Librax (Chlordiazepoxide and Clidinium) - Oral

Warning:

Avoid using Librax (chlordiazepoxide and clidinium) with opioids, such as Tylenol #3, that contain codeine or hydrocodone. Your healthcare provider should only combine these medications when other options are not appropriate. When used together, you must be closely monitored to ensure you have the lowest dose and duration necessary.

What Is Librax?

Librax (chlordiazepoxide and clidinium) is an oral capsule used to treat the emotional and physical symptoms of certain intestinal disorders. It contains both chlordiazepoxide and clidinium bromide. Chlordiazepoxide is in the benzodiazepine drug class, while clidinium bromide is an anticholinergic medication.

Librax may also be used with another medication (adjunctive therapy) to treat stomach ulcers and irritable bowel syndrome.

Chlordiazepoxide acts similarly to other medications in the benzodiazepine drug class. They both attach to specific benzodiazepine receptors in the brain and lead to increased tiredness and relaxation. Conversely, clidinium bromide is an anticholinergic drug. It will also cause relaxation and specifically relax your muscles locally in your intestinal tract.

Drug Facts

Generic Name: Chlordiazepoxide and Clidinium

Brand Name(s): Librax

Administration Route(s): Oral

Drug Availability: Prescription

Therapeutic Classification: Antimuscarinic combination

Available Generically: Yes

Controlled Substance: N/A

Active Ingredient: Chlordiazepoxide and Clidinium Bromide

Dosage Form(s): Capsule

What Is Librax Used For?

The Food and Drug Administration (FDA) approved Librax to assist with control and relief of the following:

Librax ( Chlordiazepoxide and Clidinium ) Drug Information - Illustration by Zoe Hansen

Verywell / Zoe Hansen

How to Take Librax

Generally, you will take this medication and other medications used for stomach issues, between 30 minutes to one hour before meals and at bedtime.

Librax carries a boxed warning about the dangers of using it in combination with opioids, including products with codeine and hydrocodone. This is because Librax contains chlordiazepoxide, which is a benzodiazepine. If combined use is necessary, your healthcare provider should limit your dosages and duration of treatment. If you are prescribed both types of medications, watch for signs and symptoms of respiratory depression (trouble breathing) and sedation.

Storage

Store Librax in a cool, dry place. In general, keep medications away from areas of heat, like in the kitchen, or humid places such as the bathroom. These environments can affect how well medications work. Keeping this medication away from children and pets is also important to prevent accidental consumption.

Off-Label Uses

Librax has generally only been researched for the uses approved by the FDA. However, its components have been studied for other diseases, either alone or together. For example, research has looked into chlordiazepoxide’s use in alcohol withdrawal.

One study evaluated the effectiveness of chlordiazepoxide for alcohol withdrawal compared to gabapentin. Gabapentin is generally known as the first-line treatment for alcohol withdrawal. The study’s results found that gabapentin was as effective as chlordiazepoxide. However, gabapentin appears to have fewer sedative effects associated with it. than chlordiazepoxide.

How Long Does Librax Take to Work?

Librax will generally start to work within 30 minutes.

What Are the Side Effects of Librax?

This is not a complete list of side effects and others may occur. A medical professional can advise you on side effects. If you experience other effects, contact your pharmacist or a medical professional. You may report side effects to the FDA at www.fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

Common side effects of Librax may include:

  • Drowsiness
  • Dry mouth
  • Constipation 
  • Changes in sexual drive
  • Irregular menstrual periods
  • Nausea
  • Problems urinating
  • Skin problems like swelling

Severe Side Effects

Call your healthcare provider right away if you are experiencing any of the side effects below:

  • Signs of a severe allergic reaction like sudden itching, hives, or difficulty breathing
  • Confusion
  • Severe drowsiness
  • Passing out 
  • Severe dryness of your nose, mouth, or throat
  • Yellowing of the skin

Long-Term Side Effects

Once you stop this medication, you may experience:

  • Seizures
  • Muscle cramping
  • Nausea and vomiting
  • Stomach cramps
  • Trembling

Report Side Effects

Librax may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting Program or by phone (1-800-332-1088).

Dosage: How Much Librax Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (capsules):
    • For the treatment of peptic ulcer, IBS, or enterocolitis:
      • Adults—1 or 2 capsules 3 or 4 times a day. Your doctor may adjust your dose as needed and tolerated.
      • Older adults—2 capsules per day. Your doctor may adjust your dose as needed and tolerated.
      • Children—Use and dose must be determined by your doctor.

Modifications

In some cases, you may be prescribed a different dose of Librax.

Your provider may change your dose if you:

  • Have kidney or liver problems
  • Have a history of mental illness
  • Are at an advanced age (older than 65 years)

Missed Dose

If you miss a dose of Librax, you should take it as soon as you remember. If you remember and you are close to the next scheduled dose, take just the scheduled dose and not the missed one. It is important NOT to take more than one dose at a time. If you miss a dose, it is more likely that you will feel the symptoms of your IBS or gastrointestinal issue.

Overdose: What Happens If I Take Too Much Librax?

There is no specific dose indicating you have taken too much Librax.

Generally, an overdose with Librax will look similar to severe side effects and may include:

  • Dry mouth
  • Blurred vision
  • Difficulty urinating
  • Constipation

If you overdose, a healthcare provider will treat the symptoms and primary cause of the overdose. Usually, the overdose symptoms stem from the clidinium bromide component of Librax. A drug called physostigmine can be used to undo the action of anticholinergic drugs and reverse the symptoms.

What Happens If I Overdose on Librax?

If you think you or someone else may have overdosed on Librax, call a healthcare provider or the Poison Control Center (1-800-222-1222).

If someone collapses or isn't breathing after taking Librax, call 911 immediately.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant may cause serious unwanted effects in your newborn baby. Tell your doctor right away if you think you are pregnant or if you plan to become pregnant while using this medicine.

This medicine may be habit-forming. If you feel that the medicine is not working as well, do not use more than your prescribed dose. Call your doctor for instructions.

This medicine may cause some people, especially elderly patients, to become drowsy, dizzy, lightheaded, clumsy or unsteady, or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert or able to think or see well.

Check with your doctor before using this medicine with alcohol or other medicines that affect the central nervous system (CNS). The use of alcohol or other medicines that affect the CNS with Librax® may worsen the side effects of this medicine, such as dizziness, irregular, fast or slow, or shallow breathing, poor concentration, drowsiness, unusual dreams, and trouble with sleeping. Some examples of medicines that affect the CNS are antihistamines or medicine for allergies or colds, sedatives, tranquilizers, or sleeping medicines, medicine for depression, medicine for anxiety, prescription pain medicine or narcotics, medicine for attention deficit and hyperactivity disorder, medicine for seizures or barbiturates, muscle relaxants, or anesthetics, including some dental anesthetics.

If you develop any unusual and strange thoughts or behavior while you are taking chlordiazepoxide, be sure to discuss it with your doctor. Some changes that have occurred in people taking this medicine are like those seen in people who drink alcohol and then act in a manner that is not normal. Other changes may be more unusual and extreme, such as confusion, worsening of depression, suicidal thoughts, and unusual excitement, nervousness, or irritability.

Do not suddenly stop taking this medicine without checking first with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping it completely. This may help prevent a worsening of your condition and reduce the possibility of withdrawal symptoms, including headache, nausea, general feeling of discomfort or illness, seizures, stomach or muscle cramps, tremors, or unusual behavior.

Symptoms of an overdose include: blurred vision, change in consciousness, confusion, difficult urination, difficulty having a bowel movement, dry mouth, lack of coordination, loss of consciousness, sleepiness or unusual drowsiness. Call your doctor right away if you notice these symptoms.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn’t Take Librax?

According to the FDA, you should not be on Librax if you have the following health conditions:

Librax should also be avoided if you are pregnant or think you may be pregnant. In recent years, it has been shown to have an increased risk of malformations, which was associated with the use of chlordiazepoxide in the first trimester of pregnancy. Tell your provider if you think you may become pregnant while taking this medication.

What Other Medications Interact With Librax?

Do not take benzodiazepines and opioids together, as it can cause excessive drowsiness and increase the risk of breathing troubles.

Examples of drugs in the benzodiazepine drug include:

Examples of medications in the opioid drug class include:

Generally, other medications that can cause drowsiness should be avoided since they would also increase the risk of being unable to breathe. Examples of common medications that can cause drowsiness include:

What Medications Are Similar?

Librax is used to treat IBS, along with other gastrointestinal problems.

Examples of other medications used for IBS include:

Librax can also treat stomach sores. Examples of other medications used for stomach sores include:

This is a list of medications also prescribed and used for disorders similar to Librax. It is NOT a list of drugs that is recommended to be taken together. You should always ask your pharmacist, or your healthcare provider, if you have any need for clarification or if you have any questions.

Frequently Asked Questions

  • How can I refill this medication?

    Librax contains both chlordiazepoxide and clidinium bromide. Although there may be more restrictions for chlordiazepoxide separately (as it is a Schedule IV medication, the combination of both drugs allows it to be exempt under the Controlled Substance Act. As a result, getting refills is relatively easy.

  • How can I manage the side effects of Librax?

    Generally, the most effective way to manage the side effects of medications is to decrease the dose that is causing the side effect. In this case, it is difficult to reduce the dose of either chlordiazepoxide or clidinium bromide since the two are in one capsule. If Librax is unable to be tolerated, you may be able to switch to a different recommended treatment. Talk to your provider if you think you need another treatment option.

  • How expensive is Librax? Is there a way I can get help paying for it?

    Librax is a very expensive medication. The cost averages at around $4,500. Librax is available in its generic version, which is relatively cheaper compared with the cost of the brand name. The generic version of Librax averages around $150.

  • How else can I manage my gastrointestinal issues?

    A healthy diet can be helpful for managing gastrointestinal issues, depending on your symptoms. The Centers for Disease Control and Prevention recommends a daily balanced diet consisting of fruits, vegetables, calcium-rich foods, and lean meats. Talk to your healthcare provider before initiating any major lifestyle changes.

How Can I Stay Healthy While Taking Librax?

To stay healthy while taking Librax, it is important to take it as directed by your healthcare provider. Librax should typically only be taken for a short period of time (two to four weeks). Librax is a medication that addresses the emotional factors of GI disorders, so it is important to take steps to manage sources of stress and anxiety. It is also important to live a healthy lifestyle by maintaining a balanced diet and staying well hydrated with lots of rest.

Medical Disclaimer

Verywell Health's drug information is meant for education purposes only and not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare professional. Consult your doctor before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Food and Drug Administration. Librium label.

  2. Food and Drug Administration. Librax label.

  3. Alvanzo A, Kleinschmidt K, Kmiec JA, et al. The ASAM Clinical Practice Guideline on Alcohol Withdrawal Management. J Addict Med. 2020;14(3S Suppl 1):1-72. doi:10.1097/ADM.0000000000000668

  4. Stock CJ, Carpenter L, Ying J, Greene T. Gabapentin versus chlordiazepoxide for outpatient alcohol detoxification treatment. Ann Pharmacother. 2013;47(7-8):961-969. doi:10.1345/aph.1R751

  5. Food and Drug Administration. Physostigmine label.

  6. Lacy BE, Pimentel M, Brenner DM, et al. ACG Clinical Guideline: Management of irritable bowel syndrome. Am J Gastroenterol. 2021;116(1):17-44. doi:10.14309/ajg.0000000000001036

  7. Centers for Disease Control and Prevention. Healthy Weight, Nutrition, and Physical Activity. Healthy Eating for a Healthy Weight.