Chlordiazepoxide hydrochloride

CLINICAL USE

  • Anxiety (short-term use)
  • Alcohol withdrawal

    DOSE IN NORMAL RENAL FUNCTION

  • Anxiety: 30–100 mg daily in divided doses
  • Alcohol withdrawal: 10–50 mg 4 times a day, reducing gradually

    PHARMACOKINETICS

  • Molecular weight                           :336.2
  • %Protein binding                           :96
  • %Excreted unchanged in urine     : 1–2
  • Volume of distribution (L/kg)       :0.3–0.5
  • half-life – normal/ESRD (hrs)      :6–30/Unchanged

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50     : Dose as in normal renal function
  • 10 to 20     : Dose as in normal renal function
  • <10           : 50% of normal dose

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                :Unlikely to be dialysed. Dose as in GFR <10 mL/min
  • HD                     :Not dialysed. Dose as in GFR <10 mL/min
  • HDF/high flux   :Unknown dialysability. Dose as in GFR <10 mL/min
  • CAV/VVHD      :Unknown dialysability. Dose as in normal renal function

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs

  • Antibacterials: metabolism possibly increased by rifampicinA
  • ntipsychotics: enhanced sedative effects
  • Antivirals:
  • concentration possibly increased by ritonavir
  • Sodium oxybate: enhanced effects of sodium oxybate – avoid
  • Ulcer-healing drugs: metabolism inhibited by cimetidine

    ADMINISTRATION

    Reconstition

    –

    Route

    Oral

    Rate of Administration

    –

    Comments

    –

    OTHER INFORMATION

  • Active metabolite (desmethyldiazepam) has a half-life of a few days
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