Chlordiazepoxide Hydrochloride and Clidinium Bromide 5 mg; 2.5 mg Capsule, 20-count — NDC 60687-0639-94 package photo

Chlordiazepoxide Hydrochloride and Clidinium Bromide 5 mg; 2.5 mg Capsule, 20-count

by American Health Packaging · 20 BLISTER PACK in 1 CARTON (60687-639-94) / 1 CAPSULE in 1 BLISTER PACK (60687-639-11)
NDC 60687-0639-94
🏷️ FDA NDC (as labeled) 60687-639-94 billing pads the product segment with a zero
Rx only Generic On market CIV
🗂️ Data synced Jul 24, 2026 · sources: openFDA · FDA label (DailyMed) · FDA Orange & Purple Book · First Databank · CMS NADAC, ASP, Medicare & Medicaid · RxNorm
📋 All sources & update times →

🆔 Identity & classification

FDA NDC (as labeled) 60687-639-94
Product NDC 60687-639
11-digit billing NDC 60687063994
NCPDP billing unit EA — each (per item)
RxCUI 889614
UNII MFM6K1XWDK, 91ZQW5JF1Z
Application # ANDA214065
SPL Set ID 0fb80410-4689-4b8e-bfbb-19a62c9fe888
Established class (EPC) Anticholinergic; Benzodiazepine
Mechanism of action Cholinergic Antagonists
Physiologic effect Decreased Parasympathetic Acetylcholine Activity; Digestive/GI System Activity Alteration; GI Motility Alteration
Chemical class Benzodiazepines
DEA schedule CIV
Marketing category ANDA
Marketing status On market
FDA listing status Listed (active directory)
Marketing start 2022-01-06
Route ORAL
Dosage form CAPSULE
Substance CHLORDIAZEPOXIDE HYDROCHLORIDE; CLIDINIUM BROMIDE
GPI-14 49109902450110
GPI class chlordiazePOXIDE-Clidinium
GCN Seq No 004902
GCN 74801
HICL code 002037
Ingredient (HICL) Chlordiazepoxide/Clidinium Br
HIC1 code J
Therapeutic class — broad (HIC1) Autonomic Nervous System
HIC2 code J2
Therapeutic class — intermediate (HIC2) Anticholinergics
HIC3 code J2B
Therapeutic class — specific (HIC3) Anticholinergics,Quaternary Ammonium
AHFS code 12:08.08.00
AHFS class Antimuscarinics/Antispasmodics
FDB label name CHLORDIAZEPOXIDE-CLIDINIUM CAP
FDB brand name Chlordiazepoxide-Clidinium
Legend status F — Federal legend — prescription drug or device
TE code (Orange Book) AB · RLD · RS
Why two NDCs? The FDA registers this code as 60687-639-94 — a 5-3-2 layout, and that's what's printed on the package and shown on DailyMed. For insurance claims, every NDC is standardized to a uniform 11-digit 5-4-2 format by adding a zero to the product segment → 60687-0639-94. Same drug, same package — only the format differs.
Where does this data come from?
Identifiers from the FDA openFDA NDC Directory and Structured Product Labeling; RxCUI from RxNorm (NLM); GPI from Medi-Span; GCN / HIC / AHFS / legend from First Databank.

🏷️ RxNorm drug class

This medicine belongs to the Anticholinergic class.

Pharmacologic class Anticholinergic
How it works Cholinergic Antagonists
Where does this data come from?
Therapeutic classes from RxNorm RxClass (U.S. National Library of Medicine) — Established Pharmacologic Class (FDA), ATC drug family (WHO) and mechanism of action, matched by this product’s RxCUI.

🏭 Manufacturer & labeler

LabelerAmerican Health Packaging
Application holderALKEM LABORATORIES LTD
FDA applicationANDA214065 (ANDA)
Labeler code60687
First marketedJan 2022
DEA scheduleCIV
Product typeHuman Prescription Drug
Portfolio673 products on file
The labeler markets the product; the application holder owns the FDA approval. They’re often the same company but can differ (e.g. a repackager or an authorized generic). A mailing address / phone appears here when the manufacturer includes it in the product’s FDA label (not all do).
Where does this data come from?
Labeler, application holder and registered establishment from the FDA openFDA NDC Directory and Drugs@FDA; address/contact from the product’s FDA label.

🩺 Clinical

Label name CHLORDIAZEPOXIDE-CLIDINIUM CAP Ingredient Chlordiazepoxide/Clidinium Br
📖 What it is MedlinePlus · NLM

The combination of chlordiazepoxide and clidinium is used along with other medications to treat peptic ulcers, irritable bowel syndrome (IBS; a condition that causes stomach pain, bloating, constipation, and diarrhea), and enterocolitis (swelling in the intestines). Chlordiazepoxide is in a class of medications called benzodiazepines. It works by decreasing abnormal electrical activity in the brain. Clidinium is in a class of medications called anticholinergics. It helps to decrease stomach spasms and cramps.

Read the full MedlinePlus article ↗
📗 Our plain-language guide HelloPharmacist
  • It combines two drugs in one capsule to tackle digestive problems from two directions. One ingredient — chlordiazepoxide — calms the anxiety and tension that often make gut symptom...
  • What exactly is this medication supposed to do for me?
  • No — please avoid alcohol entirely while you're on this medication. Both alcohol and this drug slow down your central nervous system, and combining them greatly increases the risk...
  • Yes, drowsiness is one of the most common side effects — especially when you first start or if your dose is adjusted. It tends to be more noticeable in older adults. Avoid driving...
📖 Read our full Chlordiazepoxide and Clidinium guide →
Where does this data come from?
Plain-language summary from MedlinePlus (U.S. National Library of Medicine); supplement & herbal interactions and nutrient depletion data from the Natural Medicines database; our full guide is HelloPharmacist editorial content.

💊 What it looks like

Color green
ShapeCapsule
ImprintCDP;CD;5;2;5
Size14 mm
ScoringNot scored
One label can cover several strengths, so colors may be combined — always confirm a loose pill against the dispensed prescription label or a pharmacist.
Where does this data come from?
Physical description (imprint, shape, color, scoring, coating) from this product’s FDA Structured Product Labeling (SPL), mirrored from DailyMed / openFDA.

🧪 Inactive Ingredients / Excipients

Inactive ingredients, also called excipients, are components of the drug product other than the active ingredient. They may include fillers, dyes, coatings, preservatives, flavors, or other formulation ingredients.

💡 Tap an ingredient (hover on desktop) to see what it is and why it’s used.

  • UNII 35SW5USQ3G
    A synthetic yellow dye used to color medicines. It helps make tablets, capsules, and liquids visually distinct so patients can easily identify their medication.
  • UNII H3R47K3TBD
    FD&C Blue No. 1 is a synthetic blue dye approved for use in foods and medicines. It serves as a colorant to give the medication its distinctive appearance and help with product identification.
  • UNII XM0M87F357
    A dark iron oxide compound that gives medicines their black or dark color. It's used as a colorant in tablets and capsules to help identify the product and make it visually distinctive.
  • UNII 2G86QN327L
    Gelatin is a protein derived from animal collagen, commonly used in medicines as a gelling agent and capsule material. It helps create soft or hard capsule shells that hold and release medication, and can also thicken liquid formulations.
  • UNII EWQ57Q8I5X
    Lactose monohydrate is a natural sugar derived from milk. It serves as a filler and binder in tablets and capsules, helping create the proper size, texture, and consistency of the medicine.
  • UNII WZH3C48M4T
    Potassium hydroxide is a strong alkaline chemical used in medicines to adjust and maintain the pH level of liquid formulations, helping keep the product stable and the active ingredients effective.
  • UNII 6DC9Q167V3
    Propylene glycol is a clear liquid derived from petroleum or vegetable sources. It acts as a solvent, humectant, and preservative in medicines, helping dissolve active ingredients and maintain product stability.
  • UNII 46N107B71O
    Shellac is a natural resin secreted by the lac beetle. It's used as a coating on tablets and capsules to control how quickly the medicine dissolves and to improve appearance and stability.
  • UNII O8232NY3SJ
    A plant-based carbohydrate derived from corn kernels. It acts as a filler to add bulk, a binder to hold ingredients together, and a disintegrant to help the tablet break apart in your stomach for absorption.
  • UNII 7SEV7J4R1U
    A powder made from a naturally occurring mineral. In medicines, talc works as a glidant and anti-caking agent, helping tablets and capsules flow smoothly during manufacturing and preventing clumping.
  • UNII 15FIX9V2JP
    Titanium dioxide is a bright white mineral powder commonly used as a colorant and opacifying agent. It makes pills and tablets white or lighter in color and helps make coatings non-transparent.

11 inactive ingredients listed in the exact product block matched to this NDC.

Where does this data come from?
Data sourced from official FDA Structured Product Labeling (SPL) via DailyMedingredient classCode="IACT" elements from the exact product block matched by this NDC. Label-section narrative from DailyMed / the openFDA label index is shown separately when available.

Inactive ingredient FAQ

Are inactive ingredients the same for every manufacturer?
No. Inactive ingredients can differ by manufacturer, dosage form, strength, and package / product version.
Why might an inactive ingredient be missing?
Some SPLs do not provide a complete structured inactive-ingredient list, and older or unusual labels may only include the information in narrative text.
Can inactive ingredients matter?
Yes. They can matter for allergies, intolerances, dyes, gluten / lactose concerns, preservatives, and formulation differences — but confirm with a pharmacist or the manufacturer when it’s clinically important.

💲 Pricing

A drug doesn't have one price. Each row is a different public payment system, and none is what you'd pay at the counter — that depends on your insurance. The ⓘ on each row explains what it measures.

Price systemPer eaPer package
Retail pharmacies payNADAC · weekly $0.255 $5.09 / 20 capsule
Medicaid paysCMS SDUD · 12 mo No recent Medicaid claims on file for this NDC — rare and low-volume NDCs are suppressed in the public data.
Medicare drug plans payPart D · quarterly No Part D plan price is available for this NDC in our data.
NADAC price history (per ea) — tap or hover for the price & month
Jun 2022 Nov 2022 Feb 2026 Aug 2026 $0.958 $0.241
▼ Down 73% over the last 18 months.
Where does this data come from?
NADAC (National Average Drug Acquisition Cost) is the CMS weekly pharmacy-acquisition-cost survey — what pharmacies pay. ASP (Average Sales Price) is the CMS Medicare Part B drug-payment file, published quarterly. Medicaid pays is computed by us from CMS State Drug Utilization Data (total reimbursed ÷ units, trailing 12 months) — gross of rebates and inclusive of dispensing fees, so it reflects what Medicaid paid, not an acquisition cost. Medicare drug plans pay is the median negotiated point-of-sale unit cost across plans listing this NDC in the CMS quarterly Prescription Drug Plan pricing files, before rebates. The VA pays is the federal contract price (FSS, and the statutory Big 4 ceiling where listed) from the VA National Acquisition Center pharmaceutical price file. All are free public government data; each measures a different payer, so the figures are not directly comparable.

🔁 Therapeutic equivalents

ProductLabelerPackNADAC/unitTEStatusPrice vs. this
Chlordiazepoxide Hydrochloride and Clidinium Bromide 5 mg/1; 2.5 mg 11534-0197-01 Sunrise 100 capsules $0.255 AB Availability likely
Chlordiazepoxide Hcl And Clidinium Bromide 5 mg/1; 2.5 mg 42571-0381-01 Micro 100 capsules $0.255 AB Availability likely
Chlordiazepoxide Hydrochloride and Clidinium Bromide 5 mg/1; 2.5 mg 59651-0524-01 Aurobindo 100 capsules $0.255 AB Availability likely
chlordiazepoxide hydrochloride and clidinium bromide 5 mg/1; 2.5 mg 60219-1677-01 Amneal 100 capsules $0.255 AB Availability likely
Chlordiazepoxide Hydrochloride and Clidinium Bromide 5 mg/1; 2.5 mgthis 60687-0639-94 American 20 capsules $0.255 AB Availability likely
Chlordiazepoxide Hydrochloride And Clidinium Bromide 5 mg/1; 2.5 mg 62135-0696-12 Chartwell 120 capsules $0.255 AB Availability likely
Chlordiazepoxide hydrochloride and clidinium bromide 5 mg/1; 2.5 mg 62332-0744-31 Alembic 100 capsules $0.255 AB Availability likely
Chlordiazepoxide Hydrochloride and Clidinium Bromide 5 mg/1; 2.5 mg 67877-0731-01 Ascend 100 capsules $0.255 AB Availability likely
Librax 5 mg/1; 2.5 mg 00187-4100-10 Bausch 100 capsules AB FDA listed
Chlordiazepoxide Hydrochloride and Clidinium Bromide 5 mg/1; 2.5 mg 00276-0500-10 Misemer 100 capsules AB FDA listed
Chlordiazepoxide hydrochloride and clidinium bromide 5 mg/1; 2.5 mg 46708-0744-31 Alembic 100 capsules AB FDA listed
Chlordiazepoxide Hydrochloride and Clidinium Bromide 5 mg/1; 2.5 mg 63629-2373-01 Bryant 100 capsules AB FDA listed
Chlordiazepoxide Hydrochloride and Clidinium Bromide 5 mg/1; 2.5 mg 63629-8859-01 Bryant 100 capsules AB FDA listed
Chlordiazepoxide Hydrochloride and Clidinium Bromide 5 mg/1; 2.5 mg 71335-2966-01 Bryant 100 capsules AB FDA listed
Chlordiazepoxide Hydrochloride and Clidinium Bromide 5 mg/1; 2.5 mg 71335-9764-01 Bryant 100 capsules AB FDA listed
Chlordiazepoxide Hydrochloride and Clidinium Bromide 5 mg/1; 2.5 mg 72162-1237-01 Bryant 100 capsules AB FDA listed
Chlordiazepoxide Hcl And Clidinium Bromide 5 mg/1; 2.5 mg 72162-2436-01 Bryant 100 capsules AB FDA listed
Chlordiazepoxide Hydrochloride and Clidinium Bromide 5 mg/1; 2.5 mg 75826-0134-10 Winder 100 capsules AB FDA listed
About this product: this is a generic version of the medicine. FDA equivalence ratings are shown when available, and other versions are listed above, least expensive first.
Where does this data come from?
Equivalents are other NDCs of the same ingredient, form and route from the openFDA NDC Directory, ranked least-expensive-first by NADAC. Therapeutic-equivalence (AB) ratings come from the FDA Orange Book; biologics use the FDA Purple Book for biosimilar & interchangeable status.

Availability & generic status

🏛️
2022
On the market since
Jan 2022
📍
2026
Currently FDA-listed
4 years listed
🔓
·
Generic on the market
this product is a generic
This is a generic drug

This product is an FDA-approved generic. Other versions of the same drug are listed under Therapeutic equivalents, least expensive first.

Where does this data come from?
Patents and exclusivity from the FDA Orange Book (small-molecule drugs), refreshed from public FDA data. Generic launch timing is an estimate, not a guarantee.

📦 Packaging — all sizes for this product

Package NDCDescription Marketing startStatus
60687-0639-94 You're viewing this 20 BLISTER PACK in 1 CARTON (60687-639-94) / 1 CAPSULE in 1 BLISTER PACK (60687-639-11) 2022-01-06 Active

📄 Full prescribing information FDA SPL

The complete FDA label for this product — the official prescribing information, verbatim, section by section. Jump with a chip, search within the label, or expand everything.
🚨 Boxed Warning ~1 min read

WARNING: RISKS FROM CONCOMITANT USE WITH OPIOIDS; ABUSE, MISUSE, AND ADDICTION; and DEPENDENCE AND WITHDRAWAL REACTIONS Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs in patients for whom alternative treatment options are inadequate. Limit dosages and durations to the minimum required.

Follow patients for signs and symptoms of respiratory depression and sedation (see WARNINGS and PRECAUTIONS and PRECAUTIONS, Drug Interactions ). The use of benzodiazepines, including chlordiazepoxide hydrochloride, a component of Chlordiazepoxide hydrochloride and clidinium bromide capsules, USP, exposes users to risks of abuse, misuse, and addiction, which can lead to overdose or death. Abuse and misuse of benzodiazepines commonly involve concomitant use of other medications, alcohol, and/or illicit substances, which is associated with an increased frequency of serious adverse outcomes.

Before prescribing Chlordiazepoxide hydrochloride and clidinium bromide capsules, USP and throughout treatment, assess each patient's risk for abuse, misuse, and addiction (see WARNINGS ). The continued use of benzodiazepines, including Chlordiazepoxide hydrochloride and clidinium bromide capsules, USP, may lead to clinically significant physical dependence. The risks of dependence and withdrawal increase with longer treatment duration and higher daily dose.

Abrupt discontinuation or rapid dosage reduction of Chlordiazepoxide hydrochloride and clidinium bromide capsules, USP after continued use may precipitate acute withdrawal reactions, which can be life-threatening. To reduce the risk of withdrawal reactions, use a gradual taper to discontinue Chlordiazepoxide hydrochloride and clidinium bromide capsules, USP or reduce the dosage (see WARNINGS and DOSAGE AND ADMINISTRATION ).

🎯 Indications and Usage 57 words

INDICATIONS AND USAGE: Chlordiazepoxide hydrochloride and clidinium bromide capsules is indicated to control emotional and somatic factors in gastrointestinal disorders. Chlordiazepoxide hydrochloride and clidinium bromide capsules may also be used as adjunctive therapy in the treatment of peptic ulcer and in the treatment of the irritable bowel syndrome (irritable colon, spastic colon, mucous colitis) and acute enterocolitis.

⏱️ Dosage and Administration 192 words

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, USP 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, USP 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 To reduce the risk of withdrawal reactions, use a gradual taper to discontinue chlordiazepoxide hydrochloride and clidinium bromide 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 ).

Contraindications 49 words

CONTRAINDICATIONS: Chlordiazepoxide hydrochloride and clidinium bromide capsules is contraindicated in the presence of glaucoma (since the anticholinergic component may produce some degree of mydriasis) and in patients with prostatic hypertrophy and benign bladder neck obstruction. It is contraindicated in patients with known hypersensitivity to chlordiazepoxide hydrochloride and/or clidinium bromide.

⚠️ Warnings ~2 min read

WARNINGS: Risks From Concomitant Use with Opioids Concomitant use of benzodiazepines, including chlordiazepoxide hydrochloride and clidinium bromide capsules and opioids may result in profound sedation, respiratory depression, coma, and death. Because of these risks, reserve concomitant prescribing of these drugs- in patients for whom alternative treatment options are inadequate. Observational studies have demonstrated that concomitant use of opioid analgesics and benzodiazepines increases the risk of drug-related mortality compared to use of opioids alone.

If a decision is made to prescribe chlordiazepoxide hydrochloride and clidinium bromide capsules concomitantly with opioids, prescribe the lowest effective dosages and minimum durations of concomitant use, and follow patients closely for signs and symptoms of respiratory depression and sedation. Advise both patients and caregivers about the risks of respiratory depression and sedation when chlordiazepoxide hydrochloride and clidinium bromide capsules is used with opioids (see PRECAUTIONS ). Abuse, Misuse, and Addiction The use of benzodiazepines, including chlordiazepoxide hydrochloride, a component of chlordiazepoxide hydrochloride and clidinium bromide capsules, exposes users to the risks of abuse, misuse, and addiction, which can lead to overdose or death.

Abuse and misuse of benzodiazepines often (but not always) involve the use of doses greater than the maximum recommended dosage and commonly involve concomitant use of other medications, alcohol, and/or illicit substances, which is associated with an increased frequency of serious adverse outcomes, including respiratory depression, overdose, or death (see DRUG ABUSE AND DEPENDENCE ). Before prescribing chlordiazepoxide hydrochloride and clidinium bromide capsules and throughout treatment, assess each patient's risk for abuse, misuse, and addiction (e.g., using a standardized screening tool).

Use of chlordiazepoxide hydrochloride and clidinium bromide capsules, particularly in patients at elevated risk, necessitates counseling about the risks and proper use of chlordiazepoxide hydrochloride and clidinium bromide capsules along with monitoring for signs and symptoms of abuse, misuse, and addiction. Prescribe the lowest effective dosage; avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (e.g., opioid analgesics, stimulants); and advise patients on the proper disposal of unused drug.

If a substance use disorder is suspected, evaluate the patient and institute (or refer them for) early treatment, as appropriate. Dependence and Withdrawal Reactions To reduce the risk of withdrawal reactions, use a gradual taper to discontinue chlordiazepoxide hydrochloride and clidinium bromide capsules or reduce the dosage (a patient-specific plan should be used to taper the dosage) (see DOSAGE AND ADMINISTRATION ). Patients at an increased risk of withdrawal adverse reactions after benzodiazepine discontinuation or rapid dosage reduction include those who take higher dosages, and those who have had longer durations of use.

Acute Withdrawal Reactions The continued use of benzodiazepines, including chlordiazepoxide hydrochloride and clidinium bromide capsules, may lead to clinically significant physical dependence. Abrupt discontinuation or rapid dosage reduction of chlordiazepoxide hydrochloride and clidinium bromide after continued use, or administration of flumazenil (a benzodiazepine antagonist) may precipitate acute withdrawal reactions, which can be life-threatening (e.g., seizures) (see DRUG ABUSE AND DEPENDENCE ). Protracted Withdrawal Syndrome In some cases, benzodiazepine users have developed a protracted withdrawal syndrome with withdrawal symptoms lasting weeks to more than 12 months (see DRUG ABUSE AND DEPENDENCE ).

Effects on the Ability to Drive or Operate Machinery As in the case of other preparations containing CNS-acting drugs, patients receiving chlordiaz…

🤒 Adverse Reactions ~1 min read

ADVERSE REACTIONS: No side effects or manifestations not seen with either compound alone have been reported with the administration of chlordiazepoxide hydrochloride and clidinium bromide capsules. However, since chlordiazepoxide hydrochloride and clidinium bromide capsules contains chlordiazepoxide hydrochloride and clidinium bromide, the possibility of untoward effects which may be seen with either of these two compounds cannot be excluded. When chlordiazepoxide hydrochloride has been used alone 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 with chlordiazepoxide hydrochloride 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 chlordiazepoxide hydrochloride treatment.

Blood dyscrasias, including agranulocytosis, jaundice and hepatic dysfunction have occasionally been reported during therapy with chlordiazepoxide hydrochloride. When chlordiazepoxide hydrochloride treatment is protracted, periodic blood counts and liver function tests are advisable. Adverse effects reported with use of chlordiazepoxide hydrochloride and clidinium bromide capsules are those typical of anticholinergic agents, i.e., dryness of the mouth, blurring of vision, urinary hesitancy and constipation.

Constipation has occurred most often when chlordiazepoxide hydrochloride and clidinium bromide capsules therapy has been combined with other spasmolytic agents and/or a low residue diet. To report SUSPECTED ADVERSE REACTIONS, contact Ascend Laboratories, LLC at 1-877-272-7901 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch .

🔄 Drug Interactions 140 words

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 GABAA 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 ~2 min read

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.

The background risk of major birth defects and miscarriage for the indicated population is unknown. All pregnancies have a background risk of birth defect, loss, or other adverse outcomes. In the U.S. general population, the estimated risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively.

Clinical Considerations Fetal/Neonatal Adverse Reactions Benzodiazepines cross the placenta and may produce respiratory depression, hypotonia and sedation in neonates. Monitor neonates exposed to chlordiazepoxide hydrochloride and clidinium bromide capsules, which contains a benzodiazepine (chlordiazepoxide hydrochloride), during pregnancy or labor for signs of sedation, respiratory depression, hypotonia, and feeding problems. Monitor neonates exposed to chlordiazepoxide hydrochloride and clidinium bromide capsules during pregnancy for signs of withdrawal.

Manage these neonates accordingly (see WARNINGS, Neonatal Sedation and Withdrawal Syndrome ). Data Human Data Published data from observational studies on the use of benzodiazepines during pregnancy do not report a clear association with benzodiazepines and major birth defects. Although early studies reported an increased risk of congenital malformations with diazepam and chlordiazepoxide, there was no consistent pattern noted.

In addition, the majority of more recent case-control and cohort studies of benzodiazepine use during pregnancy, which were adjusted for confounding exposures to alcohol. Tobacco and other medications, have not confirmed these findings. Animal Data Oral daily doses of 2.5 mg/kg chlordiazepoxide hydrochloride with 1.25 mg/kg clidinium bromide or 25 mg/kg chlordiazepoxide hydrochloride with 12.5 mg/kg clidinium bromide (0.6 and 6.1 times, respectively, the maximum recommended clinical dose for both drugs, based on body surface area) were administered to rats in a reproduction study through two successive matings.

In the first mating, no significant differences were noted between the control or the treated groups, with the exception of a slight decrease in the number of animals surviving during lactation among those receiving the highest dosage. In the second mating, similar results were obtained except for a slight decrease in the number of pregnant females and in the percentage of offspring surviving until weaning. No congenital anomalies were observed in both matings in either the control or treated groups.

🧒 Pediatric Use 12 words

Pediatric Use Safety and effectiveness in pediatric patients have not been established.

🧓 Geriatric Use 94 words

Geriatric Use Geriatric subjects may be particularly prone to experiencing drowsiness, ataxia and confusion while receiving chlordiazepoxide hydrochloride and clidinium bromide capsules. These effects can usually be avoided with proper dosage adjustment, although they have occasionally been observed even at the lower dosage ranges. Dosing in geriatric subjects should be initiated cautiously (no more than 2 capsules per day) and increased gradually if needed and tolerated (see DOSAGE AND ADMINISTRATION ). chlordiazepoxide hydrochloride and clidinium bromide capsules is contraindicated in the presence of glaucoma, prostatic hypertrophy and benign bladder neck obstruction (see CONTRAINDICATIONS ).

🆘 Overdosage ~2 min read

OVERDOSAGE Overdosage of chlordiazepoxide hydrochloride and clidinium bromide capsules, which contains a benzodiazepine (chlordiazepoxide hydrochloride) and an anticholinergic (clidinium bromide) may manifest signs and symptoms related to either of its components, although some effects such as altered levels of consciousness may be synergistic. Overdosage of benzodiazepines, such as chlordiazepoxide hydrochloride, is characterized by central nervous system depression ranging from drowsiness to coma. In mild to moderate cases, symptoms can include drowsiness, confusion, dysarthria, lethargy, hypnotic state, diminished reflexes, ataxia, and hypotonia.

Rarely, paradoxical or disinhibitory reactions (including agitation, irritability, impulsivity, violent behavior, confusion, restlessness, excitement, and talkativeness) may occur. In severe overdosage cases, patients may develop respiratory depression and coma. Signs and symptoms of anticholinergic overdosage are related to excessive anti-muscarinic anticholinergic activity.

Peripheral signs and symptoms may include dry mucous membranes and skin, flushing, tachycardia, hypertension, ileus, urinary retention, and mydriasis. Garbled speech is often pathognomonic. Central signs and symptoms may include agitation and delirium, seizures, and hyperthermia.

Benzodiazepines are considered a first-line treatment for anticholinergic toxicity acting to treat mild to moderate agitation and prevent seizures. Overdosage of benzodiazepines in combination with other CNS depressants (including alcohol and opioids) may be fatal (see WARNINGS, Dependence and Withdrawal Reactions ). Markedly abnormal (lowered or elevated) blood pressure, heart rate, or respiratory rate raise the concern that additional drugs and/or alcohol are involved in the overdosage.

Anticholinergic drugs usually increase heart rate and blood pressure. In managing benzodiazepine overdosage, employ general supportive measures, including intravenous fluids, and airway management. Flumazenil, a specific benzodiazepine receptor antagonist is indicated for the complete or partial reversal of the sedative effects of benzodiazepines in the management of benzodiazepine overdosage.

Use of flumazenil may increase the risk of seizures in mixed overdosage with drugs that may precipitate seizures, including anticholinergic medications. Benzodiazepines are used to treat agitated delirium from anticholinergic toxicity. Therefore flumazenil administration may worsen the anticholinergic delirium and should generally be avoided.

Anticholinesterase inhibitors may reverse severe agitated delirium that is not controlled by benzodiazepines. They may also improve the airway and breathing in CNS depressed patients. Caution is warranted especially in mixed drug overdoses.

Consider contacting a poison center (1-800-222-1222) or a medical toxicologist for overdosage management recommendations.

🧬 Clinical Pharmacology ~2 min read

ANIMAL PHARMACOLOGY AND/OR ANIMAL TOXICOLOGY: Effects on Reproduction: Reproduction studies in rats fed chlordiazepoxide hydrochloride, 10, 20 and 80 mg/kg daily, (2.4, 4.8 and 19.4 times, respectively, the maximum recommended clinical dose of 40 mg/day, based on body surface area), and bred through one or two matings showed no congenital anomalies, nor were there adverse effects on growth of the newborn. However, in another study at 100 mg/kg daily there was noted a significant decrease in the fertilization rate and a marked decrease in the viability and body weight of offspring which may be attributable to sedative activity, thus resulting in lack of interest in mating and lessened maternal nursing and care of the young.

One neonate in each of the first and second matings in the rat reproduction study at the 100 mg/kg dose (24.2 times the maximum recommended human dose of 40 mg/day, based on body surface area) exhibited major skeletal defects. Two series of reproduction experiments with clidinium bromide were carried out in rats, employing dosages of 2.5 and 10 mg/kg daily (1.2 and 4.9 times, respectively, the maximum recommended clinical dose of 20 mg/day, based on body surface area) in each experiment. In the first experiment, clidinium bromide was administered for a 9-week interval prior to mating; no untoward effect on fertilization or gestation was noted.

The offspring were taken by caesarean section and did not show a significant incidence of congenital anomalies when compared to control animals. In the second experiment, adult animals were given clidinium bromide for 10 days prior to and through two mating cycles. No significant effects were observed on fertility, gestation, viability of offspring or lactation, as compared to control animals, nor was there a significant incidence of congenital anomalies in the offspring derived from these experiments.

A reproduction study was carried out in rats through two successive matings with administration of oral daily doses of 2.5 mg/kg chlordiazepoxide hydrochloride and 1.25 mg/kg clidinium bromide (0.6 times the maximum recommended clinical dose for both drugs, based on body surface area) or 25 mg/kg chlordiazepoxide hydrochloride and 12.5 mg/kg clidinium bromide (6.1 times the maximum recommended clinical dose for both drugs, based on body surface area). In the first mating, no significant differences were noted between the control or the treated groups, with the exception of a slight decrease in the number of animals surviving during lactation among those receiving the high dosage.

In the second mating, similar results were obtained except for a slight decrease in the number of pregnant females and in the percentage of offspring surviving until weaning. No congenital anomalies were observed in both matings in either the control or treated groups.

📦 How Supplied / Storage and Handling 91 words

HOW SUPPLIED Chlordiazepoxide hydrochloride and clidinium bromide capsules is available in green opaque capsules, each containing 5 mg chlordiazepoxide hydrochloride and 2.5 mg clidinium bromide in Unit dose packages of 20 (2 x 10) NDC 60687-639-94 with “CDP/CD” imprinted on the cap and 5/2.5” imprinted on the body of the capsule. 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). [see USP Controlled Room Temperature]; FOR YOUR PROTECTION: Do not use if blister is torn or broken.

Keep out of reach of children.

📋 Description 156 words

DESCRIPTION: Chlordiazepoxide hydrochloride and clidinium bromide capsules, USP is a fixed-combination of chlordiazepoxide hydrochloride, a benzodiazepine, and clidinium bromide, an anticholinergic. Each chlordiazepoxide hydrochloride and clidinium bromide capsules, USP contains the active ingredients 5 mg chlordiazepoxide hydrochloride and 2.5 mg clidinium bromide. Each capsule also contains the inactive ingredients lactose monohydrate, maize starch, talc, D&C Yellow No.

10, FD&C Blue No. 1, titanium dioxide, gelatin, shellac, propylene glycol, black iron oxide and potassium hydroxide. Chlordiazepoxide hydrochloride is 7-Chloro-2-(methylamino)-5-phenyl-3H-1, 4-benzodiazepine 4-oxide monohydrochloride.

A colorless, crystalline substance, it is soluble in water. It is unstable in solution and the powder must be protected from light. The molecular weight is 336.22.

The structural formula of chlordiazepoxide hydrochloride is as follows: Clidinium bromide is a synthetic anticholinergic agent which has been shown in experimental and clinical studies to have an antispasmodic and antisecretory effects on the gastrointestinal tract. Structurally clidinium bromide is: Chlordiazepoxide Hydrochloride Structural Formula Clidinium Bromide Structural Formula

💬 Information for Patients ~1 min read

Information for Patients Abuse, Misuse, and Addiction Inform patients that the use of chlordiazepoxide hydrochloride and clidinium bromide capsules, even at recommended dosages, exposes users to risks of abuse, misuse, and addiction, which can lead to overdose and death, especially when used in combination with other medications (e.g., opioid analgesics), alcohol, and/or illicit substances. Inform patients about the signs and symptoms of benzodiazepine abuse, misuse, and addiction; to seek medical help if they develop these signs and/or symptoms; and on the proper disposal of unused drug (see WARNINGS ).

Withdrawal Reactions Inform patients that the continued use of chlordiazepoxide hydrochloride and clidinium bromide capsules may lead to clinically significant physical dependence and that abrupt discontinuation or rapid dosage reduction of chlordiazepoxide hydrochloride and clidinium bromide capsules may precipitate acute withdrawal reactions, which can be life-threatening. Inform patients that in some cases, patients taking benzodiazepines have developed a protracted withdrawal syndrome with withdrawal symptoms lasting weeks to more than 12 months.

Instruct patients that discontinuation or dosage reduction of chlordiazepoxide hydrochloride and clidinium bromide capsules may require a slow taper (see WARNINGS and DRUG ABUSE AND DEPENDENCE ). Concomitant Use with Opioids and Other CNS Depressants Inform patients and caregivers that potentially fatal additive effects may occur if chlordiazepoxide hydrochloride and clidinium bromide capsules is used with opioids or other CNS depressants, including alcohol, and not to use these concomitantly unless supervised by a health care provider (see WARNINGS and PRECAUTIONS, Drug Interactions ).

Pregnancy Advise pregnant females that use of chlordiazepoxide hydrochloride and clidinium bromide capsules late in pregnancy can result in sedation (respiratory depression, lethargy, hypotonia) and /or withdrawal symptoms (hyperreflexia, irritability, restlessness, tremors, inconsolable crying, and feeding difficulties) in newborns (see WARNINGS, Neonatal Sedation and Withdrawal Syndrome and PRECAUTIONS, Pregnancy ). Instruct patients to inform their healthcare provider if they are pregnant. Nursing Instruct patients to notify their healthcare provider if they are breastfeeding or intend to breastfeed (see PRECAUTIONS, Nursing Mothers ).

💬 Medication Guide ~2 min read

Medication Guide CHLORDIAZEPOXIDE HYDROCHLORIDE (klor-dye-az-e-POX-ide hye-droe-KLOR-ide) AND CLIDINIUM BROMIDE (kli DIN ee um BRO mide) CAPSULES for oral use What is the most important information I should know about chlordiazepoxide hydrochloride and clidinium bromide capsules? Chlordiazepoxide hydrochloride and clidinium bromide capsules contains a benzodiazepine medicine. Taking chlordiazepoxide hydrochloride and clidinium bromide capsules with opioid medicines, alcohol, or other central nervous system (CNS) depressants (including street drugs) can cause severe drowsiness, breathing problems (respiratory depression), coma, and death.

Get emergency help right away if any of the following happens: shallow or slowed breathing breathing stops (which may lead to the heart stopping) excessive sleepiness (sedation) Do not drive or operate heavy machinery until you know how taking chlordiazepoxide hydrochloride and clidinium bromide capsules with opioids affects you. Risk of abuse, misuse, and addiction. There is a risk of abuse, misuse, and addiction with benzodiazepines, including chlordiazepoxide hydrochloride and clidinium bromide capsules, which can lead to overdose or death.

Serious side effects including coma and death have happened in people who have abused or misused benzodiazepines, including chlordiazepoxide hydrochloride and clidinium bromide capsules. These serious side effects may also include delirium, paranoia, suicidal thoughts or actions, seizures, and difficulty breathing. Call your healthcare provider or go to the nearest hospital emergency room right away if you get any of these serious side effects.

You can develop an addiction even if you take chlordiazepoxide hydrochloride and clidinium bromide capsules as prescribed by your healthcare provider. Take chlordiazepoxide hydrochloride and clidinium bromide capsules exactly as your healthcare provider prescribed. Do not share your chlordiazepoxide hydrochloride and clidinium bromide capsules with other people.

Keep chlordiazepoxide hydrochloride and clidinium bromide capsules in a safe place and away from children. Physical dependence and withdrawal reactions. Chlordiazepoxide hydrochloride and clidinium bromide capsules can cause physical dependence and withdrawal reactions.

Do not suddenly stop using chlordiazepoxide hydrochloride and clidinium bromide capsules . Stopping chlordiazepoxide hydrochloride and clidinium bromide capsules suddenly can cause serious and life-threatening side effects, including unusual movements, responses, or expressions, seizures, sudden and severe mental or nervous system changes, depression, seeing or hearing things that others do not see or hear, an extreme increase in activity or talking, losing touch with reality, and suicidal thoughts or actions. Call your healthcare provider or go to the nearest hospital emergency room right away if you get any of these symptoms.

Some people who suddenly stop benzodiazepines have symptoms that can last for several weeks to more than 12 months , including anxiety, trouble remembering, learning, or concentrating, depression, problems sleeping, feeling like insects are crawling under your skin, weakness, shaking, muscle twitches, burning or prickling feeling in your hands, arms, legs or feet, and ringing in your ears. Physical dependence is not the same as drug addiction. Your healthcare provider can tell you more about the differences between physical dependence and drug addiction.

Do not take more chlordiazepoxide hydrochloride and clidinium bromide capsules than prescribed or take chlordiazepoxide hydrochloride and clidinium bromide capsules for longer than prescribed. What is chlordiazepoxide hydrochloride and clidinium bromide capsules? Chlordiazepoxide hydrochloride and clidinium bromide capsules is a prescription medicine that is used with other therapies for the treatment of: stomach (peptic) ulcers irritable bowel syndrome (IBS) inflammation of the colon called acute enterocolitis Chlor…

Source: FDA Structured Product Labeling, mirrored from DailyMed / openFDA. Prefer the government’s original formatting? View this label on DailyMed ↗
For educational and professional reference only — not medical advice. Pricing reflects published NADAC and CMS ASP (free public data) and may differ from your acquisition cost; always verify before billing or dispensing.