Librium (chlordiazepoxide) is an anti anxiety medication. Librium is in the group of drugs known as benzodiazepines; a class of antidepressants, anti-panic agents, sleep aids, and muscle relaxants. Librium (chlordiazepoxide) is usually used as a short term treatment for major anxiety. This medication is not necessary to relieve everyday stress or anxiety. Librium (chlordiazepoxide) has been successfully used as a treatment for: Anxiety disorder characterized by unrealistic fears and excessive worries. Also for the temporary symptoms of alcohol withdrawal, insomnia, pre-surgical anxiety, as a general sedative, and tremor suppression.


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Librium side effects are usually temporary, and fade with continued treatment. Higher dosage also increases the risk of side effects. Operating automobiles or heavy machinery is not recommended while taking Librium. Be aware of how this medication affects you before attempting any potentially dangerous activities.

Common Librium side effects: drowsiness, fatigue, light-headedness, or speech problems.

Less common Librium side effects: abdominal cramps, constipation, dry mouth, hyperventilation, blurred vision, nausea, chest pain, change in sex drive, confusion, headache, change in appetite, insomnia, unusual dreams, change in salivation, low blood pressure, racing heartbeat, fainting, nasal congestion, difficulty urinating, sweating, weight change, skin irritation, twitching or tremors, nervous or anxious state, sun sensitivity, respiratory infection, memory impairment, menstrual difficulties, and loss of coordination. Speak to your doctor about any of these effects; your dosage may need to be adjusted or treatment discontinued.

Rare Librium side effects: difficulty concentrating, slurred or unusual speech, double vision, fear, altered sense of taste, lack of inhibition, muscle cramps or spasms, urination problems, tingling, incontinence, warmth, weakness, change in muscle tone, or yellow eyes and skin. Speak to your doctor if you experience any of these effects; your treatment may need to be discontinued.

Librium should be taken exactly as your doctor recommends. Don't take more or less than prescribed, and don't double your doses if you should miss one. Take your doctor's advice about how quickly or slowly to ease off Librium treatment if you plan to stop taking it. Librium should not be started or stopped abruptly, as it strongly increases the likelihood of unwanted side effects. If you have a convulsive disorder, or experience severe muscle spasming, abruptly stopping or starting Librium could increase these effects.

Inform your doctor, dentist, or anesthesiologist that you are taking Librium before any kind of surgery or medical test. This medication may interfere with certain test results. Librium should not be combined with certain medications given during surgery.

Store Librium away from direct light and heat. Store in a dry location; avoid storing it in the bathroom, near sinks, or other areas where it may become damp. Do not use after the expiration date.

Keep Librium away from children; both when storing it, and when discarding any unused medication.

Librium may cause drowsiness or disorientation. Be cautious if you plan to drive or operate heavy machinery, avoid these activities if you find yourself feeling tired or experience slowed reactions.

Librium is generally prescribed in doses of 5-25 mg, 3-4 times per day, when used in the treatment of anxiety disorders in adults.

When prescribed for the treatment of alcohol withdrawal, dosage may start at 50-100 mg as needed, up to a maximum of 400 mg per day.

Librium and Seniors
Older adults taking Librium are usually encouraged to start with smaller doses (5 mg 2-4 times per day) and limit intake to the smallest effective dose. Seniors are more likely to become too heavily sedated, or experience decreased muscle coordination.

Librium treatment should be discontinued if any of the following occur: hyperexcitement, muscle spasm, anxiety, hallucinations, rage or other hostile behavior, tremors, insomnia, sleeping difficulties or overstimulation.

Cautions: Librium has been known to interact undesirably with certain medical conditions. Tell your doctor if you have, or have a history of, any of the following conditions:

Alcohol or drug abuse - may increase likelihood of Librium dependence
Allergic reaction to Librium, or other benzodiazepine. Always tell your doctor about any allergies before starting a medication.
Borderline personality disorder or a history of violent behavior.
Brain disease - may increase likelihood of side effects from Librium
Breathing difficulties such as asthma, bronchitis, emphysema, or any chronic lung disease - Librium may worsen this condition.
Difficulty swallowing - This condition may become more pronounced in children.
Epilepsy or seizures - Abruptly starting or stopping treatment with Librium may increase seizures. Although Librium can be used as an aid to anti-tremor therapy, it should be used cautiously and strictly according to a doctor's instructions in these cases.
Glaucoma - Librium should not be prescribed to patients with acute narrow-angle glaucoma. Patients receiving treatment for open angle glaucoma should consult their doctor, as Librium may be an acceptable treatment for them.
Hyperactivity
Kidney or liver problems - In isolated cases, Librium has been reported to cause jaundice. If you experience yellowing of the skin or eyes, seek medical treatment immediately. More Librium may end up in your bloodstream if you have a pre-existing kidney or liver condition, increasing the likelihood of side effects.
Major Depression
Myasthenia gravis - This autoimmune disorder characterized by muscle weakness may be aggravated by Librium treatment.
Porphyria - Librium (chlordiazepoxide) is listed as an unsafe drug for porphyria, an enzyme deficiency that can cause fragile skin that is sensitive to sunlight, digestive difficulties, anxiety, and reddish-brown urine.
Psychosis or other serious mental illness - Librium has not proved to be an effective treatment for these conditions, and is not recommended.
Sleep apnea (temporary suspension of breathing during sleep) - Librium may worsen this condition. Individuals with sleep apnea should not generally use sedatives as sleep aids. (See Sleep Disorders)
Dependence: Librium has been known to be habit-forming. Withdrawal symptoms may occur if treatment is discontinued abruptly. Follow your doctor's advice about how much, and how often, you should take Librium. If you are considering stopping Librium treatment, ask your doctor how to safely decrease and then stop Librium.

Librium slows the central nervous system, and should be taken with care with medications that do the same thing. When Librium is taken with certain other medications, the rate of side effects may increase, and the action of either medication may be increased or altered. Certain medications can cause an undesirable build-up of Librium in the body. Ask your doctor's advice about combining Librium with any of the following:

Alcohol - Librium should not be mixed with alcohol, it increases the risk of overdose and fatal toxicity.
Agenerase (amprenavir)
Any medication which may cause drowsiness
Antabuse (disulfiram)
Antibiotics (esp. macrolide antibiotics) like azithromycin, biaxin, clarythromycin, or erythromycin
Antihistamines like Tavist or Benadryl
Antiseizure medication like Cerebyx (fosphenytoin), Dilantin (phenytoin), or Tegretol (carbamazepine).
Benzodiazepines (a class of antidepressants, anti-panic agents, sleep medications, and muscle relaxants) such as Ativan (lorazepam), Dalmane (flurazepam), Valium (diazepam), Halcion (triazolam), Restoril (temazepam), Xanax (alprazolam), Tranxene-SD (clorazepate), Paxipam (halazepam), ProSom (estazolam), Klonopin (clonazepam), and others, may increase the risk of side effects.
Beta blockers like Lopressor (metoprolol) or Inderal (propranolol)
Blood thinners like Warfarin (coumadin)
Bronchodilators of the xanthine (thioxanthine) class (Aminophylline, Dyphylline, Oxtriphylline, Somophyllin, Theo-Dur, etc...) - May require dosage adjustments.
BuSpar (buspirone) - Can result in oversedation.
Cardene (nicardipine)
Cordarone (amiodarone)
Desyrel (trazodone) - Risk of additive CNS depression.
Diflucan (fluconazole)
Ergotamine derivatives
Kava kava - Do not take this herb while taking Librium.
Lanoxin (digoxin)
MAO inhibitors such as the antidepressants Nardil or Parnate.
Narcotic analgesics of any kind, like Darvon (propoxyphene), Darvocet (propoxyphene, acetaminophen), Demerol (meperidine), Codeine, Percocet (oxycodone, acetaminophen), Vicodin (hydrocodone, acetaminophen), Vicoprofen (hydrocodone and ibuprofen) or OxyContin (oxycodone) should likely be taken in much lower doses when taken with Librium.
Neoral, Sandimmune (cyclosporine)
Nicotine - Heavy smoking may reduce the effectiveness of your treatment.
Nizoral (ketoconazole) - Librium should not be mixed with this antifungal medication.
Norflex (orphenadrine) - Risk of oversedation.
Oral contraceptives - May increase the effects of Librium.
Phenobarbitol, Fioricet (butalbital, acetaminophen, and caffeine), Seconal, or other barbiturates
Prilosec (omeprazole) - May increase the effects of Librium.
Rescriptor (delavirdine)
Rifamate (isoniazid), Rifater or Rifadin (rifampin), or Mycobutin (rifabutin)
Sedatives like Butalbital, Fioricet (butalbital, acetaminophen, and caffeine), Fiorinal, Phenobarbitol, Seconal, or other barbiturates may cause oversedation in combination with Librium.
Selective serotonin reuptake inhibitors (SSRIs) like Celexa (citalopram), Paxil (paroxetine), Prozac (fluoxetine), Luvox (fluvoxamine), or Zoloft (sertraline).
Serzone (nefazodone)
Sinemet (carbidopa, levadopa) can cause oversedation.

Skeletal muscle relaxants such as Flexeril (cyclobenzaprine), Skelaxin (metaxalone), Soma (carisoprodol), or Robaxin (methocarbamol) may cause oversedation in combination with this medication.
Sleep medication like Ambien (zolpidem), Sonata (zaleplon), or over the counter sleeping pills should be used with Librium only as, and if, advised by your doctor.
Sporanox (itraconazole) - Librium should not be mixed with this antifungal medication.
Street drugs - Marijuana may increase sedative effects from Librium.
St. John's Wort - Do not take this herb while taking Librium.
Tagamet (cimetidine)
Tranquilizers such as Haldol (haloperidol), Mellaril (thioridazine), Stelazine (trifluoperazine), or Thorazine (chlorpromazine) may cause oversedation.
Tricyclic antidepressants such as Asendin (amoxapine), Anafranil (clomipramine), Pertofrane or Norpramin (desipramine), Sinequan (doxepin), Tofranil (imipramine), Aventyl or Pamelor (nortriptyline), Vivactil (protriptyline), and Surmontil (trimipramine), may increase the risk of side effects from Librium. Elavil (amitriptyline) may sometimes be combined with Librium for anxiety or depression that resists treatment with one medication.
Valerian - Do not take this herb while taking Librium.
Valproic acid, also Depakote, Depakene, and divalproex.
Talk with your doctor if you are considering mixing an antidepressant and anxiety medication like Librium with any other antidepressant, or any medication that may cause drowsiness. Anxiety medication can have increased, unexpected, or severe side effects when mixed with other medications that affect the central nervous system. Stimulants of any type may blunt the effectiveness of Librium.

Librium is not recommended for women who are breastfeeding, pregnant, or planning to become pregnant. Librium could cause breathing problems or muscle weakness in an infant. Also, a newborn whose mother had been taking Librium might experience withdrawal symptoms. Other benzodiazepines, similar to Librium, have been seen to cause an increase in birth defects. While Librium has not been demonstrated to be a high risk factor for birth defects, it could increase their likelihood. This medication is not generally prescribed to pregnant or nursing women.

Librium has not been studied for use in children under 6 years of age. The usual starting dose for older children is 5 mg, 2-4 times per day, up to a maximum of 10 mg, 3 times per day. When Librium is used in hyperactive children, watch carefully for paradoxical overexcitement and speak to your doctor about it immediately.

Librium overdose symptoms can include confusion, poor coordination, sleepiness, or coma. Seek medical treatment immediately if you suspect an overdose.