Chlordiazepoxide

Indications
 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
Muscle spasms
Adult: 10-30 mg daily in divided doses.
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.
Oral
Insomnia
Adult: 10-30 mg before bedtime.
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.
Parenteral
Severe symptoms of alcohol withdrawal
Adult: Initially, 50-100 mg, if necessary, repeat dose after 2-4 hr. May be given via deep IM or slow IV inj.
Elderly: and debilitated patients: Dose reduction may be needed.
Intramuscular
Premedication before anaesthesia
Adult: 50-100 mg given 1 hr before surgery.
Elderly: and debilitated patients: Dose reduction may be needed.

Special Populations: Reduce dose by ½ or less in elderly or debilitated patients.
Contraindications
 Acute pulmonary insufficiency, resp depression, patients with marked neuromuscular resp weakness; hypersensitivity to benzodiazepines; chronic psychosis; porphyria; pregnancy and lactation.
Warnings / 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.
Drug Interactions
 Cimetidine increases serum conc of chlordiazepoxide. Potentiates action of major neuroleptics.
Potentially Fatal: Alcohol potentiates CNS-depressant effect of chlordiazepoxide.
See Below for More chlordiazepoxide Drug Interactions
Food Interactions
 Alcohol: additive CNS effects, grape juice may increase serum levels and toxicity
Mechanism of Actions
 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.
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).
Administration
 May be taken with or without food.
Storage Conditions
 Intramuscular: Store at 25°C. Oral: Store at 15-25°C. Parenteral: Store at 25°C.
ATC Classification
 N05BA02 - chlordiazepoxide ; Belongs to the class of benzodiazepine derivatives anxiolytics. Used in the management of anxiety, agitation or tension.
Storage
 Intramuscular: Store at 25°C. Oral: Store at 15-25°C. Parenteral: Store at 25°C.
Available As
  • Chlordiazepoxide 10 mg
  • Chlordiazepoxide 12.5 mg
  • Chlordiazepoxide 20 mg
  • Chlordiazepoxide 25 mg
  • Chlordiazepoxide 5 mg

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