Chlordiazepoxide: Indication, Dosage, Side Effect, Precaution

Generic Medicine Info Patient Medicine Information

This information is not country-specific. Please refer to the local prescribing information.

Generic Medicine Info

Indications and Dosage

Oral
Insomnia

Adult: 10-30 mg at bedtime. Duration of treatment: Max 4 weeks including dose tapering of 2 weeks.
Elderly: and debilitated patients: Dose reduction may be needed.

Oral
Muscle spasms

Adult: 10-30 mg daily in divided doses.
Elderly: and debilitated patients: Dose reduction may be needed.

Oral
Anxiety

Adult: 30 mg daily in divided doses, up to 100 mg daily in severe conditions.
Elderly: and debilitated patients: Dose reduction may be needed.

Oral
Acute symptoms of alcohol withdrawal

Adult: 25-100 mg daily repeated as necessary. Max dose: 300 mg daily.
Elderly: and debilitated patients: Dose reduction may be needed.

Parenteral
Acute anxiety

Adult: Initially, 50-100 mg followed by 25-50 mg 3-4 times daily if necessary. May be given via deep IM or slow IV inj.
Elderly: and debilitated patients: Dose reduction may be needed.

Administration

May be taken with or without food.

Contraindications

Acute pulmonary insufficiency, resp depression, patients with marked neuromuscular resp weakness; hypersensitivity to benzodiazepines; chronic psychosis; porphyria; pregnancy and lactation.

Special Precautions

Alcohol; sedation, dependence. Elderly and debilitated patients. Liver or kidney dysfunction. Avoid prolonged usage.

Adverse Reactions

Physical and psychological dependence; withdrawal syndrome; impairs psychomotor performance, aggression (in predisposed individuals esp in combination with alcohol); sedation; blood dyscrasias, jaundice, hepatic dysfunction.
Potentially Fatal: May rarely cause hypoplastic or haemolytic anaemia.

Pregnancy Category (US FDA)

PO: D

Drug Interactions

Cimetidine increases serum conc of chlordiazepoxide. Potentiates action of major neuroleptics.
Potentially Fatal: Alcohol potentiates CNS-depressant effect of chlordiazepoxide.

Food Interaction

Alcohol: additive CNS effects, grape juice may increase serum levels and toxicity

Action

Description: Chlordiazepoxide enhances activity of the inhibitory transmitter GABA in different parts of CNS by increasing neuronal-membrane permeability to chloride ions resulting to hyperpolarisation and stabilisation. It has some muscle relaxant and anticonvulsant activity.
Pharmacokinetics:
Absorption: Almost complete (oral); peak plasma concentrations after 1-2 hrs.
Distribution: Crosses the placenta, diffuses into CSF, enters breast milk. Protein-binding: 96%
Metabolism: Hepatic; converted to desmethyldiazepam.
Excretion: Urine (as unchanged drug and metabolites; faeces (conjugated metabolites); 5-30 hrs (elimination half-life).

Storage

Store at 25°C.

MIMS Class

Hypnotics & Sedatives / Anxiolytics

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