CHLORDIAZEPOXIDE+ CLIDINIUM

Indications & Dose:

Ulcer, peptic (treatment adjunct) or Bowel syndrome, irritable (treatment), effective as adjunctive therapy in the treatment of peptic ulcer and irritable bowel syndrome due to anxiety & tention.

• BY MOUTH

Adult: 3-4 drages with little of water before meal & retiring. reduced in elderly patients.

Children: Not recommended

Contraindications:

Glaucoma, prostatic hypertrophy, acute pulmonary insufficiency, respiratory depression. Use of anticholinergic and sedative combinations in pregnancy is generally not recommended

For chlordiazepoxide: Chlordiazepoxide crosses the placenta. Chronic use of chlordiazepoxide during pregnancy may cause physical dependence with resulting withdrawal symptoms in the neonate. For clidinium: Appropriate studies in humans have not been performed. Reproduction studies in rats have not shown that clidinium has adverse effects on the fetus.

FIRST TRIMESTER: Chlordiazepoxide has been reported to increase the risk of congenital malformations when used during the first trimester of pregnancy. Its use during pregnancy, especially during the first trimester, should be avoided.

LABOR: For chlordiazepoxide: Use of chlordiazepoxide just prior to or during labor may cause neonatal flaccidity.

BREAST-FEEDING: Chlordiazepoxide or its metabolites may be distributed into breast milk; use by nursing mothers may cause sedation in the infant. Clidinium may tend to inhibit lactation.

PEDIATRICS: No information is available on the relationship of age to the effects of chlordiazepoxide and clidinium in pediatric patients. However, it is known that infants and young children are especially susceptible to the toxic effects of atropine-like drugs, such as clidinium, and to the central nervous system (CNS) effects of benzodiazepines, such as chlordiazepoxide.

GERIATRICS: Geriatric patients may respond to usual doses of chlordiazepoxide and clidinium with excitement, agitation, drowsiness, or confusion. Geriatric patients are especially susceptible to the anticholinergic side effects, such as constipation, dryness of mouth, and urinary retention (especially in males), of clidinium. If these side effects occur and continue or are severe, medication should probably be discontinued.Caution is also recommended when clidinium is given to geriatric patients, because of the danger of precipitating undiagnosed glaucoma. Memory may become severely impaired in geriatric patients, especially those who already have memory problems, with the continued use of clidinium since this medication blocks the action of acetylcholine, which is responsible for many functions of the brain, including memory functions.

Side Effects:

Cautions:

Precautions:

Regular visits to physician to check progress of therapy if used for extended period of time, Avoiding medicine for diarrhea within 1 to 2 hours of taking this medication, Caution if dizziness, lightheadedness, drowsiness, or blurred vision occurs, Avoiding use of alcohol or other CNS depressants during and for a few days following therapy,  Caution during exercise and hot weather; overheating may result in heat stroke, Possible dryness of mouth, nose, and throat; using sugarless gum or candy, ice, or saliva substitute for relief; checking with dentist if mouth continues to feel dry for more than 2 weeks,  Checking with physician if constipation occurs, Checking with physician before discontinuing medication after prolonged use; gradual dosage reduction may be necessary to avoid the possibility of withdrawal symptoms. 

Interaction:

Warnings:

Adverse Effects:

Note: When clidinium is given to patients where the environmental temperature is high, there is risk of a rapid increase in body temperature because of suppression of sweat gland activity.

Agranulocytosis, granulocytopenia, or leukopenia (sore throat and fever), CNS depression  (slow heartbeat, shortness of breath, or troubled breathing), decreased peristalsis (constipation)— possible paralytic ileus , hypersensitivity reaction (skin rash or hives) , increased intraocular pressure (eye pain), jaundice (yellow eyes or skin) , paradoxical reaction (trouble in sleeping; unusual excitement, nervousness, or irritability)

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: