chlordiazepoxide hydrochloride: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
chlordiazepoxide hydrochloride: clinical details
Prescribing considerations
- Agree an individual discontinuation strategy where practicable; warn about tolerance, dependence, addiction, rebound symptoms and withdrawal.
- Use particular caution in older or debilitated people and those with renal, hepatic or respiratory impairment.
- Assess alcohol or drug-use history, depression, suicidality, falls risk and concurrent central nervous-system depressants.
- Avoid routine repeat prescribing and reassess ongoing need.
- Alcohol withdrawal requires skilled assessment, supervision and monitoring for oversedation and serious complications.
Contraindications and cautions
- Hypersensitivity to chlordiazepoxide or an excipient
- Myasthenia gravis
- Severe pulmonary insufficiency or respiratory depression
- Severe hepatic insufficiency
- Sleep apnoea syndrome
- Phobic or obsessional states
- Chronic psychosis
- Spinal or cerebral ataxia
Monitoring
- Sedation, respiratory rate, consciousness and coordination
- Alcohol-withdrawal control and complications
- Confusion, falls and fractures in older people
- Tolerance, loss of control over use, dependence and withdrawal
- Mood, suicidality and paradoxical behavioural reactions
- Clinical evidence of accumulation in hepatic, renal or respiratory impairment
Clinical pharmacology
A 1,4-benzodiazepine that enhances GABA-mediated inhibition. It is absorbed orally and forms several active metabolites, contributing to prolonged effects and potential accumulation; blood concentration does not correlate reliably with clinical response.
Formulation and product differences
- The selected product is an oral hard capsule containing lactose, gelatine and colouring agents.
- Capsules must be swallowed with water and not chewed.
- People with specified rare hereditary disorders of galactose or glucose-galactose handling should not take this lactose-containing product.
chlordiazepoxide hydrochloride preparations and strengths
Capsule
Route: Oral
Strengths: 5 mg, 10 mg
chlordiazepoxide hydrochloride interactions
Tell the prescriber or pharmacist about all medicines, alcohol and non-prescribed substances. Important examples include:
Opioids
The combination can cause profound sedation, respiratory depression, coma and death.
Alcohol
Increases sedation and impairment and should be avoided.
Other sedating medicines
Sleeping medicines, antipsychotics, antidepressants, anaesthetics and sedating antihistamines can intensify central nervous-system depression and falls risk.
Sodium oxybate
May substantially increase respiratory depression; combined use should be avoided.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.