Librium (Chlordiazepoxide): Uses, Side Effects, Dosage, Etc.

Last Updated: July 6, 2021

Authored by Olivier George, Ph.D.

Librium is a psychotropic drug that has a wide range of treatment purposes interacting with a central nervous system. Chlordiazepoxide is mostly prescribed for treating moderate and severe anxiety disturbances and smoothing the consequences of alcohol withdrawal. Still, Librium poses a high risk for abuse and developing an addiction.

General Information: What Is Librium?

Chlordiazepoxide brand names are Librium, a sedative-hypnotic medicine. Typically, the substance is prescripted by a doctor in appropriate dosages to deal with a specific condition.

Librium is a pretty affordable drug that can be found in different drug stores across the United States. The average prices for 5, 10, and 25mg per 30 capsules are $13-$19, $12-$21, and $13-$21, respectively.

Librium Generic & Street Names

The Librium generic name is chlordiazepoxide. The street names include:

  • Downers
  • Tranqs
  • Bennies
  • Benzos
  • L
  • Blue bombs
  • Blues
  • Ruffies
  • Normies
  • Nerve pills, etc.

librium drug class

Chlordiazepoxide Drug Class

Is Librium A Narcotic?

The term “narcotic” usually refers to a drug belonging to the opioid class. Opioids work like pain-killers. They interact with opioid receptors in the brain providing an analgesic effect and calming down different aches. Drugs like Librium work with the central nervous system and help to cope with mental illnesses. Thus, Librium drug class is not a narcotic.

Is Librium A Depressant?

Chlordiazepoxide has depressant properties, as it influences the central nervous system and slows brain activity. Such actions cause short-term changes in one’s condition usually in the form of relaxation and anxiety decrease. In addition, it slows heart rate, pulse, and respiratory rate.

Is Librium A Benzo?

Yes, chlordiazepoxide drug class is a benzodiazepine. Like other drugs in its family, Librium provides a sedative-hypnotic effect, because of the changes in the chemical balance on GABA receptors in the brain. Also, Librium half-life is among the longest in benzodiazepine drug class.

Is Librium A Controlled Substance?

Librium classification was determined by the Drug Enforcement Administration as a Schedule IV controlled substance. Drugs in this class have less potential than drugs in Schedules I, II, and III, however, there is still a potential for dependence and addiction.

librium uses

What Is Librium Used For?

There is a wide range of disorders that can be treated by chlordiazepoxide. Being a long-acting benzodiazepine and an FDA approved medication, its labeled uses for adults include treatment of:

  • mild-moderate to severe anxiety disorder
  • preoperative apprehension and anxiety
  • withdrawal symptoms of acute alcohol use disorder.

It is also FDA approved for pediatric patients greater than six years old for anxiety. Off-label Librium uses include catatonia, social phobia, posttraumatic stress disorder, insomnia, premenstrual syndrome, and other conditions.

Librium For Anxiety

Librium use is usually prescribed by a doctor to decrease the level of anxiety for a short period of time for adults, elderly people, and children over six years old. The drug affects neurotransmitters that send signals to certain brain cells that produce a calming effect.

Librium For Opiate Withdrawal

This medicine is not approved for treating opioid withdrawal. According to users’ experience, some physicians prescribe chlordiazepoxide for those who go through narcotic withdrawal to ease symptoms like anxiety and restlessness, or to alleviate sleeping disturbances.

Librium For Benzo Withdrawal

There are no researches on using this medicine for benzodiazepine withdrawal, so the effectiveness is not determined. However, benzodiazepines that have longer action windows (like Librium) are considered to be more effective in suppressing withdrawal symptoms and produce a smooth transition to the abstinent state.

Librium For Alcohol Withdrawal

Providing the treatment for alcohol detoxification starts from a gradual weaning schedule of using alcohol itself to the use of benzodiazepines, especially diazepam, chlordiazepoxide, and lorazepam. Discussing Librium and alcohol detox, the medication can provide a gradual treatment course without the risk of rebound symptoms (e.g. seizures) that can occur later, during withdrawal.

Chlordiazepoxide Mechanism Of Action

How Does Librium Work?

Chlordiazepoxide exerts its effect by binding to the benzodiazepine site at the gamma-aminobutyric acid (GABA) receptor-chloride ionophore complex in the central nervous system. This leads to an increase in the opening of chloride channels, membrane hyperpolarization and increases the inhibitory effect of GABA on the CNS. Such activities help to alleviate anxiety, tension, reduce psychological excitement, and provide weak analgesic actions.

How Long Does Librium Take To Work?

Chlordiazepoxide HCl is slowly absorbed in the blood and it takes several hours to reach the peak of effectiveness depending on the dosage.

librium dose

Librium Dosage & Administration

There are several available chlordiazepoxide dosages: 5, 10, and  25mg gelatin capsules for oral administration and injectable form with a concentration of 100 mg/5 ml. The medicine can be prescribed for pediatric and geriatric patients, and adults, however, the Librium dosage will vary depending on the case and the age.

Adult Dosage

Condition Dosage and schedule
Mild and Moderate Anxiety Disorders 5 mg or 10 mg 3-4 times per day
Severe Anxiety Disorders 20 mg or 25 mg, 3-4 per day
Preoperative Apprehension and Anxiety On days preceding surgery: 5 to 10 mg orally, 3 or 4 times per day. If used as a preoperative medication: 50 to 100 mg intramuscular injection 1 hour before surgery.
Acute alcohol withdrawal symptoms The suggested initial Librium dosage for alcohol withdrawal in the case of oral administration is 50 to 100 mg, to be followed by repeated doses as needed until agitation is controlled (max dosage is 300 mg per day).

Geriatric Dosage

Geriatric patients or those with the debilitating disease are usually prescribed to take the smallest effective amount of the drug to prevent the development of ataxia or oversedation. Usually, Librium dose for geriatrics is 5 mg 2-4 times a day.

Pediatric Dosage

For pediatric patients over six years old it is recommended to use the lowest effective dose, usually, it is 5 mg, 2-4 times daily (may be increased in some cases to 10 mg chlordiazepoxide capsule, 2-3 times daily). Since there is not enough information in taking this medicine among children under six years of age, the use of the drug is not recommended for this age group.

Missed Dose

In case of missed Librium dosage, one should take it as soon as possible. If it is almost the time for taking the next dose, one should skip the missed dose and take a new one at the usual time, and then continue the course as before. In case of missing the pill ingestion for several days, one should call a doctor for further instructions before taking medicine again.

librium overdose

Chlordiazepoxide Overdose

There is a high chance of Librium overdose using it in large uncontrolled amounts. There is no estimated chlordiazepoxide overdose amount, but taking the substance more frequently in higher doses than those prescripted by a physician can be extremely dangerous for life. In case of any unusual symptoms, one should immediately address the doctor.

Overdose Symptoms

Librium overdose symptoms can appear in different parts of the body: in airways and lungs, kidneys, stomach, face, skin, heart and blood, nervous system. The most common signs of overdose are:

  • difficulty in breathing
  • shallow breathing
  • difficulty during urination
  • double vision or blurred vision
  • rapid side-to-side movement of the eyes
  • irregular heartbeat
  • low blood pressure
  • rapid heartbeat
  • drowsiness, stupor, even coma
  • confusion
  • depression
  • dizziness
  • feeling lightheaded, fainting
  • loss of balance or coordination
  • low body temperature
  • memory loss
  • seizures, tremors
  • weakness, uncoordinated movements
  • bluish-colored lips and fingernails
  • rash
  • yellow skin
  • abdominal pain
  • nausea

Overdose Treatment

In case of taking Librium overdose amount or mixing it with alcohol and/or other drugs, and realizing one of the above symptoms, it is essential to seek medical help. The sooner help is provided, the higher chances of a full recovery are. At the drug rehab center, the patient may be provided with oxygen and endotracheal intubation for definitive airway management in case of having difficulties in breathing. IV fluids are usually administered to stabilize the water-balance. Anticonvulsant medications can be used to deal with seizures.

side effects of librium

Chlordiazepoxide Side Effects

The most common Lithium side effects are:

  • drowsiness
  • depression
  • increased sedation
  • constipation
  • impaired muscle control
  • confusion
  • dizziness
  • skin problems
  • decreased libido

The severe Librium side effects include blood disorders, liver dysfunction, coma, and even death if taking this pharmaceutical with other CNS depressants or opioid medications at the same time. An increased risk of suicidal thoughts have patients with major depressive disorder. Reproduction studies conducted on rats that were given chlordiazepoxide HCl showed that one neonate in each of the first and second matings had major skeletal defects. Further investigations should be done in order to approve the significance of these results.

Librium High

Users report some relaxation effects from experiencing Librium high, sometimes even euphoria. Calming properties the drug provides, sometimes push abusers to take a pill in order to feel the euphoric feeling and enhance mood. People who get high on Librium mentioned feeling more enthusiastic, proactive, and motivated. On the other hand, such proactivity may be expressed in a more aggressive way of behavior.

Librium Abuse

Being a strong medication with long-lasting effects, chlordiazepoxide is considered to be a target for abuse. The most common way Librium abuse is to crush and snort it instead of taking the drug orally. In this way, the chemicals easily get into the bloodstream through the thin lining inside the nose and faster influence brain chemistry. As users mention, abuse leads to addiction over time.

There is no official data on Librium overdose, but the statistics shows that cases of benzodiazepine abuse are increasing every year. Among 30% of all overdose cases from opioids in the US include also the presence of benzodiazepines. From 1996 to 2013 the number of benzodiazepine prescriptions increased by 67%, from 8.1 million to 13.5 million users. In 2015, 23% of those who died from an opioid overdose had a positive result for benzodiazepines.

librium addiction

Is Librium Addictive?

According to the user’s experience, using the substance for a long period of time
leads to Librium addiction, requiring larger doses to achieve the same result. Even after the rapid cancellation of taking the drug, people can feel unpleasant Librium withdrawal. The most common signs of addiction include:

  • having cravings for the substance;
  • tolerance;
  • taking the drug in larger doses more frequently;
  • mixing chlordiazepoxide with alcohol and other drugs to achieve the desired effect;
  • feeling withdrawal symptoms when trying to quit.

Chlordiazepoxide Interactions

There are, at least, 406 medicines that interact with chlordiazepoxide hydrochloride.

Drug interactions may change the way the drug works and increase the possibility of obtaining serious adverse effects. Also, every Librium interaction can be differently reflected in each person.

Severe interactions and a high chance of side effects could be provoked by the following Librium drug interactions:

How To Prevent Librium Abuse

Chlordiazepoxide is a long-acting benzodiazepine that provides anxiolytic, sedative, and hypnotic effects. The medicine should be used only when prescripted by a doctor strictly for its intended purpose. According to the wide range of clinical indications for Librium medication, the optimum dosage depends on the diagnosis, individual tolerance, age, and many other indications to reach the most beneficial result. In case of any adverse effects and uncommon symptoms, one should ask for professional help at specialized rehabilitation and addiction centers.

Page Sources

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  5. National Center for Biotechnology Information. PubChem Database. Chlordiazepoxide, CID=2712,
  6. Chlordiazepoxide overdose. MedlinePlus. 2019.
  7. Kang M, Galuska MA, Ghassemzadeh S. Benzodiazepine Toxicity. [Updated 2020 Apr 11]. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2020.
  8. Bachhuber MA, Hennessy S, Cunningham CO, Starrels JL. Increasing Benzodiazepine Prescriptions and Overdose Mortality in the United States, 1996-2013. American Journal of Public Health. 2016; 106(4): 686-8. doi: 10.2105/AJPH.2016.303061.
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Published on: October 2nd, 2015

Updated on: July 6th, 2021

About Author

Olivier George, Ph.D.

Olivier George is a medical writer and head manager of the rehab center in California. He spends a lot of time in collecting and analyzing the traditional approaches for substance abuse treatment and assessing their efficiency.