side effects of Valtoco compare with those of Diastat?

Both Valtoco and Diastat (diazepam) contain the active drug diazepam. Valtoco comes as a nasal spray, while Diastat comes as a rectal gel. Both drugs are prescribed to treat seizures and share similar side effects. However, Valtoco and Diastat have some unique side effects as well.

For example, Valtoco and Diastat may cause sleepiness and lack of coordination. Both drugs also have the same boxed warnings about serious harm if taken with opioids, misuse and addiction, and dependence and withdrawal.*

Unlike Diastat, Valtoco may also cause nasal side effects, including nasal discomfort and nosebleeds.

To learn more about how the side effects of Valtoco compare with those of Diastat, talk with your doctor or pharmacist. You can also see this article to learn more about Diastat’s side effects.

* For more information about these boxed warnings, see “Side effect specifics” below.

Is Valtoco safe for older adults?

Yes, Valtoco is considered safe for most older adults (ages 65 years and older).

However, doctors may watch older adults more closely for side effects during Valtoco treatment. This is because older adults may have an increased risk of sleepiness or lack of coordination as side effects of the drug.

For this reason, doctors may prescribe a lower dosage of Valtoco for older adults than for younger adults. For details about Valtoco’s dosage, see this article.

For more information about the safety of Valtoco in older adults, talk with your doctor or pharmacist.

Learn more about some of the side effects that Valtoco may cause. To find out how often side effects occurred in clinical trials, see the prescribing information for Valtoco.

Boxed warnings

Risk of serious harm if taken with opioids

Valtoco has a boxed warning about the risk of serious harm if taken with opioids. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It lets doctors and patients know about a drug’s effects that may be dangerous.

Administering Valtoco while taking opioids may cause serious harm. Examples of opioids include hydrocodone (Hysingla ER) and oxycodone (Roxybond, Oxycontin, Xtampza ER). Taking these medications together can lead to respiratory depression and extreme sleepiness. In extreme cases, these effects may result in coma or be fatal.

What you can do

Before you’re prescribed Valtoco, be sure to tell your doctor if you’re taking an opioid. They may prescribe a drug other than Valtoco for your condition.

If they prescribe Valtoco with an opioid, your doctor will watch you closely for side effects during treatment. They may also prescribe a lower dose of either drug to help lower your risk of these side effects. If you have symptoms that seem severe or life threatening, call 911 or a local emergency number right away.

To learn more about this risk, talk with your doctor or pharmacist.

Risks of misuse and addiction

Valtoco has a boxed warning about the risks of misuse and addiction. A boxed warning is the most serious warning from the FDA. It lets doctors and patients know about a drug’s effects that may be dangerous.

Benzodiazepines, including Valtoco, carry risks of misuse and addiction. With misuse, a drug is taken in a way other than how a doctor prescribes it. With addiction, a drug is taken even if it’s causing harmful outcomes.

Valtoco is prescribed as a short-term treatment for certain seizures. The risks of misuse and addiction with Valtoco are low if you administer the drug as your doctor prescribes it.

However, misuse and addiction of Valtoco can lead to overdose or be fatal. Certain factors increase these risks, such as administering the drug while consuming alcohol.

What you can do

Before your doctor prescribes Valtoco, be sure to tell them if you have a history of substance use disorder, including alcohol use disorder. They’ll advise you about your risks of misuse and addiction with Valtoco.

Your doctor or pharmacist can tell you more about these risks.

Risks of dependence and withdrawal

Valtoco has a boxed warning about the risks of dependence and withdrawal. A boxed warning is the most serious warning from the FDA. It lets doctors and patients know about a drug’s effects that may be dangerous.

Administering higher or more frequent doses of Valtoco than your doctor recommends may lead to dependence and withdrawal. With dependence, your body needs the drug to function as it typically would. Stopping a drug your body has become dependent on can lead to withdrawal symptoms. These are uncomfortable side effects that can occur when you stop a drug your body is used to.

Symptoms of withdrawal from Valtoco may include:

Valtoco is prescribed as a short-term treatment for certain seizures. The risks of dependence and withdrawal with Valtoco are low if you administer the drug as your doctor prescribes it.

What you can do

If you administer Valtoco often, talk with your doctor before stopping treatment with the drug. They can discuss your risks of withdrawal and dependence. If necessary, they may slowly decrease your Valtoco dose over time to reduce the risk of these side effects.

To learn more about these risks, talk with your doctor or pharmacist.

Nasal side effects

Valtoco may lead to nasal side effects, including nasal discomfort or nosebleeds. These were among the more common side effects in clinical trials of the drug.

What you can do

If you have persistent or bothersome nasal side effects after administering Valtoco, talk with your doctor. They can recommend ways to ease your symptoms. Your doctor can also discuss other treatment options with you that are less likely to cause nasal side effects.

Allergic reaction

As with most drugs, Valtoco can cause an allergic reaction in some people. However, this side effect wasn’t reported in clinical trials.

Symptoms can be mild or serious and can include:

  • skin rash
  • itching
  • flushing
  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What you can do

For mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and determine whether you should continue treatment with Valtoco. However, if your symptoms are serious and you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

Was this helpful?

Keep reading to learn more about precautions for Valtoco.

Boxed warnings

This drug has boxed warnings about the risks of serious harm if taken with opioids, misuse and addiction, and dependence and withdrawal. These are serious warnings from the Food and Drug Administration (FDA). For details, see the “Side effect specifics” section above.

Other precautions

Be sure to talk with your doctor about your health history before you start Valtoco. This drug may not be the right treatment option for you if you have certain medical conditions or other factors that affect your health. These are considered drug-condition or drug-factor interactions. The conditions and factors to consider include:

Breathing conditions. Before starting Valtoco, tell your doctor if you have a breathing condition such as asthma. The drug may cause central nervous system depression, which can cause shortness of breath and worsen your breathing condition. If you have a breathing condition, your doctor will decide whether Valtoco is safe for you.

Depression or other mood disorders. In rare cases, Valtoco may increase your risk of suicidal thoughts or behaviors. This risk may be higher for people who already have depression or another mood disorder. If you have a mood disorder, your doctor can tell you whether Valtoco is a safe treatment option for you.

Glaucoma. Before starting Valtoco, tell your doctor if you have glaucoma. The drug may cause ocular hypertension (increased pressure inside of your eye), which could worsen glaucoma. Your doctor can tell you whether Valtoco is a safe treatment option for you.

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 may be better options for you.

Pregnancy or breastfeeding. If you’re pregnant or breastfeeding your child, Valtoco may not be safe for you. Treatment with Valtoco while pregnant or breastfeeding could cause side effects in an infant or child who’s breastfed. Talk with your doctor about this before starting Valtoco.

If your doctor does prescribe Valtoco during your pregnancy, they may recommend you enroll in the North American Antiepileptic Drug (NAAED) Pregnancy Registry. This registry helps healthcare professionals learn about the effects of antiepileptic drugs, such as Valtoco, on pregnant people and developing fetuses. To learn more about the NAAED Pregnancy Registry, you can call 888-233-2334 or visit the program website.

Alcohol consumption. If you drink alcohol, Valtoco may not be safe for you. Drinking alcohol during Valtoco treatment may increase the risk of CNS depression as a side effect of the drug. CNS depression could lead to overdose. If you have questions about the safety of alcohol with Valtoco, talk with your doctor or pharmacist.

If you’d like to learn more about Valtoco, talk with your doctor or pharmacist. They can help answer any questions you have about side effects from the drug.

Besides talking with your doctor, you can do some research on your own. These articles might help:

  • More information about Valtoco. For details about other aspects of Valtoco, refer to this article.
  • Cost. If you’d like to learn about diazepam and cost, see this article.
  • Dosage. For information about the dosage of Valtoco, view this article.
  • A look at seizure disorders. For details about seizure disorders, see our epilepsy and seizure hub.

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.