Chlordiazepoxide and Clidinium
Chlordiazepoxide and clidinium is a combination capsule of a benzodiazepine (a calming medicine) and an anticholinergic (a gut-spasm reliever), used for stomach and bowel disorders that have an emotional component, and as add-on treatment for peptic ulcer, irritable bowel syndrome and acute enterocolitis.
🧬 Where this information comes from Click to expand
The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 19 clinical label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →
Chlordiazepoxide and clidinium (Librax), an older standby on the market since about 1966 and available as a generic, pairs a benzodiazepine, a calming medicine, with an anticholinergic that eases gut spasms and slows the bowel, for digestive disorders where stress plays a part and as an add-on for peptic ulcer, irritable bowel syndrome and acute enterocolitis. The usual complaints are drowsiness, dry mouth, constipation and blurred vision, and older adults are prone to confusion and unsteadiness. Its boxed warning covers deep sedation and slowed breathing with opioids, plus addiction and dependence, so avoid alcohol and opioids unless your prescriber says otherwise and never stop suddenly, since withdrawal can cause seizures.
Clinical pearls
- Take each dose before meals and at bedtime, the schedule the label describes for this capsule.
- Do not take it if you have glaucoma, an enlarged prostate or a bladder neck blockage.
- Combining it with other spasm-relieving medicines makes constipation more likely, so list every gut medicine you use.
- With long-term use, expect periodic blood counts and liver tests, and report yellowing skin or eyes promptly.
⚠️ FDA Boxed Warning — the FDA’s strongest safety alert ▾
Taking this medicine with opioids can cause extreme sleepiness, slowed breathing, coma and death. It should be combined only when no other options work, at the lowest dose for the shortest time.
The benzodiazepine in it can also lead to abuse, misuse and addiction, which can cause overdose or death. The risk rises with other medicines, alcohol or illicit substances.
With continued use your body can become physically dependent. Stopping suddenly or cutting the dose quickly can cause withdrawal reactions that may be life-threatening, such as seizures. Higher doses and longer use raise the risk. Your prescriber should taper the dose gradually.
Patient information guide A plain-language walkthrough of Chlordiazepoxide and Clidinium, written from its FDA label.
What Chlordiazepoxide and Clidinium is used for
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This combination capsule is used for digestive conditions with an emotional component. The label lists these uses for the generic capsules and for Librax:
- Controlling emotional and somatic (physical) factors in gastrointestinal disorders
- Add-on treatment for peptic ulcer
- Add-on treatment for irritable bowel syndrome (irritable colon, spastic colon, mucous colitis)
- Add-on treatment for acute enterocolitis
How Chlordiazepoxide and Clidinium works
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Chlordiazepoxide is a benzodiazepine. Animal studies suggest it acts on the limbic system of the brain, which is involved in emotional responses. Clidinium is an anticholinergic. It blocks acetylcholine-driven spasms in the intestines and reduces gut movement.
Together they address both the nervous and the digestive parts of these conditions.
Chlordiazepoxide and Clidinium dosage
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These capsules are taken by mouth. The usual maintenance schedule on the label is 1 or 2 capsules, 3 or 4 times a day, before meals and at bedtime.
- Your prescriber individualizes the dose based on your diagnosis and response.
- Older adults start low, with no more than 2 capsules per day at first, and increase gradually as needed and tolerated.
- Do not stop suddenly after continued use. Your prescriber should guide a slow taper.
Dosing details from the FDA-approved label
From the Chlordiazepoxide and Clidinium prescribing information (“Dosage and Administration”). Doses are set by your prescriber for your product, condition, kidney function and age — never change a dose on your own.
- Usual maintenance dose (general)
- 1 or 2 capsules, 3 or 4 times a day administered before meals and at bedtime
- Dosage should be individualized for maximum beneficial effects
- Optimum dosage varies with the diagnosis and response of the individual patient
- Geriatric patients
- Initial dose should not exceed 2 capsules per day, to be increased gradually as needed and tolerated
- Limit to the smallest effective amount to preclude the development of ataxia, oversedation or confusion
- Discontinuation or dosage reduction
- Use a gradual taper to discontinue or reduce the dosage
- If withdrawal reactions develop, consider pausing the taper or increasing the dosage to the previous tapered dosage level, then decrease the dosage more slowly
Read the label’s full dosing text
DOSAGE AND ADMINISTRATION Recommended Dosage Because of the varied individual responses to tranquilizers and anticholinergics, the optimum dosage of chlordiazepoxide hydrochloride and clidinium bromide capsules varies with the diagnosis and response of the individual patient. The dosage, therefore, should be individualized for maximum beneficial effects. The usual maintenance dose is 1 or 2 capsules, 3 or 4 times a day administered before meals and at bedtime. Recommended Geriatric Dosage Dosage should be limited to the smallest effective amount to preclude the development of ataxia, oversedation or confusion. The initial dose should not exceed 2 chlordiazepoxide hydrochloride and clidinium bromide capsules per day, to be increased gradually as needed and tolerated. Elderly patients have an increased risk of dose-related adverse reactions (see PRECAUTIONS ). Discontinuation or Dosage Reduction of Chlordiazepoxide Hydrochloride and Clidinium Bromide Capsules To reduce the risk of withdrawal reactions, use a gradual taper to discontinue chlordiazepoxide hydrochloride and clidinium bromide capsules or reduce the dosage. If a patient develops withdrawal reactions, consider pausing the taper or increasing the dosage to the previous tapered dosage level. Subsequently decrease the dosage more slowly (see WARNINGS and DRUG ABUSE AND DEPENDENCE ).
Recommended Dosage Because of the varied individual responses to tranquilizers and anticholinergics, the optimum dosage of chlordiazepoxide hydrochloride and clidinium bromide capsules varies with the diagnosis and response of the individual patient. The dosage, therefore, should be individualized for maximum beneficial effects. The usual maintenance dose is 1 or 2 capsules, 3 or 4 times a day administered before meals and at bedtime.
Discontinuation or Dosage Reduction of Chlordiazepoxide Hydrochloride and Clidinium Bromide Capsules To reduce the risk of withdrawal reactions, use a gradual taper to discontinue chlordiazepoxide hydrochloride and clidinium bromide capsules or reduce the dosage. If a patient develops withdrawal reactions, consider pausing the taper or increasing the dosage to the previous tapered dosage level. Subsequently decrease the dosage more slowly (see WARNINGS and DRUG ABUSE AND DEPENDENCE ).
Read the full Dosage and Administration section on DailyMed →
Chlordiazepoxide and Clidinium side effects
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Most side effects come from the two ingredients. Common ones include:
Common side effects
- Dry mouth
- Blurred vision
- Trouble starting urination (urinary hesitancy)
- Constipation
- Drowsiness
- Unsteadiness (ataxia)
- Confusion, especially in older or frail people
When to get medical help
- Get emergency help for extreme sleepiness, slow or trouble breathing, or being hard to wake, especially if you also take opioids or alcohol.
- Call your doctor if you notice signs of misuse or addiction, such as taking more than prescribed or craving the medicine.
- Seek help right away for seizures or other severe withdrawal symptoms after stopping or cutting back quickly.
- Tell your doctor if you faint.
- Report skin rash, jaundice (yellowing of skin or eyes), or other signs of blood or liver problems.
- Call your doctor about worsening confusion, unsteadiness or oversedation, especially in older adults.
Fainting has been reported in a few cases. Blood and liver problems have occasionally been reported with chlordiazepoxide, so tell your doctor about rash, yellowing of the skin or eyes, or unusual symptoms.
Chlordiazepoxide and Clidinium warnings and precautions
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- Opioids: combining can cause profound sedation, slowed breathing, coma and death.
- Abuse, misuse and addiction: these can lead to overdose or death. Risk is higher with alcohol or other substances.
- Dependence and withdrawal: abrupt stopping can cause life-threatening reactions such as seizures. Some people have withdrawal symptoms lasting weeks to over 12 months.
- Driving and machinery: avoid hazardous tasks needing full alertness.
- Pregnancy: use in the first trimester should almost always be avoided.
Chlordiazepoxide and Clidinium interactions
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Sedating substances are the main concern.
- Opioids: add to breathing suppression and sedation.
- Alcohol and other CNS depressants: effects can add together.
- Oral anticoagulants: variable effects on clotting have been reported very rarely.
- Other spasm-relieving medicines: constipation has been most common with these.
- Flumazenil: can trigger withdrawal reactions, including seizures.
Interactions listed in the FDA-approved label
From the Chlordiazepoxide and Clidinium prescribing information (“Drug Interactions”): what the manufacturer studied or reported to the FDA.
- Opioids: Concomitant use of benzodiazepines, including chlordiazepoxide hydrochloride, and opioids increases the risk of respiratory depression because of actions at different receptor sites in the CNS that control respiration. Limit dosage and duration of concomitant use, and follow patients closely for respiratory depression and sedation.
- Oral anticoagulants: Variable effects on blood coagulation have been reported very rarely in patients receiving oral anticoagulants and chlordiazepoxide hydrochloride, although clinical studies have not established a cause and effect relationship. Physicians should be aware of this possibility.
Read the label’s full interactions text
Drug Interactions Opioids The concomitant use of benzodiazepines, including chlordiazepoxide hydrochloride, a component of chlordiazepoxide hydrochloride and clidinium bromide capsules, and opioids increases the risk of respiratory depression because of actions at different receptor sites in the CNS that control respiration. Benzodiazepines interact at GABA A sites and opioids interact primarily at mu receptors. When benzodiazepines and opioids are combined, the potential for benzodiazepines to significantly worsen opioid-related respiratory depression exists. Limit dosage and duration of concomitant use of chlordiazepoxide hydrochloride and clidinium bromide capsules and opioids, and follow patients closely for respiratory depression and sedation. Oral Anticoagulants Although clinical studies have not established a cause and effect relationship, physicians should be aware that variable effects on blood coagulation have been reported very rarely in patients receiving oral anticoagulants and chlordiazepoxide hydrochloride, a component of chlordiazepoxide hydrochloride and clidinium bromide capsules. Pregnancy Risk Summary Chlordiazepoxide Hydrochloride Neonates born to mothers using benzodiazepines during the later stages of pregnancy have been reported to experience symptoms of sedation and/or neonatal withdrawal (see WARNINGS , Neonatal Sedation and Withdrawal Syndrome and PRECAUTIONS , Clinical Considerations ). Available data from published observational studies of pregnant women exposed to benzodiazepines do not report a clear association with benzodiazepines and major birth defects (see Data) . Clidinium Bromide Over decades of use, there is an absence of published data on orally administered clidinium bromide in pregnant women, including an absence of any reports of a drug-associated risk of major birth defects, miscarriage, or other adverse maternal or fetal outcomes.
Excerpted — the section continues on the label. Read the full Drug Interactions section on DailyMed →
Not a complete list. The label covers the interactions the manufacturer studied or reported, and our own interaction database does not cover every medicine either. Bring your full medication list, including vitamins and herbal products, to your pharmacist.
Before taking Chlordiazepoxide and Clidinium
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- Do not use if you have glaucoma.
- Do not use if you have an enlarged prostate or benign bladder neck obstruction.
- Do not use if you are allergic to chlordiazepoxide or clidinium.
- Tell your doctor if you are pregnant or planning pregnancy.
- Tell your doctor if you are breastfeeding. Clidinium may suppress lactation, and infants should be watched for sedation and poor feeding.
- Older adults need lower starting doses and have a higher risk of side effects.
Chlordiazepoxide and Clidinium overdose
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Too much can cause drowsiness, confusion, poor coordination, slurred speech, slowed breathing and coma. Anticholinergic effects can include dry skin and mouth, flushing, fast heartbeat, urinary retention, agitation, delirium and seizures. Mixing with alcohol or opioids can be fatal. Call a poison center at 1-800-222-1222 or seek emergency care.
What Chlordiazepoxide and Clidinium does in the body
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Chlordiazepoxide is a benzodiazepine. Animal studies suggest it acts on the limbic system and has a calming effect at doses below those that cause sedation. Clidinium is an anticholinergic with activity similar to atropine against intestinal spasms. It reduces intestinal motility and can reduce saliva.
How to store Chlordiazepoxide and Clidinium
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Store at 20°C to 25°C (68°F to 77°F); excursions permitted between 15°C to 30°C (59°F to 86°F). Dispense in Tight Containers. Keep out of reach of children .
Written from the FDA-approved label with AI and reviewed by our pharmacy team. How we use AI →
Supplements & herbs that interact with Chlordiazepoxide and Clidinium
188 supplements and herbal products have documented interactions with Chlordiazepoxide and Clidinium in the licensed clinical database we use. Most are manageable — but your pharmacist should know about everything you take, including vitamins and herbals.
- Major · 10
- Moderate · 142
- Minor · 36
Educational information from a licensed clinical database (Natural Medicines) — see our data sources & update cadence. Not medical advice: an interaction being documented does not mean it will happen to you; do not start or stop medications or supplements without professional guidance.
Chlordiazepoxide and Clidinium: pharmacist answers to common questions
Quick, plain-English answers to the questions patients ask most about Chlordiazepoxide and Clidinium — the kind of thing our pharmacy team would talk through with you at the counter.
What is this medicine for?
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How should I take it?
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What side effects should I expect?
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Can I drink alcohol or take pain medicines with it?
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Who shouldn't take it?
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Is it safe for older adults?
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Is Chlordiazepoxide and Clidinium available over the counter?
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When was Chlordiazepoxide and Clidinium first available?
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Who makes Chlordiazepoxide and Clidinium?
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Answers drafted from the FDA-approved label with AI and reviewed by our pharmacy team. How we use AI →
More about Chlordiazepoxide and Clidinium on HelloPharmacist
Chlordiazepoxide and Clidinium forms and strengths (how it comes)
Chlordiazepoxide and Clidinium is available in 1 form. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.
Capsule
How this form is used
- Librax capsules are used to control emotional and somatic factors in gastrointestinal disorders.
- Librax may also be used as add-on treatment for peptic ulcer, irritable bowel syndrome and acute enterocolitis.
- Librax is taken by mouth, usually 1 or 2 capsules 3 or 4 times a day before meals and at bedtime, as individualized by the prescriber.
- Librax: older adults should start with no more than 2 capsules per day, increased gradually if needed.
- Librax should be tapered gradually when stopping or lowering the dose.
Chlordiazepoxide and Clidinium on the U.S. market: products, makers and brands
How Chlordiazepoxide and Clidinium appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.
13 companies list 18 Chlordiazepoxide and Clidinium product records with the FDA, mostly as capsule; the earliest marketing or approval year on record is 1966. Brand names on the directory include Librax, Clindex, Chlordiazepoxide Hydrochloride and Clidinium Bromide and 2 more; the rest are generics.
Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.
How widely Chlordiazepoxide and Clidinium is used (Medicaid data)
A general measure of how commonly Chlordiazepoxide and Clidinium is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.
Think of this as a proxy for how widely Chlordiazepoxide and Clidinium is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.
How commonly is Chlordiazepoxide and Clidinium prescribed? Of the 1,601 medications we measure, Chlordiazepoxide and Clidinium ranks #1,169 by Medicaid prescriptions — more than 27% of them.
Utilization by Chlordiazepoxide and Clidinium product
Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.
chlordiazepoxide hydrochloride 5 MG / clidinium bromide 2.5 MG Oral Capsule
Summed across the 4 of 42 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 889614
Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.
Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Chlordiazepoxide and Clidinium, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 4 of 42 listed Chlordiazepoxide and Clidinium NDCs with Medicaid activity.
Compare Chlordiazepoxide and Clidinium products
A representative set of FDA-listed product records for Chlordiazepoxide and Clidinium — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)
| Strength | Route | Manufacturer / Labeler | Category ⓘ | Details |
|---|---|---|---|---|
| 💊Capsule | ||||
| CHLORDIAZEPOXIDE HYDROCHLORIDE 5 mg/1; CLIDINIUM BROMIDE 2.5 mg | Oral | Alembic Pharmaceuticals Inc. | ANDA | View NDC → |
| CHLORDIAZEPOXIDE HYDROCHLORIDE 5 mg/1; CLIDINIUM BROMIDE 2.5 mg | Oral | Alembic Pharmaceuticals Limited | ANDA | View NDC → |
| CHLORDIAZEPOXIDE HYDROCHLORIDE 5 mg/1; CLIDINIUM BROMIDE 2.5 mg | Oral | American Health Packaging | ANDA | View NDC → |
| CHLORDIAZEPOXIDE HYDROCHLORIDE 5 mg/1; CLIDINIUM BROMIDE 2.5 mg | Oral | Amneal Pharmaceuticals NY LLC | ANDA | View NDC → |
| CHLORDIAZEPOXIDE HYDROCHLORIDE 5 mg/1; CLIDINIUM BROMIDE 2.5 mg | Oral | Ascend Laboratories, LLC | ANDA | View NDC → |
| CHLORDIAZEPOXIDE HYDROCHLORIDE 5 mg/1; CLIDINIUM BROMIDE 2.5 mg | Oral | Aurobindo Pharma Limited | ANDA | View NDC → |
| CHLORDIAZEPOXIDE HYDROCHLORIDE 5 mg/1; CLIDINIUM BROMIDE 2.5 mg | Oral | Bausch Health US, LLC | NDA | View NDC → |
| CHLORDIAZEPOXIDE HYDROCHLORIDE 5 mg/1; CLIDINIUM BROMIDE 2.5 mg | Oral | Bryant Ranch Prepack × 6 listings | ANDA | View NDC → |
| CHLORDIAZEPOXIDE HYDROCHLORIDE 5 mg/1; CLIDINIUM BROMIDE 2.5 mg | Oral | Chartwell RX, LLC | ANDA | View NDC → |
| CHLORDIAZEPOXIDE HYDROCHLORIDE 5 mg/1; CLIDINIUM BROMIDE 2.5 mg | Oral | Micro Labs Limited | ANDA | View NDC → |
| CHLORDIAZEPOXIDE HYDROCHLORIDE 5 mg/1; CLIDINIUM BROMIDE 2.5 mg | Oral | Misemer Pharmaceuticals, Inc | ANDA | View NDC → |
| CHLORDIAZEPOXIDE HYDROCHLORIDE 5 mg/1; CLIDINIUM BROMIDE 2.5 mg | Oral | Sunrise Pharmaceutical, Inc. | ANDA | View NDC → |
| CHLORDIAZEPOXIDE HYDROCHLORIDE 5 mg/1; CLIDINIUM BROMIDE 2.5 mg | Oral | Winder Laboratories LLC | ANDA | View NDC → |
Showing 18 of 18 products — FDA National Drug Code Directory. See every product, package size and price: browse all 18 Chlordiazepoxide and Clidinium NDCs →
Chlordiazepoxide and Clidinium side effects reported to the FDA (FAERS)
After a medicine reaches the market, patients, doctors and drugmakers can send the FDA reports of problems they think may be linked to it. Here’s what’s been reported for Chlordiazepoxide and Clidinium — a signal of what to watch for, not proof the drug caused it.
Source: openFDA, from the FDA Adverse Event Reporting System (FAERS). These are voluntary reports — they don’t prove the drug caused the effect, and counts reflect how often something was reported, not how often it actually happens. Reports also often name the very problem the medicine is taken for — a common reason to file one is that the drug didn’t help — so for a pain reliever you may see “pain” high on the list; that points to why the report was filed, not to the drug causing the symptom. This counts every report that lists Chlordiazepoxide and Clidinium in any role, so the total runs higher than the FDA’s official dashboard, which counts only cases where the drug is the suspect. For the authoritative figures, see the FDA FAERS Public Dashboard. Always talk to your pharmacist or doctor.
Chlordiazepoxide and Clidinium FDA approval history
How Chlordiazepoxide and Clidinium went from FDA review to the pharmacy shelf — the key milestones in its regulatory journey.
Source: Drugs@FDA.
Chlordiazepoxide and Clidinium recall history
A recall is when a specific batch of a medicine is pulled from the market — usually a manufacturing issue, not a problem with the drug itself. Class I is most serious, Class III least.
The FDA’s enforcement reports list no Chlordiazepoxide and Clidinium recalls since July 2021.
✅No Chlordiazepoxide and Clidinium recalls on record since July 2021Source: FDA enforcement (recall) reports, via openFDA; our copy was last updated Sep 24, 2026.
Chlordiazepoxide and Clidinium supply and shortage status
Whether Chlordiazepoxide and Clidinium is in short supply in the U.S. right now, plus any shortage history the FDA has on record. A shortage usually reflects a manufacturing or demand issue — not a safety problem with the drug.
Source: openFDA, from the FDA Drug Shortages database.
Chlordiazepoxide and Clidinium brand names
Chlordiazepoxide and Clidinium is sold under 5 brand names in the FDA directory — Librax, Clindex, Chlordiazepoxide Hydrochloride and Clidinium Bromide, Chlordiazepoxide Hcl And Clidinium Bromide and others. A brand and its generic contain the same active ingredient; the brand name belongs to one company's product.
Who makes Chlordiazepoxide and Clidinium: manufacturers and labelers
13 companies list Chlordiazepoxide and Clidinium products with the FDA. By number of product records, the largest are Bryant Ranch Prepack, Alembic Pharmaceuticals Inc., Alembic Pharmaceuticals Limited. Labelers include manufacturers and repackagers; the product in your bottle depends on which one your pharmacy stocks.
Chlordiazepoxide and Clidinium drug class (RxNorm)
Chlordiazepoxide and Clidinium belongs to the Anticholinergic class.
Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.
Sources for this Chlordiazepoxide and Clidinium page
Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.
How this page is built
HelloPharmacist combines public FDA and NLM records and does not author the underlying clinical facts. The plain-language sections are written with AI from the FDA-approved label text and reviewed by our pharmacy team before publication. Bausch Health US LLC is the representative DailyMed label linked for verification and dates. This is general education, not medical advice: always talk to your doctor or pharmacist about your own medicines. How we build and review drug pages →