Chlordiazepoxide

Synonym :

Librium

Mechanism :

Chlordiazepoxide has antianxiety, sedative, appetite-stimulating and weak analgesic actions. The precise mechanism of action is not known. The drug blocks EEG arousal from stimulation of the brain stem reticular formation.

Indication :

Anxiety disorders
Preoperative apprehension and anxiety

Contraindications :

Documented hypersensitivity, Acute alcohol intoxication, Myasthenia gravis, Narrow angle glaucoma, Severe respiratory depression, Depressed neuroses, psychotic reactions, IV use in shock, coma, depressed respiration, patients who recently received other respiratory depressants.

Dosing :

<6 years:

Safety and efficacy not established.

>6 years:

0.5 mg/kg/day divided PO q6-8hr, OR 5 mg PO q6-12hr; may increase dose to 10 mg PO q8-12hr.

>12 years:

25-50 mg IV/IM q6-8hr.

Adverse Effect :

Drowsiness, ataxia, confusion, syncope, skin eruptions, edema, minor menstrual irregularities, nausea, constipation, extrapyramidal symptoms, changes in EEG patterns (low-voltage fast activity), blood dyscrasias (agranulocytosis), jaundice.

Interaction :

Sodium oxybate: Both increase the effect of each other by pharmacodynamic synergism.
Ivacaftor: Increases the effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Hepatic Dose :

Use with caution. On repeated dosing, there is a risk of accumulation of the drug.