Apo-Chlorax

Brand Name:Apo-Chlorax, Apo-Chlordiazepoxide, Benzodiazepines, Librax

Prescription needed: Yes

What is this drug used for?

Chlordiazepoxide is used to relieve anxiety and excessive nervousness. It can also be used for sleep, to control agitation caused by alcohol withdrawal and prior to surgical procedures.

Is there any reason not to take this drug?

You should not use this drug if you are allergic to it or to other similar drugs called benzodiazepines (e.g. alprazolam, diazepam, clonazepam, clorazepate, estazolam, flurazepam, lorazepam, oxazepam, prazepam, temazepam, or triazolam). Before taking this medication, tell your doctor specifically if you have or have ever had:
  • a problem with alcohol or drug abuse
  • problems with your liver
  • problems with sleep apnea
  • problems with your lungs (e.g. severe emphysema)
  • feelings of being depressed or suicidal
  • glaucoma (especially acute narrow angle glaucoma or open angle glaucoma that is not being treated)
  • problems with memory with or without the use of these drugs

What about possible side effects?

The most common side effects are:

  • feeling tired and drowsy
  • dizziness, lightheadedness
  • feeling unsteady, loss of balance
  • feeling weak

These side effects are usually related to dose, the use of other medications and other factors (e.g. older age, other medical conditions). As well, these side effects may go away with time. Talk to your doctor or pharmacist about whether you have any risk factors that may make you more sensitive to these side effects. Contact your doctor if these symptoms continue or become worse

Other side effects include:

  • decreased mood
  • constipation, dry mouth
  • difficulty sleeping
  • breathing problems – call your doctor immediately
  • confusion, hallucinations, tremors, slurred speech – call your doctor
  • physical and mental dependence on the drug
  • rash
  • decreased memory

This is not a complete list of side effects. If you are concerned about these or other unusual symptoms while taking this medication, ask your doctor and/or pharmacist for more information and advice.

What if I am taking other drugs?

Always provide your doctor with a list of all other drugs you are taking (including over-the-counter medications and herbal/natural products) as they may interact with and/or may change the safety or effectiveness of either drug. Tell your doctor specifically if you are taking any of these drugs as he/she may need to make changes or monitor you more closely:

Drugs that can cause tiredness, sedation, dizziness – talk to your doctor or pharmacist if you are taking any of the following drugs:

  • Antihistamines (e.g. diphenhydramine, hydroxyzine)
  • Opioid pain medications (e.g. codeine, oxycodone, morphine, hydromorphone)
  • Antidepressants (e.g. amitriptyline, trazodone) and antipsychotics (e.g. risperidone, haloperidol)
  • Muscle relaxants (e.g. cyclobenzaprine)
  • Drugs for epilepsy (gabapentin, phenytoin, phenobarbital, carbamazepine, valproic acid)
  • Cimetidine, erythromycin, clarithromycin, fluoxetine, fluconazole, grapefruit juice, isoniazid, ketoconazole, omeprazole, valproic acid, oral contraceptives (may increase blood levels of chlordiazepoxide and increase chances for side effects)
  • Phenytoin
  • Rifampin, carbamazepine, phenobarbital (may see decrease blood levels of diazepam and a decrease in how well the drug works)
  • Antacids (decrease the absorption of chlordiazepoxide; separate by at least 2 hours)

This is not a complete list of drug interactions. Ask your doctor or pharmacist to review your list of medications.

Other information:

Chlordiazepoxide can be habit-forming. If you use too much chlordiazepoxide, or use it for too long (more than a few months) your body may develop a tolerance to it, which will make it less effective. Do not take more chlordiazepoxide than you are prescribed. Talk to your doctor.

If you are scheduled for medical or dental surgery make sure your healthcare providers know that you are taking chlordiazepoxide.

Children: Can be used. Reduced dose necessary.

Seniors: Should not be used in older people. This drug stays in the body much longer in the elderly and it increases the risk for side effects. Other drugs that are similar and shorter acting are available.

Pregnancy: Safety not established. Pregnant women should not take this drug without talking to their doctor. Other benzodiazepines, similar to chlordiazepoxide, have been seen to cause an increase in birth defects.

Women who are nursing: This drug passes into breast milk. Not typically recommended. Talk to your doctor.

People who drive or operate machinery: Should not do so until they know how this drug will affect them personally. It may cause drowsiness and slow your reactions.

Alcohol. Avoid alcohol as it will increase the sedative effects of chlordiazepoxide.

Overdose: If you become excessively drowsy or notice any unusual symptoms, call your doctor or 911 immediately.

Stopping the drug. It is important that you do not stop this drug without talking to your doctor.

If you miss a dose. Take the missed dose as soon as you remember it unless it is within 2 hours of your next scheduled dose, in which case take the missed dose and skip the next scheduled dose. Never take a double dose of this medicine.

Storage conditions: Closed container; cool, dry location away from excess moisture (not in the bathroom); always out of reach of children.

Dietary precautions: None