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
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
Pricing data from www.DrugStore.com in U.S.A.
- 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 - Librium 25 MG CAPS [Bottle] (VALEANT)
30 mg = $65.99
90 mg = $179.97 - 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.