Chlordiazepoxide

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Chlordiazepoxide Brand Name– Librium

What is Chlordiazepoxide

Chlordiazepoxide is a long-acting oral and parenteral benzodiazepine used to manage symptoms associated with anxiety disorders.

Chlordiazepoxide also has been used for many years in the management of ethanol withdrawal, but many clinicians now prefer lorazepam because it is shorter acting and has no active metabolites.

Although chlordiazepoxide is used to reduce preoperative anxiety, midazolam is considered the drug of choice by most clinicians because of its rapid onset of action and short duration of effect.

Use of chlordiazepoxide has declined significantly since the release of shorter-acting benzodiazepines.

Chlordiazepoxide was approved by the FDA in 1960.

The parenteral formulation of chlordiazepoxide was discontinued in the U.S.

Indications

  • alcohol withdrawal
  • anxiety

For treatment of anxiety disorders or for the short-term relief of symptoms of anxiety

Side Effects

  1. agitation
  2. agranulocytosis
  3. amnesia
  4. anxiety
  5. ataxia
  6. confusion
  7. constipation
  8. depression
  9. drowsiness
  10. dysarthria
  11. edema
  12. EEG changes
  13. elevated hepatic enzymes
  14. hostility
  15. irritability
  16. jaundice
  17. libido decrease
  18. libido increase
  19. memory impairment
  20. menstrual irregularity
  21. nausea
  22. neonatal abstinence syndrome
  23. neonatal respiratory depression
  24. physiological dependence
  25. porphyria
  26. psychological dependence
  27. purpura
  28. rash
  29. respiratory depression
  30. syncope
  31. teratogenesis
  32. tolerance
  33. urinary incontinence
  34. urinary retention
  35. withdrawal

Monitoring Parameters

  • laboratory monitoring not necessary

Contraindications

  • abrupt discontinuation
  • benzodiazepine dependence
  • benzodiazepine hypersensitivity
  • bipolar disorder
  • breast-feeding
  • children
  • chronic obstructive pulmonary disease (COPD)
  • closed-angle glaucoma
  • coadministration with other CNS depressants
  • coma
  • dementia
  • depression
  • driving or operating machinery
  • ethanol ingestion
  • ethanol intoxication
  • geriatric
  • head trauma
  • hepatic disease
  • infants
  • intraarterial administration
  • labor
  • mania
  • myasthenia gravis
  • neonates
  • neuromuscular disease
  • obstetric delivery
  • Parkinson’s disease
  • porphyria
  • pregnancy
  • psychosis
  • pulmonary disease
  • renal failure
  • renal impairment
  • respiratory depression
  • seizure disorder
  • seizures
  • shock
  • sleep apnea
  • status epilepticus
  • substance abuse
  • suicidal ideation

Interactions

  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan; Doxylamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Diphenhydramine
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Pentazocine
  • Acetaminophen; Propoxyphene
  • Acetaminophen; Tramadol
  • Acrivastine; Pseudoephedrine
  • Aldesleukin, IL-2
  • Alfentanil
  • Alprazolam
  • Amiodarone
  • Amobarbital
  • Amoxapine
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Amprenavir
  • Apomorphine
  • Apraclonidine
  • Aprepitant, Fosaprepitant
  • Aripiprazole
  • Asenapine
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Omeprazole
  • Aspirin, ASA; Oxycodone
  • Atazanavir
  • Atazanavir; Cobicistat
  • Atracurium
  • Atropine; Difenoxin
  • Atropine; Diphenoxylate
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • Azelastine
  • Azelastine; Fluticasone
  • Barbiturates
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Belladonna; Opium
  • Benzhydrocodone; Acetaminophen
  • Benztropine
  • Bosentan
  • Brimonidine
  • Brimonidine; Brinzolamide
  • Brimonidine; Timolol
  • Brompheniramine
  • Brompheniramine; Carbetapentane; Phenylephrine
  • Brompheniramine; Dextromethorphan; Guaifenesin
  • Brompheniramine; Guaifenesin; Hydrocodone
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Brompheniramine; Pseudoephedrine
  • Buprenorphine
  • Buprenorphine; Naloxone
  • Buspirone
  • Butabarbital
  • Butorphanol
  • Caffeine
  • Caffeine; Ergotamine
  • Cannabidiol
  • Carbamazepine
  • Carbetapentane; Chlorpheniramine
  • Carbetapentane; Chlorpheniramine; Phenylephrine
  • Carbetapentane; Diphenhydramine; Phenylephrine
  • Carbetapentane; Guaifenesin
  • Carbetapentane; Guaifenesin; Phenylephrine
  • Carbetapentane; Phenylephrine
  • Carbetapentane; Phenylephrine; Pyrilamine
  • Carbetapentane; Pseudoephedrine
  • Carbetapentane; Pyrilamine
  • Carbinoxamine
  • Carbinoxamine; Dextromethorphan; Pseudoephedrine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Carbinoxamine; Phenylephrine
  • Carbinoxamine; Pseudoephedrine
  • Cariprazine
  • Cenobamate
  • Ceritinib
  • Cetirizine
  • Cetirizine; Pseudoephedrine
  • Chlophedianol; Dexbrompheniramine
  • Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
  • Chlophedianol; Guaifenesin; Phenylephrine
  • Chlorcyclizine
  • Chlorpheniramine
  • Chlorpheniramine; Codeine
  • Chlorpheniramine; Dextromethorphan
  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Phenylephrine
  • Chlorpheniramine; Pseudoephedrine
  • Chlorthalidone; Clonidine
  • Cimetidine
  • Ciprofloxacin
  • Cisapride
  • Cisatracurium
  • Clarithromycin
  • Clemastine
  • Clobazam
  • Clonidine
  • Clozapine
  • Cobicistat
  • Codeine
  • Codeine; Guaifenesin
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Colchicine; Probenecid
  • COMT inhibitors
  • Conivaptan
  • Cyclizine
  • Cyproheptadine
  • Danazol
  • Darunavir
  • Darunavir; Cobicistat
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Delavirdine
  • Desflurane
  • Deutetrabenazine
  • Dexchlorpheniramine
  • Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Dexmedetomidine
  • Dextromethorphan; Diphenhydramine; Phenylephrine
  • Dextromethorphan; Guaifenesin; Phenylephrine
  • Dicyclomine
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Diltiazem
  • Dimenhydrinate
  • Diphenhydramine
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Diphenhydramine; Phenylephrine
  • Disulfiram
  • Doxacurium
  • Doxylamine
  • Doxylamine; Pyridoxine
  • Dronabinol
  • Droperidol
  • Drospirenone; Ethinyl Estradiol
  • Drospirenone; Ethinyl Estradiol; Levomefolate
  • Efavirenz
  • Efavirenz; Emtricitabine; Tenofovir
  • Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
  • Elbasvir; Grazoprevir
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
  • Enflurane
  • Esketamine
  • Eszopiclone
  • Ethanol
  • Ethinyl Estradiol
  • Ethinyl Estradiol; Desogestrel
  • Ethinyl Estradiol; Ethynodiol Diacetate
  • Ethinyl Estradiol; Etonogestrel
  • Ethinyl Estradiol; Levonorgestrel
  • Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
  • Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
  • Ethinyl Estradiol; Norelgestromin
  • Ethinyl Estradiol; Norethindrone
  • Ethinyl Estradiol; Norethindrone Acetate
  • Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
  • Ethinyl Estradiol; Norethindrone; Ferrous fumarate
  • Ethinyl Estradiol; Norgestimate
  • Ethinyl Estradiol; Norgestrel
  • Ethotoin
  • Etomidate
  • Fentanyl
  • Flumazenil
  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Fluvoxamine
  • food
  • Fosamprenavir
  • Fosphenytoin
  • Fospropofol
  • Gabapentin
  • General anesthetics
  • Green Tea
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Guaifenesin; Phenylephrine
  • Guanabenz
  • Guanfacine
  • Haloperidol
  • Halothane
  • Homatropine; Hydrocodone
  • Hydrochlorothiazide, HCTZ; Methyldopa
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hydromorphone
  • Hydroxyzine
  • Ibuprofen; Oxycodone
  • Idelalisib
  • Iloperidone
  • Imatinib
  • Indinavir
  • Isavuconazonium
  • Isoflurane
  • Isoniazid, INH; Pyrazinamide, PZA; Rifampin
  • Isoniazid, INH; Rifampin
  • Itraconazole
  • Ketamine
  • Ketoconazole
  • Lasmiditan
  • Lemborexant
  • Lesinurad
  • Lesinurad; Allopurinol
  • Letermovir
  • Levocetirizine
  • Levomethadyl
  • Levomilnacipran
  • Levorphanol
  • Lithium
  • Lofexidine
  • Lopinavir; Ritonavir
  • Lumacaftor; Ivacaftor
  • Lumateperone
  • Lurasidone
  • Magnesium Salts
  • Maprotiline
  • Meclizine
  • Meperidine
  • Meperidine; Promethazine
  • Mephobarbital
  • Meprobamate
  • Mestranol; Norethindrone
  • Methadone
  • Methocarbamol
  • Methohexital
  • Methscopolamine
  • Methyldopa
  • Metoclopramide
  • Metyrapone
  • Metyrosine
  • Milnacipran
  • Minocycline
  • Mirtazapine
  • Mitotane
  • Mivacurium
  • Monoamine oxidase inhibitors
  • Morphine
  • Morphine; Naltrexone
  • Nabilone
  • Nalbuphine
  • Nelfinavir
  • Neuromuscular blockers
  • Nevirapine
  • Nicardipine
  • Nitroglycerin
  • Olanzapine
  • Ombitasvir; Paritaprevir; Ritonavir
  • Omeprazole
  • Omeprazole; Amoxicillin; Rifabutin
  • Omeprazole; Sodium Bicarbonate
  • Oritavancin
  • Oxybutynin
  • Oxycodone
  • Oxymorphone
  • Paliperidone
  • Pancuronium
  • Papaverine
  • Pentazocine
  • Pentazocine; Naloxone
  • Pentobarbital
  • Perampanel
  • Phenobarbital
  • Phenothiazines
  • Phentermine; Topiramate
  • Phenylephrine
  • Phenylephrine; Promethazine
  • Phenytoin
  • Pimozide
  • Posaconazole
  • Pramipexole
  • Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements)
  • Prasterone, Dehydroepiandrosterone, DHEA (FDA-approved)
  • Pregabalin
  • Primidone
  • Probenecid
  • Procarbazine
  • Propofol
  • Propoxyphene
  • Protease inhibitors
  • Quetiapine
  • Ramelteon
  • Ranolazine
  • Rapacuronium
  • Rasagiline
  • Remifentanil
  • Ribociclib
  • Ribociclib; Letrozole
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Risperidone
  • Ritonavir
  • Rocuronium
  • Ropinirole
  • Rotigotine
  • Safinamide
  • Saquinavir
  • Scopolamine
  • Secobarbital
  • Sedating H1-blockers
  • Segesterone Acetate; Ethinyl Estradiol
  • Sevoflurane
  • Sincalide
  • Skeletal Muscle Relaxants
  • Sodium Oxybate
  • St. John’s Wort, Hypericum perforatum
  • Succinylcholine
  • Sufentanil
  • Suvorexant
  • Tacrine
  • Tapentadol
  • Teduglutide
  • Telithromycin
  • Telotristat Ethyl
  • Tetrabenazine
  • Thalidomide
  • Theophylline, Aminophylline
  • Thiopental
  • Thiothixene
  • Tiagabine
  • Tipranavir
  • Tizanidine
  • Topiramate
  • Tramadol
  • Trandolapril; Verapamil
  • Trazodone
  • Tricyclic antidepressants
  • Trihexyphenidyl
  • Trimethobenzamide
  • Triprolidine
  • Tubocurarine
  • Valerian, Valeriana officinalis
  • Vecuronium
  • Verapamil
  • Vigabatrin
  • Vilazodone
  • Voriconazole
  • Warfarin
  • Zafirlukast
  • Zaleplon
  • Zileuton
  • Ziprasidone
  • Zolpidem

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