| Drug Index |
| GENERIC NAME : |
| chlordiazepoxide |
| BRAND NAMES : |
| Librium 5mg, 10 mg, 25 mg capsules, Librax, Clindex, Clinoxide, Clipoxide, Lidox, Lidoxide, Zebrax, Apo-Chlorax, Corium (each containing chlordiazepoxide 5 mg & clinidium bromide 2.5 mg) |
| STREET NAMES : |
| downers, benzo's, tranq's |
| BRIEF DESCRIPTION : |
| Chlordiazepoxide is a member of the class of drugs known as benzodiazepines. It has antianxiety, sedative, appetite-stimulating and weak analgesic actions. The precise mechanism of action is not known, but it does potentiate action of GABA to produce CNS depression. The drug blocks EEG arousal from stimulation of the brain stem reticular formation. It takes several hours for peak blood levels to be reached and the half-life of the drug (the time it takes for the body to eliminate half the drug from the blood stream) is between 24 and 48 hours. After the drug is discontinued plasma levels decline slowly over a period of several days. Chlordiazepoxide is excreted in the urine, with 1 to 2% unchanged and 3 to 6% as a conjugate. |
| INDICATIONS FOR USE : |
| Chlordiazepoxide capsules are indicated for the management of anxiety disorders or for the short-term relief of symptoms of anxiety, withdrawal symptoms of acute alcoholism, and preoperative apprehension and anxiety. It is widely used for management of detoxification from alcohol and a variety of other addictive drugs. Librax (or the other brand names of the same drug combination listed above) is used to treat stomach ulcers, irritable bowel syndrome, and intestinal inflammation (enterocolitis). It may also be used for other conditions as determined by your doctor. Librax is a combination benzodiazepine and anticholinergic. The benzodiazepine works by decreasing anxiety and muscle spasms and also causing sedation. The anticholinergic medication clinidium bromide works by decreasing stomach acid and relaxing stomach and intestinal muscles. |
| ABUSE AND ADDICTIVE POTENTIAL : |
Chlordiazepoxide (like all of the benzodiazepine drugs) demonstrates potential for dependence (addiction). This is especially true in individuals with a history of drug addiction or alcoholism. In general, the shorter the duration of use of benzodiazepines, the lower the chances of becoming dependent. Extension of the treatment period should not take place without reevaluation of the need for continued therapy. Withdrawal symptoms can appear after taking this medication daily for 4 to 6 weeks. If Chlordiazepoxide is used daily for longer than 30 days, abrupt discontinuation should be avoided. Tolerance can occur in some individuals after taking the medication for several weeks or months. This means that dosages prescribed for treatment may need to be increased some over time to achieve the therapeutic response. It also means that individuals who have become addicted to chlordiazepoxide (and are abusing it for the "high") will need to progressively increase the dosage to achieve the desired mood state that the addict is seeking. Addicted individuals often take several times the recommended dosage. Significantly adverse clinical events, some life-threatening, can be a direct consequence of physical dependence to chlordiazepoxide. Rebound (a return of symptoms to a level substantially greater in frequency and, or more severe in intensity than before taking chlordiazepoxide) are possible after taking the medication for a few weeks or months. Symptoms noted in withdrawal from chlordiazepoxide may include: • heightened sensory perception • impaired concentration • clouded sensorium (confusion or difficulty thinking) • paresthesias (tingling, pricking, or numbness of the skin) • decrease appetite and weight loss • anxiety • insomnia (difficulty sleeping) • seizure (convulsions) Discontinuation of chlordiazepoxide should be done under the supervision of a physician often involves tapering the medication slowly and/or use of other medications to manage withdrawal symptoms. |
| OVERDOSAGE : |
Manifestations of overdoseage may include: • somnolence (extreme drowsiness or deep, prolonged sleep) • confusion • slurred speech • impaired coordination • diminished reflexes • coma • death Emergency medical treatment is advised if overdose is suspected. |
| CAUTIONS : |
| Individuals taking chlordiazepoxide should be cautioned about engaging in hazardous operations or activities that require complete mental alertness. Chlordiazepoxide should not be used simultaneously with alcohol or any other central nervous system depressant drugs. Taken together, these drugs can potentiate the potency and effect of each drug. Precaution should be observed in using this medication in patients who have impaired kidney, liver, or lung function. Changes in the absorption, distribution, metabolism and excretion of benzodiazepines have been reported in disease states including alcoholism, impaired liver function, in impaired kidney function. Also, in geriatric patients the half-life of elimination of the drug may be extended several hours, requiring careful monitoring and possibly a lower dosage range of prescribing this medication. Taking certain other medications, such as azole antifungal agents (e.g., itraconazole, ketoconazole), fluvoxamine, isoniazid, nefazodone, protease inhibitors (e.g., indinavir) may increase chlordiazepoxide plasma concentrations. An imbalance in the components of the blood (called blood dyscrasias, including agranulocytosis), jaundice and hepatic dysfunction have occasionally been reported during therapy with chlordiazepoxide. When chlordiazepoxide treatment is protracted (extended over several months), periodic blood counts and liver function tests are advisable. A child born of a mother who is taking benzodiazepines may be at some risk for withdrawal symptoms following birth. Benzodiazepines are also known to be excreted in human milk. |
| SIDE EFFECTS : |
| The necessity of discontinuing therapy because of undesirable effects has been rare. Drowsiness, ataxia and confusion have been reported in some patients - particularly the elderly and debilitated. While these effects can be avoided in almost all instances by proper dosage adjustment, they have occasionally been observed at the lower dosage ranges. In few instances syncope (fainting) has been reported. Other adverse reactions reported during therapy include isolated instances of skin eruptions, edema, minor menstrual irregularities, nausea and constipation, extrapyramidal symptoms (a term often abbreviated EPS that may include variety of symptoms, e.g. involuntary movements, tremors and rigidity, body restlessness, muscle contractions and changes in breathing and heart rate) , as well as increased or decreased libido (sex drive). Such side effects have been infrequent and are generally controlled with reduction of dosage. Changes in EEG patterns (low-voltage fast activity) have been observed in patients during and after chlordiazepoxide treatment. Paradoxical reactions (occasional "opposite" reactions to those expected) such as acute hyperexcited states, anxiety, hallucinations, insomnia, anger, sleep disturbances and stimulation have been reported. |
| FOR MORE INFORMATION : |
| *this is a condensed description for chlordiazepoxide. For more details check with your physician, pharmacist, or other resources such as The Physicians' Desk Reference (PDR) or http://www.drugs.com |
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