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Meds and you

Updated 11 February 2013

Chlordiazepoxide

Chlordiazepoxide is the active ingredient of Librium.

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Chlordiazepoxide is the active ingredient of Librium.

General information

Chlordiazepoxide is a benzodiazepine medication prescribed to alleviate anxiety, tension, stiff muscles and insomnia. It is also often used to treat the symptoms of alcohol withdrawal, symptoms that include sweating, tremor, vomiting, anxiety, insomnia, and muscle pain.

Treatment with chlordiazepoxide is generally limited to 2-4 weeks due to the development of dependence, and withdrawal symptoms if discontinued after a longer period of use. Tolerance, a condition where the drug loses some of its efficacy at the prescribed dose, may appear with continuous long-term use and may lead to misuse.

If prescribed for longer than 2-4 weeks, your prescriber should periodically reassess the need for chlordiazepoxide.

How does chlordiazepoxide work?

Chlordiazepoxide has an affect on gamma-aminobutyric acid (GABA). GABA is the brain's calming or tranquilising neurotransmitter, possessing an inhibitive effect on the transmission of nerve signals. Chlordiazepoxide and other benzodiazepines enhance the effect of GABA, thus slowing down the transmission of nerve signals and thereby decrease nervousness.

Fast facts

Drug schedule: Schedule 5

Available as: Tablets

What does it do? Chlordiazepoxide has an anti-anxiety and sedative action

Overdose risk: Medium

Dependence risk: Medium

Available as a generic? No

Available on prescription only? Yes

User information

Onset of effect: Within 2 hours.

Duration of action: Up to 24 hours.

Stopping this medicine: If taken for less than 14 days, the drug can be safely stopped when no longer needed. If taken for longer, chlordiazepoxide should not be stopped abruptly - sudden discontinuation may lead to withdrawal symptoms. The dosage of chlordiazepoxide should be gradually reduced according to the advice of your doctor.

Prolonged use: Prolonged use of chlordiazepoxide may lead to tolerance associated with reduced efficacy. The medication may also be habit-forming. If prescribed for longer than 2-4 weeks your prescriber should periodically reassess the need for chlordiazepoxide.

Special precautions

Never exceed the prescribed dose of chlordiazepoxide

Consult your doctor before taking chlordiazepoxide if:

  • You have a history of alcohol or substance abuse, or
  • You have kidney or liver disease.

Pregnancy: Avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant

Breastfeeding: Avoid. This medication is passed through breast milk and may affect your baby adversely. Consult your doctor before use.

Porphyria: Avoid. This medication may cause serious adverse effects. Consult your doctor before use.

Infants and children: This medication is not intended for use in children.

Elderly: Use with caution as side effects may be emphasised. A reduced dose may be needed.

Driving and hazardous work: Caution is advised as use of this medication may lead to dizziness, light-headedness and/or sedation. Avoid such activities until you know how it affects you.

Alcohol: Chlordiazepoxide may intensify the effect of alcohol and vice versa. Do not consume alcohol while taking it, as sedative effects may be drastically pronounced.

Possible side effects

Side effect

Frequency

Consult your doctor

Common

Rare

Only if severe

In all cases

Drowsiness

x

x

Dizziness / loss of coordination

x

x

Slurred speech

x

x

Confusion

x

x

Memory impairment

x

x

Headache

x

x

Nausea/vomiting

x

x

Rash/itching skin

x

x

Impaired vision

x

x

Interactions:

Drug interactions:

Alcohol, antihistamines, antidepressants, other benzodiazepines, narcotics

Increased depression of central nervous system (CNS)

Digoxin

Increased possibility of digoxin toxicity

Disulfiram

Increased possibility of chlordiazepoxide toxicity

Ketokonazole and other related antifungals

Increased possibility of chlordiazepoxide toxicity

Cimetidine

Increased possibility of chlordiazepoxide toxicity

Isoniazid

Increased possibility of chlordiazepoxide toxicity

Oral contraceptive

Increased possibility of chlordiazepoxide toxicity

Propranolol

Increased possibility of chlordiazepoxide toxicity

Valproic acid

Increased possibility of chlordiazepoxide toxicity

Isoniazid

Increased possibility of chlordiazepoxide toxicity

Levodopa

Decreases levodopa's anti-Parkinson effect

Probenecid

Increased possibility of chlordiazepoxide toxicity

Rifampicin

May decrease the effect of chlordiazepoxide

Theophylline

May counteract the sedative effects of chlordiazepoxide

Disease interactions

Consult your doctor before taking chlordiazepoxide if you have kidney or liver disease.

Overdose action

A small overdose is no cause for concern. In case of intentional large overdose, seek emergency medical attention. Symptoms may include excessive drowsiness and coma.

Recommended dosage

Adults: 12.5 - 100mg daily in divided doses.

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.

 

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