Adult Dosing
Relief of mild-moderate anxiety disorders and symptoms of anxiety
Relief of severe anxiety disorders and symptoms of anxiety
Preoperative apprehension and anxiety
Notes:- Individualize doses for maximum beneficial effects
- Start with 5 mg PO bid-qid in geriatrics and debilitated patients
- Gradually taper dose to discontinue
Alcohol withdrawal
- Start with 50-100 mg PO; Repeat the doses if needed, until agitation is controlled
- Max: 300 mg/day
- Notes: Reduce the doses to maintenance levels
Pediatric Dosing
Anxiety
- Start 5 mg PO bid-qid; may be increased in some patients to 10 mg bid-tid
Notes:- Individualize doses for maximum beneficial effects
- Gradually taper dose to discontinue
- Not recommended in patients <6 yrs because clinical experience with Librium in this age group is limited
[Outline]
Renal Dose Adjustment (Based on CrCl)
- CrCl <10 mL/min: Decrease dose by 50%
- Hemodialysis: No supplement
Hepatic Dose Adjustment
- Hepatic impairment: Use with caution, dose adjustments not defined
See Supplemental Patient Information
- Increases risk of congenital malformations associated with the therapy during the first trimester of pregnancy; avoid use
- Consider possibility that a woman of childbearing potential may be pregnant at the time of initiation of therapy
- Withdrawal symptoms of the barbiturate type have occurred on discontinuation
- Administer the smallest effective dose (< or = 10 mg/day) initially, then gradually increase as tolerated and as per need in geriatric and debilitated patients
- Avoid concomitant use with other psychotropic agents unless indicated; carefully consider pharmacology of the agents especially when potentiating compounds such as MAO inhibitors and phenothiazines are to be initiated
- Psychiatric patients and hyperactive aggressive pediatric patients are more prone to paradoxical reactions; monitor such patients during initiation of therapy
- Suicidal tendencies may occur when used in treatment of anxiety states where there is a possibility of depression; provide appropriate protective measures
- Rare occasions of variable effects on blood coagulation have occurred in patients receiving oral anticoagulants and chlordiazepoxide
- Exacerbation of porphyria has occurred
- In pediatrics patients, initiate therapy with lowest effective dose followed by gradual increments
- Gradually taper dose to discontinue
- Monitor creatinine at baseline, LFTs, and periodic blood counts in case of prolonged therapy
Cautions: Use cautiously in:
- Hepatic impairment
- Renal impairment
- Sleep apnea
- CNS depression
- Usage of alcohol
- History of alcohol or drug abuse
- History of seizure
- Depression
- Pulmonary impairment
- Porphyria
- Geriatrics
- Debilitated patients
Supplemental Patient Information
- Advise patients to avoid themselves from engaging in activities requiring mental alertness such as operating a hazardous machinery or driving a automobile
- Advise patients to communicate with their physicians if they become pregnant during course of therapy or intend to become pregnant
- Inform patients that therapy may produce psychological and physical dependence. Advise them to consult clinician before increasing the dose and during abrupt discontinuation of therapy
- Avoid concomitant use with alcohol or other CNS depressants as this may have an additive effect
Pregnancy Category:D
- Increases risk of congenital malformations associated with the therapy during the first trimester of pregnancy; Manufacturer advises to avoid use during pregnancy.
Breastfeeding: Possibly unsafe
US Trade Name(s)
US Availability
chlordiazepoxide (generic)
Librium
Canadian Trade Name(s)
Canadian Availability
chlordiazepoxide (generic)
UK Trade Name(s)
UK Availability
Librium
Australian Trade Name(s)
Australian Availability
[Outline]
Pricing data from www.DrugStore.com in U.S.A.
- Librium 25 MG CAPS [Bottle] (VALEANT)
30 mg = $65.99
90 mg = $179.97 - ChlordiazePOXIDE HCl 25 MG CAPS [Bottle] (TEVA PHARMACEUTICALS USA)
60 mg = $18.99
180 mg = $42.99 - ChlordiazePOXIDE HCl 5 MG CAPS [Bottle] (TEVA PHARMACEUTICALS USA)
60 mg = $18.88
180 mg = $45.32 - ChlordiazePOXIDE HCl 10 MG CAPS [Bottle] (TEVA PHARMACEUTICALS USA)
60 mg = $18.6
120 mg = $25.16
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.