Valium (Diazepam) is a popular benzodiazepine medication prescribed for an array of conditions including: acute anxiety, alcohol withdrawal, insomnia, panic attacks, restless leg syndrome, and seizures. Like other benzodiazepines, diazepam functions as a positive allosteric modulator (PAM) of GABAA receptors. Rather than binding to the same (“A”) subunit of GABAA receptors as the neurotransmitter GABA (gamma-aminobutyric acid), diazepam binds to the “B” subunit.
This facilitates an increase in the transportation of chloride through selective ion channels, which depresses CNS activity. As a result, most users of diazepam report: anxiety reduction, drowsiness, physical relaxation, and sedation. These effects are so potent, that the medication has been classified as a “controlled-substance” in the United States.
Although the drug can provide substantial therapeutic benefit when utilized over a short-term under medical supervision, long-term usage of benzos like Valium have been linked to dementia and memory impairment. Furthermore, ongoing usage of diazepam could interfere with school/work performance, operating a motor vehicle, and even lead to addiction. For these reasons, many users have decided to discontinue Valium, hoping to clear it from their system.
How long does Valium stay in your system after stopping?
If you’ve recently stopped taking this drug, you’re in for a whirlwind of debilitating Valium withdrawal symptoms. Discontinuation should only be conducted under supervision and collaboration with a medical professional, as abrupt discontinuation from a high dosage could be fatal. In any regards, if you’ve fully ceased your Valium usage, you’re probably wondering how long it’s going to stay in your system.
To determine how long the chemical “diazepam” within Valium stays in your system after stopping, it is necessary to review its elimination half-life. The elimination half-life of Valium is estimated to fall within the range of 30 and 56 hours, for an average of 43 hours. This indicates that it’ll take (on average) around 43 hours just to clear 50% of the final dose from your body after ingestion.
If going by the 43 hour half-life, we can estimate that it will take ~9.85 days to fully clear diazepam from your plasma. However, just because the diazepam will have been eliminated from systemic circulation doesn’t mean that its metabolites will have also been eliminated. The most prominent (and pharmacologically active) metabolite of diazepam is “nordiazepam” (also called “desmethyldiazepam”) which has a half-life ranging from 40 to 100 hours.
If considering an intermediary average between 40 hours and 100 hours for nordiazepam’s half-life, we’d come up with 70 hours. This means that on average, it’ll likely take around 70 hours to eliminate the nordiazepam metabolite from your plasma. However, if considering that half-life of nordiazepam could be up to 100 hours, we could estimate that full plasma elimination of diazepam and nordiazepam may take up to 22.92 days.
- Source: https://pubchem.ncbi.nlm.nih.gov/compound/diazepam
- Source: http://www.nhtsa.gov/people/injury/research/job185drugs/diazepam.htm
Note: In addition to major metabolite “nordiazepam,” diazepam forms other minor metabolites including “temazepam” and “oxazepam.” However, these minor metabolites have substantially shorter half-lives than diazepam itself, and therefore should be excreted quicker.
Variables that influence how long Valium stays in your system
There are a multitude of variables that can impact how long the diazepam within Valium is likely to remain in systemic circulation. When attempting to estimate how long diazepam will linger in your system after your last dose, it is necessary to consider: hepatic function, the individual taking it, term of administration, dosage, and co-ingestion of other drugs.
Perhaps the most prominent variable to consider when contemplating how long Valium will stay in your system is your hepatic (liver) function. If you exhibit compromised liver function and/or hepatic impairment, it’ll take substantially longer to excrete the drug from your body. Research has shown that the half-life of diazepam increases 5-fold among those with conditions like cirrhosis compared to healthy adults.
As opposed to exhibiting a 32.1 hour half-life, the diazepam exhibits a 164 hour half-life among individuals with cirrhosis. After doing the math, we could estimate that it would take approximately 37.58 days to completely excrete the diazepam. Though the 5-fold increase may not apply to diazepam’s chief metabolite “nordiazepam,” it may still increase its half-life in excess of 200 hours, meaning it could take over 45 days for plasma elimination.
- Source: http://www.ncbi.nlm.nih.gov/pubmed/964287
- Source: http://www.ncbi.nlm.nih.gov/pubmed/1127104
- Source: http://www.ncbi.nlm.nih.gov/pubmed/321178
Two individuals with normative hepatic function may take the same dosage of Valium simultaneously, yet one person may excrete the drug quicker than the other. The duration over which diazepam is likely to remain in your system along with its metabolites is largely influenced by individual factors. These factors include things like: a person’s age, body mass, food intake, genetics, and sex.
Age: The age of the diazepam user can have a substantial impact on its elimination half-life. Elderly patients (age 65+) are known to exhibit 2-fold increases in elimination half-lives compared to younger adults. In other words, it may take an average of 20 days among elderly to clear Valium from plasma compared to 10 days among young adults.
A variety of factors may contribute to prolonged excretion times in the elderly, including reduced albumin levels, diminished hepatic blood flow, various health conditions, administration of other medications, and increased diazepam-plasma distribution. Half-life of Valium also differs among infants, with full-term infants exhibiting 30 hour half-lives and premature infants exhibiting 54 hour half-lives.
The difference in longer retention of Valium among premature infants is due to underdeveloped metabolic pathways, leading to greater accumulation of the drug. Some sources estimate that half-life of Valium is approximately 20 hours at 20 years of age, and increases by 1 hour for each year thereafter (e.g. 30 years old = 30 hour half-life).
- Source: http://www.ncbi.nlm.nih.gov/pubmed/6487752
- Source: http://www.ncbi.nlm.nih.gov/pubmed/7312934
- Source: https://pubchem.ncbi.nlm.nih.gov/compound/diazepam
Body Fat (%): Both a person’s body mass and percentage body fat can influence how long diazepam is likely to remain in a person’s system after discontinuation. Studies have compared the elimination half-life of diazepam among those of normative body weight to those who are classified as “obese.” One study noted that the “accumulation half-life” or time the diazepam continues to accumulate is longer in obese individuals (7.8 days) than non-obese individuals (3.1 days).
Among obese subjects, the elimination half-life of diazepam was approximately 82 hours, compared to 32 hours among non-obese individuals; this was due to a larger volume of distribution at 228 liters rather than 70 liters. Rather than clearing the drug from plasma within 8 days, it takes obese individuals up to 19 days (on average). If you have a high percentage of body fat and/or are a large person, the diazepam will be distributed to a greater extent and it’ll stay in your system for considerably longer than a smaller individual.
- Source: http://www.ncbi.nlm.nih.gov/pubmed/6415130
Genetics: Diazepam is metabolized by various enzymes in the liver that are influenced by genetics. Enzymes primarily responsible for the metabolism of diazepam include CYP2C19 and CYP3A4. Genetics are known to influence the functional expression of both CYP2C19 and CYP3A4.
Therefore, individuals with poor expression of either enzyme may exhibit slightly different pharmacokinetics of diazepam. Individuals with reduced function of one or both of these enzymes is likely to accumulate the drug to a greater extent, resulting in a prolonged elimination half-life. On the other hand, those with optimal function of CYP2C19 and CYP3A4 may clear the drug quicker from their plasma than average.
Metabolic rate: The elimination of many drugs is influenced by a person’s basal metabolic rate (BMR). Although it is unclear as to whether diazepam’s elimination half-life is influenced by BMR, it is necessary to consider that it may have an effect. The elimination half-life of oxazepam (a metabolite of diazepam) is expedited among those with hyperthyroidism.
In cases of hyperthyroidism, individuals exhibit an increased BMR. Though hypothyroidism isn’t associated with prolonged elimination, increased body fat percentage is. Since BMR is thought to be linked to a person’s body fat percentage, and elimination of diazepam is longer among obese individuals, lower BMR is likely to prolong elimination. That said, the degree to which metabolic rate affects excretion of diazepam isn’t fully elucidated.
Term of Administration
The greater the duration over which you’ve consistently administered Valium, the longer it’ll likely take to excrete from your body after your final dose. Long-term administration results in greater overall accumulation of both diazepam and its metabolites: nordiazepam, temazepam, and oxazepam throughout the body. Short-term administration of diazepam results in less accumulation of diazepam and metabolites throughout the body and more efficient excretion.
Short-term users may never reach peak-concentrations of diazepam throughout their system, especially if the drug is administered infrequently (or on an intermittent basis). On the other hand, long-term users often reach peak concentrations quickly and continuously increase that peak via dosage increases and/or frequent administration of diazepam. Both increased dosages and greater frequency of administration among long-term users leads to less efficient systemic elimination following your final dose.
Dosage + Frequency
Both the dosage of Valium taken as well as the frequency at which it is administered can influence how long it stays in your system. A person taking a single 10 mg dose will take longer to fully metabolize and excrete it than a person taking just 0.5 mg. This is due to the fact that greater doses place a greater burden on hepatic enzymes for metabolism, leading to reduced efficiency of diazepam breakdown.
Furthermore greater dosages can facilitate greater accumulation of both diazepam and metabolites throughout the body. This increased accumulation is known to prolong elimination half-life. In addition to the dosing, it is also necessary to account for the frequency at which the drug is taken. Someone taking a single-dose of Valium will excrete it quicker than a person taking it several times throughout the day.
This is because with each successive dose, the drug accumulates to a greater extent than single dosing. Frequent administration also allows the drug to reach steady state plasma concentrations, whereas a single dose does not. Therefore, the more doses of Valium administered throughout the day, the longer you can expect it to remain in your system after your last dose.
Co-ingestion of Drugs
Taking other drugs along with Valium may influence how long diazepam and its metabolites remain in your system. Diazepam is metabolized primarily by enzymes CYP2C19 and CYP3A4. Therefore simultaneous ingestion of drugs that serve to either enhance (induce) or decrease (inhibit) function of these enzymes may affect diazepam elimination.
Specifically, agents that inhibit CYP2C19 and CYP3A4 will reduce functionality of enzymes necessary to metabolize diazepam. Examples of CYP2C19 inhibitors include: Chloramphenicol, Luvox, Moclobemide, and Prozac. Examples of CYP3A4 inhibitors include: Clarithromycin, Cobicistat, Indinavir, Ketoconazole, and Ritonavir.
Should you have taken any of these inhibitory agents along with Valium, you may retain the drug for longer than expected within your system. On the other hand, agents that induce activity of CYP2C19 and CYP3A4 may expedite the metabolism and elimination of diazepam from your system. Examples of CYP2C19 inducers include: Artemisinin, Aspirin, Carbamazepine, Norethisterone, Prednisone, and Rifampicin.
Examples of CYP3A4 inducers include: Carbamazepine, Oxcarbazepine, Phenytoin, Rifampicin, and St. John’s wort. The degree to which these inducers and/or inhibitors affect metabolism and elimination of Valium may be a result of the specific drug administered, as well as the dosage.
Valium (Diazepam): Absorption, Metabolism, Excretion (Details)
Following Valium administration, approximately 90% of the dosage is absorbed by the gastrointestinal (GI) Tract, reaching peak plasma concentrations in around 1 to 2 hours. Absorption can be subject to slight delay (by ~30 minutes) should an individual have recently consumed a high-fat meal prior to administration of Valium. Time to reach peak plasma concentrations may be delayed by up to 1.25 hours and total concentrations may decrease by up to 20% when taken with food.
The drug is then distributed throughout the body at 0.8 to 1.0 L/kg. After absorption, diazepam is subject to extensive hepatic metabolism via cytochrome P450 enzymes. It is metabolized principally via CYP2C19 and CYP3A4 pathways to form metabolites: desmethyldiazepam (nordiazepam), temazepam, and oxazepam.
Diazepam undergoes N-demethylation via CYP2C19 and CYP3A4 to form its chief metabolite desmethyldiazepam (nordiazepam). Further metabolism via 3-hydroxylation via CYP3A4 isoenzymes facilitates formation of a minor metabolite, temazepam. Both desmethyldiazepam and temazepam are then metabolized to form oxazepam.
The minor metabolites temazepam and oxazepam undergo glucuronidation, getting excreted via urine as glucuronide conjugates. Oxazepam conjugate is thought to account for 33% of the excreted dose in urine, whereas temazepam conjugate accounts for a lesser extent. Only small amounts of diazepam and its primary metabolite nordiazepam are detectable via urinary excretion.
Since the elimination half-life of diazepam is ~43 hours and that of its nordiazepam metabolite is 40 to 100 hours, it takes most people between 10 and 23 days to completely eliminate the drug from their system. Only a small percentage of the drug is thought to get excreted as bile within the feces.
- Source: https://pubchem.ncbi.nlm.nih.gov/compound/diazepam
- Source: http://www.nhtsa.gov/people/injury/research/job185drugs/diazepam.htm
Types of Valium Drug Tests
There are various types of drug tests capable of detecting Valium, as well as other benzodiazepines. Common drug tests for diazepam (and its metabolites) include: blood tests, urine tests, hair tests, and saliva tests. Should you attempt to determine how long the drug remains in your system, these tests may be helpful.
Blood tests: It is possible to determine whether someone has ingested Valium via a blood sample. Blood tests can accurately detect levels of diazepam and its metabolites, especially when administered frequently. Diazepam is thought to accumulate within the bloodstream when administered repeatedly over a long-term, resulting in easy detection via a blood sample taken from a long-term user.
Blood samples are known to be substantially greater among chronic users of Valium compared to single users, and are often greater in the elderly. Since blood tests are highly invasive, they are not commonly preferred over urine tests. However, they are usually more accurate in detecting diazepam and its metabolite nordiazepam than urine tests, as well as ideal for investigating cases of diazepam abuse.
Urine tests: A urine test doesn’t easily detect diazepam specifically, since only a small percentage of the drug is excreted in unchanged form. However, a urine test is capable of detecting diazepam metabolites including: nordiazepam, temazepam, and oxazepam. Using a technique called “Liquid Chromatography-Mass Spectrometry” (LC/MS), between 50% and 80% of the metabolites can be recovered.
It is thought that concentrations of these metabolites remain detectable for different amounts of time based on the individual. For some people they may be detectable for just several days after ingestion, while for others they may be detected for weeks after administration. Since oxazepam conjugates are most abundant in urine (compared to other diazepam metabolites), most urinalyses will measure oxazepam conjugate levels to determine diazepam usage.
- Source: http://www.ncbi.nlm.nih.gov/pubmed/18618924
- Source: http://www.ncbi.nlm.nih.gov/pubmed/10022206
Hair tests: An effective method for determining whether an individual had ingested Valium, as well as abused it is via a hair test. A hair test involves collecting a sample of hair follicles (usually from the head) and sending them to a laboratory for analysis. Diazepam and metabolites may appear in hair samples in less than a week after administration, and may remain detectable for up to 3 months after drug ingestion.
Due to the accuracy in estimating Valium ingestion over a long-term, hair samples are often utilized by law enforcement to detect abuse and/or illicit usage among criminals (e.g. drug offenders). In cases of abuse, diazepam may appear in concentrations of 5 to 7 ng/mg and its metabolite nordiazepam may appear at levels of 0.5 to 2 ng/mg. These concentrations are easier to detect in pigmented (compared to non-pigmented) hair.
- Source: http://www.ncbi.nlm.nih.gov/pubmed/11731192
- Source: http://www.ncbi.nlm.nih.gov/pubmed/21619726
Saliva tests: A relatively non-invasive, convenient method for detecting diazepam and nordiazepam metabolites is via an oral fluid (saliva) sample. Saliva testing typically involves collecting a specific amount of oral fluid, followed by analysis of the fluid via a preprogrammed device or within a laboratory using gas chromatography/mass spectrometry (GC/MS). Research has shown that Valium remains detectable along with its nordiazepam metabolite between 7 and 9 days after administration.
The greater the dosage of Valium administered, the easier it is to detect in oral fluid samples. Some evidence suggests that oral fluid samples probably aren’t ideal for assessing diazepam ingestion due to the fact that the drug (and other benzos) are highly protein bound and weakly acidic, hence only appearing in saliva at low levels. Only with laboratory detection methods (e.g. GC/MS) would saliva tests be preferred over other modalities.
- Source: http://www.ncbi.nlm.nih.gov/pubmed/25549207
- Source: http://www.ncbi.nlm.nih.gov/pubmed/19571773
Who may get tested for Valium?
A variety of individuals could get tested for diazepam or other benzodiazepines. Examples of such individuals include: criminals, rehab patients, employees, and military personnel. Realize that certain occupations and/or individuals may be subject to more frequent testing than others.
- Criminals: Should a law enforcement agent suspect that an individual is intoxicated with a benzodiazepine, or that the individual may have used a benzo as part of crime – drug panels may be administered. Criminals are often tested with hair tests to determine whether they’ve illicitly ingested diazepam within the past several months. Should they get caught with the drug in their system, they could face harsher legal penalization.
- Drug rehab patients: In rehabilitation, many patients continue to seek out intoxicating substances to attain a “high.” If they can find a way to get their hands on some Valium, it may be tempting to ingest during rehab. To make sure that rehab patients maintain sobriety, they are often tested with extensive drug panels, capable of detecting diazepam.
- Employees: Those working as truck drivers, machinists, or even pilots are banned from using benzodiazepines. Should an individual in any of the aformentioned occupations take Valium, they could put others’ lives at risk. In addition, usage of benzodiazepines in these occupations may result in decreased productivity and/or other damages. As a result, employers may conduct ongoing benzodiazepine screenings among employees.
- Military personnel: In the military, it is necessary to maintain optimal cognitive function and performance. Since Valium is known to increase drowsiness, decrease coordination, and impairs memory – it is not recommended to be used by troops. For this reason, military personnel may be tested for benzodiazepines – especially prior to handling weaponry or operating heavy machinery.
How to get Valium out of your system
If you’ve discontinued Valium, you may want to expedite the speed by which it is eliminated from your plasma. Below are some suggestions that could provide benefit to certain individuals that want to eliminate diazepam from systemic circulation as fast as possible. Prior to implementing any of these suggestions, be sure to discuss their safety and efficacy with a licensed medical professional.
- Cease usage: The most obvious way to ensure that Valium stops accumulating within your body is to cease taking it. Cessation of this drug should always be done under supervision and guidance of a professional. Realize that the sooner you stop taking Valium, the quicker you can expect it (as well as its metabolites) to leave your system.
- Burn fat: Diazepam accumulates slower and is eliminated at a slower rate upon cessation among obese individuals compared to non-obese people. Burning body fat (usually through exercise) can be an effective way to eliminate diazepam as fast as possible – especially if you are obese. The more obese you are, and the greater your body fat, the slower you’ll eliminate diazepam.
- Stay hydrated: Hydration may aid in eliminating diazepam completely from your body as quickly as possible. Though the drug is extensively metabolized in the liver (via various CYP450 enzymes), it is excreted via the kidneys. Renal excretion can be affected by urinary flow rate, which is often influenced by hydration. Staying hydrated is thought to increase urinary flow rate, thereby leading to more efficient excretion of diazepam metabolites.
- Supplements: Any supplements that serve to enhance hepatic and/or renal function may aid in excretion of diazepam (and metabolites). Other supplements that act as either CYP3A4/CYP2C19 inducers may expedite metabolism and clearance of your final dose. Furthermore, a supplement like activated charcoal may help flush out any excess remnants of diazepam and/or metabolites following your last dose. Talk to a doctor prior to taking any supplements following Valium discontinuation.
How long has Valium stayed in your system after stopping?
If you’ve taken Valium and discontinued, share a comment regarding how long you believe it stayed in your system. Do you believe it remained in systemic circulation for longer than the average of 9.85 days? Or do you think you were able to excrete it much quicker than usual based on individual factors?
To help others understand how long Valium stayed in your system, discuss various factors that influence its elimination such as: hepatic function, dosage, frequency of administration, body fat percentage, and ingestion of other medications. Realize that there is often significant interindivdiual variance in how long diazepam is likely to stay in your system following your final dose – ranging from 10 to 23 days. Most individuals can expect the drug to have been excreted within a month unless they’re suffering from hepatic impairment.