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Can you take Xanax and Valium together?

Last reviewed by Editorial Team on August 28th, 2018.

What is Valium? What are Valium indications?

Valium is a Brand name for a medicine that contains long-acting benzodiazepine drug named diazepam as an active ingredient. Diazepam works by affecting chemicals in the brain known as neurotransmitters that may be unbalanced in patients with different types of anxiety disorder.

Valium indications are: treatment of severe anxiety disorders, short-term management of insomnia, use as a sedative and premedication, refractory Epilepsy, status epilepticus, anticonvulsant for muscle spasms and management of alcohol withdrawal syndrome.

Valium is available in the form of tablet in doses of: 2, 5 and 10 mg and also as a liquid for intramuscular or intravenous injection in dose of 10 mg. FDA approved diazepam for use in 1963 under the brand name Valium of Roche drug company.

How Xanax and Valium work in the body?

Alprazolam which is active ingredient of Xanax and Diazepam which is active ingredient of Valium are both benzodiazepines drugs that work by binding to benzodiazepine BNZ-1 receptors, responsible for sleep induction and benzodiazepine BNZ-2 receptors responsible for anticonvulsant activity, memory functions and motor coordination.

Those receptors receptors are coupled with GABAA receptors, and when alprazolam and diazepam binds to them it increases inhibitory effects of GABA neurotransmitter by increasing GABA affinity for its binding sites. When GABA binds to its receptors, chloride channels are opening which results in a hyperpolarization of cell membrane and prevention of further cell excitation.

Difference and similarities between Valium and Xanax

Both drugs are classified as benzodiazepines or minor tranquilizers. They have similar mechanism of action as they potentiate the inhibitory effects of GABA. However, Xanax is intermediate-acting while Valium is long-acting benzodiazepine drug. Valium reaches maximal concentrations in plasma after 1 hour, while Xanax reaches after 30-40 minutes.

Xanax half-life time is approximately 12-14 hours, while Valium half-life time is about 35 hours. So Xanax begins to work faster than Valium effects, but Valium effects last longer. Also Xanax metabolizes faster than Valium so it does not stay in body for long time such as Valium. Xanax is approved for the treatment of panic disorder, while Valium is not.

However, Valium works better as anticonvulsive agent then Xanax. Valium is indicated for status epilepticus, refractory epilepsy, muscle spasms and chronic treatment of sleep disorders while Xanax is not.

Valium may be used for treatment in children while Xanax safety for children has not been established.  Both drugs can cause dependence and serious withdrawal symptoms. Neither of these drugs is recommended for women who are pregnant or breast-feeding.

Can you mix valium and xanax?

Patients should never take these drugs together at the same time without doctor advice. Both drugs belong to the same class of benzodiazepines and are CNS depressors. If they are taken together, their effects will be added, so there is a high chance of causing dangerous side effects. Those who take them together will certainly feel numb, drowsy and sleepy.

But there is also increased chance of causing serious side effects such as low blood pressure and respiratory depression. Patients always need to talk with their doctor first before they take these drugs on their own.


If these drugs are taken together they may increase the risk of following side effects:

  • Drowsiness
  • Depression
  • Headache
  • Constipation
  • Diarrhea
  • Dry mouth
  • Tachycardia
  • Confusion
  • Insomnia
  • Nausea/vomiting
  • Blurred vision
  • Nasal congestion
  • Hypotension
  • Syncope
  • Akathisia
  • Dizziness
  • Increased salivation
  • Nervousness
  • Tremor
  • Weight change
  • Somnolence
  • Ataxia
  • Rash
  • Incoordination

Warnings and precautions while taking Valium and Xanax

  • Patients should not take Valium if they have a condition called myasthenia gravis.
  • Valium and Xanax should never be taken if you have acute narrow-angle glaucoma. You should tell your doctor about any other eye symptoms.
  • Patients who have severe lung disease, liver disease, or sleep apnea should not take Valium and Xanax
  • You should inform your doctor if you have heart problems, seizures, alcohol or drug abuse, and depression before taking Valium or Xanax.
  • Patients older than 65 years should talk with their doctor about other medications that may work instead of Valium.
  • Antifungal drugs such as ketoconazole and itraconazole should not be taken with Valium and Xanax
  • Patients with seizures or epilepsy have to avoid Xanax
  • Do not use Xanax or Valium if you are pregnant. This medicine can cause birth defects. Newborn may also become dependent on these drugs. These drugs can cause life-threatening withdrawal symptoms. Such newborns may need medical treatment for several weeks. You should tell your doctor if you are pregnant or plan to become pregnant. Use effective birth control to prevent pregnancy while you are taking Xanax.
  • Alprazolam and Diazepam can pass into breast milk and may harm a nursing baby. You should not breast-feed a baby while you are taking Valium or Xanax.

Taking Valium or Xanax together with Grapefruit

Most drugs are compatible for use together with grapefruit; however some classes of drugs are contraindicated with grapefruit. Benzodiazepines such as Xanax or Valium can interact with grapefruit. Combining Xanax or Valium with Grapefruit can lead to significant drug interactions thus should not be used together.

Antioxidants that can be found in grapefruit juice can block the action of the liver enzyme CYP3A4. This inhibition can last even for 1 day. This enzyme is responsible for metabolism of medications, including Xanax and Valium. High amounts of grapefruit can inhibit the action of CYP3A4 enzyme thus reducing elimination of these drugs from the body.

Also, too much of grapefruit in the diet can lead to abnormally high and potentially toxic levels of Xanax and Valium. Grapefruit is also known to inhibit the metabolism of other drugs that include some cholesterol-lowering drugs, antihypertensive drugs and anti-anxiety drugs.

Reasons for Valium abuse

Valium like all other benzodiazepines has a high potential for abuse. The major reason for Valium abuse is because that this drug can increase the effects of opioids drugs such as morphine and heroine, thus abusers and addicts use benzodiazepines, especially Valium, because of its long-lasting effects alongside with opioids for the state of relaxed, euphoric “high” that this combination offers.

Cocaine addicts also use Valium to relieve cocaine uncomfortable side effects such as irritability and agitation. Valium abuse also includes using them to enhance the effects of alcohol and ease the symptoms of alcohol withdrawal.

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