Management of

OVERDOSE

Manifestations of Librium (chlordiazepoxide hydrochloride) overdosage include somnolence, confusion, coma and diminished reflexes. Respiration, pulse and blood pressure should be monitored, as in all cases of drug overdosage, although, in general, these effects have been minimal following Librium (chlordiazepoxide hydrochloride) overdosage.

While the signs and symptoms of Librax overdosage may be produced by either of its components, usually such symptoms will be overshadowed by the anticholinergic actions Of Quarzan (clidinium bromide). The symptoms of overdosage of Quarzan (clidinium bromide) are excessive dryness of mouth, blurring of vision, urinary hesitancy and constipation.

General supportive measures should be employed, along with immediate gastric lavage. Administer physostigmine (Antilirium) 0.5 to 2 mg at a rate of no more than 1 mg per minute. This may be repeated in 1 to 4 mg doses if arrhythmias, convulsions or deep coma recur. Intravenous fluids should be administered and an adequate airway maintained. Hypotension may be combated by the use of Levophed (levarterenol) or Aramine (metaraminol), Ritalin (methylphenidate) or caffeine and sodium benzoate may be given to combat CNS-depressive effects. Dialysis is of limited value. Should excitation occur, barbiturates should not be used. As with the management of intentional overdosage with any drug, it should be borne in mind that multiple agents may have been ingested.

Withdrawal symptoms of the barbiturate type have occurred after the discontinuation of benzodiazepines (see ADVERSE REACTIONS: DRUG ABUSE AND DEPENDENCE section).

Librax is contraindicated in the presence of glaucoma (since the anticholinergic component may produce some degree of mydriasis) and in patients with prostatic hypertrophy and benign bladder neck obstruction. It is contraindicated in patients with known hypersensitivity to chlordiazepoxide hydrochloride and/or clidinium bromide.

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