Chlordiazepoxidum

Description
A long-acting drug belonging to the benzodiazepine group, characterized by anxiolytic, sedative, hypnotic, muscle relaxant, and anticonvulsant effects.
Indications
Anxiety disorders; insomnia; skeletal muscle spasms; alcohol withdrawal; premedication.
Contraindications
Acute respiratory failure; respiratory depression; increased sensitivity to benzodiazepines; sleep apnea syndrome; severe myasthenia, phobias, obsessive disorders, chronic psychosis; depression (monotherapy).
Dosage
For adults. Oral administration. Anxiety disorders: usual dose – 30 mg per day in divided doses, the daily dose can be increased up to 100 mg if needed. Insomnia: 10-30 mg before bedtime. Muscle spasms: 10-30 mg per day in divided doses. Acute alcohol withdrawal: initial dose – 25-100 mg, may repeat up to a maximum of 300 mg per day. Premedication: 10-25 mg in the evening or 2 hours before surgery.
For children. Not recommended.
For elderly patients. Reduce the dose, usual dose – 5 mg 1-3 times per day.
In renal impairment. Reduce the dose if severe.
In hepatic impairment. Reduce the dose.
Adverse reactions
Most common: drowsiness, next-day drowsiness, ataxia, confusion (in the elderly), impaired cognitive function, slowed psychomotor reactions, lethargy.
Others: respiratory depression; allergic skin reactions; amnesia; dependency; paradoxical aggression reactions; headache, dizziness; hypotension; impaired digestion; dysarthria, tremors; altered libido, urinary incontinence or retention; impaired blood circulation; jaundice.
Pregnancy
Risk category – D. Suppresses newborn respiration, causes drowsiness, hypotonia, withdrawal syndrome.
Breastfeeding
No data on drug use during breastfeeding. The drug can accumulate and have a toxic effect on the breastfed infant, so nursing mothers should not use it.
Warnings
Use with caution in cases of kidney or liver disease, respiratory system disorders, porphyria, muscle weakness, severe personality disorder, history of alcohol or drug dependence. Avoid alcohol consumption. Do not prescribe for a long treatment course, discontinue treatment gradually (sudden cessation can lead to mental and physical dependence, and abrupt discontinuation can cause withdrawal symptoms).

Source | Drug Guide | Lithuanian University of Health Sciences | Institute of Physiology and Pharmacology | Doctor of Medical Sciences Rimas Jankūnas, Doctor of Medical Sciences Arvydas Milašius | Clinic of Internal Diseases | Doctor of Medical Sciences Palmira Leišytė