Side effects of chlordiazepoxide

Chlordiazepoxide Side Effects

Medically reviewed by Drugs.com. Last updated on Nov 18, 2018.

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In Summary

More frequently reported side effects include: dizziness, drowsiness, insomnia, vertigo, confusion, headache, and irritability. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to chlordiazepoxide: oral capsule

Along with its needed effects, chlordiazepoxide may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking chlordiazepoxide:

Rare

  • Fainting
  • mood or mental changes
  • shakiness and unsteady walk
  • unsteadiness, trembling, or other problems with muscle control or coordination

Incidence not known

  • Abdominal and muscle cramps
  • chills
  • clay-colored stools
  • convulsions
  • cough or hoarseness
  • dark urine
  • difficulty in speaking
  • dizziness
  • drooling
  • fever with or without chills
  • general feeling of tiredness or weakness
  • headache
  • itching
  • light-colored stools
  • loss of appetite
  • loss of balance control
  • lower back or side pain
  • muscle trembling, jerking, or stiffness
  • nausea and vomiting
  • painful or difficult urination
  • pale skin
  • rash
  • restlessness
  • shakiness in the legs, arms, hands, or feet
  • shuffling walk
  • sleeplessness
  • sore throat
  • sores, ulcers, or white spots on the lips or in the mouth
  • stiffness of the limbs
  • stomach pain
  • sweating
  • swelling
  • trouble sleeping
  • twisting movements of the body
  • unable to sleep
  • uncontrolled movements, especially of the face, neck, and back
  • unpleasant breath odor
  • unusual bruising or bleeding
  • unusual tiredness or weakness
  • vomiting of blood
  • yellow eyes or skin

Get emergency help immediately if any of the following symptoms of overdose occur while taking chlordiazepoxide:

Symptoms of overdose

  • Change in consciousness
  • lack of coordination
  • loss of consciousness
  • sleepiness or unusual drowsiness

Some side effects of chlordiazepoxide may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

  • Decreased interest in sexual intercourse
  • difficulty having a bowel movement (stool)
  • inability to have or keep an erection
  • increased in sexual ability, desire, drive, or performance
  • increased interest in sexual intercourse
  • loss in sexual ability, desire, drive, or performance
  • menstrual changes
  • skin blisters

For Healthcare Professionals

Applies to chlordiazepoxide: injectable powder for injection, oral capsule, oral tablet

General

The most commonly reported side effects were light-headedness, drowsiness, sedation, unsteadiness, and ataxia.

Nervous system

Common (1% to 10%): Ataxia, balance disorder, confusional state, dizziness, sedation, somnolence, unsteadiness

Rare (less than 0.1%): Headache, reduced alertness, vertigo

Frequency not reported: Amnesia, anterograde amnesia, changes in EEG patterns, confusion, depressed level of consciousness, dysarthria, dyskinesia, extrapyramidal symptoms, gait disturbance, syncope, tremor

Other

Common (1% to 10%): Fatigue

Frequency not reported: Falls, paradoxical drug reaction, rebound phenomena

Hematologic

Rare (0.01% to 0.1%): Agranulocytosis, bone marrow depression, leukopenia, pancytopenia, thrombocytopenia

Frequency not reported: Blood dyscrasias

Genitourinary

Rare (less than 0.1%): Erectile dysfunction, incontinence, menstrual disorder, urinary retention

Frequency not reported: Minor menstrual irregularities

Ocular

Rare (less than 0.1%): Blurred vision, diplopia, visual disturbance

Psychiatric

Rare (less than 0.1%): Libido disorders, numbed emotions

Frequency not reported: Abnormal behavior, aggression, aggressive outbursts, agitation, anxiety, delusion, dependence, depression, drug abuse, emotional disturbances, hallucinations, inappropriate behavior, increased/decreased libido, insomnia, irritability, nightmares, physical dependence, psychological dependence, psychosis, psychotic disorder, rage, restlessness, sleep disorders, suicidal ideation, suicide attempt, withdrawal

Dermatologic

Rare (less than 0.1%): Rash, skin reactions

Frequency not reported: skin eruptions

Gastrointestinal

Rare (less than 0.1%): Gastrointestinal symptoms/upset

Frequency not reported: Constipation, nausea, salivation altered/changes

Cardiovascular

Rare (less than 0.1%): Hypotension

Frequency not reported: Edema

Hypersensitivity

Very rare (less than 0.01%): Angioedema, anaphylactic reaction

Frequency not reported: Hypersensitivity

Hepatic

Frequency not reported: Blood bilirubin increased, hepatic dysfunction, jaundice, transaminases increased

Metabolic

Frequency not reported: Blood alkaline phosphatase increased, increased appetite

Musculoskeletal

Frequency not reported: Fractures, muscle weakness

Respiratory

Frequency not reported: Respiratory depression

1. Cerner Multum, Inc. “UK Summary of Product Characteristics.” O 0

2. “Product Information. Librium (chlordiazepoxide).” Roche Laboratories, Nutley, NJ.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.

Medical Disclaimer

More about chlordiazepoxide

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  • Drug class: benzodiazepines

Consumer resources

  • Chlordiazepoxide
  • Chlordiazepoxide hydrochloride (Advanced Reading)

Other brands: Librium

Professional resources

  • Chlordiazepoxide (AHFS Monograph)
  • … +4 more

Related treatment guides

  • Alcohol Withdrawal
  • Anxiety
  • Burning Mouth Syndrome
  • Light Sedation
  • … +3 more

Librium

Librium is the brand name of the prescription drug chlordiazepoxide, which is used to treat anxiety disorders and withdrawal symptoms associated with alcoholism.

The medicine is sometimes used in patients to reduce anxiety before a surgical procedure.

It’s also used to treat symptoms of irritable bowel syndrome.

Librium is in a class of drugs known as benzodiazepines, which work by slowing down activity in the pathways in the brain.

The Food and Drug Administration (FDA) first approved the medicine in 1960. It’s manufactured by ICN Pharmaceuticals, Inc.

Librium Warnings

Librium can be habit-forming and may lead to dependence if it’s used in high doses or for a long period of time.

You may also develop a tolerance to the medicine. Discuss these potential risks with your physician.

If you’re on this medicine for a long time or you take high doses, you may experience unpleasant withdrawal symptoms if you stop taking it suddenly.

Don’t stop taking this medicine without first talking with your doctor. Your health care provider will probably decrease your dose of Librium gradually.

This medicine must be taken regularly to be effective. Don’t skip doses even if you feel well.

Before using Librium, tell your doctor if you have or have ever had:

  • Acute narrow-angle glaucoma (an eye condition)
  • Liver disease
  • Psychosis
  • A lung condition such as chronic obstructive pulmonary disease (COPD)
  • Muscle problems
  • Depression or suicidal tendencies
  • Seizures
  • Heart disease
  • Porphyria (a blood disorder)
  • A history of drug abuse
  • Allergies to certain medications

Also, tell your doctor if you’re using sodium oxybate (GHB) before taking Librium.

This drug’s safety in children has not been confirmed. Librium should be used with extreme caution in kids.

Talk to your doctor if you’re over 65 years of age. Librium typically isn’t used in older adults because it’s not as safe or effective as other medications.

Tell your health care provider that you’re taking Librium before having any type of surgery, including a dental procedure.

Pregnancy and Librium

Librium can harm an unborn baby. Don’t take this medicine if you’re pregnant or plan to become pregnant.

You should also know that this drug can cause a false pregnancy result when using the Gravindex pregnancy test.

Librium may pass into breast milk and harm a breastfeeding baby. Don’t take this medicine while breastfeeding.

Side Effects of Librium Use

Table of Contents Authored By Marisa Crane, BS Reviewed By Lauren Brande, MA

Librium, which is a brand name formulation of chlordiazepoxide, belongs to a class of sedative medications known as benzodiazepines. Librium has been widely used as a treatment for anxiety and for managing the symptoms of alcohol and other sedative withdrawal syndromes 1, 2, 3, 4.

Benzodiazepines are controlled substances due to their high potential for abuse and addiction 5.

Is Librium Harmful?

When used properly and under the supervision of a doctor, Librium is considered safe. However, if Librium is used in higher doses, more frequently, or for a longer period of time than directed by a doctor, it can speed up the onset of tolerance, give rise to number of damaging health effects, and ultimately lead to compulsive patterns of use 1. Tolerance occurs when the individual experiences a diminished response to Librium, thus requiring more of the drug to feel desired effects. Misusing and abusing Librium can also increase the likelihood of addiction.

The potential for adverse effects increases when Librium is mixed with other substances, including certain illicit and prescription drugs, as well as alcohol 1,2. Mixing alcohol or opioids, such as heroin or prescription painkillers, with Librium can increase the risk of overdose and death 5.

Treatment Advisors Are On Call 24/7 Who Answers? Thinking About Getting Rehab?

Librium’s Short-Term Effects

Librium is a central nervous system (CNS) depressant, which means that it slows down brain activity. The short-term effects of Librium may include 5:

  • Anxiety-relief.
  • Relaxation.
  • Feelings of well-being.
  • Drowsiness.

Benzodiazepines can reduce feelings of anxiety and provide these effects relatively quickly, which makes them more likely to be abused by people looking for quick relaxation or an escape from stress and anxiety 6. Many people struggle to deal with emotions and common stressors in day-to-day life, and these individuals may abuse Librium or other benzodiazepines to achieve a state of emotional numbness 5. Other abusers may simply be seeking a sedating “high”.

People who are addicted to or abuse multiple substances may use Librium for other purposes, such as to 5:

  • Self-manage symptoms of opioid or alcohol withdrawal.
  • Come down from a cocaine high.
  • Increase the euphoric high from opioids like hydrocodone or oxycodone.
  • Increase the effects of alcohol.

Side Effects

Physical and psychological side effects may occur even with appropriate prescription use of Librium. However, misusing or abusing Librium will increase the risk of experiencing these harmful effects, as well as other complications.

Physical Side Effects

Physical side effects may include 1, 5, 6, 7:

  • Dry mouth.
  • Slurred speech.
  • Weakness.
  • Dizziness.
  • Coordination problems.
  • Unsteady gait.
  • Uncontrolled eye movements.
  • Changes in appetite.
  • Upset stomach.
  • Diarrhea.
  • Low blood pressure.
  • Slowed breathing.
  • Stupor.
  • Coma.

Psychological Side Effects

Psychological side effects can include 5, 6, 7:

  • Confusion.
  • Depression.
  • Emotional blunting.
  • Difficulty concentrating.
  • Memory loss.
  • Suicidal ideation.

In addition, it’s possible that a Librium user may experience paradoxical disinhibition, which is a reaction characterized by symptoms that differ from its usual anxiolytic and sedating effects profile. These symptoms include 5:

  • Aggression.
  • Hostility.
  • Irritability.
  • Increased excitement.
  • Impulsivity.

In rare cases, this type of reaction may result in violent or antisocial behaviors 5.

Long-Term Effects of Abusing Librium

Librium and other benzodiazepines are not recommended for long-term use 1. Although Librium is generally considered safe when taken as prescribed by a doctor, chronic Librium misuse or abuse can lead to the following long-term effects:

  • Physical dependence: Physical dependence develops due to changes in the brain. The body becomes accustomed to the presence of Librium and users may begin to require the drug to prevent withdrawal symptoms. (Note: While dependence may occur in individuals who do not misuse the drug and is a normal effect of continued use of any drug, it can be a contributing factor to the development of addiction.
  • Tolerance: The user may require increasing amounts of Librium to experience the same effects. As tolerance develops, Librium users may incorporate alcohol or other drugs to achieve the desired effect.
  • Addiction: Many people abuse Librium for the feelings of euphoria and relaxation it produces. This abuse can lead to problematic patterns of Librium use that cause significant impairment and distress in the user’s life.
  • Polydrug abuse: Substance users typically abuse multiple drugs. Benzodiazepines are often used concurrently with alcohol or opioids 5. Polydrug use can increase the risk of harmful consequences and death.

Social and Lifestyle Consequences

Long-term Librium abuse can lead to several consequences in a user’s life, such as:

  • Impaired work or school performance.
  • Excessive absences.
  • Job loss.
  • Suspension or expulsion from school.
  • Divorce.
  • Loss of friends.
  • Child neglect.
  • Physical injuries due to accidents.
  • Legal problems.
  • Overreliance on Librium 5.
  • Loss of self-confidence 5.
  • Drug-seeking behaviors 5.

Addiction is characterized by continued Librium use despite the aforementioned consequences. If you or a loved one suffers from an addiction to Librium, call 1-888-744-0069Who Answers? to learn about different treatment options.

Dependence and Addiction

Librium is a medication that can precipitate substance abuse, especially when taken in any way other than prescribed 1. Chronic use of Librium is associated with an increased risk of tolerance and dependence. Dependence is the state in which the body has come to rely on Librium to function as expected. Once tolerance and dependence develop, the user may get caught in a vicious cycle of compulsively using and increasing the dose to dangerous levels in order to achieve the “high” and avoid withdrawal symptoms 5.

Long-term Librium abuse can lead to physiologic dependence on the drug, and can ultimately lead to an addiction or Librium use disorder. Warning signs of Librium addiction can include 7:

  • Combining Librium with alcohol or other drugs to achieve the desired effect.
  • Experiencing strong cravings for Librium.
  • Feeling unable to quit using Librium.
  • Failing to meet responsibilities at school, work, or home.
  • Continuing to use Librium despite physical, psychological, and interpersonal problems.
  • Feeling the need to use Librium regularly.
  • Participating in risky activities while under the influence (such as driving).
  • Reducing social activities that don’t involve Librium.
  • Taking larger doses of Librium or for longer periods of time than prescribed or intended.
  • Tolerance.
  • Experiencing withdrawal symptoms when trying to quit.

Withdrawal Treatment

An acute Librium withdrawal syndrome can occur after use is stopped or suddenly reduced. Some of the symptoms are unpleasant or uncomfortable, while others can be life-threatening.

Librium withdrawal is typically comprised of acute or short-term symptoms and protracted or post-acute withdrawal symptoms 5. Acute withdrawal symptoms typically develop within a few hours to a few days after quitting Librium use 7. These symptoms may include 5,7:

Protracted withdrawal symptoms, which may last several months, include 5:

  • Prolonged anxiety.
  • Depression.
  • Chronic insomnia.
  • Sweating.
  • Hand tremors.
  • Rebound anxiety.
  • Increased heart rate and blood pressure.
  • Unintentional and repetitive movements.
  • Nausea.
  • Vomiting.
  • Rebound insomnia.
  • Increased sensitivity to sensory stimuli.
  • Hallucinations.
  • Seizures.

These prolonged symptoms may result from chemical changes in the brain due to chronic Librium use 5.

Since Librium withdrawal is associated with seizures and delirium tremens similar to that of alcohol withdrawal syndrome, the safest approach to quitting Librium is to detox under the supervision of a doctor or in a specialized detox facility. These facilities ensure that you are closely monitored by trained medical staff while withdrawing from Librium. A professional treatment team can help to alleviate unpleasant, physical symptoms and provide emotional support throughout the process.

Librium Taper

The detox program typically involves gradually tapering the medication, while monitoring withdrawal symptoms 8. A detox facility provides the patient with a safe and controlled environment free of stressors and triggers. The treatment team will create an individualized detox plan based on your needs and will address any underlying conditions, such as an anxiety disorder 8. Besides tapering, management of Librium withdrawal may be conducted in other ways, including 8:

  • Preparing the patient for detox in a low-stress environment.
  • Using anti-seizure medications, such as carbamazepine or valproate.
  • Administering antidepressants with sedative effects, such as trazodone or imipramine.

When combined with cognitive and behavioral therapies, medication-assisted detox can benefit those recovering from benzodiazepine dependence. It’s important to note that detox is just the first step on the road to recovery. Transitioning to an extended treatment program, such as an inpatient or outpatient program, once detox is completed can help you to address the underlying issues influencing your addiction and build coping skills for the future. There are multiple types of treatment for those seeking to get help for Librium addiction, including inpatient or residential programs, partial hospitalization, and other outpatient substance abuse treatment programs.

If you or someone you know is abusing Librium or other drugs, call our helpline at 1-888-744-0069Who Answers? to learn about these various treatment types.

Resources, Articles, and More Information

For more information, check out the following related articles:

  • Finding Help for Benzodiazepine Addiction.
  • The Effects of Benzodiazepine Abuse.
  • 7 Things About Benzo Withdrawal You Might Not Know.
  • Are Benzos Overprescribed?

Last updated on November 25, 2018 2018-11-25T03:46:13+00:00 Finding the perfect treatment is only one phone call away!

SIDE EFFECTS

The necessity of discontinuing therapy because of undesirable effects has been rare. Drowsiness, ataxia and confusion have been reported in some patients particularly the elderly and debilitated. While these effects can be avoided in almost all instances by proper dosage adjustment, they have occasionally been observed at the lower dosage ranges. In a few instances syncope has been reported.

Other adverse reactions reported during therapy include isolated instances of skin eruptions, edema, minor menstrual irregularities, nausea and constipation, extrapyramidal symptoms, as well as increased and decreased libido. Such side effects have been infrequent, and are generally controlled with reduction of dosage. Changes in EEG patterns (low-voltage fast activity) have been observed in patients during and after Librium (chlordiazepoxide) treatment.

Blood dyscrasias (including agranulocytosis), jaundice and hepatic dysfunction have occasionally been reported during therapy. When Librium (chlordiazepoxide) treatment is protracted, periodic blood counts and liver function tests are advisable.

DRUG ABUSE AND DEPENDENCE: Chlordiazepoxide hydrochloride capsules are classified by the Drug Enforcement Administration as a Schedule IV controlled substance.

Withdrawal symptoms, similar in character to those noted with barbiturates and alcohol (convulsions, tremor, abdominal and muscle cramps, vomiting and sweating), have occurred following abrupt discontinuance of chlordiazepoxide. The more severe withdrawal symptoms have usually been limited to those patients who had received excessive doses over an extended period of time. Generally milder withdrawal symptoms (eg, dysphoria and insomnia) have been reported following abrupt discontinuance of benzodiazepines taken continuously at therapeutic levels for several months. Consequently, after extended therapy, abrupt discontinuation should generally be avoided and a gradual dosage tapering schedule followed. Addiction-prone individuals (such as drug addicts or alcoholics) should be under careful surveillance when receiving chlordiazepoxide or , other, psychotropic agents because of the predisposition of such patients to habituation and dependence.

Read the entire FDA prescribing information for Librium (Chlordiazepoxide)

What Are the Uses of Librium?

The tapering process is tailored to the individual in withdrawal. There are numerous medically relevant factors involved in the initial and ongoing dosing during the tapering process. For instance, a doctor will take into account the individual’s physiology, any existing mental and/or physical health conditions, the volume of Librium abuse, and length of the abuse. The many nuances involved in this process only highlight how far off the mark a “cold turkey” approach to withdrawal can be. At present, the safest way to withdrawal from Librium or other benzodiazepine abuse is to undergo medical detox at a rehab center that offers this service, a dedicated detoxification facility, a hospital, or other qualified clinical setting.

Finding Help for Librium Abuse

There are numerous ways a person can find recovery services for Librium abuse and addiction. In some instances, the individual’s loved ones or another third party will need to take the lead on finding help. Short of contacting a rehab center directly, one helpful approach can be to contact professionals who work in or around addiction treatment. Such individuals include but are not limited to family doctors, mental health counselors, a local nonprofit organization, an insurance company (to find an in-network rehab center), or a government agency.

Some individuals may choose to do some research on rehab center programs and then reach out to those facilities that appear to be a suitable match. In other instances, a person may get a referral from a trusted source, such as someone who has experience with a particular rehab center. In addition, the Substance Abuse and Mental Health Services Administration has published A Quick Guide to Finding Effective Alcohol and Drug Addiction Treatment for the public that provides additional insight into learning about and identifying rehab centers.

Much of addiction treatment that is provided after medical detox relates to individual and group therapy. It is in therapist-led sessions, which may follow a particular approach, such as Cognitive Behavioral Therapy (among other research-based therapy approaches), where recovering individuals learn about the root causes of their addiction. Therapy can help a recovering person to gain an understanding of how the drug abuse started, why it continued, and the emotional, psychological, behavioral triggers that were involved. In this way, therapy provides individuals with an education about drug abuse and addiction as well guidance on how to build a drug-free life with a new understanding of how all aspects of life can positively support that goal.

5 Deadliest Diet Trends: Pills That Really Can Kill

Sizing down too fast: risky business

June is just around the corner, and bridal blogs and magazines are filled with suggestions for nervous brides hoping to shed pounds before the big day.

Scary new weight loss drugs are winning market approval and the world — including Forbes — is talking about the über-creepy feeding tube diet.

But any time you try to speed weight loss beyond the doctor-recommended 1 to 2 pounds a week, you take risks.

So now it’s time to look at how far we’re willing to go to lose weight – and what risks we’re willing to take. Here are the latest diet trends, and a realistic assessment of the dangers they pose.

1. The Japanese Weight Loss Pill

What it is: A supplement imported from Japan known as Xiushentang, marketed as Japan Rapid Weight Loss Diet Pills in three colors: green, yellow, and blue. Ten days ago, the FDA issued a strong warning, stating that the medications contain the chemical phenolphthalein and the weight loss drug sibutramine.

Why it’s dangerous: Phenolphthalein is listed by the FDA as a suspected carcinogen, and sibutramine, sold as the brand name diet drug Meridia, was pulled from the market in 2010 for raising the risk of heart attack and stroke.

2. Clen Fat Burner

What it is: Clenbuterol is a steroid used to treat repiratory illnesses in horses. It’s not approved for human use, but is taken illegally by athletes and models to boost muscle mass and trigger weight loss. It made headlines last summer when athletes were banned from the Pan Am games after testing positive for “Clen,” as it’s familiarly known.

Why it’s dangerous: Clenbuterol hasn’t been tested in humans, but there’s evidence from animal studies that it’s taken up by muscle tissues throughout the body, and therefore can damage the heart muscle. It’s illegal to use it in human consumption, yet it’s easily available from many pharmaceutical websites with a quick Google search. There’s a separate concern that we might be taking clenbuterol unknowingly; this summer the FDA warned that up to 40 percent of imported meat had tested positive for clenbuterol, carried over from animal use.

3. The Brazilian Diet Pill

What it is: Nutritional supplements imported from Brazil, sold under the name of Emagrece Sim and Herbaslim. The long list of ingredients includes Librium, the antidepressant Prozac, and the stimulant Fenproporex. Since 2006,when the FDA issued a warning against these drugs, news reports have sounded the alarm.

Why it’s dangerous: The combination of uppers and downers can cause severe mood swings. Allure Magazine reported on models who were experiencing extreme personality changes, as well as other odd symptoms, such as a hypersensitivity to touch. Meanwhile the drugs continue to sell briskly via websites that tout their amazing weight loss benefits.

4. Qnexa and Successors

What it is: The supposed future blockbuster diet drug Qnexa is just the first of several weight loss drugs in final phase testing. All are combinations of existing drugs, making for a faster approval process. Contrave, from Orexigen, is a mix of bupropion, an antidepressant also used to quit smoking, and naltrexone, used for alcoholism and addiction to opiates. Arena pharmaceuticals’ Lorcaserin, an appetite suppressant, may finally be approved by the FDA later this year.

Why it’s dangerous: Honestly, any drug that messes with metabolism and mood is likely to have tricky side effects. Last year the FDA sent Contrave back into testing, requiring long-term studies to make sure it — like many diet drugs that work as stimulants — doesn’t raise heart attack risk. Lorcaserin, which had much better safety in studies, was also sent back by the FDA for further testing due to concerns about heart valve damage.

5. The K-E Diet

What it is: Forever more to be known as the “feeding tube diet” or “nose drip diet,” the K-E method involves inserting a naso-gastric tube through the nose, through which a nutrient solution is delivered directly to the stomach. As reported by Forbes, the K-E method limits calorie intake to approximately 800 calories a day, as you eat no food while you’re doing it. There’s not a lot more to say about this crazy new diet trend that hasn’t been said. Popularized by brides looking to drop the proverbial 1o pounds in two weeks (except this diet promises a 20-pound loss in 10 days), the procedure involves finding a doctor who will oversee the procedure.

Why it’s dangerous: Well, it involves inserting a feeding tube down the nose into the stomach. There’s considerable risk of inflammation and infection. The process puts the body into a metabolic state known as ketosis, which means burning fat instead of glucose for energy. Technically it works to lose weight, but ketosis elevates the levels of ketones in the blood, which puts considerable stress on the liver and kidneys. And consider the questionable credentials of any doctor willing to do this procedure on an otherwise healthy patient. There’s just no other way to describe this trend than courting disaster.

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“Pills” feature prominently in the online chat rooms and forums dedicated to right-wing extremism. These are not actual pharmaceuticals; instead, each “pill” sends a message about a person’s level of dedication to an extremist ideology or cause. Are they just beginning to learn about an ideology, or have they progressed further to embrace a nihilistic, potentially violent mindset?

While online posts about “pills” can help outside audiences gauge individuals’ states of mind, they are primarily used as a shorthand within extremist groups’ internal conversations.

This shorthand is critically important, as today’s extremist movements largely operate online. From the incel movement to the alt right, many subcultures are born online, and members use the internet as their primary method of contact and radicalization. This means group “belonging” is demarcated by language and nomenclature rather than the uniforms and marches that defined earlier extremist groups. Earlier groups – and most subcultures in general — maintained their own language to establish and solidify a sense of group belonging, but for some of these more recently established groups, coded language is vital. It’s used for everything from explaining how far one might be willing to go in the name of an extremist cause to weeding out interlopers and spies.

For the novice forum browser and researcher, these linguistic codes can be baffling to navigate, and for good reason: much of it is designed to confuse the uninitiated. Not only are the references often utterly opaque, they can also be wildly offensive, counter-intuitive and/or essentially meaningless.

This primer is meant to explain the fringe internet’s conspiratorial obsession with “pills,” widely used as a shorthand to identify one’s progress through radicalization, or to put it another way: a handy guide to how committed you are to a particular extremist ideology.

Most “pill” references harken back to the Red Pill, featured in the 1999 blockbuster movie “The Matrix,” in which Neo, played by Keanu Reeves, is offered a chance to see the world the way it really is.

Like many who find themselves drawn to fringe political ideas, Neo “feels something he can’t explain…that there’s something wrong with the world.” He is offered a choice: swallow the blue pill and remain in the world he knows, oblivious to the real truth, or take the red pill and finally see the *real* world.

What follows is a guide to the vast and confusing dispensary of virtual “pills” frequently referenced in extremist forums, chats and messages.

Note: Many of these pills have different meanings within different groups. It should also be noted that the term “redpilled” (it can be a noun, a verb and an adjective) can be completely innocuous. For the purposes of this explainer, we are examining the terminology primarily in its extremist context.

The Red Pill

The red pill is the most basic of pills, and it can refer to almost any kind of political awakening (and does not necessarily indicate a move towards extremism).

In posts about American political parties, the red pill generally refers to the GOP, while the blue pill is aligned with the Democratic Party.

For many, the red pill is just the first step in a longer journey. Being “redpilled” means shifting away from one set of beliefs to another set of (antithetical) beliefs. This can be as basic as a Democrat becoming a Republican, or as radical as someone coming to believe that Jews control the world or that feminism is destroying the West.

Mainstream usage of the term includes conservative speaker Candace Owens naming her YouTube channel “Redpilled Black,” a reference to her “awakening” as a black American and moving away from liberal beliefs in favor of conservatism and nationalism. Similarly, Fox News once referred to Kanye West as having taken the “red pill” when the rapper expressed his support for President Trump.

Crossover between the term’s mainstream and extremist application was on display during the 2016 presidential campaign, when candidate Donald Trump tweeted a picture of Hillary Clinton next to a Star of David with the caption “Most Corrupt Candidate Ever!” This prompted well-known white supremacist David Duke to tweet: “Nice to see Mr. Trump slipping some ‘Red Pills’ to the American people!”

In extremist terms, being redpilled means you have bought into at least one of the anti-Semitic, racist and conspiratorial tropes of the far-right movement. For many, it is the first tentative step down the rabbit hole toward radicalization.

In MRA (Men’s Rights Activists) and incel circles, the red pill is extremely specific and serves as an introduction to a particularly dystopian and misogynistic world view.

The incel red pill can be explained by the 80/20 rule, which says that 80% of women desire just 20% of men. This means that the vast majority of men will never be desirable and consequentially will never find sexual fulfillment and happiness. Among incels, the red pill represents the realization that feminism has caused a massive shift in power, and that feminism (understood by incels as women having the right to sleep with anyone they wish), gives women far too much power, and has led to “hypergamy,” incel speak for women pairing up with men who are more attractive. In most cases, the red pill is only a stepping stone; the far-right and the manosphere consider the red pill a call to action. For white supremacists, the redpill encourages political activism and fighting an anti-white system. For incels it means trying to be more attractive in an effort to join the 20% of men who get women. In this context, the red pill is almost optimistic. The world is unfair, and the odds are stacked against you, but you can fight back.

The Black Pill

For those on the extreme right, the black pill represents nihilism, or a realization that the system is too far gone to change. The powers that govern our lives are too deeply entrenched and too powerful to do anything about.

In the incel movement, the black pill is far more pernicious. The term was popularized on the men’s rights blog Omega Virgin Revolt, where it was first used by commenter Paragon in 2011. Like their extreme right counterparts, incels believe that taking the black pill means realizing that their situation is hopeless. Where redpilled incels are not happy about their place in society, they believe there are ways out of inceldom, including working out, plastic surgery and a host of dubious self-improvement strategies; blackpilled incels believe that their situation is permanent and inescapable. In a blackpilled world the sexual marketplace is governed exclusively by genetics. A man is either attractive to the opposite sex or he is not, and no amount of self-improvement can change this.

This is where the incel movement takes on characteristics of a death cult. Taking the black pill leaves a person with relatively few options: Giving up, or in incel parlance “LDAR” (Lie Down and Rot), suicide (incel forums are filled with suicidal fantasies and threats, as well as encouraging comments to those considering suicide) and “going ER.” The latter is a reference to Elliot Rodger, who killed six people near campus at the University of California, Santa Barbara, in 2014. In incel forums members, “Saint Elliot” or “The Supreme Gentleman” as they call him (and he called himself), is hailed as a hero.

While Rodger didn’t explicitly refer to himself as blackpilled, he displayed the key trait of the blackpill: He believed that attempting to change the status quo was futile and the only possible outcomes were death and violence. In a manifesto posted shortly before his killing spree, Rodger wrote:

think like beasts, and in truth, they are beasts. Women are incapable of having morals or thinking rationally. They are completely controlled by their depraved emotions and vile sexual impulses…Women should not have the right to choose who to mate and breed with. That decision should be made for them by rational men of intelligence…Women are vicious, evil, barbaric animals, and they need to be treated as such.

Similarly, Alek Minassian, who killed 10 people when he rammed a truck into a crowd in Toronto in 2018, and Scott Beierle, who killed two and injured four in a Tallahassee yoga studio in that same year did not publicly identify as blackpilled, but were viewed as blackpilled by others in the incel community.

The Rape Pill

The rape pill is a term used within a subset of the incel community whose members identify as “rapecels.” They believe all sexual interaction between men and women is (or should be) coercive. Women, they figure, are mindless beings incapable of making sexual decisions for themselves, so it is incumbent upon men to make those decisions for them. In the unlikely event an incel encounters a woman who does have the intellectual wherewithal to make this decision, the rape pill mentality holds that rape is still necessary. This is because incels believe every relationship requires one person to be dominant (the man) and the other to be submissive (the woman).

Rapecels believe that women who are raped are reassured on a primal level that because the (male) perpetrator is forceful, he is capable of taking care of her.

The Siege Pill

This is the most extreme pill, and represents the divergence between the “mainstream” far right — the faction that tries to bring about change within the established political system — and the radical, revolutionary vanguard.

The pill takes its name from neo-Nazi James Mason’s newsletter (and book) Siege, which encouraged and praised right-wing terror. A siegepilled person embraces violent acts of terror to accelerate the impending race war. Members of groups like Atomwaffen Division, an organization linked to several murders and terror plots, are siegepilled by nature of their membership. There are multiple references to Christchurch shooter Brenton Tarrant as having been siegepilled. The red, black and siegepills are the most concerning in terms of radicalization. The red pill represents the initial stage of radicalization and the blackpill and siegepill advance that radicalization and eliminate all but the direst possible outcomes of the radicalization process. Only a small minority of siegepilled and blackpilled individuals will go on to commit acts of violence, but individuals who have been black- or siegepilled tend to condone and encourage violence, creating a group dynamic and online echo chamber where violence is glorified, and violent actors canonized.

Other pills:

In addition to the three “pills” mentioned above, there are a host of extremely specific (often abhorrent) variations on the pill meme.

The Blue Pill

The blue pill is the counterpart to the red pill. The blue pill means remaining blissfully ignorant about how the world works. To those who have been redpilled, everyone else is bluepilled.

The Purple Pill

The purple pill is the incel version of centrism. It rejects both redpill and bluepill philosophies as misguided at best and idiotic or repulsive at worst. Purplepillers attempt to explain male-female behaviors in a more moderate and, relatively speaking, sensible way.

The Pink Pill

This pill is the female version of the incel black pill. While many incels argue that women by definition cannot be incels, since there will always be incels willing to sleep with women, femcels (female incels) do make up a small subset of incel culture. (Ironically, the original incel was a woman, a Canadian student who was outspoken about her lack of sexual activity). The pinkpill is femcels’ realization that no matter how fully they embody the perceived ideals of femininity (being thin, submissive and fully made-up) they will never be attractive to men.

The White Pill

The white pill refers to an optimistic worldview in the face of adversity. Like the red pill and the black pill, the white pill is not limited to a single subculture and is used by extremists of all stripes. Being whitepilled is believing in whatever movement you belong to and feeling good about your role within it. For instance, when President Trump declared that certain U.S. representatives should go back where they came from, white supremacist podcaster Nick Fuentes wrote on Telegram:

“I’m totally whitepilled by this latest Trump controversy. It reminds me of the reaction to the “drugs crime and rapists” comment at his announcement or the Muslim ban.”

The Bread Pill

The bread pill has different meanings to different subcultures. Among the extreme right it refers to embracing traditional Christian values of gender roles and family.

On the extreme left, the breadpill is a reference to the 1892 book The Conquest of Bread by Russian anarcho-communist Peter Kropotkin. In the book, which has become something of a primer for modern day activists, being breadpilled refers to joining the ranks of anarcho-communists.

The Iron Pill

Taking the iron pill most often refers to lifting weights and working out. Among the extreme right, being ironpilled refers to working out in preparation for the impending race war.

The Green Pill

The green pill is shorthand for environmentalism. Within the extreme right it can refer to eco-fascism, an ideology that mixes totalitarian fascism with radical environmentalism.

Those who subscribe to an eco-fascist world view, while not directly linked to any known acts of violence, are increasingly calling for violence against those whom they believe pose a threat to the environment. This perceived threat most often comes from Jews, whom eco-fascists believe care only about making money, even at the cost of the environment. As such, the siege pill may follow the green pill.

The Dog Pill

The dog pill is the belief among certain incels that women would rather sleep with dogs than them. They base this on extremely anecdotal evidence combined with speculation about canine anatomy relative to their own.

The Reverse Dog Pill

The is the incel response to the dog pill, and the idea is that if women would rather sleep with dogs than with them, then they in turn will start sleeping with dogs instead of women. The debate around this pill was tagged “SERIOUS” on a popular incel message board – which may be a strong indication it is not, in fact, taken seriously.

The JB Pill

Short for “jail bait” the JBpill is a reference to pedophilia. It is used mostly in the incel world, but even there only rarely, and incels should not be confused with pedophiles.

CHLORDIAZEPOXIDE 10MG CAPSULES

PATIENT INFORMATION LEAFLET- KENT & ALMUS
CHLORDIAZEPOXIDE 5mg AND 10mg CAPSULES
Read all of this leaflet carefully before you start taking this medicine because it contains important
information for you.
 Keep this leaflet. You may need to read it again.
 If you have further questions, ask your doctor or pharmacist.
 This medicine has been prescribed for you only. Do not pass it on to others. It may harm
them, even if their signs of illness are the same as yours.
 If you get any side effects, talk to your doctor or pharmacist or nurse. This includes any
possible side effects not listed in this leaflet. See section 4.
What is in this leaflet
1. What your medicine is and what it is used for
2. What you need to know before you take your medicine
3. How to take your medicine
4. Possible side effects
5. How to store your medicine
6. Contents of the pack and other information
1. WHAT YOUR MEDICINE IS AND WHAT IT IS USED FOR
The name of your medicine is Chlordiazepoxide 5mg Capsules or Chlordiazepoxide 10mg Capsules.
Chlordiazepoxide is a member of a group of medicines called benzodiazepine anxiolytics.
Your medicine can be used for the short-term relief (2-4 weeks treatment only) of:
 muscle spasm of varied cause.
 symptoms of alcohol withdrawal
 anxiety causing distress or insomnia (difficulty sleeping)
 anxiety occurring with mental health problems
2. WHAT YOU NEED TO KNOW BEFORE YOU TAKE YOUR MEDICINE
DO NOT take your medicine if you:
 are allergic to chlordiazepoxide or any of the other ingredients in chlordiazepoxide capsules. An
allergic reaction may include a rash, itching, difficulty breathing or swelling of the face, lips, throat or
tongue
 have reduced blood flow to the lungs- symptoms may include coughing and shortness of breath
 have any problems with your breathing
 have anxiety disorders due to unreasonable thoughts and fears (obsessional states)
 havea long-term mental condition causing hallucinations and delusions etc.
 have sleep apnoea (stopping breathing while asleep)
 have a severe liver disorder
 have a muscle weakness disorder known as myasthenia gravis
 suffer from depression that is not being treated.
 Chlordiazepoxide capsules are not to be used in anyone under 18 years of age.
Warnings and precautions
Talk to your doctor or pharmacist or nurse before taking Chlordiazepoxide capsules if you:
 if you are elderly, have suffered long-term lung, kidney or liver problems (as you may need to take a
lower dose)
 have recently suffered a bereavement or loss (your medicine may make it harder to come to terms
with your loss) should not be used as primary treatment or alone.
 suffer from psychiatric disorders such as schizophrenia, manic depression, delirium or senile
dementia have been taking this medication for a long period, as there is a risk of dependence; abrupt
termination of treatment results in withdrawal symptoms. These include headache, muscle pain,
extreme anxiety, tension, restlessness, nervousness, sweating, confusion and irritability; sleep
disturbance, diarrhoea, depression, rebound insomnia and mood changes.
 have a decrease in mental functions you should receive a lower dose
 have a history of drug or alcohol abuse
 Chlordiazepoxide capsules relax the muscles, therefore elderly patients should take extra care when
they get up at night as there is a risk of falls and consequently injuries, including hip fractures.
Taking other medicines
Your medicine may interfere with other medicines that you are taking. Please tell your doctor or
pharmacist if you are taking, or have recently taken any other medicines even those not prescribed.
Tell your doctor or pharmacist if you are taking any of the following medicines:

Anti-depressants, tranquillisers (e.g. diazepam), 
sleeping tablets, neuroleptics, hypnotics and
other such medicines which act on the brain and

nerves

drugs used to treat epilepsy (e.g. phenytoin,
phenobarbitone) or barbiturates or combinations
including them.

anaesthetic drugs (drugs used to put you to sleep
during an operation or surgery)




Medicines that affect the liver e.g. rifampicin, (a
drug used in the treatment of tuberculosis)
cimetidine (used to treat acid indigestion & 
ulcers), omeprazole (used to treat stomach
problems) disulfiram and contraceptive agents.

drugs known as dopaminergics, (e.g. levodopa,
used to treat Parkinson’s disease)

baclofen (muscle relaxant), cisparide (prevent
constipation), nabilone (anti sickness)
pain killers (e.g. codeine, morphine)
and anaesthetics.
drugs to treat high blood pressure
(antihypertensives)e.g., ACE inhibitors,
alpha blockers, angiotensin–II receptor
antagonists, calcium channel blockers,
adrenergic neurone blockers and
moxonidine.
drugs used to open blood vessels
(vasodilators) e.g. nitrates, hydralazine,
minoxidil and sodium nitroprusside.
drugs used to treat heart conditions
(cardiac drugs) e.g. digoxin.
drugs used to thin the
(anticoagulants) e.g. warfarin
blood
drugs that increase the loss of salt and
water from the body (diuretics) e.g.
furosemide.

sodium oxybate, used in patients with
narcolepsy

theophylline used to make breathing
easier

Antihistamines (used to for treating
allergies) that cause drowsiness (e.g
chlorphenamine)
Pregnancy, breast-feeding and fertility
DO NOT take this medicine if you are pregnant (especially during the first and last trimester), or might
become pregnant without consulting your doctor. Chlordiazepoxide may cause damage to the foetus.
DO NOT take this medicine if you are breast-feeding, as the drug may pass into breast milk. Always ask
your doctor or pharmacist for advice before taking any medicine.
Driving and using machines
This medicine may make you feel drowsy or affect your concentration. . Patients should be advised that
sedation, amnesia (forgetfulness), impaired concentration, dizziness, blurred vision and impaired
muscular function may occur and that, if affected, you should not drive or operate machinery or take part
in other activities where this would put themselves or others at risk. If insufficient sleep duration occurs,
the likelihood of impaired alertness may be increased.
Alcohol
You should avoid drinking any alcohol while you are taking chlordiazepoxide capsules, as you may feel
drowsy.
Important information about some of the ingredients of your medicine
Chlordiazepoxide Capsules contain lactose monohydrate. If you have been told by your doctor that you
have an intolerance to some sugars, contact your doctor before taking this medicinal product.
3. HOW TO TAKE YOUR MEDICINE
Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or
pharmacist if you are not sure. This medicine is for short-term relief only and should not be used beyond
4 weeks.The dose that your doctor prescribes will depend on the nature of your illness, your reaction to
the medicine, your age, and bodyweight. Do not change the prescribed dose yourself. The label on your
medicine should also tell you.. If you think that the effect of your medicine is too weak or too strong,talk
to your doctor.
Your doctor will decide the correct dosage for your condition.
Swallow the capsule(s) whole with a glass of water.
Adults
 Anxiety: The usual dose is 5mg three times daily and increased if necessary up to 100mg daily in
divided doses.
 Sleeping disorders (insomnia) associated with anxiety: The usual dose is 10mg to 30mg before going
to bed.
 Relief of symptoms of withdrawal from alcohol: The usual dose is 25mg to 100mg repeated if
necessary 2 to 4 hours after the initial dose, if necessary.
 Relaxation of muscle spasms: The usual dose is 10mg to 30mg daily in divided doses throughout the
day.
Children
Chlordiazepoxide Capsules are NOT recommended for use in children.
Elderly
The elderly are particularly sensitive to the effects of this medicine and may experience confusion. The
usual maximum dose for elderly patients is half the adult dose.
Overdose: If you take more of your medicine than you should
If you take too many capsules tell a doctor or contact your nearest hospital casualty department
immediately. Take your medicine with you.
If you forget to take your medicine
If you forget to take a dose of your medicine at the correct time, take it as soon as you remember then
carry on as before. Do not take a double dose to make up for a forgotten dose.
If you stop taking your medicine
Long term treatment with chlordiazepoxide, especially in high doses, may lead to dependence, with
withdrawal symptoms after stopping treatment. Your doctor will advise you on this. Keep taking your
medicine until your doctor tells you to stop. Withdrawal effects may occur if the medicine is stopped
suddenly. This is less likely if your dose is gradually reduced towards the end of your treatment.
Withdrawal symptoms may include:







Difficulty sleeping
Depression
Nervousness
Irritability
Changes in behaviour
restlessness
extreme anxiety





Sweating
Diarrhoea
Confusion
headaches and muscle pain
tension
In severe cases the following symptoms may occur:
 changes in mood and behaviour or the way you are feeling
 tingling sensations and numbness of the extremities
 over-sensitivity to light, noise and touch
 feeling of unreality or being separated from the body
 hallucinations
 Fits (seizures and convulsions)
 If you are woken up soon after taking the medicine your memory maybe temporarily affected.
The number of Chlordiazepoxide Capsules and how often you take them should always be reduced slowly
before stopping them. Treatment should not be continued at the full dose beyond 4 weeks. Long term use
is not recommended.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist or nurse.
4. POSSIBLE SIDE EFFECTS
Like all medicines, Chlordiazepoxide can cause side effects, although not everybody gets them.
Stop taking Chlordiazepoxide Capsules and see a doctor or go to a hospital straight away if develop
any of the following symptoms: A severe allergic (anaphylaxis) or serious allergic reaction which causes
swelling of your face or throat (angioedema), difficulty breathing, thoughts of self harm, yellowing of
the skin and eyes (jaundice), abnormality in the blood with symptoms such as weakness, bleeding
problems, pale skin, sore throat and frequent infections.
If these behavioural symptoms occur, you must inform your doctor. He/she may want you to stop
taking this medicine. Tell your doctor or pharmacist if you develop any of the following side
effects:
Common side effects may affect up to 1 in 10 people





drowsiness and lightheadedness the next day.
sedation and dizziness- symptoms include slurred speech, lack of co-ordination, tiredness or
sometimes blackouts
ataxia- symptoms include unsteadiness and clumsiness
difficulty controlling movements
dependence
Rare side effects may affect up to 1 in 1,000 people









dizziness
vertigo
skin rashes
changes in sex drive
difficulty passing urine
incontinence


headache
problems with your eye sight
including double vision and
blurred vision
 stomach upsets
 numbed emotions
 menstrual disorder
blood disorders (e.g. blood dyscrasias symptoms include weakness, pale skin and bleeding problems)
lowering of blood pressure- symptoms include light-headedness, feeling dizzy or faint.
The following side effects have also been reported (Frequency unknown):
 Decreased level of consciousness
 Aggressive outbursts, inappropriate behaviour
 restlessness, agitation, delusion, nightmares, increased liver enzymes, changes in the way you walk
and muscle weakness.
 Paradoxical reactions (e.g. saliva altered, anxiety, sleep disorders, insomnia, suicide attempt, suicidal
ideation)
 tremors, stiffness and slow movement.
 hallucinations and nightmares
If any of the side effects get serious, or if you notice any side effects not listed in this leaflet, please
tell your doctor or pharmacist.
Reporting of side effects
If you get any side effects, talk to your doctor or pharmacist or nurse. This includes any possible side
effects not listed in this leaflet. You can also report side effects directly via the yellow card scheme at
www.mhra.gov.uk/yellowcard. By reporting side effects you can help provide more information on the
safety of this medicine.
5. HOW TO STORE YOUR MEDICINE
Keep this medicine out of the sight and reach of children.
Do not take your medicine after the expiry date, which is stated on the carton or pot label. The expiry date
refers to the last day of that month.
Store your capsules below 25oC.
Return any unused capsules to your pharmacist. Only keep them if your doctor tells you to.
Do not use this medicine if you notice any visible signs of deterioration or damage.
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw
away medicines you no longer use.
These measures will help protect the environment.
6. CONTENTS OF THE PACK AND OTHER INFORMATION
What Chlordiazepoxide contains
The capsules contain either 5mg or 10mg of the active substance chlordiazepoxide hydrochloride.
The other ingredients are lactose monohydrate, maize starch and magnesium stearate. The capsule shell
contains the ingredients Erythrosine (E127) (5mg Capsules only), Iron oxide black (10mg Capsules only),
Titanium dioxide, Indigo Carmine (E132), Quinoline Yellow (E104), Gelatin. The printing ink contains
the ingredients: Shellac, Dehydrated alcohol, Isopropyl alcohol, Butyl alcohol, Propylene glycol, Strong
Ammonia solution, Purified water, Potassium hydroxide and Titanium dioxide
What Chlordiazepoxide looks like and the contents of the pack
The 5mg capsules have a yellow body and turquoise cap and are marked “CDP 5” in white.
The 10mg capsules have a green body and black cap and are marked “CDP 10” in white.
The capsules are available in pots containing 28, 30, 56, 60, 100 and 500 capsules and blisters containing
28, 30 and 100 capsules, only on prescription from your doctor. Not all pack types or sizes may be
marketed.
Marketing Authorisation Holder
Athlone Laboratories Limited, Ballymurray, Co. Roscommon, Ireland.
Company responsible for release of this medicine
Kent Pharmaceuticals Limited, Crowbridge Road, Ashford, Kent, TN24 0GR, U.K.
Kent Pharmaceuticals Limited, Repton Road, Measham, DE12 7DT, U.K.
Distributor
Kent Pharmaceuticals Limited, Repton Road, Measham, DE12 7DT, U.K.
PL 06453/0002 and PL 06453/0003
This leaflet was last revised May 2017
ALMUS LEAFLET STATES:
Distributor
Almus Pharmaceuticals, 43 Cox Lane, Chessington, KT9 1SN, UK
This leaflet was last revised

The Effects of Mixing Chlordiazepoxide and Alcohol

Alcohol addiction is a condition that can be treated outside a drug and alcohol rehabilitation facility. A healthcare professional can prescribe a benzodiazepine such as chlordiazepoxide after a medical examination. However, some people find it hard to restrain from drinking alcohol while in therapy. Before discussing the effects of mixing chlordiazepoxide and alcohol, it is best to learn first what chlordiazexopide is and the benefits and risks of taking it as an alcohol withdrawal treatment.

What is Chlordiazepoxide?

Chlordiazepoxide is a sedative and hypnotic drug that belongs to the drug class of benzodiazepines, a class of psychoactive drugs that are used for treating anxiety, agitation, insomnia, muscle spasms, seizures, and alcohol withdrawal.

Chlordiazepoxide is a sedative and hypnotic drug that belongs to the drug class of benzodiazepines, a class of psychoactive drugs that are used for treating anxiety, agitation, insomnia, muscle spasms, seizures, and alcohol withdrawal. Chlordiazepoxide is the most prescribed drug for alcohol withdrawal due to its long half-life, which means that some of its active metabolites are still in effect even after two days of prior of intake. The drug’s very long half-life makes it ideal for relieving symptoms of alcohol withdrawal. However, elderly people require special precaution, as there are risks of drug accumulation and prolonged action, which, in turn, may lead to cases of drug abuse, dependence, or overdose. Similarly, pregnant and lactating women must first consult a healthcare provider prior to the drug’s intake or continuation of use.

Taking chlordiazepoxide can induce common side effects like confusion, constipation, fainting, liver problems, drowsiness, nausea, allergy, swelling caused by fluid retention, lack of muscle coordination, jaundice, and menstrual irregularities. If you experience uncommon symptoms, consult your doctor immediately.

Have you been drinking?

Apo-Chlordiazepoxide

How does this medication work? What will it do for me?

Chlordiazepoxide belongs to the class of medications called benzodiazepines. Chlordiazepoxide is used for the short-term relief of the symptoms of excessive anxiety and tension experienced with anxiety disorders. It may also be used to control symptoms, such as agitation, caused by alcohol withdrawal. It works by slowing down the speed at which the nerves in the brain (i.e., the central nervous system) send messages through the body.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

This medication is available as 5 mg, 10 mg, and 25 mg capsules.

How should I use this medication?

The recommended initial adult dose of chlordiazepoxide ranges from 10 mg to 40 mg daily in divided doses. Children’s doses usually start at 5 mg to 10 mg daily and may be increased to 30 mg daily divided into 2 or 3 doses if necessary. It is important that the dose be individualized to your specific needs to avoid excessive drowsiness. For some adults, the dose may be increased to 100 mg daily in divided doses.

Chlordiazepoxide is normally used for a short period of time or as an “as required” medication. It may be habit-forming when taken for long periods of time. If you have been taking this medication regularly for a long period of time (i.e., for more than one month), do not stop taking the medication without first speaking with your doctor. To avoid withdrawal effects, a gradual dose reduction is usually recommended when stopping this medication.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If your doctor has told you to take this medication regularly and you miss a dose, take it as soon as possible and continue with your regular schedule. If your next dose is in less than 4 hours, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take chlordiazepoxide if you:

  • are allergic to chlordiazepoxide or any ingredients of the medication
  • are allergic to any other benzodiazepines (e.g., diazepam, lorazepam)
  • have myasthenia gravis
  • have acute narrow angle glaucoma

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • changes in sexual desire or ability
  • clumsiness or unsteadiness
  • constipation
  • dizziness or lightheadedness
  • drowsiness
  • false sense of well-being
  • menstrual changes
  • nausea
  • trouble sleeping
  • unusual tiredness or weakness
  • vomiting

Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • agitation
  • anxiety
  • behavioural changes, including:
    • aggressiveness
    • bizarre behaviour
    • decreased inhibition
    • angry outbursts
  • confusion
  • signs of breathing problems such as shallow, irregular breathing, or slow or troubled breathing
  • signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
  • skin rash or itching
  • swelling ankles and feet
  • more frequent symptoms of infection (e.g., sore throat, fever, and chills)
  • uncontrolled movements of body, including the eyes
  • unusual excitement, nervousness, or irritability

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • symptoms of a severe allergic reaction (such as hives, difficulty breathing, or swelling of the face or throat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take this medication.

Dependence/withdrawal: Physical dependence (a need to take regular doses to prevent physical symptoms) has been associated with benzodiazepines such as chlordiazepoxide. Severe withdrawal symptoms may occur if the dose is significantly reduced or suddenly discontinued. These symptoms include seizures, irritability, nervousness, sleep problems, agitation, tremors, diarrhea, abdominal cramps, vomiting, memory impairment, headache, muscle pain, extreme anxiety, tension, restlessness, and confusion. Reducing the dose gradually under medical supervision can help prevent or decrease these withdrawal symptoms.

Drowsiness/reduced alertness: Because chlordiazepoxide causes drowsiness and sedation, do not engage in activities requiring mental alertness, judgment, and physical coordination (such as driving or operating machinery) while taking it. This is particularly true when first starting the medication and until you have established that chlordiazepoxide does not affect you in this way. Avoid alcohol because it can increase the drowsy effect of the medication.

Medical conditions: Chlordiazepoxide is not recommended for people with depression or psychosis. You should not take chlordiazepoxide if you are addicted to alcohol or other medications except in rare situations under medical supervision.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication may pass into breast milk. If you are a breast-feeding mother and are taking chlordiazepoxide, it may affect your baby. This medication is not recommended for breast-feeding women.

Seniors: Seniors may be at increased risk for the drowsiness and impaired coordination effects of this medication. You should use extra caution, for example, when getting up during the night.

What other drugs could interact with this medication?

There may be an interaction between chlordiazepoxide and any of the following:

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

All material copyright MediResource Inc. 1996 – 2020. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Apo-Chlordiazepoxide

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