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Chlordiazepoxide

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Chlordiazepoxide is a type of benzodiazepine. It is prescribed to treat the symptoms of anxiety, to help with alcohol withdrawal, or for its properties as a muscle relaxant. Long term use is not recommended, as it can become addictive if used for longer than a few weeks.

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    • Chlordiazepoxide is most commonly used to treat anxiety or alcohol withdrawal
    • Chlordiazepoxide helps you to feel calmer
    • This medication is also a muscle relaxant
    • It is sometimes known by its trade name Librium
    • Chlordiazepoxide is available as a capsule
    • Chlordiazepoxide is not usually prescribed for longer than four weeks
    • It is important to read the patient leaflet for a full list of side effects and cautions.

    Chlordiazepoxide affects the way that neurotransmitters work in the brain. This helps them pass on calming messages to the brain cells, helping to ease feelings of anxiety. This calming effect is helpful for short periods of treatment.

    Chlordiazepoxide is also prescribed to help people who are undergoing an alcohol detoxification or ‘detox’. If you consume large quantities of alcohol, your body gets used to this. When you stop drinking, it leads to withdrawal symptoms as the alcohol start to wear off. These withdrawal symptoms can make it difficult to stop drinking. Taking chlordiazepoxide helps to reduce symptoms of withdrawal, helping you to succeed in abstaining from alcohol. 

    Chlordiazepoxide capsules should be swallowed with water. The capsules can be taken with or without food.

    For anxiety, it is common to start on 5mg of chlordiazepoxide a day. This can be increased up to 10mg three times a day. For severe anxiety, some people may take 20mg three or four times each day. The maximum dose of chlordiazepoxide for anxiety is 100mg each day in divided doses.

    For insomnia, the usual dose is 10mg to 30mg at bedtime. 

    Treatment should not continue for longer than four weeks, and this includes time to taper the dose down to avoid withdrawal.

    When prescribed for the relief of alcohol withdrawal symptoms, 25mg to 100mg can be prescribed. It is common to take three or four doses each day, with the dose gradually reducing over 5 to 10 days until the symptoms of alcohol withdrawal have settled.

    Some people are prescribed chlordiazepoxide as a muscle relaxant. The dose is usually between 10mg to 30mg each day, but this is divided across several doses.

    Elderly patients and people with brain damage, lung, liver or kidney disease may need a lower dose of chlordiazepoxide.

    Like all medications, chlordiazepoxide can have some side effects. The most common side effects include:

    • Feeling sleepy or drowsy
    • Feeling light-headed or dizzy
    • Tiredness
    • Unsteadiness, loss of balance and falls
    • Confusion
    • Memory difficulties.

    If these do not settle or are troublesome, speak to your GP for advice.

    Occasionally, benzodiazepines like chlordiazepoxide can cause restlessness, irritability, agitation or aggressive behaviour, delusions and hallucinations. Speak to your GP if you notice any of these side effects.

    If you have a severe allergic reaction (anaphylaxis) including breathlessness, lip or tongue swelling, call 999 immediately.

    Chlordiazepoxide may not be suitable for everyone. In particular, you should tell your doctor if you:

    • Are pregnant, trying to conceive, or breastfeeding
    • Have lung disease or sleep apnoea
    • Have a phobia or obsessive compulsive disorder
    • Have psychosis
    • Have depression
    • Have liver or kidney disease
    • Have myasthenia gravis
    • Have ataxia.

    You should not drink alcohol whilst taking chlordiazepoxide.

    Some medications can interact with chlordiazepoxide. You may be advised that chlordiazepoxide will not suit you if you already take:

    • Another benzodiazepine medication
    • Opioid medications
    • Certain antibiotics
    • Anti-epileptics
    • Antidepressants
    • Sedative antihistamines
    • Hypnotic medications
    • Neuroleptic medications
    • Certain contraceptive pills
    • Certain muscle relaxants including baclofen
    • Certain medications for indigestion or acid reflux
    • Certain medications for high blood pressure
    • Dopamine for Parkinson’s disease.

    You should also tell your prescriber about any herbal remedies or supplements you take. This will allow your prescriber to check that chlordiazepoxide will not interact with them.

    It is important that your doctor checks that chlordiazepoxide will suit you. Your doctor should complete a thorough health questionnaire and review your current medications before prescribing this medication. 

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