Chlordiazepoxide ( Libritabs, Librium )

Chlordiazepoxide ( Libritabs, Librium )

Chlordiazepoxide ( Libritabs, Librium ) was the first antianxiety agent ( benzodiazepines. ) Used primarily for relief anxiety. It may also be used to treat symptoms of acute alcohol withdrawals. Sometimes given before surgery.

Symptomatic relief of mild anxiety and tension and for reduction of tension states that may accompany muscle spasm. As an adjunct in tension states associated with insomnia, pre and postoperative apprehension, tension headache, premenstrual tension and stress, and functional gastrointestinal, cardiovascular, gynecological, and dermatological disorders with an emotional overlay. Chlordiazepoxide ( Libritabs, Librium ) may be useful in the alleviation of alcohol withdrawal syndromes, although drug dependence may result, substituting for alcohol dependence. Chlordiazepoxide ( Libritabs, Librium ) may also reduce anxiety associated with psychosis, but is not a specific management of psychosis.

Chlordiazepoxide ( Libritabs, Librium ) is indicated for the relief of acute agitation and hyperactivity (e.g., alcoholism, anxiety, hysterical and panic states, drug withdrawal symptoms) when rapid action is required or oral administration is not feasible.


5 mg, 10 mg, 25 mg.

100 mg dry chlordiazepoxide HCl.
2 mL special diluent for i.m. injection only.

Dosages: Actual dosage must be determined by a physician.


Usually 10 to 40 mg daily in divided doses. In severe cases, 25 mg 3 or 4 times a day may be given.

Elderly or debilitated patients:
5 mg 2 to 4 times daily.

Preoperative apprehension:
5 to 10 mg, 3 to 4 times daily on days prior to surgery.

25 to 50 mg on admission.

Initiate therapy with 10 mg daily in divided doses, increasing if necessary to 30 mg daily in 2 to 3 divided doses.

Injections should be prepared immediately before administration. Chlordiazepoxide for i.m. injection is prepared by adding 2 mL of the i.m. diluent to 100 mg of drug and agitating gently until a clear solution is obtained. (The diluent should not be used if it is opalescent or hazy.) Injection should be made into the deltoid or deep into the upper outer quadrant of the gluteal muscle. A solution suitable for i.v. injection may be prepared by adding 5 mL of isotonic sodium chloride injection or sterile water for injection to 100 mg of chlordiazepoxide and agitating gently. Do not add to parenteral fluids or further dilute or mix with other drugs. The appropriate i.v. dose may be injected directly into a large lumen vein slowly over a one minute period.

50 to 100 mg i.m. or i.v. initially. Repeat in 2 to 4 hours if necessary.

Acute anxiety:
50 to 100 mg i.m. or i.v. initially. Then 25 to 50 mg 3 or 4 times daily, if necessary.

Acute phobia or panic reaction:
50 to 100 mg i.m. or i.v. initially. Repeat in 4 to 6 hours, if necessary.

Acute psychotic agitation:
50 to 100 mg i.m. or i.v. initially. Repeat in 4 to 6 hours, if necessary.

Preoperative anxiety:
50 to 100 mg i.m. 1 hour prior to surgery.

Acute drug withdrawal:
100 mg i.m. or i.v. initially. Then 50 to 100 mg in 4 to 6 hours, if necessary. Lower doses (usually 25 to 50 mg) should be used for elderly or debilitated patients and for children.

Maximum recommended parenteral dose:
300 mg daily in divided doses. In most cases, acute symptoms may be rapidly controlled by parenteral administration so that subsequent treatment, if necessary, may be given orally.

Problems with:

Liver Function: N/A
Kidney Function: N/A

Take With: Water,

Full Benefits In: 1 to 3 days.

Missed Dose(s): If within one hour take, if over an hour skip and then continue on your normal schedule. Never Take a Double Dose.

If Stop Taking: Do not stop without consulting your physician .

Overdose: Drowsiness, ataxia, coma, confusion, diminished reflexes. Depression of the cardiovascular and respiratory centers may occur.


Narcotics may increase the sedative effects of this drug. Do not take other sedative, benzodiazepines, or sleeping pills with this drug. The combinations could be fatal. Do not drink alcohol when taking benzodiazepines. Alcohol can lower blood pressure and decrease your breathing rate to the point of unconsciousness.

The habit-forming potential is high. It is possible to become dependent in only two weeks. This drugs should not be taken for more then four weeks on a regular basis ( Yudofsky, Hales and Ferguson ). If you have been taking this drug regularly for three or more weeks then do not stop taking this drug abruptly, this could cause psychological and physical withdrawal symptoms.

Do not take this drug if you are pregnant. Do not take this drug if planning to become pregnant. Do not take if you are breast-feeding.

Do not give this drug to anyone under the age six. Only use drug in small doses if over sixty with very close monitoring.

Do not use if: You had negative reactions to other benzodiazepines, if you have a history of drug dependence, if you have had a stroke, if you have multiple sclerosis, if you have Alzheimer's disease, if you are seriously depressed or if you have other brain disorders.

Chlordiazepoxide ( Symptoms or Effects )

Common:drowsiness, fatigue, light-headedness, or speech problems.

Less common: abdominal cramps, constipation, dry mouth, hyperventilation, blurred vision, nausea, chest pain, change in sex drive, confusion, headache, change in appetite, insomnia, unusual dreams, change in salivation, low blood pressure, racing heartbeat, fainting, nasal congestion, difficulty urinating, sweating, weight change, skin irritation, twitching or tremors, nervous or anxious state, sun sensitivity, respiratory infection, memory impairment, menstrual difficulties, and loss of coordination.

Rare: difficulty concentrating, slurred or unusual speech, double vision, fear, altered sense of taste, lack of inhibition, muscle cramps or spasms, urination problems, tingling, incontinence, warmth, weakness, change in muscle tone, or yellow eyes and skin.

See physician always: Abdominal cramps, blurred vision, dry mouth, racing heartbeat / palpitations, shaking / slurred speech, urination problems, convulsions, hallucinations, memory loss, trouble breathing, staggering / trembling, headache or confusion., memory loss, confusion or staggering / trembling.

Stop taking and see physician NOW: Convulsions, hallucinations, trouble breathing, hyperexcitement, muscle spasm, anxiety, hallucinations, rage or other hostile behavior, tremors, insomnia, sleeping difficulties or overstimulation.

Librium has been known to interact undesirably with certain medical conditions. Tell your doctor if you have, or have a history of, any of the following conditions:

  • Alcohol or drug abuse - may increase likelihood of Librium dependence
  • Allergic reaction to Librium, or other benzodiazepine. Always tell your doctor about any allergies before starting a medication.
  • Borderline personality disorder or a history of violent behavior.
  • Brain disease - may increase likelihood of side effects from Librium
  • Breathing difficulties such as asthma, bronchitis, emphysema, or any chronic lung disease - Librium may worsen this condition.
  • Difficulty swallowing - This condition may become more pronounced in children.
  • Epilepsy or seizures - Abruptly starting or stopping treatment with Librium may increase seizures. Although Librium can be used as an aid to anti-tremor therapy, it should be used cautiously and strictly according to a doctor's instructions in these cases.
  • Glaucoma - Librium should not be prescribed to patients with acute narrow-angle glaucoma. Patients receiving treatment for open angle glaucoma should consult their doctor, as Librium may be an acceptable treatment for them.
  • Hyperactivity
  • Kidney or liver problems - In isolated cases, Librium has been reported to cause jaundice. If you experience yellowing of the skin or eyes, seek medical treatment immediately. More Librium may end up in your bloodstream if you have a pre-existing kidney or liver condition, increasing the likelihood of side effects.
  • Major Depression
  • Myasthenia gravis - This autoimmune disorder characterized by muscle weakness may be aggravated by Librium treatment.
  • Porphyria - Librium ( chlordiazepoxide) is listed as an unsafe drug for porphyria, an enzyme deficiency that can cause fragile skin that is sensitive to sunlight, digestive difficulties, anxiety, and reddish-brown urine.
  • Psychosis or other serious mental illness - Librium has not proved to be an effective treatment for these conditions, and is not recommended.
  • Sleep apnea ( temporary suspension of breathing during sleep ) - Librium may worsen this condition. Individuals with sleep apnea should not generally use sedatives as sleep aids.


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