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 &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :336.2

%Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :96

%Excreted unchanged in urine &nbsp &nbsp : 1–2

Volume of distribution (L/kg) &nbsp &nbsp &nbsp :0.3–0.5

half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :6–30/Unchanged

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 &nbsp &nbsp : Dose as in normal renal function

10 to 20 &nbsp &nbsp : Dose as in normal renal function

<10 &nbsp &nbsp &nbsp &nbsp &nbsp : 50% of normal dose

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Unlikely to be dialysed. Dose as in GFR <10 mL/min

HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Not dialysed. Dose as in GFR <10 mL/min

HDF/high flux &nbsp :Unknown dialysability. Dose as in GFR <10 mL/min

CAV/VVHD &nbsp &nbsp &nbsp: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

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Route

Oral

Rate of Administration

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Comments

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OTHER INFORMATION

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

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