Chlordiazepoxide-Clidinium

Reviewed on 4/25/2022

What Is Chlordiazepoxide/Clidinium and How Does It Work?

Chlordiazepoxide/Clidinium is a combination medication used to treat stomach (peptic) ulcers, irritable bowel syndrome (IBS), and enterocolitis (inflammation of the colon). 

  • Chlordiazepoxide/Clidinium is available under the following different brand names: Librax

What Are Dosages of Chlordiazepoxide/Clidinium?

Adult dosage

Capsule

  • 5mg/2.5mg

Peptic Ulcer, IBS, & EnterocolitisAdult dosage

  • 1-2 caps orally every 6-8 hours before meals and at bedtime

Geriatric dosage

  • Use the smallest effective dose
  • Not to exceed 2 capsules orally per day initially; may increase gradually as needed and tolerated

Dosage Considerations – Should be Given as Follows: 

  • See “Dosages”

What Are Side Effects Associated with Using Chlordiazepoxide/Clidinium?

Common side effects of Chlordiazepoxide/Clidinium include:

  • dizziness,
  • tiredness,
  • weakness,
  • blurred vision,
  • dry eyes,
  • dry mouth,
  • nausea,
  • vomiting,
  • constipation,
  • abdominal bloating,
  • swelling,
  • skin rash
  • irregular menstrual periods,
  • increase and decreased desire for sex (libido),
  • problems starting to urinate, and 
  • drowsiness, coordination problems, and confusion especially in people who are elderly or weak.

Serious side effects of Chlordiazepoxide/Clidinium include:

  • decreased sweating,
  • dry/hot/flushed skin,
  • fast or irregular heartbeat,
  • loss of coordination,
  • slurred speech,
  • fainting,
  • uncontrollable or unusual muscle movements,
  • mental/mood changes: such as confusion, agitation, unusual excitement, depression, strange thoughts,
  • difficulty urinating,
  • decreased sexual ability, and
  • slow or shallow breathing.

Rare side effects of Chlordiazepoxide/Clidinium include:

  • none 

This is not a complete list of side effects and other serious side effects or health problems that may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

QUESTION

What is irritable bowel syndrome or IBS? See Answer

What Other Drugs Interact with Chlordiazepoxide/Clidinium?

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

  • Chlordiazepoxide/Clidinium has severe interactions with no other drugs.
  • Chlordiazepoxide/Clidinium has serious interactions with the following drugs:
  • Chlordiazepoxide/Clidinium has moderate interactions with at least 238 other drugs.
  • Chlordiazepoxide/Clidinium has minor interactions with at least 25 other drugs. 

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.

What Are Warnings and Precautions for Chlordiazepoxide/Clidinium?

Contraindications

Effects of drug abuse

  • Addiction
  • Physical dependence

Short-Term Effects

  • See “What Are Side Effects Associated with Using Chlordiazepoxide/Clidinium?”

Long-Term Effects

  • See “What Are Side Effects Associated with Using Chlordiazepoxide/Clidinium?”

Cautions

  • Decrease dose in debilitated or elderly patients
  • Concomitant administration with other psychotropic agents is not recommended; if such a combination seems indicated, give careful consideration to the pharmacology of agents to be employed, particularly when known potentiating compounds such as MAO inhibitors and phenothiazines are to be used; usual precautions in treating patients with impaired renal or hepatic function should be observed
  • Paradoxical reactions to chlordiazepoxide have occurred (eg, excitement, stimulation, acute rage)
  • Anterograde amnesia reported with benzodiazepine use
  • May cause anticholinergic effects
  • May cause CNS depression, which may impair the ability to perform hazardous tasks, including operating heavy machinery, driving
  • Although clinical studies have not established a cause and effect relationship, variable effects on blood coagulation have been reported very rarely in patients receiving oral anticoagulants and chlordiazepoxide hydrochloride
  • Use caution in hot weather; may cause heat prostration
  • Use of the drugs, particularly in patients at elevated risk of abuse, necessitates counseling about risks and proper use of the drugs along with monitoring for signs and symptoms of abuse, misuse, and addiction; do not exceed recommended dosing frequency
  • Avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); advise patients on proper disposal of unused drugs; if a substance use disorder is suspected, evaluate patient and institute (or refer them for) early treatment, as appropriate
  • For patients using treatment more frequently than recommended, to reduce the risk of withdrawal reactions, use a gradual taper to discontinue therapy (a patient-specific plan should be used to taper the dose)
  • Patients at an increased risk of withdrawal adverse reactions after benzodiazepine discontinuation or rapid dosage reduction include those who take higher dosages and those who have had longer durations of use
  • In some cases, benzodiazepine users have developed a protracted withdrawal syndrome with withdrawal symptoms lasting weeks to more than 12 months
  • Usual precautions are indicated when chlordiazepoxide hydrochloride is used to treat anxiety states where there is any evidence of impending depression; it should be borne in mind that suicidal tendencies may be present and protective measures may be necessary
  • Caution in patients with an impaired gag reflex or respiratory disease
  • Concomitant use of opioid analgesics and benzodiazepines increases the risk of drug-related mortality compared to the use of opioids alone; if the decision is made to prescribe drugs concomitantly with opioids prescribe the lowest effective dosages and minimum durations of concomitant use; follow patients closely for signs and symptoms of respiratory depression and sedation; advise both patients and caregivers about risks of respiratory depression and sedation when the drug is used with opioids

Pregnancy and Lactation

  • Use in LIFE-THREATENING emergencies when no safer drug is available. Positive evidence of human fetal risk; increased risk of congenital malformations associated with the use of benzodiazepines during 1st trimester
  • Lactation
    • Distributed in breast milk, avoid using; anticholinergic agents are known to inhibit lactation 
References
Medscape. Chlordiazepoxide-Clidinium.

https://reference.medscape.com/drug/librax-chlordiazepoxide-clidinium-999569#0

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