About Librium
Librium (chlordiazepoxide) is an anti-anxiety medication. Librium
is in the group of drugs known as benzodiazepines; a class of antidepressants,
anti-panic agents, sleep aids, and muscle relaxants. Librium is
usually used as a short term treatment for major anxiety. This medication
is not necessary to relieve everyday stress or anxiety.
Librium has been successfully used as a treatment for:
- Anxiety disorder characterized by unrealistic fears and excessive
worries.
- Also for the temporary symptoms of alcohol withdrawal, insomnia, pre-surgical anxiety, as a general sedative, and tremor
suppression. Dosage varies.
Librium is only available by prescription. Do not mix with
alcohol, narcotic pain medications, or other sedatives.
Librium Side Effects
Librium side effects are usually temporary, and fade with continued
treatment. Higher dosage also increases the risk of side effects.
Operating automobiles or heavy machinery is not recommended while
taking Librium. Be aware of how this medication affects you before
attempting any potentially dangerous activities.
Common Librium side effects: drowsiness, fatigue, light-headedness,
or speech problems.
Less common Librium side effects: abdominal cramps, constipation,
dry mouth, hyperventilation, blurred vision, nausea, chest pain,
change in sex drive, confusion, headache, change in appetite, insomnia,
unusual dreams, change in salivation, low blood pressure, racing
heartbeat, fainting, nasal congestion, difficulty urinating, sweating,
weight change, skin irritation, twitching or tremors, nervous or
anxious state, sun sensitivity, respiratory infection, memory impairment,
menstrual difficulties, and loss of coordination. Speak to your
doctor about any of these effects; your dosage may need to be adjusted
or treatment discontinued.
Rare Librium side effects: difficulty concentrating, slurred
or unusual speech, double vision, fear, altered sense of taste,
lack of inhibition, muscle cramps or spasms, urination problems,
tingling, incontinence, warmth, weakness, change in muscle tone,
or yellow eyes and skin. Speak to your doctor if you experience
any of these effects; your treatment may need to be discontinued.
Librium treatment should be discontinued if any of the following
occur: hyperexcitement, muscle spasm, anxiety, hallucinations,
rage or other hostile behavior, tremors, insomnia, sleeping difficulties
or overstimulation.
Cautions: Librium has been known to interact undesirably with certain medical conditions. Tell your doctor if you have, or have a history of, any of the following conditions:
- Alcohol or drug abuse - may increase likelihood of Librium dependence
- Allergic reaction to Librium, or other benzodiazepine. Always
tell your doctor about any allergies before starting a medication.
- Borderline personality disorder or a history of violent behavior.
- Brain disease - may increase likelihood of side effects from
Librium
- Breathing difficulties such as asthma, bronchitis, emphysema,
or any chronic lung disease - Librium may worsen this condition.
- Difficulty swallowing - This condition may become more pronounced
in children.
- Epilepsy or seizures - Abruptly starting or stopping treatment
with Librium may increase seizures. Although Librium can be used as
an aid to anti-tremor therapy, it should be used cautiously and
strictly according to a doctor's instructions in these cases.
- Glaucoma - Librium should not be prescribed to patients with acute
narrow-angle glaucoma. Patients receiving treatment for open angle
glaucoma should consult their doctor, as Librium may be an acceptable
treatment for them.
- Hyperactivity
- Kidney or liver problems - In isolated cases, Librium has been
reported to cause jaundice. If you experience yellowing of the
skin or eyes, seek medical treatment immediately. More Librium may
end up in your bloodstream if you have a pre-existing kidney or
liver condition, increasing the likelihood of side effects.
- Major Depression
- Myasthenia gravis - This autoimmune disorder characterized by
muscle weakness may be aggravated by Librium treatment.
- Porphyria - Librium (chlordiazepoxide) is listed as an unsafe
drug for porphyria, an enzyme deficiency that can cause fragile
skin that is sensitive to sunlight, digestive difficulties, anxiety,
and reddish-brown urine.
- Psychosis or other serious mental illness - Librium has not proved
to be an effective treatment for these conditions, and is not
recommended.
- Sleep apnea (temporary suspension of breathing during sleep)
- Librium may worsen this condition. Individuals with sleep apnea
should not generally use sedatives as sleep aids. (See Sleep Disorders)
Dependence: Librium has been known to be habit-forming.
Withdrawal symptoms may occur if treatment is discontinued abruptly.
Follow your doctor's advice about how much, and how often, you should
take Librium. If you are considering stopping Librium treatment,
ask your doctor how to safely decrease and then stop Librium.
Overdose: Librium overdose symptoms can include confusion,
poor coordination, sleepiness, or coma. Seek medical treatment immediately
if you suspect an overdose.
Librium Interactions
Librium slows the central nervous system, and should be taken with
care with medications that do the same thing. When Librium is taken
with certain other medications, the rate of side effects may increase,
and the action of either medication may be increased or altered.
Certain medications can cause an undesirable build-up of Librium in
the body. Ask your doctor's advice about combining Librium with any
of the following:
- Alcohol - Librium should not be mixed with alcohol, it
increases the risk of overdose and fatal toxicity.
- Agenerase (amprenavir)
- Any medication which may cause drowsiness
- Antabuse (disulfiram)
- Antibiotics (esp. macrolide antibiotics) like azithromycin,
biaxin, clarythromycin, or erythromycin
- Antihistamines like Tavist or Benadryl
- Antiseizure medication like Cerebyx (fosphenytoin), Dilantin
(phenytoin), or Tegretol
(carbamazepine).
- Benzodiazepines (a class of antidepressants, anti-panic
agents, sleep medications, and muscle relaxants) such as
Ativan (lorazepam),
Dalmane (flurazepam), Valium
(diazepam), Halcion
(triazolam), Restoril
(temazepam), Xanax
(alprazolam), Tranxene-SD (clorazepate), Paxipam (halazepam),
ProSom (estazolam), Klonopin
(clonazepam), and others, may increase the risk of side
effects.
- Beta blockers like Lopressor
(metoprolol) or Inderal
(propranolol)
- Blood thinners like Warfarin (coumadin)
- Bronchodilators of the xanthine (thioxanthine) class (Aminophylline,
Dyphylline, Oxtriphylline, Somophyllin, Theo-Dur,
etc...) - May require dosage adjustments.
- BuSpar (buspirone) - Can result in oversedation.
- Cardene (nicardipine)
- Cordarone (amiodarone)
- Desyrel (trazodone) - Risk
of additive CNS depression.
- Diflucan (fluconazole)
- Ergotamine derivatives
- Kava kava - Do not take this herb while taking Librium.
- Lanoxin (digoxin)
- MAO inhibitors such as the antidepressants Nardil or Parnate.
- Narcotic analgesics of any kind, like Darvon (propoxyphene),
Darvocet (propoxyphene, acetaminophen), Demerol
(meperidine), Codeine, Percocet
(oxycodone, acetaminophen), Vicodin
(hydrocodone, acetaminophen), Vicoprofen
(hydrocodone and ibuprofen) or OxyContin
(oxycodone) should likely be taken in much lower doses
when taken with Librium.
- Neoral, Sandimmune (cyclosporine)
- Nicotine - Heavy smoking may reduce the effectiveness
of your treatment.
- Nizoral (ketoconazole)
- Librium should not be mixed with this antifungal medication.
- Norflex (orphenadrine)
- Risk of oversedation.
- Oral contraceptives - May increase the effects of Librium.
- Phenobarbitol, Fioricet
(butalbital, acetaminophen, and caffeine), Seconal, or other
barbiturates
- Prilosec (omeprazole) - May increase the effects of Librium.
- Rescriptor (delavirdine)
- Rifamate (isoniazid), Rifater or Rifadin (rifampin), or
Mycobutin (rifabutin)
- Sedatives like Butalbital, Fioricet
(butalbital, acetaminophen, and caffeine), Fiorinal,
Phenobarbitol, Seconal, or other barbiturates may cause
oversedation in combination with Librium.
- Selective serotonin reuptake inhibitors (SSRIs) like Celexa
(citalopram), Paxil
(paroxetine), Prozac
(fluoxetine), Luvox (fluvoxamine), or Zoloft
(sertraline).
- Serzone (nefazodone)
- Sinemet (carbidopa, levadopa) can cause oversedation.
- Skeletal muscle relaxants such as Flexeril
(cyclobenzaprine), Skelaxin
(metaxalone), Soma
(carisoprodol), or Robaxin
(methocarbamol) may cause oversedation in combination
with this medication.
- Sleep medication like Ambien
(zolpidem), Sonata
(zaleplon), or over the counter sleeping pills should
be used with Librium only as, and if, advised by your doctor.
- Sporanox (itraconazole)
- Librium should not be mixed with this antifungal medication.
- Street drugs - Marijuana may increase sedative effects
from Librium.
- St. John's Wort - Do not take this herb while taking Librium.
- Tagamet (cimetidine)
- Tranquilizers such as Haldol (haloperidol), Mellaril (thioridazine),
Stelazine (trifluoperazine), or Thorazine (chlorpromazine)
may cause oversedation.
- Tricyclic antidepressants such as Asendin (amoxapine),
Anafranil (clomipramine), Pertofrane or Norpramin (desipramine),
Sinequan (doxepin),
Tofranil (imipramine), Aventyl or Pamelor (nortriptyline),
Vivactil (protriptyline), and Surmontil (trimipramine),
may increase the risk of side effects from Librium. Elavil
(amitriptyline) may sometimes be combined with Librium
for anxiety or depression that resists treatment with one
medication.
- Valerian - Do not take this herb while taking Librium.
- Valproic acid, also Depakote, Depakene, and divalproex.
Talk with your doctor if you are considering mixing an antidepressant
and anxiety medication like Librium with any other antidepressant,
or any medication that may cause drowsiness. Anxiety medication
can have increased, unexpected, or severe side effects when mixed
with other medications that affect the central nervous system. Stimulants
of any type may blunt the effectiveness of Librium.
Librium Dosages
Librium is generally prescribed in doses of 5-25 mg, 3-4 times
per day, when used in the treatment of anxiety disorders in adults.
When prescribed for the treatment of alcohol withdrawal, dosage
may start at 50-100 mg as needed, up to a maximum of 400 mg per
day.
Librium Directions
Librium should be taken exactly as your doctor recommends. Don't
take more or less than prescribed, and don't double your doses if
you should miss one. Take your doctor's advice about how quickly
or slowly to ease off Librium treatment if you plan to stop taking
it. Librium should not be started or stopped abruptly, as it strongly
increases the likelihood of unwanted side effects. If you have a
convulsive disorder, or experience severe muscle spasming, abruptly
stopping or starting Librium could increase these effects.
Inform your doctor, dentist, or anesthesiologist that you are taking
Librium before any kind of surgery or medical test. This medication
may interfere with certain test results. Librium should not be combined
with certain medications given during surgery.
Store Librium away from direct light and heat. Store in a dry location;
avoid storing it in the bathroom, near sinks, or other areas where
it may become damp. Do not use after the expiration date.
Keep Librium away from children; both when storing it, and when
discarding any unused medication.
Librium may cause drowsiness or disorientation. Be cautious if
you plan to drive or operate heavy machinery, avoid these activities
if you find yourself feeling tired or experience slowed reactions.
Librium and Pregnancy
Librium is not recommended for women who are breastfeeding, pregnant,
or planning to become pregnant. Librium could cause breathing problems
or muscle weakness in an infant. Also, a newborn whose mother had
been taking Librium might experience withdrawal symptoms.
Other benzodiazepines, similar to Librium, have been seen to cause
an increase in birth defects. While Librium has not been demonstrated
to be a high risk factor for birth defects, it could increase their
likelihood.
This medication is not generally prescribed to pregnant or nursing
women.
Librium and Children
Librium has not been studied for use in children under 6 years
of age. The usual starting dose for older children is 5 mg, 2-4
times per day, up to a maximum of 10 mg, 3 times per day.
When Librium is used in hyperactive children, watch carefully for
paradoxical overexcitement and speak to your doctor about it immediately.
Librium and Seniors
Older adults taking Librium are usually encouraged to start with
smaller doses (5 mg 2-4 times per day) and limit intake to the smallest
effective dose. Seniors are more likely to become too heavily sedated,
or experience decreased muscle coordination.
Librium is a trademark of Hoffman-LaRoche
Back to top
This document is provided for information only. It is not a substitute for consultation with a physician, either to diagnose symptoms or prescribe treatment. Any dosages mentioned are general guidelines only, please follow the directions of your doctor or pharmacist exactly when taking medication. We have made every effort to ensure that this information is accurate, but only your doctor can say if a medication, or drug combination, is safe for you. Information intended for US residents only.
|
