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Valium (diazepam) has a long half-life of 30-60 hours in addition diazepam has a number of active metabolites, all of which are benzodiazepines like diazepam. The primary active metabolite is nordazepam (aka desmethyldiazepam), best known under the brand name Calmday (not available in North America) which has a half-life of 30-100 hours. Its other active metabolites are temazepam, brand name Restoril in North America, and finally both temazepam and nordazepam break down further into the final active metabolite oxazepam, brand name Serax and Oxpam in North America. Both temazepam and oxazepam have a modest half-life of 8-9 hours.

Due to the long half-life of diazepam it works for a significant period of time. Most of the effects last about 6-8 hours, after that time Valium and its active metabolites continue to exert very subtle and very mild effects that are often unnoticed. This is part of the reason diazepam is one of the most used drugs in people physically dependent to alcohol, barbiturates, other sedative/hypnotics, or other benzodiazepines. Even once the primary effects have worn off withdrawal does not normally occur for 24-48 hours. Since alcohol, most barbiturates, and many benzodiazepines last such a short time Valium is effective in providing a more slow, even, and comfortable withdrawal largely due to its unnoticed effects from lingering metabolites. On the other hand Valium has fallen out of favour by some physicians since, when taken continuously, its metabolites can have greater effects and rarely people have experienced toxicity due to an over accumulation of diazepam and its active metabolites. However this is not typically a concern in healthy individuals except the elderly.

Normally Valium is prescribed 2-3 times a day although in cases of severe anxiety it may be prescribed as often as four times a day. Generally speaking Valium is most typically prescribed 3 times daily for continuous use.

Lastly people with a greater tolerance to the effects of Valium tend to require increased dosing. However tolerance does not typically occur to the anti-anxiety effects although some develop a slow tolerance. On the other hand tolerance to the hypnotic, muscle relaxant, anticonvulsant, and amnesic effects occur more quickly although some people don't develop tolerance to those effects either.

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