Description and Brand Names

Drug information provided by: Merative, Micromedex®

US Brand Name

  1. Librax

Descriptions


Chlordiazepoxide and clidinium combination is used in combination with other medicines to treat stomach or bowel problems including peptic ulcers, irritable bowel syndrome (IBS), and enterocolitis (inflammation of the colon and small intestines).

Chlordiazepoxide is a benzodiazepine. Benzodiazepines belong to the group of medicines called central nervous system (CNS) depressants, which are medicines that slow down the nervous system. Clidinium is an anticholinergic agent. It reduces stomach acid and decreases bowel spasms.

This medicine is available only with your doctor's prescription.

This product is available in the following dosage forms:

  • Capsule

Before Using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of chlordiazepoxide and clidinium combination in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of chlordiazepoxide and clidinium combination in the elderly. However, elderly patients are more likely to have serious unwanted effects (eg, severe drowsiness, confusion, clumsiness, or unsteadiness), which may require caution in patients receiving this medicine.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions

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 Citrate

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
  • Amantadine
  • Amifampridine
  • Amobarbital
  • Aripiprazole
  • Benzhydrocodone
  • Bromazepam
  • Bromopride
  • Buprenorphine
  • Bupropion
  • Butabarbital
  • Butalbital
  • Butorphanol
  • Calcium Oxybate
  • Cannabidiol
  • Cannabis
  • Carbinoxamine
  • Carisoprodol
  • Cetirizine
  • Chloral Hydrate
  • Chlorzoxazone
  • Clobazam
  • Clonazepam
  • Clozapine
  • Codeine
  • Dantrolene
  • Daridorexant
  • Dexmedetomidine
  • Dihydrocodeine
  • Donepezil
  • Doxylamine
  • Esketamine
  • Ethchlorvynol
  • Fentanyl
  • Flibanserin
  • Fospropofol
  • Gabapentin
  • Gabapentin Enacarbil
  • Glucagon
  • Glycopyrrolate
  • Glycopyrronium Tosylate
  • Hydrocodone
  • Hydromorphone
  • Ivacaftor
  • 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
  • Olanzapine
  • Oxycodone
  • Oxymorphone
  • Pentazocine
  • Pentobarbital
  • Periciazine
  • Phenobarbital
  • Potassium Oxybate
  • Pregabalin
  • Primidone
  • Propofol
  • Quetiapine
  • Remimazolam
  • Revefenacin
  • Ropeginterferon Alfa-2b-njft
  • Scopolamine
  • Secobarbital
  • Secretin Human
  • Sodium Oxybate
  • Sufentanil
  • Tapentadol
  • Thiopental
  • Tiotropium
  • Topiramate
  • Tramadol
  • Trazodone
  • Zolpidem
  • Zuranolone

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

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. 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 may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

  • Ethanol

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Alcohol or drug abuse or dependence, history of or
  • Bleeding problems or
  • Depression, history of or
  • Eye or vision problems or
  • Mental health problems, history of or
  • Trouble urinating or
  • Weakened physical condition—Use with caution. May make these conditions worse.
  • Enlarged prostate or
  • Glaucoma or
  • Urinary bladder blockage—Should not be used in patients with these conditions.
  • Kidney disease or
  • Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use

Take this medicine exactly as directed by your doctor to benefit your condition as much as possible. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. If too much of this medicine is taken for a long time, it may become habit-forming (causing mental or physical dependence) or cause an overdose.

This medicine should come with a Medication Guide. Read and follow the instructions carefully. Ask your doctor if you have any questions.

Take this medicine before meals and at bedtime.

Swallow the capsule whole. Do not crush, break, or chew it.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (capsules):
    • For the treatment of peptic ulcer, IBS, or enterocolitis:
      • Adults—1 or 2 capsules 3 or 4 times a day. Your doctor may adjust your dose as needed and tolerated.
      • Older adults—2 capsules per day. Your doctor may adjust your dose as needed and tolerated.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood tests may be needed to check for unwanted effects.

Tell your doctor if you are pregnant or planning to become pregnant. Using this medicine during the later pregnancy may cause problems in your newborn baby (eg, sedation or withdrawal symptoms). Tell your doctor right away if your baby has an abnormal sleep pattern, diarrhea, feeding problems, a high-pitched cry, irritability, low muscle tone, restlessness, shakiness or tremors, sluggishness, trouble breathing, weight loss, vomiting, or fails to gain weight. If you think you have become pregnant while using the medicine, tell your doctor right away.

This medicine may be habit-forming. If you feel that the medicine is not working as well, do not use more than your prescribed dose. Call your doctor for instructions.

This medicine may cause some people, especially elderly patients, to become drowsy, dizzy, lightheaded, clumsy or unsteady, or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert or able to think or see well.

Check with your doctor before using this medicine with alcohol or other medicines that affect the central nervous system (CNS). The use of alcohol or other medicines that affect the CNS with Librax® may worsen the side effects of this medicine, such as dizziness, irregular, fast or slow, or shallow breathing, poor concentration, drowsiness, unusual dreams, and trouble with sleeping. Some examples of medicines that affect the CNS are antihistamines or medicine for allergies or colds, sedatives, tranquilizers, or sleeping medicines, medicine for depression, medicine for anxiety, prescription pain medicine or narcotics, medicine for attention deficit and hyperactivity disorder, medicine for seizures or barbiturates, muscle relaxants, or anesthetics, including some dental anesthetics.

If you develop any unusual and strange thoughts or behavior while you are taking chlordiazepoxide, be sure to discuss it with your doctor. Some changes that have occurred in people taking this medicine are like those seen in people who drink alcohol and then act in a manner that is not normal. Other changes may be more unusual and extreme, such as confusion, worsening of depression, suicidal thoughts, and unusual excitement, nervousness, or irritability.

Do not suddenly stop taking this medicine without checking first with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping it completely. This may help prevent a worsening of your condition and reduce the possibility of withdrawal symptoms, including headache, nausea, general feeling of discomfort or illness, seizures, stomach or muscle cramps, tremors, or unusual behavior.

Symptoms of an overdose include: blurred vision, change in consciousness, changes in patterns and rhythms of speech, confusion, difficult urination, difficulty having a bowel movement, dry mouth, hallucinations, lack of coordination, loss of consciousness, loss of strength or energy, muscle pain or weakness, nightmares, sleepiness or unusual drowsiness, shakiness and unsteady walk, slurred speech, trouble in speaking, trouble sleeping, unsteadiness, trembling, or other problems with muscle control or coordination, unusual drowsiness, dullness, tiredness, weakness or feeling of sluggishness, unusual excitement, nervousness, restlessness, or irritability, unusual weak feeling. Call your doctor right away if you notice these symptoms.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects

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

  1. Chills
  2. clay-colored stools
  3. confusion
  4. cough or hoarseness
  5. dark urine
  6. difficulty with speaking
  7. dizziness
  8. drooling
  9. drowsiness
  10. fever with or without chills
  11. general feeling of tiredness or weakness
  12. headache
  13. itching or rash
  14. loss of appetite
  15. loss of balance control
  16. lower back or side pain
  17. muscle trembling, jerking, or stiffness
  18. nausea
  19. painful or difficult urination
  20. pale skin
  21. restlessness
  22. shakiness and unsteady walk
  23. shuffling walk
  24. sore throat
  25. sores, ulcers, or white spots on the lips or in the mouth
  26. stiffness of the limbs
  27. stomach pain
  28. swelling
  29. twisting movements of the body
  30. uncontrolled movements, especially of the face, neck, and back
  31. unpleasant breath odor
  32. unsteadiness, trembling, or other problems with muscle control or coordination
  33. unusual bruising or bleeding
  34. unusual tiredness or weakness
  35. vomiting of blood
  36. yellow eyes or skin

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

  1. Agitation
  2. blurred vision
  3. change in consciousness
  4. changes in patterns and rhythms of speech
  5. confusion
  6. difficulty having a bowel movement (stool)
  7. dry mouth
  8. lack of coordination
  9. loss of consciousness
  10. loss of strength or energy
  11. nightmares
  12. shakiness and unsteady walk
  13. sleepiness or unusual drowsiness
  14. slurred speech
  15. talkativeness
  16. trouble speaking
  17. unsteadiness, trembling, or other problems with muscle control or coordination
  18. unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
  19. unusual excitement, nervousness, restlessness, or irritability
  20. unusual paleness

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

  1. Inability to have or keep an erection
  2. increase or loss in sexual ability, desire, drive, or performance
  3. increased or decreased interest in sexual intercourse
  4. menstrual changes
  5. 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.