Chlordiazepoxide: what is it and what are its side effects

Chlordiazepoxide is a drug from the benzodiazepine family, used as an anxiolytic. Keep reading and know what its contraindications and side effects are.

Last update: 04 December, 2021

Chlordiazepoxide belongs to the family of benzodiazepines. It is used alone or as a compound in various commercially known drugs with a variety of names, such as Huberplex ®, Librium ®, Mitran ®, Librax ®, among others.

It is an anxiolytic agent that helps reduce the electrical activity of the brain. Therefore, it is used in the treatment of anxiety, insomnia and to alleviate the symptoms derived from withdrawal from alcohol and other addictive substances.

Below we will know, in more detail, what chlordiazepoxide is, what its general characteristics are, what it is indicated for, how it is used, as well as contraindications and side effects. It is clarified that the intention of this article is only informative.

What is chlordiazepoxide?

Chlordiazepoxide is part of the benzodiazepine family. In fact, it was the first to be discovered, studied and synthesized within this group. Although his finding was causal. Its formula is C16H14N3Cl.

In addition to the active ingredient, medicines containing chlordiazepoxide include some excipients. These include lactose, sucrose, wheat starch, talc, titanium or silicon dioxide, edetate disodium, magnesium stearate, polyvidone, crospovidone, copolymers (methacrylic), beeswax and some dyes.

Its half-life is 6 to 24 hours, although its metabolites can remain in the body for several days. This varies with some factors, such as age or whether the person has liver failure. Chlordiazepoxide is excreted through urine and feces.

What is chlordiazepoxide recommended for?

Chlordiazepoxide is a medicine that helps reduce abnormal electrical activity in the brain. It is used as an anxiolytic, antispasmodic, and antidepressant.

In this sense, it is recommended for the treatment of disorders related to anxiety and depression. Also, for the reduction of symptoms such as insomnia, agitation or even in people with alcohol withdrawal syndrome.

Too it is used to treat muscle spasms of various origin, for irritable bowel syndrome and in the symptomatic approach of other conditions related to the gastrointestinal tract (gastritis, duodenitis, biliary dyskinesia) or urogenital (nocturnal enuresis and irritable bladder).

The use as an anxiolytic is the most widespread of this drug, although it has secondary applications in various pathologies.

How to use?

Chlordiazepoxide is administered orally, like other benzodiazepines. It usually comes in coated tablets that range from 5 to 25 milligrams (mg), depending on the brand.

It is recommended to consume the minimum dose with which the symptoms can be controlled. For anxiety, insomnia and muscle spasms, 10 to 30 mg are suggested, preferably dividing the intake into several doses, between half an hour and an hour before meals.

In the symptomatic relief of anxiety syndrome, the dose can be higher (25 to 100 mg / day), divided into several doses and waiting an average of 4 hours for the next dose. But people with chronic liver, kidney or respiratory failure should not exceed 5 to 10 mg / day.

The same is suggested for debilitated patients and older adults, who should start with low doses, since they can suffer anticholinergic effects. It is appropriate to note that chlordiazepoxide not suitable for children under 12 years.

Secondly, not recommended for long-term treatments. At most, it should not exceed 4 weeks. And likewise, when suspending it should be gradually withdrawn.

Chlordiazepoxide interactions

This is a product for delicate use, which should only be administered under strict medical supervision. It should be carefully evaluated and used with extreme caution in patients with a history of alcoholism or drug addiction.

In general, chlordiazepoxide interacts with several drugs:

  • Neuroleptics.
  • Antiepileptics.
  • Opiates
  • Barbiturates.
  • Other anxiolytics.
  • Antidepressants
  • Sedative antihistamines.
  • Muscle relaxants.
  • Valproic acid.

Interaction with the aforementioned drugs can cause a variety of reactions, from seizures to arrhythmias. What’s more, concomitant use with antiepileptic drugs makes adverse effects more evident and toxicity. For example, antiparkinson drugs increase anticholinergic effects; and with antithyroid drugs the risk of agranulocytosis is increased.

If the person is taking chlordiazepoxide and has to undergo surgery, they should inform the doctor. This drug can interact with anesthesia.

In turn, the sedative effect of chlordiazepoxide is enhanced by alcohol, as well as by inhibitors of cytochrome P450. On the other hand, in patients receiving antihypertensive drugs, beta receptor blockers and anticoagulants, the nature and extent of the interactions is unknown.


Before starting to take this medicine, inform your doctor if you are allergic to benzodiazepines. In general, chlordiazepoxide is contraindicated in the following cases:

  • Kids.
  • Pregnant women.
  • People with hypersensitivity to benzodiazepines.
  • Myasthenia gravis.
  • Sleep apnea.
  • Epilepsy.
  • Severe respiratory failure or moderate to severe liver failure.
  • Angle closure glaucoma,
  • Prostatic hypertrophy.
  • Hyperthyroidism
  • Bipolar disorder:
  • Alcoholism.

This medicine contains wheat starch. However, gluten levels are low (0.1 micrograms per tablet). Therefore, it is not considered likely to cause problems for people with celiac disease.

It also contains lactose and sucrose. Patients with hereditary intolerances to these substances, with deficiencies of lactase or sucrase-isomaltase or with problems of absorption of glucose or galactose, should not consume the medicine.

Celiac patients can take the drug because the gluten content is minimal.

Chlordiazepoxide Side Effects

Chlordiazepoxide Side Effects They can occur by interaction with other drugs, by prolonged use or by themselves. The most common are the following:

  • Shaking.
  • Dizziness
  • Nausea and vomiting
  • Drowsiness.
  • Ataxia and vertigo.
  • Muscular weakness.
  • Decreased concentration and confusion
  • Delirium and hallucinations.
  • Dry mouth
  • Hypotension
  • Blurry vision.


One of the biggest risks of taking chlordiazepoxide is that it could be addictive, However, the potential for dependency is low if used for short periods. But it can be increased when the doses are high or the treatment is maintained over time.

As with other addictions, withdrawal symptoms occur when treatment is stopped. Thus, it is recommended not to consume a higher or more frequent dose than what the doctor indicates. Nor should it be stopped taking suddenly and without authorization.

Emergency situations

Call a doctor or emergency services if symptoms such as ringing in the ears, uncontrolled anxiety, memory loss, tremors, spasms, tachycardia, tingling in the arms and legs, hallucinations, or suicidal wishes develop while taking the drug.

If a dose is missed, wait for the next time and take the one that corresponds. That is, it should not be duplicated or taken over in compensation.

Symptoms of benzodiazepine overdose include drowsiness, confusion, and lethargy. In more severe cases, there may be ataxia, hypotension, and respiratory distress.

In cases of such overdose, if care is immediate (within an hour), vomiting and gastric lavage can be induced, administering activated charcoal. The common antidote is flumazenil.

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