Chlordiazepoxide: Difference between revisions
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Latest revision as of 21:57, 20 March 2026
General
- Type: Benzodiazepines
- Dosage Forms: 5,10, 25mg tab
- Common Trade Names: Librium
Adult Dosing
- EtOH withdrawal
- Example taper:
- Day 1: 50mg q6h
- Day 2: 25mg q6h
- Day 3: 25mg q12h
- Day 4: 25mg at night
- (Rx fifteen 25mg tabs)
- Max 300mg per 24 hours
- Example taper:
Pediatric Dosing
- N/A
Special Populations
- Pregnancy Rating: Category D
- Lactation risk categories: L4; enters breast milk, not recommended
- Renal Dosing: CrCl < 10 cc/min : 1/2 normal dose
- Hepatic Dosing: No specific guidelines. Use caution as hepatically metabolized
Contraindications
- Allergy to class/drug
Adverse Reactions
Serious
- CNS depression
- Paradoxical agitation
- Drug induced EPS
- Bone marrow suppression, agranulocytosis
Common
- Drowsiness
Pharmacology
- Time to peak: 0.5-2 h
- Half-life: Parent compound 6-28 h, demoxepam (metabolite) 14-95 h
- Metabolism: Hepatic to desmethyldiazepam (active), desmethylchlordiazepoxide, demoxepam
- Excretion: Urine
- Mechanism of Action: Benzodiazepines
Indications by Condition
The following table is automatically generated from disease/condition pages across WikEM.
| Indication | Dose | Context | Route | Population |
|---|---|---|---|---|
| Ethanol withdrawal | 50 mg PO q8h x2 days, then 25 mg q8h x2 days, then 25 mg PRN | Outpatient taper (mild cases) | PO | Adult |
See Also
- Alcohol withdrawal
- EBQ:Outpatient use of benzodiazepines for the treatment of acute alcohol withdrawal
References
- Lexicomp
- 2019 American Geriatrics Society Beers Criteria Update Expert Panel. American Geriatrics Society 2019 updated AGS Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc. 2019;67(4):674-694. doi: 10.1111/jgs.15767. [PubMed 30693946]
- Aronoff GR, Bennett WM, Berns JS, et al, Drug Prescribing in Renal Failure: Dosing Guidelines for Adults and Children, 5th ed. Philadelphia, PA: American College of Physicians; 2007, p 125.
- Baskin SI, and Esdale A, “Is Chlordiazepoxide the Rational Choice Among Benzodiazepines?” Pharmacotherapy, 1982, 2(2):110-19. [PubMed 6152590]
- Bergman U, Rosa FW, Baum C, et al, "Effects of Exposure to Benzodiazepine During Fetal Life," Lancet, 1992, 340(8821):694-6. [PubMed 1355799]
- Chlordiazepoxide [prescribing information]. Cranbury, NJ: Solco Healthcare; December 2017.
- Dolder CR, Nelson MH. Hypnosedative-induced complex behaviours: incidence, mechanisms and management. CNS Drugs. 2008;22(12):1021-1036. doi:10.2165/0023210-200822120-00005. [PubMed 18998740]
- Iqbal MM, Sobhan T, Ryals T, et al, "Effects of Commonly Used Benzodiazepines on the Fetus, the Neonate, and the Nursing Infant," Psychiatr Serv, 2002, 53(1):39-49. [PubMed 11773648]
- Jennum P, Baandrup L, Ibsen R, et al. Increased all-cause mortality with use of psychotropic medication in dementia patients and controls: A population-based register study. Eur Neuropsychopharmacol. 2015;25(11):1906-1913. doi: 10.1016/j.euroneuro.2015.08.014. [PubMed 26342397]
- Librium (chlordiazepoxide) [prescribing information]. Costa Mesa, CA: ICN Pharmaceuticals Inc; July 2005.
- Mancuso CE, Tanzi MG, Gabay M. Paradoxical reactions to benzodiazepines: literature review and treatment options. Pharmacotherapy. 2004;24(9):1177-1185. [PubMed 15460178]