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Chlordiazepoxide oral

Updated 2 Feb 2023 | Anxiolytics


Oral formulations of chlordiazepoxide.

Drugs List

  • chlordiazepoxide 10mg capsules
  • chlordiazepoxide 10mg tablets
  • chlordiazepoxide 25mg tablets
  • chlordiazepoxide 5mg capsules
  • chlordiazepoxide 5mg tablets
  • LIBRIUM 10mg capsules
  • LIBRIUM 5mg capsules
  • Therapeutic Indications


    Acute alcohol withdrawal
    Anxiety state (severe) - short term relief
    Muscle spasms



    Initial: 10mg two to three times a day. Increased to 30mg a day, in divided doses.
    For severe symptoms 20mg two to four times day.
    Maximum dose: 100mg a day, given in divided doses.
    Treatment should not exceed four weeks on maximum dose, including tapering off process.

    Insomnia associated with anxiety
    10mg to 30mg to be taken at bedtime.
    Treatment should not exceed four weeks on maximum dose, including tapering off process.

    Muscle Spasm
    10mg to 30mg a day, given in divided doses.

    Symptomatic Relief of Acute Alcohol Withdrawal
    25mg to 100mg. Dose may be repeated in 2 to 4 hours, if considered necessary.

    The following alternative dosing schedule may be suitable:
    10mg to 50mg in divided doses of four times a day. For the first two days an extra 10mg to 40mg may be given when required.
    Doses should be gradually reduced over a period of seven to ten days.
    Maximum daily dose should not exceed 250mg.


    Doses should not exceed half the recommended dose for adults.

    Patients with Renal Impairment

    Doses should not exceed half the recommended dose for adults.

    The Renal Drug Handbook suggests patients with a glomerular filtration rate of less than 10ml/minute should be given a 50% dose reduction of the recommended adult dose.

    Patients with Hepatic Impairment

    Doses should not exceed half the recommended dose for adults.

    Additional Dosage Information

    Debilitated patients
    Doses should not exceed half the recommended dose for adults.

    Patients who have taken benzodiazepines for a prolonged time may require a longer period during which doses are reduced.


    Children under 18 years
    Cerebellar ataxia
    Chronic psychosis
    Myasthenia gravis
    Obsessional states
    Phobic states
    Respiratory depression
    Severe hepatic impairment
    Severe respiratory impairment
    Sleep apnoea
    Spinal ataxia

    Precautions and Warnings

    Females of childbearing potential
    Fertile males
    Glucose-galactose malabsorption syndrome
    Hepatic impairment
    History of alcohol abuse
    History of drug misuse
    Lactose intolerance
    Organic brain syndrome
    Personality disorder
    Renal impairment
    Respiratory impairment

    Advise patient ability to drive or operate machinery may be impaired
    Advise patient not to drive until they know how the medicine affects them
    Advise patient this medicine may be subject to driving restrictions
    Contains lactose
    Prolonged or excessive use may result in dependence
    Refer women considering pregnancy for specialist advice and monitoring
    Amnesia may occur
    Discontinue if psychiatric disturbances develop
    Psychological adjustment may be impaired in loss or bereavement
    Tolerance may develop with continued use
    Avoid abrupt withdrawal
    Advise patient to seek advice at first indications of pregnancy
    Maintain treatment at the lowest effective dose
    Reduce dose in elderly
    Not recommended for use longer than 4 weeks
    Only recommended for short term use
    Advise patient to avoid alcohol during treatment
    Advise that effects are potentiated by CNS depressants (including alcohol)
    Female: Contraception required during and for 7 months after treatment
    Male & female: Ensure adequate contraception during treatment
    Male: Contraception required during and for 4 months after treatment
    Advise patient of increased risk of falls
    Advise patient on possible rebound phenomena on withdrawal

    Do not use benzodiazepines alone to treat depression or anxiety associated with depression.

    Pregnancy and Lactation


    Chlordiazepoxide is contraindicated during pregnancy.

    The manufacturer does not recommend using chlordiazepoxide during pregnancy, particularly during the first and last trimester unless the benefit to the mother outweighs the potential risk. At the time of writing there is limited published information regarding the use of chlordiazepoxide during pregnancy. Chlordiazepoxide is known to cross the placenta.

    Animal studies have shown reproductive toxicity. If chlordiazepoxide has been administered at high doses during the late phase of pregnancy or during labour, neonates can suffer effects such as hypothermia, irregularities in foetal heart rate and hypotonia, poor-sucking and moderate respiratory depression. Infants may have physical dependence and be at some risk for withdrawal symptoms in the postnatal period.


    Chlordiazepoxide is contraindicated during breastfeeding.

    Chlordiazepoxide is found in breast milk. The manufacturer does not recommend breastfeeding whilst taking chlordiazepoxide.

    Side Effects

    Blood dyscrasias
    Changes in libido
    Excitement (paradoxical)
    Gastro-intestinal disturbances
    Increased hostility and aggression (paradoxical)
    Muscle weakness
    Salivation changes
    Suicidal tendencies
    Unsteady gait
    Urinary retention
    Visual disturbances


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: August 2019

    Reference Sources

    Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 10th edition (2015) ed. Briggs, G., Freeman, R. Wolters Kluwer Health, Philadelphia.

    Summary of Product Characteristics: Librium capsules 5mg. Mylan Products Ltd. Revised April 2022.
    Summary of Product Characteristics: Librium capsules 10mg. Mylan Products Ltd. Revised April 2022.

    The Renal Drug Handbook. Fourth Edition (2014) ed. Ashley, C and Dunleavy, A, Radcliffe Publishing Ltd, London.

    NICE - Evidence Services
    Available at:
    Last accessed: 06 July 2019

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