Chlordiazepoxide

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
  • Max 300mg per 24 hours

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

See Also

• Alcohol withdrawal
• EBQ:Outpatient use of benzodiazepines for the treatment of acute alcohol withdrawal

References

Lexicomp, UpToDate

Authors

Joe Carpenter, Ross Donaldson, Andy Gausepohl, Neil Young, Daniel Ostermayer