Side Effects of Librium (chlordiazepoxide)

Librium (chlordiazepoxide) is a long-acting benzodiazepine used to manage symptoms associated with anxiety disorders. Librium has anti-anxiety, sedative, appetite-stimulating, and weak pain-relieving properties. 

The exact mechanism of how Librium 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.

Common side effects of Librium include

• drowsiness,
• impaired muscle control,
• confusion,
• dizziness,
• skin problems,
• fluid retention (edema),
• minor menstrual irregularities,
• nausea,
• constipation,
• movement disorders, and
• decreased sexual desire.

Serious side effects of Librium include

• blood disorders,
• yellowing skin and eyes (jaundice), and
• liver dysfunction.

Drug interactions of Librium include drugs that inhibit cytochrome P450 3A4 enzymes, because they reduce the metabolism of Librium and have the potential for causing side effects.

• Examples of CYP3A4 inhibitors include
  • amiodarone,
  • anti-retroviral protease inhibitors,
  • fluconazole,
  • itraconazole,
  • ketoconazole,
  • voriconazole,
  • miconazole,
  • cimetidine, and
  • clarithromycin.
• Additionally, inducers of the CYP 3A4 enzymes may increase the activity of these enzymes and cause blood levels of Librium to decrease.
• Examples of CYP3A4 inducers include
  • carbamazepine,
  • rifampin,
  • phenytoin, and
  • St. John's wort.
• Librium has depressant effects on the central nervous system.
• Medications that have similar activity may increase the risk for drowsiness, respiratory depression, and other CNS depressant effects.
• Co-administration with alcohol, kava-kava, other benzodiazepines, and opiates should generally be avoided.

Due to the risk of potential harm to the fetus, use of Librium during pregnancy is not recommended.

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

Reported side effects include:

• Drowsiness
• Impaired muscle control (ataxia)
• Confusion
• Dizziness
• Skin problems
• Edema
• Minor menstrual irregularities
• Nausea
• Constipation
• Movement disorders
• Decreased desire for sexual activity (decreased libido).

Serious side effects that have been reported are:

• Blood disorders
• Jaundice
• Liver dysfunction

• 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 a few instances syncope has been reported.
• Other adverse reactions reported during therapy include isolated instances of
  • skin eruptions,
  • edema,
  • minor menstrual irregularities,
  • nausea and constipation,
  • extrapyramidal symptoms, as well as
  • increased and decreased libido.
• 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 Librium (chlordiazepoxide) treatment.
• Blood dyscrasias (including agranulocytosis), jaundice and hepatic dysfunction have occasionally been reported during therapy.
• When Librium (chlordiazepoxide) treatment is protracted, periodic blood counts and liver function tests are advisable.

• Chlordiazepoxide hydrochloride capsules are classified by the Drug Enforcement Administration as a Schedule IV controlled substance.
• Withdrawal symptoms, similar in character to those noted with barbiturates and alcohol (convulsions, tremor, abdominal and muscle cramps, vomiting and sweating), have occurred following abrupt discontinuance of chlordiazepoxide.
• The more severe withdrawal symptoms have usually been limited to those patients who had received excessive doses over an extended period of time.
• Generally milder withdrawal symptoms (eg, dysphoria and insomnia) have been reported following abrupt discontinuance of benzodiazepines taken continuously at therapeutic levels for several months.
• Consequently, after extended therapy, abrupt discontinuation should generally be avoided and a gradual dosage tapering schedule followed.
• Addiction-prone individuals (such as drug addicts or alcoholics) should be under careful surveillance when receiving chlordiazepoxide or, other, psychotropic agents because of the predisposition of such patients to habituation and dependence.

No information provided.