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Benzodiazepine (long-acting)

Chlordiazepoxide

Brand names: Librium

Chlordiazepoxide is a long-acting benzodiazepine used mainly for the management of acute alcohol withdrawal and, less commonly, for short-term relief of 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 potentiates the inhibitory neurotransmitter GABA at the GABA-A receptor, producing anxiolytic, sedative and anticonvulsant effects.

Prescribing in practice

  • In alcohol withdrawal it is usually given as a reducing regimen; combined with continued alcohol or opioids it can cause dangerous respiratory depression.
  • Tolerance and dependence occur with prolonged use, so treatment should be short and tapered.
  • Reduce the dose and use caution in the elderly and in hepatic impairment, where accumulation can precipitate encephalopathy.

Monitoring

Monitor withdrawal severity, conscious level and respiratory status during treatment rather than by routine bloods.

Counselling the patient

  • Do not drink alcohol while taking this medicine.
  • It may cause drowsiness; do not drive if affected.
  • Take it exactly as the reducing schedule directs and do not stop suddenly.

Evidence & guidelines

Benzodiazepines such as chlordiazepoxide are recommended by NICE for medically assisted alcohol withdrawal.

Reference: SmPC Librium; NICE CG100 (Alcohol-Use Disorders Diagnosis 2010); NICE CG115 (Alcohol-Use Disorders Management); SIGN 156; 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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