Classes
DEA Class; Rx
Common Brand Names; Librium
- Antianxiety Agents;
- Anxiolytics, Benzodiazepines
Description
Binds receptors at several sites within the CNS, including the limbic system and reticular formation. Effects may be mediated through the GABA receptor system. Increase in neuronal membrane permeability to chloride ions enhances the inhibitory effects of GABA; the shift in chloride ions causes hyperpolarization (less excitability) and stabilization of the neuronal membrane
Indications
Indicated for the Anxiety, Preoperative Apprehension & Anxiety
Contraindications
Documented hypersensitivity to drug or component of the formulation
Adverse Effects
- Ataxia
- Drowsiness
- Memory impairment
- Sedation
- Muscle weakness
- Rash
- Decreased libido
- Menstrual disorders
- Xerostomia
- Salivation decreased
- Increased/decreased appetite
- Weight gain/loss
- Micturition difficulties
- Confusion
- Dizziness
- Disinhibition
- Akathisia
- Dermatitis
- Hypotension
- Salivation increased
- Sexual dysfunction
- Incontinence
- Rigidity
- Tremor
- Muscle cramps
- Tinnitus
- Nasal congestion
Warnings
Patient should be observed for up to 3 hours following administration
Anterograde amnesia associated with treatment
Use caution in renal and hepatic impairment
Use caution in respiratory disease (COPD), sleep apnea, porphyria, open-angle glaucoma (questionable), depression, suicidal ideation, impaired gag reflex
May impair ability to perform hazardous tasks
Paradoxical reactions, including hyperactive or aggressive behavior, reported
Use caution in patients with depression, especially if suicidal risk present
Ataxia and oversadation may occur in the elderly and debilitated patients; there also increased risk of falls
Use caution in patients with history of drug abuse or acute alcoholism; tolerance, psychological and physical dependence may occur with prolonged use
Pregnancy and Lactation
Pregnancy category: D
Lactation: Enters breast milk/not recommended
Maximum Dosage
Anxiety
Mild/moderate: 5-10 mg PO q6-8hr
Severe: 20-25 mg PO q6-8hr
Preoperative Apprehension & Anxiety
5-10 mg PO q6-8hr
Pediatric
Anxiety
<6 years: Safety and efficacy not established
>6 years: 5 mg PO BID/QID; may increase dose to 10 mg PO BID/TID if necessary
GERIATRIC
Anxiety
Lower initial dose: 5 mg PO q6-12hr; adjust gradually based on response and incidence of adverse effects
How supplied
Chlordiazepoxide
capsule: Schedule IV
- 5mg
- 10mg
- 25mg