Drug Interaction:
Benzodiapines include-
Alprozolam, Chlordiazepoxide, Clonazepam, Clorazepate,Diazepam, Halazepam, Lorazepam,Oxazepam, Prazazepam
Refer Diazepam
Alcohol potentiates chlordiazepoxide & concurrent use of both can be potentially dangerous.
Cimetidine increases half-life of chlodiazpoxide.
Absorption is impaired by mag trisilicate, morphine, pethidine & atropine.
Absorption enhanced by metoclopramide & alum hydrox.
Potentiates action of major neuroleptics,can be used in useful combination.
Indication:
SHORT SUMMARY
CHLORDIAZEPOXIDE
Ind- Adjunct in peptic ulcer, irritable bowel syndrome
Dose- 5mg tabs 1-2 tbs thrice dailyc before meals and bed time daily, max 8 tabs Elderly or debilitated -1 tab twice daily then increased gradually
ADR- dry mouth,blurred viion,drowsiness, D/INT- Antacids,CNS depressants,alcohol C/I- Glaucoma,myasthena gravis,
S/P- Glaucoma, myasthena gravis,GI or urinary tract obstruction, jaundice
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FIXED DOSE COMBINATIONS APPROVED BY DCG(I)
FROM JANUARY 1961 TILL NOVEMBER 2014
Name of Drug Indication Date of Approval
Chlordiazepoxide 5mg + July- 1973
Clidimium bromide 2.5mg per tablet
Anxiety disorders.
Adverse Reaction:
Amongst the safest drug available.
May rarely cause hypoplastic or haemolytic anaemia.
Physical & psychological dependence, withdrawal syndrome, impairs psychomotor performance, more accident prone,
Aggression(in predisposed individuals especially in combination with alcohol),
sedation and mild skin rashes.
Contra-Indications:
Jaundice.
Myasthemia gravis, acute pulmonary insufficiency and respiratory depression. Hypersensitivity to benzodiapiness.
Depression, 3rd trimester of pregnancy
Special precautions:
Alcohol.Handling of machinary & driving vehicles.
Sedation, dependence,
pregnancy, lactation.
Elderly & debilitated patients.
Dosages/ Overdosage Etc:
Date of Approval - 1973
Indications:
Anxiety disorders.
Dosage:
Mild to moderate anxiety- 5 to 10mg 3 times/day
Severe anxiety - 20 to 25mg 3 or 4 times/day.
Geriatric patients - 5mg 2 or 3 times/day.
Other Information:
Porphyria exacerbation-
Porphyrias are a group of clinically heterogenous diseases associated with inherited or acquired disturbances in heme boisynthesis. Porphyrins are tetrapyrrole pigments that serve as intermediates in the pathway.
They are formed from the precursors akph- aminolevilinic acid ( ALA ) and porphobilinogen. Heme the ferrous iron complex of protoporphrrins IX , functions as a prosthetic group and mitochondrial cytochromes, catalase,tryptophan oxygenase and others.
Drugs causing adverse reactions-
1. Barbiturates
2. Chlordiazepoxide
3. Meprobamate
4. Sulfonamides
5. Estrogens
6. Oral contraceptives
7. Chlorpropamide
8. Phenytoin
9. Glutethimide
10. Griseofluvin
11. Rifampicin
Patient Information:
Benzodiapines include-
Alprozolam, Bromozepam, Chlordiazepoxide, Clonazepam, Clorazepate,Diazepam, Estazolam, Flurazepam, Halazepam, ketazolam,Lorazepam,Nitrazepam, Oxazepam, Prazepam, Quazepam, Temazepam, Triazolam
Refer Diazepam
1.May cause drowsiness; avoid driving or other tasks requiring alertness.
2.Alcohol and other CNS depresants.
3.May be taken with food or water if stomach upset occurs.
4.Patients on long term use make experience withdrawal syndrome. Do not discontinue the therapy abpruptly.
Pharmacology/ Pharmacokinetics:
Refer - Diazepam
Interaction with Food:
Take with or without food
Pregnancy and lactation:
Pregnancy:
Avoid using the drug during pregnancy.
Lactation:
Drug excreted in breast milk,and accumulation of the drug or its metabolites to toxic levels is possible.
Manufacturer Details