Chlordiazepoxide belongs to the class of medications called benzodiazepines. Chlordiazepoxide is used for the short-term relief of the symptoms of excessive anxiety and tension experienced with anxiety disorders. It may also be used to control symptoms, such as agitation, caused by alcohol withdrawal. It works by slowing down the speed at which the nerves in the brain (i.e., the central nervous system) send messages through the body.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

The recommended initial adult dose of chlordiazepoxide ranges from 10 mg to 40 mg daily in divided doses. Children's doses usually start at 5 mg to 10 mg daily and may be increased to 30 mg daily divided into 2 or 3 doses if necessary. It is important that the dose be individualized to your specific needs to avoid excessive drowsiness. For some adults, the dose may be increased to 100 mg daily in divided doses.

Chlordiazepoxide is normally used for a short period of time or as an "as required" medication. It may be habit-forming when taken for long periods of time. If you have been taking this medication regularly for a long period of time (i.e., for more than one month), do not stop taking the medication without first speaking with your doctor. To avoid withdrawal effects, a gradual dose reduction is usually recommended when stopping this medication.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If your doctor has told you to take this medication regularly and you miss a dose, take it as soon as possible and continue with your regular schedule. If your next dose is in less than 4 hours, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

This medication is available as 5 mg, 10 mg, and 25 mg capsules.

Do not take chlordiazepoxide if you:

• are allergic to chlordiazepoxide or any ingredients of the medication
• are allergic to any other benzodiazepines (e.g., diazepam, lorazepam)
• have myasthenia gravis
• have acute narrow angle glaucoma

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• changes in sexual desire or ability
• clumsiness or unsteadiness
• constipation
• dizziness or lightheadedness
• drowsiness
• false sense of well-being
• menstrual changes
• nausea
• trouble sleeping
• unusual tiredness or weakness
• vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• agitation
• anxiety
• behavioural changes, including:
• aggressiveness
• bizarre behaviour
• decreased inhibition
• angry outbursts
• confusion
• signs of breathing problems such as shallow, irregular breathing, or slow or troubled breathing
• signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
• skin rash or itching
• swelling ankles and feet
• more frequent symptoms of infection (e.g., sore throat, fever, and chills)
• uncontrolled movements of body, including the eyes
• unusual excitement, nervousness, or irritability

Stop taking the medication and seek immediate medical attention if any of the following occur:

• symptoms of a severe allergic reaction (such as hives, difficulty breathing, or swelling of the face or throat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take this medication.

Dependence/withdrawal: Physical dependence (a need to take regular doses to prevent physical symptoms) has been associated with benzodiazepines such as chlordiazepoxide. Severe withdrawal symptoms may occur if the dose is significantly reduced or suddenly discontinued. These symptoms include seizures, irritability, nervousness, sleep problems, agitation, tremors, diarrhea, abdominal cramps, vomiting, memory impairment, headache, muscle pain, extreme anxiety, tension, restlessness, and confusion. Reducing the dose gradually under medical supervision can help prevent or decrease these withdrawal symptoms.

Drowsiness/reduced alertness: Because chlordiazepoxide causes drowsiness and sedation, do not engage in activities requiring mental alertness, judgment, and physical coordination (such as driving or operating machinery) while taking it. This is particularly true when first starting the medication and until you have established that chlordiazepoxide does not affect you in this way. Avoid alcohol because it can increase the drowsy effect of the medication.

Medical conditions: Chlordiazepoxide is not recommended for people with depression or psychosis. You should not take chlordiazepoxide if you are addicted to alcohol or other medications except in rare situations under medical supervision.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication may pass into breast milk. If you are a breast-feeding mother and are taking chlordiazepoxide, it may affect your baby. This medication is not recommended for breast-feeding women.

Seniors: Seniors may be at increased risk for the drowsiness and impaired coordination effects of this medication. You should use extra caution, for example, when getting up during the night.

There may be an interaction between chlordiazepoxide and any of the following:

• alcohol
• clarithromycin
• fluconazole
• fluvoxamine
• itraconazole
• ketoconazole
• medications that cause drowsiness, such as antidepressants (e.g., paroxetine), benzodiazepines (e.g., diazepam), barbiturates (e.g., phenobarbital), MAO inhibitors (e.g., phenelzine), narcotics (e.g., morphine), phenothiazines (e.g., chlorpromazine), antihistamines (e.g., diphenhydramine)
• phenytoin
• theophylline
• warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.