Chlordiazepoxide + Clidinium Bromide information from DrugsUpdate
L - Contraindicated in lactation
Librax is used, in combination with other therapy, for the treatment of peptic ulcer, irritable bowel syndrome (spastic colon), and acute enterocolitis (inflammation of the colon and small intestine). Librax is a combination of a benzodiazepine (chlordiazepoxide) and an antispasmodic medication (clidinium).
Chlordiazepoxide exerts anxiolytic effect by stimulating the GABA receptor-complex activity. Clidinium is an anticholinergic agent. This combination can control some emotional and somatic factors in GI disease.
Mouth dryness, blurring, hesitancy and urgency in micturition, constipation, rise in body temperature, heat stroke, tachycardia, mydriasis, headache, nervousness, drowsiness, weakness, nausea, aggression, dependence, mild skin rashes and impaired psychomotor performance.
Potentially Fatal: Severe hypersensitive reaction, hemolytic anemia (rarely).
In debilitated patients, it is recommended that the dosage be limited to the smallest effective amount to preclude the development of ataxia, oversedation or confusion (not more than 2 Chlordiazepoxide HCl/Clidinium Bromide capsules per day initially, to be increased gradually as needed and tolerated). In general, the concomitant administration of Chlordiazepoxide HCl/Clidinium Bromide and other psychotropic agents is not recommended. If such combination therapy seems indicated, careful consideration should be given to the pharmacology of the agents to be employed — particularly when the known potentiating compounds such as the MAO inhibitors and phenothiazines are to be used. The usual precautions in treating patients with impaired renal or hepatic function should be observed.
Paradoxical reactions to chlordiazepoxide hydrochloride, eg, excitement, stimulation and acute rage, have been reported in psychiatric patients and should be watched for during Chlordiazepoxide HCl/Clidinium Bromide therapy. The usual precautions are indicated when chlordiazepoxide hydrochloride is used in the treatment of anxiety states where there is any evidence of impending depression; it should be borne in mind that suicidal tendencies may be present and protective measures may be necessary. Although clinical studies have not established a cause and effect relationship, physicians should be aware that variable effects on blood coagulation have been reported very rarely in patients receiving oral anticoagulants and chlordiazepoxide hydrochloride.
Driving, hazardous work, elderly, renal disease, hepatic disease, hypertension, CVS disease, ulcerative colitis, hernia, reflux esophagitis, elderly and debilitated, autonomic neuropathy.
Cimetidine increases T1/2 of chlordiazepoxide. Absorption of chlordiazepoxide enhanced by metoclopramide and aluminum hydroxide. Chlordiazepoxide absorption hindered by Mg trisilicate, morphine and pethidine. Clidinium faces additive anticholinergic effects with antidepressants, quinidine and some antihistamines.
Potentially Fatal: Alcohol potentiates chlordiazepoxide and concurrent use of both can be potentially dangerous.
Irritable bowel syndrome
Adult: Each capsule containing chlordiazepoxide 5 mg and clidinium 2.5 mg: 1-2 capsule 3-4 times a day, before meals and at bedtime.
Elderly: Minimal effective dose.
Should be taken on an empty stomach. (Take ½-1 hour before meals.)
List of Contraindications
Contraindicated in pregnancy
Contraindicated in lactation
Hypersensitivity, myasthenia gravis, pregnancy and lactation, glaucoma, obstructive uropathy, GI obstruction, paralytic ileus, unstable CVS status, acute hemorrhage, acute resp conditions.
Store at 25°C