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Chlordiazepoxide

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Chlordiazepoxide, Librium

  • See Also
  1. Benzodiazepine
  • Class
  1. Long Acting Benzodiazepine
  • Dosing
  1. Anxiety Disorder
    1. Adult: 5 to 10 mg orally 2 to 4 times daily (up to 20 to 25 mg per dose)
    2. Elderly: 5 mg orally 2 to 4 times daily
    3. Child (over age 6 years): 5 mg orally 2 to 4 times daily (up to 10 mg orally 2 to 3 times daily)
  2. Alcohol Withdrawal
    1. See Alcohol Withdrawal
    2. Dose: 50 to 100 mg orally every 3 to 4 hours as needed
    3. Repeat dosing every 3-4 hours up to 300 mg per day
  • Safety
  1. Pregnancy Category X
  2. Avoid in Lactation
  3. Schedule IV Controlled Substance
  • Pharmacokinetics
  1. Half Life: 7-48 hours (up to 100 hours)
  2. Chlordiazepoxide has the longest duration of action of any Benzodiazepine
  • Metabolism
  1. Chlordiazepoxide is metabolized first to desmethyldiazepam via CYP1A2
  2. Desmethyldiazepam is then metabolized to Oxazepam via CYP3A4 and CYP2C19
  • Resources
  1. Chlordiazepoxide Capsule (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=e3ff8641-ae8a-4016-acb1-cb1b7890f5ed
  • References
  1. (2019) Med Lett Drugs Ther 61(1578): 121-6
  2. (2020) Presc Lett, Resource #361206, Appropriate Use of Benzodiazepines
  3. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 55
  4. Hamilton (2020) Tarascon Pocket Pharmacopoeia