chlordiazepoxide / clidinium
Librax (chlordiazepoxide / clidinium) is a medication that contains a benzodiazepine and an anticholinergic. It's used to help with emotional and physical factors related to stomach conditions by relaxing the mind and gut muscles. It can also be used with other medications to treat stomach ulcers, irritable bowel syndrome (IBS), and inflammation in the small intestine and colon (acute enterocolitis). Librax (chlordiazepoxide / clidinium) comes as brand-name and generic capsules that are approved for adults only. Side effects can include drowsiness and confusion. It's considered a controlled substance in some states.
What is Librax (chlordiazepoxide / clidinium)?
What is Librax (chlordiazepoxide / clidinium) used for?
- To control emotional and somatic (physical) factors related to stomach conditions
- Add-on therapy for peptic (stomach) ulcer
- Add-on therapy for irritable bowel syndrome (IBS)
- Add-on therapy for acute enterocolitis
How Librax (chlordiazepoxide / clidinium) works
Librax (chlordiazepoxide / clidinium) is a combination of two medications that work together to help with the emotional and physical stressors related to stomach problems.
- Chlordiazepoxide is a benzodiazepine that works in your brain to produce a calming effect.
- Clidinium is an anticholinergic that lessens muscle spasms and secretions in your stomach.
Drug facts
Side effects of Librax (chlordiazepoxide / clidinium)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Sleepiness or drowsiness
- Dizziness
- Confusion
- Dry mouth
- Blurry vision
- Constipation
- Trouble urinating
- Problems with balance and coordination
Less Common Side Effects
- Rash
- Swelling
- Nausea
- Extrapyramidal symptoms (movement problems)
- Changes in period (menstrual) cycles
- Changes in desire for sex (libido)
Librax (chlordiazepoxide / clidinium) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Excessive drowsiness
- Trouble breathing
The following Librax (chlordiazepoxide / clidinium) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Incidence not known
Chills
clay-colored stools
confusion
cough or hoarseness
dark urine
difficulty with speaking
dizziness
drowsiness
fever with or without chills
general feeling of tiredness or weakness
headache
itching or rash
loss of appetite
loss of balance control
lower back or side pain
muscle trembling, jerking, or stiffness
painful or difficult urination
pale skin
restlessness
shakiness and unsteady walk
shuffling walk
sores, ulcers, or white spots on the lips or in the mouth
stiffness of the limbs
stomach pain
swelling
twisting movements of the body
uncontrolled movements, especially of the face, neck, and back
unpleasant breath odor
unsteadiness, trembling, or other problems with muscle control or coordination
unusual bruising or bleeding
unusual tiredness or weakness
vomiting of blood
yellow eyes or skin
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
Blurred vision
change in consciousness
difficulty having a bowel movement (stool)
lack of coordination
loss of consciousness
sleepiness or unusual drowsiness
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Incidence not known
Inability to have or keep an erection
increase or loss in sexual ability, desire, drive, or performance
increased or decreased interest in sexual intercourse
menstrual changes
skin blisters
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Librax (chlordiazepoxide / clidinium)
Pros
- Available as a lower-cost generic medication
- Combines two medications into one pill for convenience
- Can be used with other medications to help with stomach problems
Cons
- Might have to take the medication three to four times a day
- Higher risk of side effects for older adults
- Can cause dependence and withdrawal if used for a long period of time
Pharmacist tips for Librax (chlordiazepoxide / clidinium)
- Librax (chlordiazepoxide / clidinium) can cause sleepiness and dizziness. The medication can also affect your ability to focus. Don't drive or do anything that requires concentration until you know how your body reacts to Librax (chlordiazepoxide / clidinium).
- Avoid drinking alcohol while you're taking Librax (chlordiazepoxide / clidinium). Taking this medication with alcohol can raise your risk for severe drowsiness, slow and shallow breathing, coma, and death.
- Taking too much Librax (chlordiazepoxide / clidinium) can lead to an overdose, which can be life-threatening. Contact your provider or get emergency medical help if you accidentally take too many Librax (chlordiazepoxide / clidinium) capsules or if you feel extremely sleepy or confused while you're taking the medication.
- Don't stop taking Librax (chlordiazepoxide / clidinium) suddenly or lower your dose suddenly without talking to your provider. Otherwise, it might lead to withdrawal symptoms that can be bothersome and sometimes life-threatening. Talk to your provider if you have symptoms of withdrawal, such as vomiting, diarrhea, sweating, shaking, or seizures, after you lower your dose or stop this medication.
- Keep Librax (chlordiazepoxide / clidinium) out of reach from children to prevent them from accidentally taking this medication.
- Speak with your provider if you're pregnant, planning to get pregnant, or breastfeeding before you start taking Librax (chlordiazepoxide / clidinium). This medication can cause harm to your baby.
Common questions about Librax
Librax contains chlordiazepoxide, which is a controlled medication, and clidinium, which is a non-controlled medication. As a combination, the federal law allows Librax to be labeled as a non-controlled medication. This is allowed when a small amount of a controlled medication like chlordiazepoxide is mixed in with a non-controlled medication. Certain states, like California, have different and stricter laws, which consider Librax as a controlled medication. Check with your provider or pharmacist if you're not sure whether this medication is considered controlled in your state.
Everyone responds to medications differently, and this applies to Librax. As separate ingredients, the effects of clidinium typically start after about an hour and chlordiazepoxide works within 1 to 2 hours of taking the medication. Speak with your provider about when to expect your symptoms to start to improve while you're taking Librax.
It's possible for chlordiazepoxide, one of the ingredients of Librax, to cause weight gain, but this side effect is rare. Contact your provider if you notice concerning weight gain. Your provider can help see whether it's a side effect of Librax or whether it's due to another reason.
It's best to take Librax before meals since eating food triggers your gut muscles to become more active, which might trigger symptoms of your stomach condition. After you take Librax, it'll start working to calm down your gut muscles. This can help with symptoms like cramping.
It's best to check with your healthcare provider before you start any new medications. It isn't clear whether omeprazole (Prilosec), a medication that's commonly used to treat stomach problems like ulcers, might interact with Librax. In a small clinical study of people who took Librax with omeprazole (Prilosec), the most commonly reported side effect was drowsiness and sleepiness. No serious side effects were reported. Work with your provider to determine the safest medications for you to take together with Librax to treat your condition.
Constipation is a possible side effect of Librax. The risk is higher if you're taking other medications that can slow down your gut or if you're following a certain diet called a low residue diet. If you're not following a special diet, make sure to eat plenty of fiber in your diet and stay well hydrated to help prevent constipation. Getting regular exercise can also help. Contact your provider if you're having trouble managing constipation.
Yes, sleepiness is a possible side effect of Librax. Wait and see how this medication affects you before you drive or perform any activities that require you to be alert. Let your provider know if this side effect becomes bothersome. Your provider might be able to adjust your dose or switch you to a different medication.
There isn't a set amount of time that you can take Librax. Keep in mind that you can become dependent on Librax if you take it for a long period of time. This means that you might start to rely on the medication to function normally. This can put you at risk for withdrawal if you lower your dose suddenly or stop the medication suddenly. It's also recommended for your provider to periodically check your blood cell counts and liver health if you happen to take the medication for a long period of time to make sure it continues to be safe for you. Discuss with your healthcare provider about how well the medication is working for you, whether you're having bothersome side effects, and how long you should continue taking it.
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Risks and warnings for Librax (chlordiazepoxide / clidinium)
Librax (chlordiazepoxide / clidinium) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risks when taken with opioids
Taking Librax (chlordiazepoxide / clidinium) with pain medications called opioids can cause dangerous risks, such as extreme sleepiness or slowed breathing. It might also lead to coma and death.
Don't take Librax (chlordiazepoxide / clidinium) together with opioids unless your healthcare provider tells you that it's okay and unless your provider is following up with you closely. Speak with your provider to see whether there's a safer alternative.
Let your family and caretakers know about the risks with taking Librax (chlordiazepoxide / clidinium) together with opioids. Get emergency medical help right away if you have trouble breathing, slow or shallow breathing, severe sleepiness, or trouble waking up after you take Librax (chlordiazepoxide / clidinium).
Misuse and addiction
- Risk factors: Taking Librax (chlordiazepoxide / clidinium) at higher doses | Taking Librax (chlordiazepoxide / clidinium) together with other medications, alcohol, or illegal substances
Taking medications containing benzodiazepines like Librax (chlordiazepoxide / clidinium) can raise your risk of misuse. Misuse is when the medication is taken for reasons other than prescribed. Misusing Librax (chlordiazepoxide / clidinium) can cause stomach pain, aggression, confusion, depression, tremors, and dizziness. More seriously, misuse can lead to paranoia, trouble breathing, suicidal thoughts, seizures, and death.
Continued misuse of Librax (chlordiazepoxide / clidinium) can lead to addiction. This can cause dangerous behaviors, such as a strong desire to take the medication or prioritizing using the medication over other responsibilities.
Although misuse and addiction can happen at recommended doses, it's more likely to happen if you take higher doses of Librax (chlordiazepoxide / clidinium) than prescribed or if you take it with certain medications (e.g., opioids), alcohol, or illegal substances. Misuse and addiction can also lead to overdose or death. Take Librax (chlordiazepoxide / clidinium) exactly as prescribed to lower your risk for misuse, addiction, and overdose.
Dependence and withdrawal
- Risk factors: Taking Librax (chlordiazepoxide / clidinium) for a long period of time
Taking Librax (chlordiazepoxide / clidinium) for a long time might lead to dependence (when your body relies on the medication to function normally). This can lead to withdrawal symptoms if you stop the medication or lower your dose all of a sudden. Some withdrawal symptoms, such as nausea, shakiness, sweating, and anxiety, can be bothersome. Other symptoms like seizures and depression can be more serious. Sometimes, withdrawal can last for weeks to more than a year. To prevent withdrawal, your provider will slowly lower your dose.
Harder to focus or concentrate
- Risk factors: Age 65 and older | Taking with alcohol | Taking other medications that make you less alert
Librax (chlordiazepoxide / clidinium) lowers your ability to focus, think, and react. Librax (chlordiazepoxide / clidinium) shouldn't be taken with other medications that also make you less alert, such as medications that help with your mood or behavior (antidepressants or antipsychotics), unless your provider says it's okay. Be careful and avoid activities that require you to be alert, such as driving a car or operating machinery, until you know how Librax (chlordiazepoxide / clidinium) affects you.
Harm to your unborn baby
- Risk factors: Pregnant or planning to become pregnant
Librax (chlordiazepoxide / clidinium) might raise the risk of harm to your unborn baby. In general, taking medications that contain a benzodiazepine such as Librax (chlordiazepoxide / clidinium) during pregnancy can put your newborn baby at risk for dangerously slowed breathing, extreme sleepiness, and withdrawal symptoms like irritability and feeding problems. Speak with your provider to discuss the risks and benefits of this medication if you're pregnant or planning to become pregnant.
Librax (chlordiazepoxide / clidinium) dosage
Capsule| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 5mg/2.5mg | 90 capsules | $25.80 | $0.29 |
Typical dosage for Librax (chlordiazepoxide / clidinium)
Your provider will prescribe a dose based on your condition and response to Librax (chlordiazepoxide / clidinium). Each capsule contains 5 mg of chlordiazepoxide and 2.5 mg of clidinium.
The typical dose is 1 or 2 capsules by mouth 3 or 4 times a day, before meals and at bedtime.
Your dose might differ if you're 65 years or older.
Interactions between Librax (chlordiazepoxide / clidinium) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Flumazenil
- Potassium
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Alfentanil
- Alprazolam
- Amifampridine
- Amobarbital
- Benzhydrocodone
- Bromazepam
- Bromopride
- Buprenorphine
- Bupropion
- Butabarbital
- Butalbital
- Butorphanol
- Calcium Oxybate
- Cannabidiol
- Carbinoxamine
- Carisoprodol
- Cetirizine
- Chloral Hydrate
- Chlorzoxazone
- Clobazam
- Clozapine
- Codeine
- Dantrolene
- Dihydrocodeine
- Donepezil
- Doxylamine
- Esketamine
- Ethchlorvynol
- Fentanyl
- Flibanserin
- Fospropofol
- Gabapentin
- Gabapentin Enacarbil
- Glucagon
- Glycopyrrolate
- Glycopyrronium Tosylate
- Hydrocodone
- Hydromorphone
- Ketamine
- Lacosamide
- Lemborexant
- Levocetirizine
- Levorphanol
- Lofexidine
- Loxapine
- Magnesium Oxybate
- Meclizine
- Meperidine
- Mephenesin
- Mephobarbital
- Meprobamate
- Metaxalone
- Methacholine
- Methadone
- Methocarbamol
- Methohexital
- Metoclopramide
- Midazolam
- Mirtazapine
- Morphine
- Morphine Sulfate Liposome
- Nalbuphine
- Oxycodone
- Oxymorphone
- Pentazocine
- Pentobarbital
- Periciazine
- Phenobarbital
- Potassium Oxybate
- Pregabalin
- Primidone
- Propofol
- Quetiapine
- Remimazolam
- Revefenacin
- Scopolamine
- Secobarbital
- Secretin Human
- Sodium Oxybate
- Sufentanil
- Tapentadol
- Thiopental
- Tiotropium
- Tramadol
- Trazodone
- Zolpidem
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Ketoconazole
- Rifapentine
- St John's Wort
- Theophylline
How much does Librax (chlordiazepoxide / clidinium) cost?
Librax (chlordiazepoxide / clidinium) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Librax (chlordiazepoxide / clidinium) will not be safe for you to take.
- Glaucoma
- Enlarged prostate (benign prostatic hypertrophy or BPH)
- Blockage of the bladder (benign bladder neck obstruction)
What are alternatives to Librax (chlordiazepoxide / clidinium)?
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