chlordiazepoxide (Librium)

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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What is chlordiazepoxide-oral, and how does it work (mechanism of action)?

Chlordiazepoxide is a psychotropic agent that is used to manage symptoms associated with anxiety disorders. It is a long acting benzodiazepine that is available for oral administration. Examples of other members of the benzodiazepine include:

Chlordiazepoxide has anti-anxiety, sedative, appetite-stimulating, and weak pain relieving properties. The exact mechanism of how chlordiazepoxide provides therapeutic benefits is not yet understood. However, current understanding of benzodiazepines indicates that they enhance or increase the activity of GABA, an inhibitory neurotransmitter, a chemical that cells in the brain use to suppress the activity of other cells.

Chlordiazepoxide was initially approved by the US FDA in 1960. The injectable formulation of chlordiazepoxide is no longer available in the US.

What brand names are available for chlordiazepoxide-oral?

Librium

Is chlordiazepoxide-oral available as a generic drug?

GENERIC AVAILABLE: Yes

Do I need a prescription for chlordiazepoxide-oral?

Yes

What are the side effects of chlordiazepoxide-oral?

Reported side effects include:

Serious side effects that have been reported are:

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What is the dosage for chlordiazepoxide-oral?

Adults

  • For the treatment of mild to moderate anxiety disorders or symptoms: 5 to 10 mg by mouth 3-4 times daily.
  • For the treatment of severe anxiety disorders or symptoms: 20 to 25 mg by mouth 3-4 times daily.
  • For the management of preoperative apprehension and anxiety: 5 to 10 mg by mouth 3-4 times daily on days preceding surgery.

Dosing: Pediatrics

  • For the treatment of anxiety symptoms in children = 6 years to adolescents the usual daily recommended dose is 5 mg 2-4 times daily.
  • Dosage may be increased to 10 mg per day given in 2-3 divided doses if necessary.
  • Chlordiazepoxide is not recommended for use in children below the age of 6 years.

Dosing: Geriatric patients

  • The usual recommended dose is 5 mg 2 to 4 times daily.

Which drugs or supplements interact with chlordiazepoxide-oral?

Chlordiazepoxide is metabolized or broken down by a group of enzymes in the liver known as the cytochrome P450 3A4 enzymes. Drugs which inhibit these enzymes reduce the metabolism of chlordiazepoxide and have the potential for causing side effects.

Examples of CYP3A4 inhibitors are:

Additionally, inducers of the CYP 3A4 enzymes may increase the activity of these enzymes and cause blood levels of chlordiazepoxide to decrease.

Examples of CYP 3A4 inducers are:

Chlordiazepoxide has depressant effects on the central nervous system. Medications which have similar activity may increase the risk for drowsiness, respiratory depression, and other CNS depressant effects. Therefore, co-administration with alcohol, kava-kava, other benzodiazepines, and opiates should generally be avoided.

Is chlordiazepoxide-oral safe to take if I'm pregnant or breastfeeding?

Chlordiazepoxide is classified as FDA pregnancy risk category D. Due to the risk of potential harm to the fetus, use of chlordiazepoxide during pregnancy is not recommended.

This medication is thought to be excreted into breast milk. Due to the lack of conclusive safety data, use in nursing mothers is not recommended.

What else should I know about chlordiazepoxide-oral?

What preparations of chlordiazepoxide-oral are available?

Oral capsules: 5, 10, and 25 mg

How should I keep chlordiazepoxide-oral stored?

Capsules should be stored at room temperature, between 20 C to 25 C (68 F to 77 F).

Medically reviewed by Eni Williams; PharmD., Ph.D.

REFERENCE:

FDA Prescribing Information.

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Summary

Chlordiazepoxide hydrochloride (Librium) is a medication prescribed to manage anxiety disorders, and provide short term relief of anxiety symptoms, withdrawal of acute alcoholism, and preoperative apprehension and anxiety. Side effects, drug interactions, dosing and storage information, and pregnancy safety should be reviewed prior to taking this medication.

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Reviewed on 5/10/2017
References
Medically reviewed by Eni Williams; PharmD., Ph.D.

REFERENCE:

FDA Prescribing Information.

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