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Librium

Chlordiazepoxide
Chlordiazepoxide structure.svg
Chlordiazepoxide-from-xtal-1982-3D-balls.png
Clinical data
Pronunciation /ˌklɔərd.əzˈpɒksd/
Trade names Librium
AHFS/Drugs.com Monograph
MedlinePlus a682078
Pregnancy
category
  • US: D (Evidence of risk)
Routes of
administration
oral
intramuscular
ATC code
Legal status
Legal status
Pharmacokinetic data
Metabolism Hepatic
Biological half-life 5–30 hours (Active metabolite desmethyldiazepam 36–200 hours: other active metabolites include oxazepam)
Excretion Renal
Identifiers
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
ECHA InfoCard 100.000.337
Chemical and physical data
Formula C16H14ClN3O
Molar mass 299.75 g/mol
3D model (Jmol)
  

Chlordiazepoxide, trade name Librium, is a sedative and hypnotic medication of the benzodiazepine class.

Chlordiazepoxide has a medium to long half-life but its active metabolite has a very long half-life. The drug has amnestic, anticonvulsant, anxiolytic, hypnotic, sedative and skeletal muscle relaxant properties.

Chlordiazepoxide was discovered in 1959. It was the first benzodiazepine to be synthesized and the discovery of chlordiazepoxide was by pure chance. Chlordiazepoxide and other benzodiazepines were initially accepted with widespread public approval but were followed with widespread public disapproval and recommendations for more restrictive medical guidelines for its use.

Chlordiazepoxide is indicated for the short-term (2–4 weeks) treatment of anxiety that is severe and disabling or subjecting the person to unacceptable distress. It is also indicated as a treatment for the management of acute alcohol withdrawal syndrome. When combined with Amitriptyline (known as Limbitrol), it can be used to treat new daily persistent headache disorder.

Use of chlordiazepoxide should be avoided in individuals with the following conditions:

Chlordiazepoxide is generally considered an inappropriate benzodiazepine for the elderly due to its long elimination half-life and the risks of accumulation. Benzodiazepines require special precaution if used in the elderly, pregnancy, children, alcohol- or drug-dependent individuals and individuals with comorbid psychiatric disorders.

The research into the safety of benzodiazepines during pregnancy is limited and it is recommended that use of benzodiazepines during pregnancy should be based on whether the benefits outweigh the risks. If chlordiazepoxide is used during pregnancy the risks can be reduced via using the lowest effective dose and for the shortest time possible. Benzodiazepines should generally be avoided during the first trimester of pregnancy. Chlordiazepoxide and diazepam are considered to be among the safer benzodiazepines to use during pregnancy in comparison to other benzodiazepines. Possible adverse effects from benzodiazepine use during pregnancy include, abortion, malformation, intrauterine growth retardation, functional deficits, carcinogenesis and mutagenesis. Caution is also advised during breast feeding as chlordiazepoxide passes into breast milk.


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