Chlordiazepoxide (Metaminodiazepoxide Hydrochloride)(klor dye az e pox’ ide)
Apo-Chlordiazepoxide (CAN), Librium
PREGNANCY CATEGORY D
CONTROLLED SUBSTANCE C-IV
Drug Classes
Anxiolytic
Benzodiazepine
Therapeutic Actions
Exact mechanisms of action not understood; acts mainly at subcortical levels of the CNS; main sites of action may be the limbic system and reticular formation; potentiates the effects of GABA.
Indications
Management of anxiety disorders or for short-term relief of symptoms of anxiety
Acute alcohol withdrawal; may be useful in symptomatic relief of acute agitation, tremor, delirium tremens, hallucinosis
Preoperative relief of anxiety and tension
Contraindications and Cautions
Contraindicated with hypersensitivity to benzodiazepines, psychoses, acute narrow-angle glaucoma, shock, coma, acute alcoholic intoxication with depression of vital signs, pregnancy (increased risk of congenital malformations, neonatal withdrawal syndrome), labor and delivery (“floppy infant” syndrome reported), lactation (infants may become lethargic and lose weight).
Use cautiously with hepatic or renal impairment, debilitation and in geriatric patients who are at increased risk for mental status changes.
Available Forms
Capsules—5, 10, 25 mg
Dosages
Adults
Individualize dosage; increase dosage cautiously to avoid adverse effects.
Anxiety disorders: 5 or 10 mg PO, up to 20 or 25 mg, tid–qid, depending on severity of symptoms.
Preoperative apprehension: 5–10 mg PO tid–qid on days preceding surgery.
Alcohol withdrawal: Initial dose is 50–100 mg PO, followed by repeated doses as needed up to 300 mg/day; then reduce to maintenance levels.
Pediatric patients
Younger than 6 yr: Not recommended.
Older than 6 yr: Initially, 5 mg PO bid–qid; may be increased in some children to 10 mg bid–tid.
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