Chlordiazepoxide and Clidinium
Also known as: Librium, Librax
* **Administration**: Give exactly as directed by your veterinarian. If using for stress-related diarrhea, give at the first sign of cramping or stressful events. * **Behavioral Changes**: In some animals (especially dogs), this medication can cause paradoxical excitement or agitation instead of calming them. Notify your veterinarian immediately if your pet's behavior worsens or if they become aggressive. * **Side Effects**: May cause dry mouth (ensure fresh water is always available), constipation, or mild sleepiness. * **Cats**: Watch closely for loss of appetite, vomiting, lethargy, or yellowing of the eyes/gums, as oral anti-anxiety medications in this class can rarely cause liver issues in cats. * **Safety**: Keep strictly out of reach of children and other pets. Store in a tightly closed container.
Dosage must be set by your veterinarian for your specific pet. Never give human medication or another pet’s prescription without veterinary guidance.
What it is used for
- As an anxiolytic
- Behavior indications (thunderstorm/noise phobias)
- Symptomatic treatment of irritable bowel syndrome
- Symptomatic treatment of irritable bowel syndrome
How it is given
Possible side effects
- Paradoxical CNS excitement or agitation (especially in dogs)
- Variable sedation and lethargy
- Behavioral changes (irritability, aberrant demeanor in cats)
- Potential hepatotoxicity (idiosyncratic hepatic failure reported with oral diazepam in cats; unknown if chlordiazepoxide shares this risk)
- Dry mouth (xerostomia)
- Constipation or dysphagia
- Urinary retention or hesitancy
- Tachycardia (at higher doses) or initial bradycardia
Cautions & contraindications
- Known hypersensitivity to benzodiazepines or antimuscarinics
- Coma, shock, or significant respiratory depression
- Aggressive patients (may disinhibit bite inhibition and worsen aggression)
- Tachycardia secondary to thyrotoxicosis or cardiac insufficiency
- Myocardial ischemia
- Gastrointestinal obstructive disease or paralytic ileus
- Severe ulcerative colitis
- Obstructive uropathy
- Myasthenia gravis
- Known or suspected GI infections (may prolong retention of toxins/pathogens)
- > **Warning**: Use benzodiazepines with extreme caution in aggressive animals, as they may disinhibit anxiety-based bite inhibition, leading to worsened aggressive behavior. * **Hepatic/Renal Impairment**: Use cautiously in patients with liver or kidney disease, and in debilitated or geriatric patients. * **Working Animals**: Benzodiazepines may impair the abilities of working or service animals. * **Autonomic Neuropathy**: Use antimuscarinics with extreme caution. * **Pregnancy**: Benzodiazepines are potentially teratogenic (FDA Category D). Use during the first trimester only if benefits clearly outweigh risks. * **Nursing**: Distributed into milk and may cause CNS effects in nursing neonates.
Drug interactions
- Digoxin: Pharmacologic effects of digoxin may be increased; clidinium may also increase serum levels of slow-dissolving digoxin.
- CNS Depressants (barbiturates, opiates, anesthetics): Additive CNS depression and sedative effects.
- Probenecid: May interfere with benzodiazepine metabolism in the liver, causing increased or prolonged effects.
- Rifampin: May induce hepatic microsomal enzymes and decrease the pharmacologic effects of benzodiazepines.
- Cimetidine: May decrease the metabolism of chlordiazepoxide, leading to excessive sedation.
- Erythromycin: May decrease the metabolism of chlordiazepoxide, leading to excessive sedation.
- Fluoxetine: May decrease the metabolism of chlordiazepoxide, leading to excessive sedation.
- Isoniazid: May decrease the metabolism of chlordiazepoxide, leading to excessive sedation.
- Ketoconazole: May decrease chlordiazepoxide metabolism. Additionally, increased gastric pH from clidinium may decrease GI absorption of ketoconazole (administer clidinium 2 hours after ketoconazole).
- Metoprolol: May decrease the metabolism of chlordiazepoxide, leading to excessive sedation.
Frequently asked questions
What is Chlordiazepoxide and Clidinium used for in pets?
* **Administration**: Give exactly as directed by your veterinarian. If using for stress-related diarrhea, give at the first sign of cramping or stressful events. * **Behavioral Changes**: In some animals (especially dogs), this medication can cause paradoxical excitement or agitation instead of calming them. Notify your veterinarian immediately if your pet's behavior worsens or if they become aggressive. * **Side Effects**: May cause dry mouth (ensure fresh water is always available), constipation, or mild sleepiness. * **Cats**: Watch closely for loss of appetite, vomiting, lethargy, or yellowing of the eyes/gums, as oral anti-anxiety medications in this class can rarely cause liver issues in cats. * **Safety**: Keep strictly out of reach of children and other pets. Store in a tightly closed container.
Is Chlordiazepoxide and Clidinium safe for my pet?
Dosage must be set by your veterinarian for your specific pet. Never give human medication or another pet’s prescription without veterinary guidance.
This article is for general education and is not a substitute for professional veterinary advice. If your pet is unwell, please consult a veterinarian.
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