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Long-acting benzodiazepine

Chlordiazepoxide hydrochloride

Brand names: Librium

Chlordiazepoxide is a long-acting benzodiazepine used mainly for the management of acute alcohol withdrawal and, short term, for severe anxiety.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It enhances the inhibitory action of GABA at the GABA-A receptor, increasing chloride conductance to produce anxiolytic, sedative and anticonvulsant effects.

Prescribing in practice

  • It carries a risk of dependence and should be used in a short, reducing course; in alcohol withdrawal it is given as a tapering regimen rather than open-ended.
  • Combining it with alcohol or other CNS depressants, particularly opioids, increases the risk of profound sedation and respiratory depression.
  • Use reduced dosing and added caution in the elderly and in hepatic impairment, where accumulation increases the risk of falls and confusion.

Monitoring

Monitor withdrawal severity (for example using a recognised withdrawal scale), level of sedation and respiratory status during treatment.

Counselling the patient

  • Do not drink alcohol while taking this medicine.
  • It can make you drowsy and impair driving and operating machinery.
  • Take it only for the planned short course, as longer use can lead to dependence.

Evidence & guidelines

Benzodiazepines such as chlordiazepoxide are the recommended treatment for preventing and managing alcohol-withdrawal symptoms in NICE guidance.

Reference: NICE CG100; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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