All About Schedule IV Drugs

The United States mandated the Controlled Substance Acts or CSA as a drug policy, under which the manufacture, use, possession, importation, and distribution of substances are regulated. Under the said Act, it is stated that all substances that are regulated in some way under federal law must be put into five schedules. These substances can be prescription medications and even illegal ones, are all part of the said act. Some of these drugs regulated are those that belong to Schedule IV drugs. 

What Types Of Drugs Are They?

Schedule IV drugs are substances or chemicals that are defined to be drugs with a low potential for abuse and at the same time risk of dependence. Medicines in this classification can and are abused or can be addictive or create dependency but not as much as those in Schedule 1, 2, and 3. Among the best examples of drugs in this schedule are:

  • Xanax
  • Soma
  • Valium
  • Ativan
  • Talwin
  • Ambien
  • Tramadol


Xanax is a benzodiazepine (alprazolam) that affects the chemicals of the brain that causes anxiety in an individual. It is mainly used to treat anxiety disorders and anxiety caused by depression. Xanax is also used in treating panic disorders with or without fear of situations and places that cause feelings of helplessness, panic, and embarrassment. 

This drug may be habit-forming and can cause addiction, overdose, and death if misused. Taking Xanax with alcohol and other drugs can cause drowsiness or slow breathing. 

Side Effects:

Taking Xanax needs precaution as this can cause an allergic reaction. If you have hives, swelling in the face, lips, throat, and tongue, call emergency services immediately. If you have the following signs and symptoms, call the doctor right away:

  • Seizures
  • Lightheadedness or feelings of passing out
  • Hallucinations
  • Engaging in risky behaviors
  • An increase in energy 
  • Lack of sleep
  • Double vision
  • Being talkative, agitated or hyperactivity
  • Racing thoughts
  • Jaundice or yellowing of the eyes, skin

Adults may experience longer side effects of Xanax. Elderly who take benzodiazepines are prone to accidental falls and other injuries. Some of the most common side effects of Xanax include drowsiness and light-headedness. It is important to call your physician right away if you experience other side effects than the ones listed above. 


Soma or carisoprodol is a drug that blocks pain sensations in the muscles between the nerves and the brain. It is a muscle relaxer and is used together with physical therapy and rest to treat any skeletal muscle conditions like injury or pain. It must be used for a short period only, usually around 2 to 3 weeks. This is because there is no evidence of it being effective in long term use and it is also because most skeletal muscle injuries only last a short time. 

Side Effects:

In case you have more than the common side effects of this drug and they do not subside and becomes severe, call your doctor or seek medical attention immediately:

  • Constipation
  • Dizziness
  • Drowsiness or sleepiness
  • Dry mouth
  • Dry eyes
  • Headaches
  • Trouble urinating


Diazepam is an oral tablet that is a controlled substance drug available as a brand-name drug Valium. It also comes in a generic form that costs less than the original ones. In some cases, the strength of the generic diazepam is not as strong as the brand-name version. It is also available in oral solution and rectal gel. Diazepam is used to treat anxiety, symptoms of alcohol withdrawal like tremors and agitation. It is also used for skeletal muscle spasms and as an add-on treatment for certain types of seizures. In some cases, diazepam is used as part of combination therapy which means you need to take it with other drugs prescribed for your underlying condition. 

Side Effects

Taking diazepam can slow down the brain’s activity and even interfere with your motor skills, judgment, and critical thinking. It must not be taken with alcohol or other drugs that can slow your brain’s activity. Driving is also prohibited as well as operating machines. The most common side effects of diazepam include:

  • Constipation
  • Dizziness
  • Dryness of the mouth
  • Drowsiness
  • Fatigue or tiredness
  • Headache
  • Inability to control muscle movements
  • Muscle weakness
  • Nausea
  • tremors

Mild effects may go away within a couple of days or weeks but if they grow into severe ones and do not go away after a month or two, it is best to call or see your doctor right away. 

Serious side effects of valium include life-threatening ones. If you experience the following, seek medical attention immediately:

  • Increased frequency and severity of seizures
  • Drastic changes in the brain’s activity like how you think as well as confusion, depression, slowed or slurred speech, vertigo, blurred vision, memory loss, or suicidal thoughts.
  • There are also unexpected reactions that you should watch out for like anxiety, extreme excitement, increased muscle spasms, hallucinations, agitation, and trouble sleeping. 
  • Yellowing of the sclera and skin
  • Inability to urinate and inability to hold urine.
  • A severe increase or decrease in sex drive
  • Withdrawal symptoms like tremors, abdominal cramps, convulsions, and sweating. 


Ativan (lorazepam) is a prescribed medication belonging to the benzodiazepine class. It is usually used to treat anxiety symptoms as well as insomnia and status epilepticus, which is a type of severe seizure. It is also given to patients who will be undergoing surgery to make them sleep. Ativan comes in two forms; tablet and intravenous solution which is given through injection. 

Side Effects

Ativan can cause mild or serious side effects. If the reactions are severe, it is best to seek medical treatment immediately. The most common side effects of Ativan are as follows:

  • Dizziness
  • Drowsiness
  • Weakness

Less common side-effects are:

  • Confusion
  • Depression
  • Headache
  • Fatigue
  • Lack of coordination
  • Restlessness

If Ativan is taken via injection, side effects may include redness and pain at the injection. These are common reactions but if the side is swelling and itching, contact your physician right away. 

Side effects may go away within a couple of days or weeks but if there is a more severe reaction than normal, then seek emergency treatment. 

Serious side effects include:

  • Breathing problems like slowed breathing and respiratory failure.
  • Psychological and physical signs of dependence on Ativan like anxiety, body aches, depression, muscle weakness, nightmares, nausea, sweating, and vomiting.
  • Allergic reactions may also occur. Watch out for symptoms like severe rashes, hives, trouble swallowing or breathing, swelling of your face, tongue and lips, as well as increased heart rate. 
  • Suicidal thoughts are also among the severe side effects of Ativan and must be reported immediately. 


Naloxone (Talwin Nx) works by blocking certain effects of opioid medications which include the feelings of euphoria that can lead to the abuse. It is usually given to treat moderate to severe pain. 

Side Effects

Side effects of Talwin may range from mild to severe, temporary, or permanent. The most common side effects of this medication include:

  • Blurry vision
  • Constipation
  • Confusion
  • Diarrhea
  • Dizziness or fainting feeling
  • Dry mouth
  • Drowsiness
  • A false sense of well-being
  • Headache
  • Loss of appetite
  • Nightmares
  • Nausea or vomiting
  • Redness, swelling, pain or burning at the injection site
  • Stomach pain or cramps
  • Sleeping problems
  • Unusual weakness or tiredness


Ambien (zolpidem) is a sedative that works by affecting the chemicals in the brain which is unbalanced in people with sleeping problems. It is used to treat insomnia and comes in an immediate-release tablet to help individuals fall asleep. There is also the extended-release form called Ambien CR, which dissolves quickly to help you get the needed sleep for long hours. Since this is a prescribed medication, only your physician can decide which Ambien will work best for you, depending on your diagnosis. 

Side Effects

Some of the side effects of Ambien can range from mild to severe. Do not use this drug if you have severe allergic reactions to Zolpidem. Stop using this medication and seek immediate medical assistance if you experience the following:

  • Chest pain
  • Fast or irregular heartbeat
  • Shortness of breath
  • Trouble breathing or swallowing
  • Feelings of passing out

Ambien may have stronger sedative effects on older adults which can cause dizziness or severe drowsiness. 

Common side effects of Ambien include the following:

  • Weakness
  • Dizziness
  • Drowsiness during day time
  • Feelings of being “drugged”
  • Light-headedness
  • Lethargy
  • Loss of coordination
  • Stuffy nose
  • Dry mouth, nose or throat
  • Irritation
  • Constipation
  • Nausea
  • Diarrhea
  • Upset stomach
  • Headache
  • Muscle pain


Tramadol is a narcotic-like pain reliever used to treat moderate to severe pain in adults. Its extended-release form is used for the around-the-clock treatment of pain.

Side Effects

Common side effects with Tramadol include constipation, nausea, vomiting, stomach pain, dizziness, drowsiness, and tiredness. It can also cause itching and sometimes headaches. Immediate medical assistance must be called if serious side effects begin to appear: 

  • Shallow breathing with long pauses
  • Blue colored lips
  • Loss of consciousness
  • Noisy breathing
  • Sighing, shallow breathing or stops breathing while sleeping
  • Slow heart rate or weak pulse
  • Feelings of passing out
  • Seizures
  • Missed menstrual periods
  • Sexual problems like decreased libido, impotence, loss of interest in sex 
  • Vomiting, nausea
  • Loss of appetite
  • Dizziness
  • Weakness or severe tiredness

Call the physician if the patient shows symptoms of serotonin syndrome like:

  • Agitation
  • Hallucinations
  • Fever and sweating
  • Shivering
  • Fast heart rate
  • Muscle stiffness or twitching
  • Loss of coordination
  • Diarrhea

Are Schedule IV Drugs Dangerous?

Schedule IV drugs are made from opioids and narcotics which could produce a sedating effect. If misused, this could lead to an addiction that may be hard to overcome. While it is considered low risk for addiction, users can develop a dependence on them. If the user is found to be using or possession of these drugs illegally then they can face jail time as well as suspension of driver’s license for at least six months for their first offense. If caught on their second and third offenses, they could be jailed for at least two years. 

In conclusion, do not abuse or misuse Schedule IV drugs. Not only are you going to face rehab but you could also go to prison. Follow the doctor’s prescription and make sure to only follow the given doses. This way you avoid developing dependence and jail time.