Valtoco

Overview

diazepam

benzodiazepine

• CYP2C19 substrate
• CYP3A4 substrate
• affected by altered fat absorption
• antiepileptic agent
• CNS depression
• hypotensive effects

Contraindicated

• amifampridine
Valtoco (diazepam nasal)

+

amifampridine

1 interaction

Contraindicated

diazepam + amifampridine

contraindicated if seizure disorder use; otherwise, caution advised: combo may alter seizure control (antagonistic effects, amifampridine may decr. seizure threshold)

• bupropion
Valtoco (diazepam nasal)

+

bupropion

1 interaction

Contraindicated

diazepam + bupropion

contraindicated if seizure disorder use; otherwise, consider lower bupropion doses: combo may alter seizure control (antagonistic effects, bupropion may decr. seizure threshold)

• dalfampridine
Valtoco (diazepam nasal)

+

dalfampridine

1 interaction

Contraindicated

diazepam + dalfampridine

contraindicated if seizure disorder use; otherwise, caution advised: combo may alter seizure control (antagonistic effects, dalfampridine may decr. seizure threshold)

Avoid/Use Alternative

• alfentanil
Valtoco (diazepam nasal)

+

alfentanil

1 interaction

Avoid/Use Alternative

diazepam + alfentanil

use alternative or monitor BP, resp. rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, severe hypotension (incl. orthostasis, syncope), delayed recovery from anesthesia; may alter seizure control (additive effects; antagonistic effects, alfentanil may decr. seizure threshold)

• alprazolam
Valtoco (diazepam nasal)

+

alprazolam

1 interaction

Avoid/Use Alternative

diazepam + alprazolam

use alternative or monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects, duplicate tx)

• aripiprazole lauroxil
Valtoco (diazepam nasal)

+

aripiprazole lauroxil

1 interaction

Avoid/Use Alternative

diazepam + aripiprazole lauroxil

ARISTADA INITIO: avoid combo; ARISTADA: monitor resp. rate, BP; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, hypotension, incl. orthostasis; may alter seizure control (additive effects; antagonistic effects, aripiprazole may decr. seizure threshold)

• baclofen intrathecal
Valtoco (diazepam nasal)

+

baclofen intrathecal

1 interaction

Avoid/Use Alternative

diazepam + baclofen intrathecal

use alternative or monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, baclofen may decr. seizure threshold)

• buprenorphine
Valtoco (diazepam nasal)

+

buprenorphine

1 interaction

Avoid/Use Alternative

diazepam + buprenorphine

use alternative or monitor resp. rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, severe hypotension, incl. orthostasis, syncope; may alter seizure control (additive effects; antagonistic effects, buprenorphine may decr. seizure threshold)

• butalbital
Valtoco (diazepam nasal)

+

butalbital

1 interaction

Avoid/Use Alternative

diazepam + butalbital

avoid combo: combo may decr. diazepam levels, efficacy; may incr. risk of profound CNS and resp. depression, psychomotor impairment (hepatic metab. induced; additive effects)

• butorphanol
Valtoco (diazepam nasal)

+

butorphanol

1 interaction

Avoid/Use Alternative

diazepam + butorphanol

use alternative or monitor resp. rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, hypotension, incl. syncope; may alter seizure control (additive effects; antagonistic effects, butorphanol may decr. seizure threshold)

• chlordiazepoxide
Valtoco (diazepam nasal)

+

chlordiazepoxide

1 interaction

Avoid/Use Alternative

diazepam + chlordiazepoxide

use alternative or monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects, duplicate tx)

• clobazam
Valtoco (diazepam nasal)

+

clobazam

1 interaction

Avoid/Use Alternative

diazepam + clobazam

use alternative or monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects, duplicate tx)

• clonazepam
Valtoco (diazepam nasal)

+

clonazepam

1 interaction

Avoid/Use Alternative

diazepam + clonazepam

use alternative or monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects, duplicate tx)

• clonidine
Valtoco (diazepam nasal)

+

clonidine

1 interaction

Avoid/Use Alternative

diazepam + clonidine

if ADHD use, avoid combo; otherwise, monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• clorazepate
Valtoco (diazepam nasal)

+

clorazepate

1 interaction

Avoid/Use Alternative

diazepam + clorazepate

use alternative or monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects, duplicate tx)

• codeine
Valtoco (diazepam nasal)

+

codeine

1 interaction

Avoid/Use Alternative

diazepam + codeine

avoid combo if antitussive use; otherwise use alternative or monitor resp. rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, severe hypotension, incl. orthostasis, syncope; may alter seizure control (additive effects; antagonistic effects, codeine may decr. seizure threshold)

• desflurane
Valtoco (diazepam nasal)

+

desflurane

1 interaction

Avoid/Use Alternative

diazepam + desflurane

use alternative or monitor resp. rate; consider decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• dexmedetomidine injection
Valtoco (diazepam nasal)

+

dexmedetomidine injection

1 interaction

Avoid/Use Alternative

diazepam + dexmedetomidine injection

use alternative or monitor resp. rate; consider decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• diazepam
Valtoco (diazepam nasal)

+

diazepam

1 interaction

Avoid/Use Alternative

diazepam + diazepam

use alternative or monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects, duplicate tx)

• dihydrocodeine
Valtoco (diazepam nasal)

+

dihydrocodeine

1 interaction

Avoid/Use Alternative

diazepam + dihydrocodeine

use alternative or monitor resp. rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, severe hypotension, incl. orthostasis, syncope; may alter seizure control (additive effects; antagonistic effects, dihydrocodeine may decr. seizure threshold)

• doxylamine
Valtoco (diazepam nasal)

+

doxylamine

1 interaction

Avoid/Use Alternative

diazepam + doxylamine

avoid combo if doxylamine use for pregnancy-related nausea/vomiting, otherwise monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• estazolam
Valtoco (diazepam nasal)

+

estazolam

1 interaction

Avoid/Use Alternative

diazepam + estazolam

use alternative or monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects, duplicate tx)

• ethanol
Valtoco (diazepam nasal)

+

ethanol

1 interaction

Avoid/Use Alternative

diazepam + ethanol

avoid combo: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• ethanol (in some formulations)
Valtoco (diazepam nasal)

+

ethanol (in some formulations)

1 interaction

Avoid/Use Alternative

diazepam + ethanol (in some formulations)

use alternative or monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• fentanyl
Valtoco (diazepam nasal)

+

fentanyl

1 interaction

Avoid/Use Alternative

diazepam + fentanyl

use alternative or monitor resp. rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, severe hypotension (incl. orthostasis, syncope); may alter seizure control (additive effects; antagonistic effects, fentanyl may decr. seizure threshold)

• flurazepam
Valtoco (diazepam nasal)

+

flurazepam

1 interaction

Avoid/Use Alternative

diazepam + flurazepam

use alternative or monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects, duplicate tx)

• fluvoxamine
Valtoco (diazepam nasal)

+

fluvoxamine

1 interaction

Avoid/Use Alternative

diazepam + fluvoxamine

use alternative or monitor resp. rate; consider decr. diazepam dose, use lowest effective doses and shortest duration of concomitant tx: combo may incr. diazepam levels, risk of profound CNS and resp. depression, psychomotor impairment, other adverse effects; may alter seizure control (hepatic metab. inhibited, additive effects; antagonistic effects, fluvoxamine may decr. seizure threshold)

• gabapentin
Valtoco (diazepam nasal)

+

gabapentin

1 interaction

Avoid/Use Alternative

diazepam + gabapentin

use alternative or monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• gabapentin enacarbil
Valtoco (diazepam nasal)

+

gabapentin enacarbil

1 interaction

Avoid/Use Alternative

diazepam + gabapentin enacarbil

use alternative or monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• ginkgo
Valtoco (diazepam nasal)

+

ginkgo

1 interaction

Avoid/Use Alternative

diazepam + ginkgo

if seizure disorder use, avoid consumption of ginkgo seeds; otherwise, caution advised: combo may alter seizure control (antagonistic effects, ginkgotoxin may decr. seizure threshold)

• grapefruit
Valtoco (diazepam nasal)

+

grapefruit

1 interaction

Avoid/Use Alternative

diazepam + grapefruit

avoid grapefruit juice w/ oral diazepam: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (GI metab. inhibited)

• hydrocodone
Valtoco (diazepam nasal)

+

hydrocodone

1 interaction

Avoid/Use Alternative

diazepam + hydrocodone

avoid combo if antitussive use; otherwise use alternative or monitor resp. rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, severe hypotension (incl. orthostasis, syncope); may alter seizure control (additive effects; antagonistic effects, hydrocodone may decr. seizure threshold)

• hydromorphone
Valtoco (diazepam nasal)

+

hydromorphone

1 interaction

Avoid/Use Alternative

diazepam + hydromorphone

use alternative or monitor resp. rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, severe hypotension (incl. orthostasis, syncope); may alter seizure control (additive effects; antagonistic effects, hydromorphone may decr. seizure threshold)

• isocarboxazid
Valtoco (diazepam nasal)

+

isocarboxazid

1 interaction

Avoid/Use Alternative

diazepam + isocarboxazid

use alternative during and x10 days after isocarboxazid use: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, isocarboxazid may decr. seizure threshold)

• isoflurane
Valtoco (diazepam nasal)

+

isoflurane

1 interaction

Avoid/Use Alternative

diazepam + isoflurane

use alternative or monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• kava
Valtoco (diazepam nasal)

+

kava

1 interaction

Avoid/Use Alternative

diazepam + kava

avoid combo: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• ketamine
Valtoco (diazepam nasal)

+

ketamine

1 interaction

Avoid/Use Alternative

diazepam + ketamine

use alternative or monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression (incl. life-threatening), psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, ketamine may decr. seizure threshold)

• kratom
Valtoco (diazepam nasal)

+

kratom

1 interaction

Avoid/Use Alternative

diazepam + kratom

use alternative or monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, kratom may decr. seizure threshold)

• levorphanol
Valtoco (diazepam nasal)

+

levorphanol

1 interaction

Avoid/Use Alternative

diazepam + levorphanol

use alternative or monitor resp. rate, BP; decr. levorphanol start dose by at least 50%, consider decr. diazepam dose, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, severe hypotension (incl. orthostasis, syncope); may alter seizure control (additive effects; antagonistic effects, levorphanol may decr. seizure threshold)

• lindane topical
Valtoco (diazepam nasal)

+

lindane topical

1 interaction

Avoid/Use Alternative

diazepam + lindane topical

use alternative if seizure disorder use; otherwise, caution advised: combo may alter seizure control (antagonistic effects, lindane may decr. seizure threshold)

• lorazepam
Valtoco (diazepam nasal)

+

lorazepam

1 interaction

Avoid/Use Alternative

diazepam + lorazepam

use alternative or monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects, duplicate tx)

• meperidine
Valtoco (diazepam nasal)

+

meperidine

1 interaction

Avoid/Use Alternative

diazepam + meperidine

use alternative or monitor resp. rate, BP; decr. meperidine dose 25-50%, consider decr. diazepam dose, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, severe hypotension, incl. orthostasis syncope; may alter seizure control (additive effects; antagonistic effects, meperidine may decr. seizure threshold)

• metaxalone
Valtoco (diazepam nasal)

+

metaxalone

1 interaction

Avoid/Use Alternative

diazepam + metaxalone

use alternative or monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• methadone
Valtoco (diazepam nasal)

+

methadone

1 interaction

Avoid/Use Alternative

diazepam + methadone

use alternative or monitor resp. rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. diazepam levels, risk of profound CNS and resp. depression, psychomotor impairment, severe hypotension (incl. orthostasis, syncope), other adverse effects; may alter seizure control (hepatic metab. inhibited, additive effects; antagonistic effects, methadone may decr. seizure threshold)

• methohexital
Valtoco (diazepam nasal)

+

methohexital

1 interaction

Avoid/Use Alternative

diazepam + methohexital

use alternative or monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• metoclopramide
Valtoco (diazepam nasal)

+

metoclopramide

1 interaction

Avoid/Use Alternative

diazepam + metoclopramide

use alternative or monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may alter seizure control; may incr. risk of profound CNS and resp. depression, psychomotor impairment (antagonistic effects, metoclopramide may decr. seizure threshold; additive effects)

• midazolam
Valtoco (diazepam nasal)

+

midazolam

1 interaction

Avoid/Use Alternative

diazepam + midazolam

use alternative or monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects, duplicate tx)

• morphine
Valtoco (diazepam nasal)

+

morphine

1 interaction

Avoid/Use Alternative

diazepam + morphine

use alternative or monitor resp. rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, severe hypotension, incl. orthostasis, syncope; may alter seizure control (additive effects; antagonistic effects, morphine may decr. seizure threshold)

• nalbuphine
Valtoco (diazepam nasal)

+

nalbuphine

1 interaction

Avoid/Use Alternative

diazepam + nalbuphine

use alternative or monitor resp. rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, severe hypotension, incl. orthostasis, syncope; may alter seizure control (additive effects; antagonistic effects, nalbuphine may decr. seizure threshold)

• olanzapine
Valtoco (diazepam nasal)

+

olanzapine

1 interaction

Avoid/Use Alternative

diazepam + olanzapine

avoid combo w/ parenteral diazepam and IM olanzapine; otherwise, monitor BP, resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, hypotension, incl. orthostasis, syncope; may alter seizure control (additive effects; antagonistic effects, olanzapine may decr. seizure threshold)

• oliceridine
Valtoco (diazepam nasal)

+

oliceridine

1 interaction

Avoid/Use Alternative

diazepam + oliceridine

use alternative or monitor resp. rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, severe hypotension, incl. orthostasis, syncope; may alter seizure control (additive effects; antagonistic effects, oliceridine may decr. seizure threshold)

• opium
Valtoco (diazepam nasal)

+

opium

1 interaction

Avoid/Use Alternative

diazepam + opium

use alternative or monitor resp. rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, severe hypotension incl. orthostasis, syncope; may alter seizure control if seizure disorder use (additive effects; antagonistic effects, morphine in opium may decr. seizure threshold)

• oxazepam
Valtoco (diazepam nasal)

+

oxazepam

1 interaction

Avoid/Use Alternative

diazepam + oxazepam

use alternative or monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects, duplicate tx)

• oxybate
Valtoco (diazepam nasal)

+

oxybate

1 interaction

Avoid/Use Alternative

diazepam + oxybate

use alternative or monitor resp. rate; decr. dose of one or both drugs: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, hypotension, syncope (additive effects)

• oxycodone
Valtoco (diazepam nasal)

+

oxycodone

1 interaction

Avoid/Use Alternative

diazepam + oxycodone

use alternative or monitor BP, resp. rate; decr. oxycodone start dose by at least 50%, consider decr. diazepam dose, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, severe hypotension, incl. orthostasis, syncope; may alter seizure control (additive effects; antagonistic effects, oxycodone may decr. seizure threshold)

• oxymorphone
Valtoco (diazepam nasal)

+

oxymorphone

1 interaction

Avoid/Use Alternative

diazepam + oxymorphone

use alternative or monitor resp. rate, BP; decr. oxymorphone start dose by at least 50%, consider decr. diazepam dose, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, severe hypotension, incl. orthostasis, syncope; may alter seizure control (additive effects; antagonistic effects, oxymorphone may decr. seizure threshold)

• paliperidone
Valtoco (diazepam nasal)

+

paliperidone

1 interaction

Avoid/Use Alternative

diazepam + paliperidone

use alternative or monitor BP, resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, hypotension, incl. orthostasis, syncope; may alter seizure control (additive effects; antagonistic effects, paliperidone may decr. seizure threshold)

• pentazocine
Valtoco (diazepam nasal)

+

pentazocine

1 interaction

Avoid/Use Alternative

diazepam + pentazocine

use alternative or monitor resp. rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, severe hypotension, incl. orthostasis, syncope; may alter seizure control (additive effects; antagonistic effects, pentazocine may decr. seizure threshold)

• pentobarbital
Valtoco (diazepam nasal)

+

pentobarbital

1 interaction

Avoid/Use Alternative

diazepam + pentobarbital

use alternative or monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may decr. diazepam levels, efficacy; may incr. risk of profound CNS and resp. depression, psychomotor impairment (hepatic metab. induced; additive effects)

• phenelzine
Valtoco (diazepam nasal)

+

phenelzine

1 interaction

Avoid/Use Alternative

diazepam + phenelzine

use alternative or monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, phenelzine may decr. seizure threshold)

• phenobarbital
Valtoco (diazepam nasal)

+

phenobarbital

1 interaction

Avoid/Use Alternative

diazepam + phenobarbital

use alternative or monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may decr. diazepam levels, efficacy; may incr. risk of profound CNS and resp. depression, psychomotor impairment (hepatic metab. induced; additive effects)

• pregabalin
Valtoco (diazepam nasal)

+

pregabalin

1 interaction

Avoid/Use Alternative

diazepam + pregabalin

use alternative or monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• primidone
Valtoco (diazepam nasal)

+

primidone

1 interaction

Avoid/Use Alternative

diazepam + primidone

use alternative or monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may decr. diazepam levels, efficacy; may incr. risk of profound CNS and resp. depression, psychomotor impairment (hepatic metab. induced; additive effects)

• promethazine
Valtoco (diazepam nasal)

+

promethazine

1 interaction

Avoid/Use Alternative

diazepam + promethazine

use alternative or monitor resp. rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, promethazine may decr. seizure threshold)

• propofol
Valtoco (diazepam nasal)

+

propofol

1 interaction

Avoid/Use Alternative

diazepam + propofol

use alternative or monitor resp. rate, BP; consider decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, severe hypotension; may alter seizure control (additive effects; antagonistic effects, propofol may decr. seizure threshold)

• quazepam
Valtoco (diazepam nasal)

+

quazepam

1 interaction

Avoid/Use Alternative

diazepam + quazepam

use alternative or monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects, duplicate tx)

• remifentanil
Valtoco (diazepam nasal)

+

remifentanil

1 interaction

Avoid/Use Alternative

diazepam + remifentanil

use alternative or monitor resp. rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, severe hypotension, incl. orthostasis, syncope; may alter seizure control (additive effects; antagonistic effects, remifentanil may decr. seizure threshold)

• remimazolam
Valtoco (diazepam nasal)

+

remimazolam

1 interaction

Avoid/Use Alternative

diazepam + remimazolam

use alternative or monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects, duplicate tx)

• ropeginterferon alfa-2b
Valtoco (diazepam nasal)

+

ropeginterferon alfa-2b

1 interaction

Avoid/Use Alternative

diazepam + ropeginterferon alfa-2b

use alternative or monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• sufentanil
Valtoco (diazepam nasal)

+

sufentanil

1 interaction

Avoid/Use Alternative

diazepam + sufentanil

use alternative or monitor resp. rate, BP; decr. sufentanil start dose, consider decr. diazepam dose; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, severe hypotension (incl. orthostasis, syncope); may alter seizure control (additive effects; antagonistic effects, sufentanil may decr. seizure threshold)

• tapentadol
Valtoco (diazepam nasal)

+

tapentadol

1 interaction

Avoid/Use Alternative

diazepam + tapentadol

use alternative or monitor resp. rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, severe hypotension, incl. orthostasis, syncope; may alter seizure control (additive effects; antagonistic effects, tapentadol may decr. seizure threshold)

• temazepam
Valtoco (diazepam nasal)

+

temazepam

1 interaction

Avoid/Use Alternative

diazepam + temazepam

use alternative or monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects, duplicate tx)

• thalidomide
Valtoco (diazepam nasal)

+

thalidomide

1 interaction

Avoid/Use Alternative

diazepam + thalidomide

use alternative or monitor resp. rate; consider decr. dose of one or both drugs; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, thalidomide may decr. seizure threshold)

• tramadol
Valtoco (diazepam nasal)

+

tramadol

1 interaction

Avoid/Use Alternative

diazepam + tramadol

use alternative or monitor resp. rate, BP, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, severe hypotension, incl. orthostasis, syncope; may alter seizure control (additive effects; antagonistic effects, tramadol may decr. seizure threshold)

• tranylcypromine
Valtoco (diazepam nasal)

+

tranylcypromine

1 interaction

Avoid/Use Alternative

diazepam + tranylcypromine

use alternative or monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, tranylcypromine may decr. seizure threshold)

• triazolam
Valtoco (diazepam nasal)

+

triazolam

1 interaction

Avoid/Use Alternative

diazepam + triazolam

use alternative or monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects, duplicate tx)

• zuranolone
Valtoco (diazepam nasal)

+

zuranolone

1 interaction

Avoid/Use Alternative

diazepam + zuranolone

use alternative or monitor resp. rate; consider decr. dose of one or both drugs; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

Monitor/Modify Tx

• 5-HTP
Valtoco (diazepam nasal)

+

5-HTP

1 interaction

Monitor/Modify Tx

diazepam + 5-HTP

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• adagrasib
Valtoco (diazepam nasal)

+

adagrasib

1 interaction

Monitor/Modify Tx

diazepam + adagrasib

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• aldesleukin
Valtoco (diazepam nasal)

+

aldesleukin

1 interaction

Monitor/Modify Tx

diazepam + aldesleukin

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx; withhold aldesleukin if mod-severe somnolence occurs: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, aldesleukin may decr. seizure threshold)

• allopurinol
Valtoco (diazepam nasal)

+

allopurinol

1 interaction

Monitor/Modify Tx

diazepam + allopurinol

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• almotriptan
Valtoco (diazepam nasal)

+

almotriptan

1 interaction

Monitor/Modify Tx

diazepam + almotriptan

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• amantadine
Valtoco (diazepam nasal)

+

amantadine

1 interaction

Monitor/Modify Tx

diazepam + amantadine

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• amitriptyline
Valtoco (diazepam nasal)

+

amitriptyline

1 interaction

Monitor/Modify Tx

diazepam + amitriptyline

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, amitriptyline may decr. seizure threshold)

• amoxapine
Valtoco (diazepam nasal)

+

amoxapine

1 interaction

Monitor/Modify Tx

diazepam + amoxapine

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, amoxapine may decr. seizure threshold)

• apomorphine
Valtoco (diazepam nasal)

+

apomorphine

1 interaction

Monitor/Modify Tx

diazepam + apomorphine

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• apraclonidine ophthalmic
Valtoco (diazepam nasal)

+

apraclonidine ophthalmic

1 interaction

Monitor/Modify Tx

diazepam + apraclonidine ophthalmic

monitor resp. rate if apraclonidine IOP adjunct use; postop use OK: combo may incr. risk of CNS and resp. depression, psychomotor impairment (additive effects)

• aripiprazole bimonthly injection
Valtoco (diazepam nasal)

+

aripiprazole bimonthly injection

1 interaction

Monitor/Modify Tx

diazepam + aripiprazole bimonthly injection

monitor BP, resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, hypotension, incl. orthostasis, syncope; may alter seizure control (additive effects; antagonistic effects, aripiprazole may decr. seizure threshold)

• aripiprazole monthly injection
Valtoco (diazepam nasal)

+

aripiprazole monthly injection

1 interaction

Monitor/Modify Tx

diazepam + aripiprazole monthly injection

monitor BP, resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, hypotension, incl. orthostasis; may alter seizure control (additive effects; antagonistic effects, aripiprazole may decr. seizure threshold)

• aripiprazole oral
Valtoco (diazepam nasal)

+

aripiprazole oral

1 interaction

Monitor/Modify Tx

diazepam + aripiprazole oral

monitor resp. rate, BP; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, hypotension, incl. orthostasis; may alter seizure control (additive effects; antagonistic effects, aripiprazole may decr. seizure threshold)

• armodafinil
Valtoco (diazepam nasal)

+

armodafinil

1 interaction

Monitor/Modify Tx

diazepam + armodafinil

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• asenapine
Valtoco (diazepam nasal)

+

asenapine

1 interaction

Monitor/Modify Tx

diazepam + asenapine

monitor resp. rate, BP; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, hypotension, incl. orthostasis, syncope; may alter seizure control (additive effects; antagonistic effects, asenapine may decr. seizure threshold)

• atazanavir
Valtoco (diazepam nasal)

+

atazanavir

1 interaction

Monitor/Modify Tx

diazepam + atazanavir

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• baclofen
Valtoco (diazepam nasal)

+

baclofen

1 interaction

Monitor/Modify Tx

diazepam + baclofen

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, baclofen may decr. seizure threshold)

• brexpiprazole
Valtoco (diazepam nasal)

+

brexpiprazole

1 interaction

Monitor/Modify Tx

diazepam + brexpiprazole

monitor BP, resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, hypotension, incl. orthostasis, syncope; may alter seizure control (additive effects; antagonistic effects, brexpiprazole may decr. seizure threshold)

• brimonidine ophthalmic
Valtoco (diazepam nasal)

+

brimonidine ophthalmic

1 interaction

Monitor/Modify Tx

diazepam + brimonidine ophthalmic

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx if elevated IOP use; OTC ocular redness use OK: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• brimonidine topical
Valtoco (diazepam nasal)

+

brimonidine topical

1 interaction

Monitor/Modify Tx

diazepam + brimonidine topical

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• brivaracetam
Valtoco (diazepam nasal)

+

brivaracetam

1 interaction

Monitor/Modify Tx

diazepam + brivaracetam

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• bromocriptine
Valtoco (diazepam nasal)

+

bromocriptine

1 interaction

Monitor/Modify Tx

diazepam + bromocriptine

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• brompheniramine
Valtoco (diazepam nasal)

+

brompheniramine

1 interaction

Monitor/Modify Tx

diazepam + brompheniramine

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• buspirone
Valtoco (diazepam nasal)

+

buspirone

1 interaction

Monitor/Modify Tx

diazepam + buspirone

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• cannabidiol
Valtoco (diazepam nasal)

+

cannabidiol

1 interaction

Monitor/Modify Tx

diazepam + cannabidiol

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. diazepam levels, risk of profound CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited, additive effects)

• cannabis
Valtoco (diazepam nasal)

+

cannabis

1 interaction

Monitor/Modify Tx

diazepam + cannabis

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. diazepam levels, risk of profound CNS and resp. depression, psychomotor impairment, other adverse effects; may alter seizure control (hepatic metab. inhibited, additive effects; antagonistic effects, cannabis may decr. seizure threshold)

• carbamazepine
Valtoco (diazepam nasal)

+

carbamazepine

1 interaction

Monitor/Modify Tx

diazepam + carbamazepine

monitor BP, resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may decr. diazepam levels, efficacy; may incr. risk of profound CNS and resp. depression, psychomotor impairment, hypotension, incl. syncope (hepatic metab. induced; additive effects)

• carbinoxamine
Valtoco (diazepam nasal)

+

carbinoxamine

1 interaction

Monitor/Modify Tx

diazepam + carbinoxamine

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• cariprazine
Valtoco (diazepam nasal)

+

cariprazine

1 interaction

Monitor/Modify Tx

diazepam + cariprazine

monitor resp. rate, BP; use lowest effective doses and shortest duration of concomitant tx: combo may alter seizure control; may incr. risk of profound CNS and resp. depression, psychomotor impairment, hypotension, incl. orthostasis, syncope (antagonistic effects, cariprazine may decr. seizure threshold; additive effects)

• carisoprodol
Valtoco (diazepam nasal)

+

carisoprodol

1 interaction

Monitor/Modify Tx

diazepam + carisoprodol

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• cenobamate
Valtoco (diazepam nasal)

+

cenobamate

1 interaction

Monitor/Modify Tx

diazepam + cenobamate

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. or decr. diazepam levels, incr. risk of profound CNS and resp. depression, psychomotor impairment, other adverse effects or decr. efficacy (hepatic metab. altered; additive effects)

• ceritinib
Valtoco (diazepam nasal)

+

ceritinib

1 interaction

Monitor/Modify Tx

diazepam + ceritinib

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• cetirizine
Valtoco (diazepam nasal)

+

cetirizine

1 interaction

Monitor/Modify Tx

diazepam + cetirizine

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• chamomile, German
Valtoco (diazepam nasal)

+

chamomile, German

1 interaction

Monitor/Modify Tx

diazepam + chamomile, German

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• chlophedianol
Valtoco (diazepam nasal)

+

chlophedianol

1 interaction

Monitor/Modify Tx

diazepam + chlophedianol

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• chloramphenicol
Valtoco (diazepam nasal)

+

chloramphenicol

1 interaction

Monitor/Modify Tx

diazepam + chloramphenicol

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• chlorpheniramine
Valtoco (diazepam nasal)

+

chlorpheniramine

1 interaction

Monitor/Modify Tx

diazepam + chlorpheniramine

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• chlorpromazine
Valtoco (diazepam nasal)

+

chlorpromazine

1 interaction

Monitor/Modify Tx

diazepam + chlorpromazine

monitor resp. rate; consider decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, chlorpromazine may decr. seizure threshold)

• chlorzoxazone
Valtoco (diazepam nasal)

+

chlorzoxazone

1 interaction

Monitor/Modify Tx

diazepam + chlorzoxazone

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• cimetidine
Valtoco (diazepam nasal)

+

cimetidine

1 interaction

Monitor/Modify Tx

diazepam + cimetidine

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• citalopram
Valtoco (diazepam nasal)

+

citalopram

1 interaction

Monitor/Modify Tx

diazepam + citalopram

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, citalopram may decr. seizure threshold)

• clarithromycin
Valtoco (diazepam nasal)

+

clarithromycin

1 interaction

Monitor/Modify Tx

diazepam + clarithromycin

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• clemastine
Valtoco (diazepam nasal)

+

clemastine

1 interaction

Monitor/Modify Tx

diazepam + clemastine

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• clomipramine
Valtoco (diazepam nasal)

+

clomipramine

1 interaction

Monitor/Modify Tx

diazepam + clomipramine

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, clomipramine may decr. seizure threshold)

• clopidogrel
Valtoco (diazepam nasal)

+

clopidogrel

1 interaction

Monitor/Modify Tx

diazepam + clopidogrel

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• clozapine
Valtoco (diazepam nasal)

+

clozapine

1 interaction

Monitor/Modify Tx

diazepam + clozapine

monitor resp. rate, BP, HR; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, hypotension, incl. orthostasis, syncope; may alter seizure control (additive effects; antagonistic effects, clozapine may decr. seizure threshold)

• cobicistat
Valtoco (diazepam nasal)

+

cobicistat

1 interaction

Monitor/Modify Tx

diazepam + cobicistat

monitor resp. rate; consider decr. diazepam dose: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• cyclobenzaprine
Valtoco (diazepam nasal)

+

cyclobenzaprine

1 interaction

Monitor/Modify Tx

diazepam + cyclobenzaprine

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, cyclobenzaprine may decr. seizure threshold)

• cyproheptadine
Valtoco (diazepam nasal)

+

cyproheptadine

1 interaction

Monitor/Modify Tx

diazepam + cyproheptadine

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• dantrolene
Valtoco (diazepam nasal)

+

dantrolene

1 interaction

Monitor/Modify Tx

diazepam + dantrolene

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• daridorexant
Valtoco (diazepam nasal)

+

daridorexant

1 interaction

Monitor/Modify Tx

diazepam + daridorexant

monitor resp. rate; consider decr. dose of one or both drugs; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• darifenacin
Valtoco (diazepam nasal)

+

darifenacin

1 interaction

Monitor/Modify Tx

diazepam + darifenacin

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• darunavir
Valtoco (diazepam nasal)

+

darunavir

1 interaction

Monitor/Modify Tx

diazepam + darunavir

monitor resp. rate; consider diazepam dose decr.: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• desipramine
Valtoco (diazepam nasal)

+

desipramine

1 interaction

Monitor/Modify Tx

diazepam + desipramine

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, desipramine may decr. seizure threshold)

• desvenlafaxine
Valtoco (diazepam nasal)

+

desvenlafaxine

1 interaction

Monitor/Modify Tx

diazepam + desvenlafaxine

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, desvenlafaxine may decr. seizure threshold)

• deutetrabenazine
Valtoco (diazepam nasal)

+

deutetrabenazine

1 interaction

Monitor/Modify Tx

diazepam + deutetrabenazine

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• dexbrompheniramine
Valtoco (diazepam nasal)

+

dexbrompheniramine

1 interaction

Monitor/Modify Tx

diazepam + dexbrompheniramine

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• dexchlorpheniramine
Valtoco (diazepam nasal)

+

dexchlorpheniramine

1 interaction

Monitor/Modify Tx

diazepam + dexchlorpheniramine

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• dexmedetomidine
Valtoco (diazepam nasal)

+

dexmedetomidine

1 interaction

Monitor/Modify Tx

diazepam + dexmedetomidine

monitor resp. rate; consider decr. dose of one or both drugs: combo may incr. risk of CNS and resp. depression, psychomotor impairment (additive effects)

• dichlorphenamide
Valtoco (diazepam nasal)

+

dichlorphenamide

1 interaction

Monitor/Modify Tx

diazepam + dichlorphenamide

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• difelikefalin
Valtoco (diazepam nasal)

+

difelikefalin

1 interaction

Monitor/Modify Tx

diazepam + difelikefalin

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• difenoxin
Valtoco (diazepam nasal)

+

difenoxin

1 interaction

Monitor/Modify Tx

diazepam + difenoxin

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• dimenhydrinate
Valtoco (diazepam nasal)

+

dimenhydrinate

1 interaction

Monitor/Modify Tx

diazepam + dimenhydrinate

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• diphenhydramine
Valtoco (diazepam nasal)

+

diphenhydramine

1 interaction

Monitor/Modify Tx

diazepam + diphenhydramine

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• diphenoxylate
Valtoco (diazepam nasal)

+

diphenoxylate

1 interaction

Monitor/Modify Tx

diazepam + diphenoxylate

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• domperidone
Valtoco (diazepam nasal)

+

domperidone

1 interaction

Monitor/Modify Tx

diazepam + domperidone

monitor resp. rate use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• doxepin
Valtoco (diazepam nasal)

+

doxepin

1 interaction

Monitor/Modify Tx

diazepam + doxepin

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, doxepin may decr. seizure threshold)

• doxepin topical
Valtoco (diazepam nasal)

+

doxepin topical

1 interaction

Monitor/Modify Tx

diazepam + doxepin topical

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• dronabinol
Valtoco (diazepam nasal)

+

dronabinol

1 interaction

Monitor/Modify Tx

diazepam + dronabinol

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, dronabinol may decr. seizure threshold)

• droperidol
Valtoco (diazepam nasal)

+

droperidol

1 interaction

Monitor/Modify Tx

diazepam + droperidol

monitor resp. rate; decr. dose of one or both drugs; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• duloxetine
Valtoco (diazepam nasal)

+

duloxetine

1 interaction

Monitor/Modify Tx

diazepam + duloxetine

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, duloxetine may decr. seizure threshold)

• efavirenz
Valtoco (diazepam nasal)

+

efavirenz

1 interaction

Monitor/Modify Tx

diazepam + efavirenz

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. or decr. diazepam levels, incr. risk of profound CNS and resp. depression, psychomotor impairment, other adverse effects or decr. efficacy (hepatic metab. altered, additive effects)

• elagolix
Valtoco (diazepam nasal)

+

elagolix

1 interaction

Monitor/Modify Tx

diazepam + elagolix

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• eletriptan
Valtoco (diazepam nasal)

+

eletriptan

1 interaction

Monitor/Modify Tx

diazepam + eletriptan

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• enasidenib
Valtoco (diazepam nasal)

+

enasidenib

1 interaction

Monitor/Modify Tx

diazepam + enasidenib

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• entacapone
Valtoco (diazepam nasal)

+

entacapone

1 interaction

Monitor/Modify Tx

diazepam + entacapone

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• entrectinib
Valtoco (diazepam nasal)

+

entrectinib

1 interaction

Monitor/Modify Tx

diazepam + entrectinib

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• escitalopram
Valtoco (diazepam nasal)

+

escitalopram

1 interaction

Monitor/Modify Tx

diazepam + escitalopram

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, escitalopram may decr. seizure threshold)

• esketamine
Valtoco (diazepam nasal)

+

esketamine

1 interaction

Monitor/Modify Tx

diazepam + esketamine

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• eslicarbazepine acetate
Valtoco (diazepam nasal)

+

eslicarbazepine acetate

1 interaction

Monitor/Modify Tx

diazepam + eslicarbazepine acetate

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. diazepam levels, risk of profound CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited, additive effects)

• esomeprazole
Valtoco (diazepam nasal)

+

esomeprazole

1 interaction

Monitor/Modify Tx

diazepam + esomeprazole

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• estradiol (contraceptive)
Valtoco (diazepam nasal)

+

estradiol (contraceptive)

1 interaction

Monitor/Modify Tx

diazepam + estradiol (contraceptive)

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• eszopiclone
Valtoco (diazepam nasal)

+

eszopiclone

1 interaction

Monitor/Modify Tx

diazepam + eszopiclone

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• ethinyl estradiol (contraceptive)
Valtoco (diazepam nasal)

+

ethinyl estradiol (contraceptive)

1 interaction

Monitor/Modify Tx

diazepam + ethinyl estradiol (contraceptive)

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• ethosuximide
Valtoco (diazepam nasal)

+

ethosuximide

1 interaction

Monitor/Modify Tx

diazepam + ethosuximide

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• etomidate
Valtoco (diazepam nasal)

+

etomidate

1 interaction

Monitor/Modify Tx

diazepam + etomidate

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• etravirine
Valtoco (diazepam nasal)

+

etravirine

1 interaction

Monitor/Modify Tx

diazepam + etravirine

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• fedratinib
Valtoco (diazepam nasal)

+

fedratinib

1 interaction

Monitor/Modify Tx

diazepam + fedratinib

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• felbamate
Valtoco (diazepam nasal)

+

felbamate

1 interaction

Monitor/Modify Tx

diazepam + felbamate

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. diazepam levels, risk of profound CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited, additive effects)

• fenfluramine
Valtoco (diazepam nasal)

+

fenfluramine

1 interaction

Monitor/Modify Tx

diazepam + fenfluramine

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• fesoterodine
Valtoco (diazepam nasal)

+

fesoterodine

1 interaction

Monitor/Modify Tx

diazepam + fesoterodine

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• fexinidazole
Valtoco (diazepam nasal)

+

fexinidazole

1 interaction

Monitor/Modify Tx

diazepam + fexinidazole

monitor resp. rate: combo may incr. or decr. diazepam levels, incr. risk of CNS and resp. depression, psychomotor impairment, other adverse effects or decr. efficacy (hepatic metab. altered)

• flibanserin
Valtoco (diazepam nasal)

+

flibanserin

1 interaction

Monitor/Modify Tx

diazepam + flibanserin

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• fluconazole
Valtoco (diazepam nasal)

+

fluconazole

1 interaction

Monitor/Modify Tx

diazepam + fluconazole

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• fluoxetine
Valtoco (diazepam nasal)

+

fluoxetine

1 interaction

Monitor/Modify Tx

diazepam + fluoxetine

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. diazepam levels, risk of profound CNS and resp. depression, psychomotor impairment, other adverse effects; may alter seizure control (hepatic metab. inhibited, additive effects; antagonistic effects, fluoxetine may decr. seizure threshold)

• fluphenazine
Valtoco (diazepam nasal)

+

fluphenazine

1 interaction

Monitor/Modify Tx

diazepam + fluphenazine

monitor resp. rate; consider decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, fluphenazine may decr. seizure threshold)

• foslevodopa
Valtoco (diazepam nasal)

+

foslevodopa

1 interaction

Monitor/Modify Tx

diazepam + foslevodopa

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• fosphenytoin
Valtoco (diazepam nasal)

+

fosphenytoin

1 interaction

Monitor/Modify Tx

diazepam + fosphenytoin

monitor resp. rate, phenytoin levels; use lowest effective doses and shortest duration of concomitant tx: combo may incr. or decr. phenytoin levels, incr. risk of adverse effects or decr. efficacy; may decr. diazepam levels, efficacy; may incr. risk of profound CNS and resp. depression, psychomotor impairment (mechanism unknown, hepatic metab. possibly altered; hepatic metab. induced; additive effects)

• frovatriptan
Valtoco (diazepam nasal)

+

frovatriptan

1 interaction

Monitor/Modify Tx

diazepam + frovatriptan

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• ganaxolone
Valtoco (diazepam nasal)

+

ganaxolone

1 interaction

Monitor/Modify Tx

diazepam + ganaxolone

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• garlic
Valtoco (diazepam nasal)

+

garlic

1 interaction

Monitor/Modify Tx

diazepam + garlic

monitor resp. rate w/ supplemental garlic; dietary intake OK: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• givosiran
Valtoco (diazepam nasal)

+

givosiran

1 interaction

Monitor/Modify Tx

diazepam + givosiran

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited; givosiran effects on hepatic heme biosynthesis may reduce CYP450 enzyme activity)

• glofitamab
Valtoco (diazepam nasal)

+

glofitamab

1 interaction

Monitor/Modify Tx

diazepam + glofitamab

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• glycopyrrolate
Valtoco (diazepam nasal)

+

glycopyrrolate

1 interaction

Monitor/Modify Tx

diazepam + glycopyrrolate

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• guanfacine
Valtoco (diazepam nasal)

+

guanfacine

1 interaction

Monitor/Modify Tx

diazepam + guanfacine

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• haloperidol
Valtoco (diazepam nasal)

+

haloperidol

1 interaction

Monitor/Modify Tx

diazepam + haloperidol

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, haloperidol may decr. seizure threshold)

• hydroxyzine
Valtoco (diazepam nasal)

+

hydroxyzine

1 interaction

Monitor/Modify Tx

diazepam + hydroxyzine

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• hyoscyamine
Valtoco (diazepam nasal)

+

hyoscyamine

1 interaction

Monitor/Modify Tx

diazepam + hyoscyamine

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• idelalisib
Valtoco (diazepam nasal)

+

idelalisib

1 interaction

Monitor/Modify Tx

diazepam + idelalisib

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• ifosfamide
Valtoco (diazepam nasal)

+

ifosfamide

1 interaction

Monitor/Modify Tx

diazepam + ifosfamide

D/C one or both drugs if encephalopathy occurs; otherwise, monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, ifosfamide may decr. seizure threshold)

• iloperidone
Valtoco (diazepam nasal)

+

iloperidone

1 interaction

Monitor/Modify Tx

diazepam + iloperidone

monitor resp. rate, BP; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, hypotension, incl. orthostasis, syncope; may alter seizure control (additive effects; antagonistic effects, iloperidone may decr. seizure threshold)

• imipramine
Valtoco (diazepam nasal)

+

imipramine

1 interaction

Monitor/Modify Tx

diazepam + imipramine

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, imipramine may decr. seizure threshold)

• isoniazid
Valtoco (diazepam nasal)

+

isoniazid

1 interaction

Monitor/Modify Tx

diazepam + isoniazid

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects; may alter seizure control (hepatic metab. inhibited; antagonistic effects, isoniazid may decr. seizure threshold)

• itraconazole
Valtoco (diazepam nasal)

+

itraconazole

1 interaction

Monitor/Modify Tx

diazepam + itraconazole

monitor resp. rate; consider decr. diazepam dose during and x2wk after itraconazole tx: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• ketoconazole
Valtoco (diazepam nasal)

+

ketoconazole

1 interaction

Monitor/Modify Tx

diazepam + ketoconazole

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• lacosamide
Valtoco (diazepam nasal)

+

lacosamide

1 interaction

Monitor/Modify Tx

diazepam + lacosamide

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• lamotrigine
Valtoco (diazepam nasal)

+

lamotrigine

1 interaction

Monitor/Modify Tx

diazepam + lamotrigine

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• lasmiditan
Valtoco (diazepam nasal)

+

lasmiditan

1 interaction

Monitor/Modify Tx

diazepam + lasmiditan

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• lemborexant
Valtoco (diazepam nasal)

+

lemborexant

1 interaction

Monitor/Modify Tx

diazepam + lemborexant

monitor resp. rate; consider decr. dose of one or both drugs; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• levetiracetam
Valtoco (diazepam nasal)

+

levetiracetam

1 interaction

Monitor/Modify Tx

diazepam + levetiracetam

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• levocetirizine
Valtoco (diazepam nasal)

+

levocetirizine

1 interaction

Monitor/Modify Tx

diazepam + levocetirizine

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• levodopa
Valtoco (diazepam nasal)

+

levodopa

1 interaction

Monitor/Modify Tx

diazepam + levodopa

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• levoketoconazole
Valtoco (diazepam nasal)

+

levoketoconazole

1 interaction

Monitor/Modify Tx

diazepam + levoketoconazole

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• levomilnacipran
Valtoco (diazepam nasal)

+

levomilnacipran

1 interaction

Monitor/Modify Tx

diazepam + levomilnacipran

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, levomilnacipran may decr. seizure threshold)

• lofexidine
Valtoco (diazepam nasal)

+

lofexidine

1 interaction

Monitor/Modify Tx

diazepam + lofexidine

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• lonafarnib
Valtoco (diazepam nasal)

+

lonafarnib

1 interaction

Monitor/Modify Tx

diazepam + lonafarnib

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• lopinavir/ritonavir
Valtoco (diazepam nasal)

+

lopinavir/ ritonavir

1 interaction

Monitor/Modify Tx

diazepam + lopinavir/ ritonavir

monitor resp. rate: combo may incr. or decr. diazepam levels, incr. risk of CNS and resp. depression, psychomotor impairment, other adverse effects or decr. efficacy (hepatic metab. altered)

• loxapine
Valtoco (diazepam nasal)

+

loxapine

1 interaction

Monitor/Modify Tx

diazepam + loxapine

monitor resp. rate, BP; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, hypotension, incl. orthostasis, syncope; may alter seizure control (additive effects; antagonistic effects, loxapine may decr. seizure threshold)

• luliconazole topical
Valtoco (diazepam nasal)

+

luliconazole topical

1 interaction

Monitor/Modify Tx

diazepam + luliconazole topical

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• lumateperone
Valtoco (diazepam nasal)

+

lumateperone

1 interaction

Monitor/Modify Tx

diazepam + lumateperone

monitor resp. rate, BP; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, hypotension, incl. orthostasis, syncope; may alter seizure control (additive effects; antagonistic effects, lumateperone may decr. seizure threshold)

• lurasidone
Valtoco (diazepam nasal)

+

lurasidone

1 interaction

Monitor/Modify Tx

diazepam + lurasidone

monitor resp. rate, BP; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, hypotension, incl. orthostasis, syncope; may alter seizure control (additive effects; antagonistic effects, lurasidone may decr. seizure threshold)

• meclizine
Valtoco (diazepam nasal)

+

meclizine

1 interaction

Monitor/Modify Tx

diazepam + meclizine

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• melatonin
Valtoco (diazepam nasal)

+

melatonin

1 interaction

Monitor/Modify Tx

diazepam + melatonin

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, melatonin may decr. seizure threshold)

• meprobamate
Valtoco (diazepam nasal)

+

meprobamate

1 interaction

Monitor/Modify Tx

diazepam + meprobamate

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• methocarbamol
Valtoco (diazepam nasal)

+

methocarbamol

1 interaction

Monitor/Modify Tx

diazepam + methocarbamol

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, methocarbamol may decr. seizure threshold)

• methsuximide
Valtoco (diazepam nasal)

+

methsuximide

1 interaction

Monitor/Modify Tx

diazepam + methsuximide

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• methyldopa
Valtoco (diazepam nasal)

+

methyldopa

1 interaction

Monitor/Modify Tx

diazepam + methyldopa

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• metyrapone
Valtoco (diazepam nasal)

+

metyrapone

1 interaction

Monitor/Modify Tx

diazepam + metyrapone

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of CNS and resp. depression, psychomotor impairment (additive effects)

• metyrosine
Valtoco (diazepam nasal)

+

metyrosine

1 interaction

Monitor/Modify Tx

diazepam + metyrosine

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• mifepristone
Valtoco (diazepam nasal)

+

mifepristone

1 interaction

Monitor/Modify Tx

diazepam + mifepristone

monitor resp. rate w/in 14 days of daily mifepristone use: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• milnacipran
Valtoco (diazepam nasal)

+

milnacipran

1 interaction

Monitor/Modify Tx

diazepam + milnacipran

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, milnacipran may decr. seizure threshold)

• mirtazapine
Valtoco (diazepam nasal)

+

mirtazapine

1 interaction

Monitor/Modify Tx

diazepam + mirtazapine

monitor resp. rate; consider decr. dose of one or both drugs; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, mirtazapine may decr. seizure threshold)

• mitotane
Valtoco (diazepam nasal)

+

mitotane

1 interaction

Monitor/Modify Tx

diazepam + mitotane

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may decr. diazepam levels, efficacy; may incr. risk of profound CNS and resp. depression, psychomotor impairment (hepatic metab. induced; additive effects)

• modafinil
Valtoco (diazepam nasal)

+

modafinil

1 interaction

Monitor/Modify Tx

diazepam + modafinil

monitor resp. rate: combo may incr. or decr. diazepam levels, incr. risk of CNS and resp. depression, psychomotor impairment, other adverse effects or decr. efficacy (hepatic metab. altered)

• molindone
Valtoco (diazepam nasal)

+

molindone

1 interaction

Monitor/Modify Tx

diazepam + molindone

monitor resp. rate, BP; use lowest effective doses and shortest duration of concomitant tx: combo may alter seizure control; may incr. risk of profound CNS and resp. depression, psychomotor impairment, hypotension, incl. orthostasis (antagonistic effects, molindone may decr. seizure threshold; additive effects)

• mosunetuzumab
Valtoco (diazepam nasal)

+

mosunetuzumab

1 interaction

Monitor/Modify Tx

diazepam + mosunetuzumab

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• mycophenolate mofetil
Valtoco (diazepam nasal)

+

mycophenolate mofetil

1 interaction

Monitor/Modify Tx

diazepam + mycophenolate mofetil

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• naltrexone
Valtoco (diazepam nasal)

+

naltrexone

1 interaction

Monitor/Modify Tx

diazepam + naltrexone

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• naratriptan
Valtoco (diazepam nasal)

+

naratriptan

1 interaction

Monitor/Modify Tx

diazepam + naratriptan

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• nefazodone
Valtoco (diazepam nasal)

+

nefazodone

1 interaction

Monitor/Modify Tx

diazepam + nefazodone

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. diazepam levels, risk of profound CNS and resp. depression, psychomotor impairment, other adverse effects; may alter seizure control (hepatic metab. inhibited, additive effects; antagonistic effects, nefazodone may decr. seizure threshold)

• nelarabine
Valtoco (diazepam nasal)

+

nelarabine

1 interaction

Monitor/Modify Tx

diazepam + nelarabine

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx; withhold nelarabine if Grade 2 or greater somnolence occurs: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, nelarabine may decr. seizure threshold)

• nelfinavir
Valtoco (diazepam nasal)

+

nelfinavir

1 interaction

Monitor/Modify Tx

diazepam + nelfinavir

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• nortriptyline
Valtoco (diazepam nasal)

+

nortriptyline

1 interaction

Monitor/Modify Tx

diazepam + nortriptyline

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, nortriptyline may decr. seizure threshold)

• omeprazole
Valtoco (diazepam nasal)

+

omeprazole

1 interaction

Monitor/Modify Tx

diazepam + omeprazole

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• opicapone
Valtoco (diazepam nasal)

+

opicapone

1 interaction

Monitor/Modify Tx

diazepam + opicapone

monitor resp. rate; consider decr. dose of one or both drugs; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• orphenadrine
Valtoco (diazepam nasal)

+

orphenadrine

1 interaction

Monitor/Modify Tx

diazepam + orphenadrine

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• osilodrostat
Valtoco (diazepam nasal)

+

osilodrostat

1 interaction

Monitor/Modify Tx

diazepam + osilodrostat

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• oxcarbazepine
Valtoco (diazepam nasal)

+

oxcarbazepine

1 interaction

Monitor/Modify Tx

diazepam + oxcarbazepine

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. diazepam levels, risk of profound CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited, additive effects)

• oxybutynin
Valtoco (diazepam nasal)

+

oxybutynin

1 interaction

Monitor/Modify Tx

diazepam + oxybutynin

monitor resp. rate; decr. dose of one or both drugs or consider oxybutynin transdermal patch, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; somnolence less likely w/ oxybutynin transdermal patch (additive effects)

• paroxetine
Valtoco (diazepam nasal)

+

paroxetine

1 interaction

Monitor/Modify Tx

diazepam + paroxetine

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, paroxetine may decr. seizure threshold)

• passion flower
Valtoco (diazepam nasal)

+

passion flower

1 interaction

Monitor/Modify Tx

diazepam + passion flower

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• perampanel
Valtoco (diazepam nasal)

+

perampanel

1 interaction

Monitor/Modify Tx

diazepam + perampanel

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• perphenazine
Valtoco (diazepam nasal)

+

perphenazine

1 interaction

Monitor/Modify Tx

diazepam + perphenazine

monitor resp. rate; consider decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, perphenazine may decr. seizure threshold)

• pheniramine
Valtoco (diazepam nasal)

+

pheniramine

1 interaction

Monitor/Modify Tx

diazepam + pheniramine

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• phenylephrine injection
Valtoco (diazepam nasal)

+

phenylephrine injection

1 interaction

Monitor/Modify Tx

diazepam + phenylephrine injection

monitor BP: combo may decr. phenylephrine efficacy (antagonistic effects)

• phenytoin
Valtoco (diazepam nasal)

+

phenytoin

1 interaction

Monitor/Modify Tx

diazepam + phenytoin

monitor resp. rate, phenytoin levels; use lowest effective doses and shortest duration of concomitant tx: combo may incr. or decr. phenytoin levels, incr. risk of adverse effects or decr. efficacy; may decr. diazepam levels, efficacy; may incr. risk of profound CNS and resp. depression, psychomotor impairment (mechanism unknown, hepatic metab. possibly altered; hepatic metab. induced; additive effects)

• pimozide
Valtoco (diazepam nasal)

+

pimozide

1 interaction

Monitor/Modify Tx

diazepam + pimozide

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, pimozide may decr. seizure threshold)

• pirtobrutinib
Valtoco (diazepam nasal)

+

pirtobrutinib

1 interaction

Monitor/Modify Tx

diazepam + pirtobrutinib

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• posaconazole
Valtoco (diazepam nasal)

+

posaconazole

1 interaction

Monitor/Modify Tx

diazepam + posaconazole

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• pramipexole
Valtoco (diazepam nasal)

+

pramipexole

1 interaction

Monitor/Modify Tx

diazepam + pramipexole

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• procarbazine
Valtoco (diazepam nasal)

+

procarbazine

1 interaction

Monitor/Modify Tx

diazepam + procarbazine

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, procarbazine may decr. seizure threshold)

• prochlorperazine
Valtoco (diazepam nasal)

+

prochlorperazine

1 interaction

Monitor/Modify Tx

diazepam + prochlorperazine

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, prochlorperazine may decr. seizure threshold)

• propranolol
Valtoco (diazepam nasal)

+

propranolol

1 interaction

Monitor/Modify Tx

diazepam + propranolol

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (mechanism unknown, hepatic metab. possibly inhibited)

• protriptyline
Valtoco (diazepam nasal)

+

protriptyline

1 interaction

Monitor/Modify Tx

diazepam + protriptyline

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, protriptyline may decr. seizure threshold)

• pyrilamine
Valtoco (diazepam nasal)

+

pyrilamine

1 interaction

Monitor/Modify Tx

diazepam + pyrilamine

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• quetiapine
Valtoco (diazepam nasal)

+

quetiapine

1 interaction

Monitor/Modify Tx

diazepam + quetiapine

monitor resp. rate, BP; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, hypotension, incl. orthostasis, syncope; may alter seizure control (additive effects; antagonistic effects, quetiapine may decr. seizure threshold)

• ramelteon
Valtoco (diazepam nasal)

+

ramelteon

1 interaction

Monitor/Modify Tx

diazepam + ramelteon

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• rasagiline
Valtoco (diazepam nasal)

+

rasagiline

1 interaction

Monitor/Modify Tx

diazepam + rasagiline

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• repotrectinib
Valtoco (diazepam nasal)

+

repotrectinib

1 interaction

Monitor/Modify Tx

diazepam + repotrectinib

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may decr. diazepam levels, efficacy; may incr. risk of profound CNS and resp. depression, psychomotor impairment (hepatic metab. induced; additive effects)

• ribociclib
Valtoco (diazepam nasal)

+

ribociclib

1 interaction

Monitor/Modify Tx

diazepam + ribociclib

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• risperidone
Valtoco (diazepam nasal)

+

risperidone

1 interaction

Monitor/Modify Tx

diazepam + risperidone

monitor resp. rate, BP; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, hypotension, incl. orthostasis, syncope; may alter seizure control (additive effects; antagonistic effects, risperidone may decr. seizure threshold)

• ritonavir
Valtoco (diazepam nasal)

+

ritonavir

1 interaction

Monitor/Modify Tx

diazepam + ritonavir

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• rizatriptan
Valtoco (diazepam nasal)

+

rizatriptan

1 interaction

Monitor/Modify Tx

diazepam + rizatriptan

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• ropinirole
Valtoco (diazepam nasal)

+

ropinirole

1 interaction

Monitor/Modify Tx

diazepam + ropinirole

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• rotigotine transdermal
Valtoco (diazepam nasal)

+

rotigotine transdermal

1 interaction

Monitor/Modify Tx

diazepam + rotigotine transdermal

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• rucaparib
Valtoco (diazepam nasal)

+

rucaparib

1 interaction

Monitor/Modify Tx

diazepam + rucaparib

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• rufinamide
Valtoco (diazepam nasal)

+

rufinamide

1 interaction

Monitor/Modify Tx

diazepam + rufinamide

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• safinamide
Valtoco (diazepam nasal)

+

safinamide

1 interaction

Monitor/Modify Tx

diazepam + safinamide

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• scopolamine
Valtoco (diazepam nasal)

+

scopolamine

1 interaction

Monitor/Modify Tx

diazepam + scopolamine

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, scopolamine may decr. seizure threshold)

• selegiline
Valtoco (diazepam nasal)

+

selegiline

1 interaction

Monitor/Modify Tx

diazepam + selegiline

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• selegiline transdermal
Valtoco (diazepam nasal)

+

selegiline transdermal

1 interaction

Monitor/Modify Tx

diazepam + selegiline transdermal

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, selegiline transdermal may decr. seizure threshold)

• selinexor
Valtoco (diazepam nasal)

+

selinexor

1 interaction

Monitor/Modify Tx

diazepam + selinexor

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• sertraline
Valtoco (diazepam nasal)

+

sertraline

1 interaction

Monitor/Modify Tx

diazepam + sertraline

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, sertraline may decr. seizure threshold)

• sevoflurane
Valtoco (diazepam nasal)

+

sevoflurane

1 interaction

Monitor/Modify Tx

diazepam + sevoflurane

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, sevoflurane may decr. seizure threshold)

• solifenacin
Valtoco (diazepam nasal)

+

solifenacin

1 interaction

Monitor/Modify Tx

diazepam + solifenacin

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• stiripentol
Valtoco (diazepam nasal)

+

stiripentol

1 interaction

Monitor/Modify Tx

diazepam + stiripentol

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. diazepam levels, risk of profound CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited, additive effects)

• sumatriptan
Valtoco (diazepam nasal)

+

sumatriptan

1 interaction

Monitor/Modify Tx

diazepam + sumatriptan

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, sumatriptan may decr. seizure threshold)

• suvorexant
Valtoco (diazepam nasal)

+

suvorexant

1 interaction

Monitor/Modify Tx

diazepam + suvorexant

monitor resp. rate; consider decr. dose of one or both drugs; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• tasimelteon
Valtoco (diazepam nasal)

+

tasimelteon

1 interaction

Monitor/Modify Tx

diazepam + tasimelteon

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• tecovirimat
Valtoco (diazepam nasal)

+

tecovirimat

1 interaction

Monitor/Modify Tx

diazepam + tecovirimat

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• tetrabenazine
Valtoco (diazepam nasal)

+

tetrabenazine

1 interaction

Monitor/Modify Tx

diazepam + tetrabenazine

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• thioridazine
Valtoco (diazepam nasal)

+

thioridazine

1 interaction

Monitor/Modify Tx

diazepam + thioridazine

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may alter seizure control; may incr. risk of profound CNS and resp. depression, psychomotor impairment (antagonistic effects, thioridazine may decr. seizure threshold; additive effects)

• thiotepa
Valtoco (diazepam nasal)

+

thiotepa

1 interaction

Monitor/Modify Tx

diazepam + thiotepa

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, thiotepa may decr. seizure threshold)

• thiothixene
Valtoco (diazepam nasal)

+

thiothixene

1 interaction

Monitor/Modify Tx

diazepam + thiothixene

monitor resp. rate; consider decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, thiothixene may decr. seizure threshold)

• tiagabine
Valtoco (diazepam nasal)

+

tiagabine

1 interaction

Monitor/Modify Tx

diazepam + tiagabine

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• tipranavir
Valtoco (diazepam nasal)

+

tipranavir

1 interaction

Monitor/Modify Tx

diazepam + tipranavir

monitor resp. rate: combo may incr. or decr. diazepam levels, incr. risk of CNS and resp. depression, psychomotor impairment, other adverse effects or decr. efficacy (hepatic metab. altered)

• tizanidine
Valtoco (diazepam nasal)

+

tizanidine

1 interaction

Monitor/Modify Tx

diazepam + tizanidine

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• tolcapone
Valtoco (diazepam nasal)

+

tolcapone

1 interaction

Monitor/Modify Tx

diazepam + tolcapone

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• tolterodine
Valtoco (diazepam nasal)

+

tolterodine

1 interaction

Monitor/Modify Tx

diazepam + tolterodine

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• topiramate
Valtoco (diazepam nasal)

+

topiramate

1 interaction

Monitor/Modify Tx

diazepam + topiramate

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. diazepam levels, risk of profound CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited, additive effects)

• trazodone
Valtoco (diazepam nasal)

+

trazodone

1 interaction

Monitor/Modify Tx

diazepam + trazodone

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• treosulfan
Valtoco (diazepam nasal)

+

treosulfan

1 interaction

Monitor/Modify Tx

diazepam + treosulfan

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects; may alter seizure control (hepatic metab. possibly inhibited; antagonistic effects, treosulfan may decr. seizure threshold)

• triclabendazole
Valtoco (diazepam nasal)

+

triclabendazole

1 interaction

Monitor/Modify Tx

diazepam + triclabendazole

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. possibly inhibited)

• trifluoperazine
Valtoco (diazepam nasal)

+

trifluoperazine

1 interaction

Monitor/Modify Tx

diazepam + trifluoperazine

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, trifluoperazine may decr. seizure threshold)

• trihexyphenidyl
Valtoco (diazepam nasal)

+

trihexyphenidyl

1 interaction

Monitor/Modify Tx

diazepam + trihexyphenidyl

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• trimethobenzamide
Valtoco (diazepam nasal)

+

trimethobenzamide

1 interaction

Monitor/Modify Tx

diazepam + trimethobenzamide

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• trimipramine
Valtoco (diazepam nasal)

+

trimipramine

1 interaction

Monitor/Modify Tx

diazepam + trimipramine

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, trimipramine may decr. seizure threshold)

• triprolidine
Valtoco (diazepam nasal)

+

triprolidine

1 interaction

Monitor/Modify Tx

diazepam + triprolidine

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• trospium
Valtoco (diazepam nasal)

+

trospium

1 interaction

Monitor/Modify Tx

diazepam + trospium

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• tucatinib
Valtoco (diazepam nasal)

+

tucatinib

1 interaction

Monitor/Modify Tx

diazepam + tucatinib

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• valbenazine
Valtoco (diazepam nasal)

+

valbenazine

1 interaction

Monitor/Modify Tx

diazepam + valbenazine

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• valerian
Valtoco (diazepam nasal)

+

valerian

1 interaction

Monitor/Modify Tx

diazepam + valerian

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• valproic acid
Valtoco (diazepam nasal)

+

valproic acid

1 interaction

Monitor/Modify Tx

diazepam + valproic acid

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• venlafaxine
Valtoco (diazepam nasal)

+

venlafaxine

1 interaction

Monitor/Modify Tx

diazepam + venlafaxine

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, venlafaxine may decr. seizure threshold)

• vigabatrin
Valtoco (diazepam nasal)

+

vigabatrin

1 interaction

Monitor/Modify Tx

diazepam + vigabatrin

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• vilazodone
Valtoco (diazepam nasal)

+

vilazodone

1 interaction

Monitor/Modify Tx

diazepam + vilazodone

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, vilazodone may decr. seizure threshold)

• viloxazine
Valtoco (diazepam nasal)

+

viloxazine

1 interaction

Monitor/Modify Tx

diazepam + viloxazine

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• vonoprazan
Valtoco (diazepam nasal)

+

vonoprazan

1 interaction

Monitor/Modify Tx

diazepam + vonoprazan

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. possibly inhibited)

• voriconazole
Valtoco (diazepam nasal)

+

voriconazole

1 interaction

Monitor/Modify Tx

diazepam + voriconazole

monitor resp. rate: combo may incr. diazepam levels, risk of CNS and resp. depression, psychomotor impairment, other adverse effects (hepatic metab. inhibited)

• zaleplon
Valtoco (diazepam nasal)

+

zaleplon

1 interaction

Monitor/Modify Tx

diazepam + zaleplon

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• ziconotide
Valtoco (diazepam nasal)

+

ziconotide

1 interaction

Monitor/Modify Tx

diazepam + ziconotide

monitor resp. rate; consider decr. dose of one or both drugs; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• ziprasidone
Valtoco (diazepam nasal)

+

ziprasidone

1 interaction

Monitor/Modify Tx

diazepam + ziprasidone

monitor resp. rate, BP; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment, hypotension, incl. orthostasis, syncope; may alter seizure control (additive effects; antagonistic effects, ziprasidone may decr. seizure threshold)

• zolmitriptan
Valtoco (diazepam nasal)

+

zolmitriptan

1 interaction

Monitor/Modify Tx

diazepam + zolmitriptan

monitor resp. rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• zolpidem
Valtoco (diazepam nasal)

+

zolpidem

1 interaction

Monitor/Modify Tx

diazepam + zolpidem

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)

• zonisamide
Valtoco (diazepam nasal)

+

zonisamide

1 interaction

Monitor/Modify Tx

diazepam + zonisamide

monitor resp. rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and resp. depression, psychomotor impairment (additive effects)