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Concomitant use of benzodiazepiones, including Valium, and opioids may result in profound sedation, respiratory depression, coma, and death. Because of these risks, reserve concomitant prescribing of these drugs for use in patients for whom alternative treatment options are inadequate.
Observational studies have demonstrated that concomitant use of opioid analgesics and benzodiazepines increases the risk of drug-elated mortality compared to use of opioids alone. If a decision is made to prescribe Valium concomitantly with opioids, prescribe the lowest effective dosages and minimum durations of concomitant use, and follow patients closely for signs and symptoms of respiratory depression and sedation. In patients already receiving an opioid analgesic, prescribe a lower initial dose of Valium than indicated in the absence of an opioid and titrate based on clinical response. If an opioid is initiated in a patient already taking Valium, prescribe a lower initial dose of the opioid and titrate based upon clinical response.

Diazepam Side Effects
As with other medications, taking diazepam comes with a risk of developing side effects. Keep in mind your doctor prescribed you the drug because they believe that the potential benefits to you outweigh the potential risks and side effects. The good news is that most people who take this medication will not develop side effects. Drowsiness, dizziness, unsteadiness, and blurred vision are some of the more common side effects. You should talk to your doctor pharmacist if you develop these side effects.

Most common practice
You should take 5-10 mg of the drug before sleep, if it used as a sleeping pill, or 15-20 mg to achieve a stronger euphoric effect. The use of Valium as a muscle relaxant is unsafe, while the most serious side effect is addiction. Unfortunately, as the drug causes dependence very quickly, many people start to increase the dose to achieve the primary effect, which becomes weaker with every intake. Such symptoms are observed during the therapy with other benzodiazepines as well. Therefore, in case of the long-term treatment with Valium (even for therapeutic purposes), daily dosage must be decreased slowly.

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