Klonopin vs. Valium: Differences, similarities, and which is better for you

In this article:

• Main differences
• Conditions treated
• Efficacy
• Coverage and cost
• Side effects
• Interactions
• Warnings
• FAQs

In this article

• Main differences
• Conditions treated
• Efficacy
• Coverage and cost
• Side effects
• Interactions
• Warnings
• FAQs

If you experience anxiety or other mental health conditions, you are not alone. According to the National Alliance on Mental Illness, anxiety affects 40 million adults in the United States—that’s 19% of the population. 

Klonopin (clonazepam) and Valium (diazepam) are two medications from the benzodiazepine class of drugs. They are used in the treatment of anxiety and other conditions. Both prescription drugs are approved by the United States Food and Drug Administration (FDA). 

Benzodiazepines work in the central nervous system (CNS) by increasing the activity of the neurotransmitter (chemical messenger) gamma-aminobutyric acid (GABA). By doing so, the medication slows down the brain and nervous system, resulting in a relaxing and calming effect, and can help aid sleep when taken at bedtime. Because benzodiazepines (sometimes referred to as benzos) have the potential for substance abuse or dependence, they are classified by the Drug Enforcement Agency (DEA) as Schedule IV controlled substances. 

Main differences between Klonopin and Valium
	Klonopin	Valium
Drug class	Benzodiazepine	Benzodiazepine
Brand/generic status	Brand and generic versions available	Brand and generic versions available
What is the generic name?	Clonazepam	Diazepam
What form(s) does the drug come in?	Oral tablet Orally disintegrating tablet	Oral tablet Injection Oral solution (liquid)  Rectal gel (Diastat AcuDial) Nasal spray (Valtoco)
What is the standard dosage?	Varies; a common dose of Klonopin is 1 mg by mouth twice a day	Varies; a common dose of Valium is 5 mg by mouth 2 to 4 times a day
How long is the typical treatment?	Varies; length of treatment is not established, so patients should be closely monitored	Varies; length of treatment is not established, so patients should be closely monitored
Who typically uses the medication?	Adults and children	Adults and children

What are the main differences between Klonopin and Valium?

Klonopin and Valium are both anxiety medications, also called anxiolytics. Klonopin is a benzodiazepine drug also known by its generic name, clonazepam. It is available in the form of an oral tablet and an orally disintegrating tablet. Klonopin is considered a long-acting benzodiazepine. It takes about one to four hours to reach its maximum effect. The half-life of a drug is the time it takes for about half of the drug to leave the body, and it takes up to five half-lives for a dose of a drug to be almost completely eliminated from the body. The average half-life of Klonopin is 30-40 hours. 

Valium is also a benzodiazepine drug, and its generic name is diazepam. It is available in tablet, injection, and oral solution form. Diazepam is also available as a rectal gel and a nasal spray. The rectal gel and nasal spray are used only for seizure treatment. Valium is considered a long-acting benzodiazepine. It starts working quickly—the maximum effect of the oral tablet can be felt within an hour to an hour and a half, and it stays in the body for a longer time than Klonopin. The average half-life of Valium is up to 100 hours.

Conditions treated by Klonopin and Valium

Klonopin is FDA-approved for the treatment of seizure disorders and panic disorders (with or without agoraphobia). Valium is FDA-approved for the following conditions: anxiety disorders, short-term relief of anxiety symptoms, acute alcohol withdrawal, and muscle spasm conditions, including skeletal muscle spasm, spasticity, athetosis (a movement condition characterized by involuntary writhing movements), and stiff-person syndrome. 

Condition	Klonopin	Valium
Seizure disorders	Yes	Yes
Panic disorder (with or without agoraphobia)/ panic attacks	Yes	Off-label
Anxiety disorders/short-term relief of the symptoms of anxiety	Off-label	Yes
Symptoms of alcohol withdrawal (agitation/tremors)	No	Yes
Skeletal muscle spasm, spasticity, athetosis, and stiff-person syndrome	Off-label	Yes

Is Klonopin or Valium more effective?

Klonopin and Valium have different indications—for example, Valium is FDA-approved for symptoms of alcohol withdrawal, while Klonopin is not (but may be used off-label, which means for a non-FDA-approved use). The selection of whether Klonopin or Valium is the better choice, therefore, will depend on the reason for use and other individual factors.

The most effective medication for you should be determined by your doctor, who can consider your medical condition(s) and medical history, as well as any medications you take that may interact with Klonopin or Valium. 

Coverage and cost comparison of Klonopin vs. Valium

Clonazepam, or generic Klonopin, is generally covered by insurance and Medicare prescription plans. The generic form of clonazepam is significantly less expensive than Klonopin. The brand name may not be covered or may have a much higher copay. A common prescription would be 30 tablets of 0.5 mg generic clonazepam, and the out-of-pocket price is about $30. You can purchase it for as low as about $5 at participating pharmacies with a SingleCare coupon. 

Valium is also usually covered by insurance and Medicare Part D in its generic form of diazepam. The brand name product would be much more expensive or may not be covered. A typical prescription would be for 30 tablets of 5 mg generic diazepam. The out-of-pocket price is approximately $20, but you can purchase it for as low as $3 with a SingleCare discount.

	Klonopin	Valium
Typically covered by insurance?	Yes (generic)	Yes (generic)
Typically covered by Medicare Part D?	Yes (generic)	Yes (generic)
Standard dosage	#30, 0.5 mg tablets	#30, 5 mg tablets
Typical Medicare Part D copay	$0-$20	$0-$20
SingleCare cost	$5+ for generic clonazepam	$3+ for generic diazepam

Common side effects of Klonopin vs. Valium

Side effects vary widely, depending on the dose and condition being treated.

The most common side effects of Klonopin are:

• Dizziness
• Drowsiness
• Tiredness
• Depression
• Problems with walking, coordination, and memory 

The most common side effects of Valium are:

• Drowsiness
• Tiredness
• Muscle weakness
• Ataxia (impaired balance or coordination)

Serious side effects may occur. If you have symptoms of an allergic reaction, such as hives, trouble breathing, or swelling of the face, lips, tongue, or throat, get emergency medical help right away. 

This is not a full list of side effects. Other side effects may occur. Consult your healthcare provider for a full list of adverse effects. 

Drug interactions of Klonopin vs. Valium

Before you take Klonopin or Valium, tell your healthcare provider about all your medicines, including prescription medications, OTC drugs, vitamins, and supplements. Benzodiazepines should not be taken with opioids because of the risk of overdose, severe respiratory depression, coma, or even death. If the combination cannot be avoided, healthcare providers prescribe the lowest effective dose for the shortest duration of time and closely monitor the patient. Benzodiazepines also interact with other CNS depressants (drugs or substances that slow down brain activity), including alcohol, antidepressants, muscle relaxants, and anticonvulsants. This is not a full list of drug interactions. Other drug interactions may occur. Consult your healthcare provider for a full list of drug interactions. 

Drug	Drug Class	Interacts with Klonopin?	Interacts with Valium?
Codeine Hydrocodone Hydromorphone  Morphine Oxycodone  Tramadol	Opioids	Yes	Yes
Alcohol	Alcohol	Yes	Yes
Amitriptyline  Desipramine  Imipramine  Nortriptyline	Tricyclic antidepressants	Yes	Yes
Carbamazepine  Lamotrigine  Phenobarbital  Phenytoin	Anticonvulsants	Yes	Yes
Phenelzine Rasagiline Selegiline Tranylcypromine	MAOIs (monoamine oxidase inhibitors)	Yes	Yes
Diphenhydramine	Sedating antihistamines	Yes	Yes

Warnings of Klonopin and Valium

Any time you fill a prescription for Klonopin or Valium, you will receive a medication guide with important information about potential side effects and warnings. Because they are both benzodiazepines, Klonopin and Valium have similar warnings. Both drugs have a boxed warning, which is the strongest warning required by the FDA. Benzodiazepines such as Klonopin or Valium should not be used in combination with opioids due to the risk of extreme sedation, severe respiratory depression, coma, or even death. If the combination of an opioid and a benzodiazepine cannot be avoided, the patient will be prescribed the lowest dose for the shortest period of time and be closely monitored by the prescriber. 

Other warnings include:

• Benzodiazepines may cause both physical and psychological dependence, and the risk is higher with higher doses, longer duration of use, or a history of drug or alcohol abuse. If you take a benzodiazepine, take the medication exactly as prescribed. Do not take extra doses, and do not take the medication for any other reason than for which it was prescribed. Keep the medication out of reach and out of sight of children and under lock and key if possible. Keep track of your medicine so you know if any is missing.
• Do not drive or operate heavy machinery until you know how Klonopin or Valium affects you.
• Avoid alcohol and other CNS depressant medications when taking a benzodiazepine. Check with your healthcare provider to make sure your medications are safe to take with Klonopin or Valium.
• When discontinuing a benzodiazepine, you will not stop cold turkey. The drug should be tapered slowly to avoid withdrawal symptoms. Withdrawal symptoms may include seizures, agitation, confusion, rapid heartbeat, vertigo, and other symptoms. Patients with seizure disorders are at higher risk for withdrawal symptoms. Your healthcare professional can provide you with a tapering schedule so you can stop taking the medicine gradually and safely.
• Patients, their caregivers, and families should be aware that benzodiazepines may cause an increased risk of suicidal thoughts or behavior. Be alert to any signs and symptoms of depression, changes in mood or behavior, or new suicidal thoughts, behavior, or thoughts of self-harm. Any concerning behavior should be reported immediately to the healthcare provider, or you can call 988 for immediate help from the Suicide & Crisis Lifeline. 
• Tell your healthcare provider if you have any medical conditions, especially if you have liver or kidney problems or a lung condition such as COPD or sleep apnea.
• Klonopin or Valium should not be used in pregnancy because of the potential risk of harm to the unborn baby. If you are taking Klonopin or Valium and find out that you are pregnant, contact your healthcare provider right away. 
• Both drugs are on the Beers’ List of drugs that may be inappropriate for use in older adults. Older adults have increased sensitivity to benzodiazepines, and there is an increased risk of cognitive impairment, delirium, falls, fractures, and motor vehicle crashes in older adults who take medications such as Klonopin or Valium.

Frequently asked questions about Klonopin vs. Valium

Are Klonopin and Valium the same?

No. Klonopin and Valium are both benzodiazepines, but they are not exactly the same. Read above to find out more about the differences between Klonopin and Valium. Other common benzodiazepines you may have heard of include Xanax (alprazolam) and Ativan (lorazepam). 

RELATED: Xanax Coupons | Ativan Coupons

Is Klonopin or Valium better?

Because they vary in FDA-approved uses, it is difficult to compare the two drugs. Your healthcare provider can determine if one of these drugs is appropriate for you, taking into account individual considerations such as your medical conditions, medical history, and other medications you take.

Can I use Klonopin or Valium while pregnant?

These medications are generally not used in pregnancy. They could cause harm to the unborn baby. If you are already taking Klonopin or Valium and find out that you are pregnant, consult your healthcare provider right away. 

Can I use Klonopin or Valium with alcohol?

No. Combining Klonopin or Valium with alcohol is dangerous and can cause respiratory depression (slowed breathing, not getting enough oxygen), extreme sedation, coma, or even death.

Is Klonopin a muscle relaxant?

Klonopin is not FDA-approved for use as a muscle relaxant. Valium does have an FDA-approved use as an adjunct (add-on medicine) for skeletal muscle spasms. Occasionally, Klonopin may be used off-label for muscle spasms, but it is not a first-line or common treatment. 

Does Valium help with sleep?

Drowsiness is one of the most common side effects of Valium. However, Valium may cause the opposite effect—insomnia or sleep disturbances—in some people. Although Valium often causes drowsiness, it is not prescribed (or approved by the FDA) to help with sleep. If you are having trouble sleeping, consult your healthcare provider for medical advice.