CHLORDIAZEPOXIDE + CLIDINIUM BROMIDE

Tell your doctor or pharmacist promptly if any of these effects persist or worsen:

• Dizziness
• Drowsiness
• Weakness
• blurred vision
• dry eyes
• dry mouth
• nausea
• constipation
• abdominal bloating

Tell your doctor immediately if any of these unlikely but serious side effects occur:

• decreased sweating
• dry/hot/flushed skin
• fast/irregular heartbeat
• loss of coordination
• slurred speech
• fainting
• uncontrollable/unusual muscle movements
• mental/mood changes (such as confusion, agitation, unusual excitement, depression, strange thoughts)
• difficulty urinating
• decreased sexual ability
• slow/shallow breathing
• signs of infection (such as fever, persistent sore throat)
• signs of liver problems (dark urine, persistent nausea, vomiting, stomach/abdominal pain, yellowing eyes/skin, unusual tiredness)

Get medical help right away if you eye pain/swelling/redness, or vision changes (such as seeing rainbows around lights at night).

A very serious allergic reaction to this drug is rare.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

Precautions

Consult your doctor regarding these precautions:

• Allergic reaction to this medication.
• Patients with medical history of:

1. personal or family history of glaucoma (angle-closure type)
2. enlarged prostate
3. problems with urination due to a blocked urinary tract
4. other stomach/intestinal problems (such as slow gut, blockage, ulcerative colitis, infection, little/no stomach acid, ileostomy/colostomy patients with diarrhea)
5. overactive thyroid
6. heart problems (such as coronary artery disease, angina, congestive heart failure, fast/irregular heartbeat, heart problems due to severe bleeding)
7. high blood pressure
8. heartburn problems (such as acid reflux, hiatal hernia, esophagus problems)
9. a certain nervous system problem (autonomic neuropathy)
10. myasthenia gravis
11. liver problems
12. kidney problems
13. breathing/lung problems
14. drug/alcohol abuse
15. mental/mood conditions (such as depression, thoughts of suicide, psychosis, schizophrenia), a certain blood disorder (porphyria)

• Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely.
• Avoid doing things that may cause you to overheat, such as hard work or exercise in hot weather, or using hot tubs.
• Older adults may be more sensitive to drowsiness, confusion, unusual excitement, memory problems, constipation, urination problems, and unsteadiness.
• This medication is not recommended for use during pregnancy.
• Breast-feeding while using this drug is not recommended.

Interactions

The effects of some drugs can change if you take other drugs or herbal products at the same time. This can increase your risk for serious side effects or may cause your medications not to work correctly.

Some products that may interact with this drug include:

• potassium tablets/capsules
• sodium oxybate
• drugs that are affected by slowed gut movement (such as metoclopramide, pramlintide)

This medication may affect the absorption of other products such as certain azole anti-fungal drugs (ketoconazole, itraconazole), slowly-dissolving forms of digoxin, among others. If you are taking either ketoconazole or itraconazole, take it at least 2 hours before this medication.

Other medications may affect how chlordiazepoxide works. Examples include cimetidine, disulfiram, among others.

Cigarette smoking decreases blood levels of chlordiazepoxide.

Many other drugs that also cause dry mouth and constipation may interact with anticholinergics/antispasmodics such as clidinium. Tell your doctor or pharmacist about all the products you take, including:

• Amantadine
• other anticholinergic drugs (such as atropine, glycopyrrolate, scopolamine)
• other antispasmodic drugs (such as dicyclomine, propantheline)
• belladonna alkaloids
• certain drugs used to treat Parkinson’s disease (such as benztropine, trihexyphenidyl)
• certain drugs used to treat irregular heart rhythms (such as disopyramide, quinidine)
• MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine)
• phenothiazines (such as chlorpromazine)
• tricyclic antidepressants (such as amitriptyline)

Tell your doctor or pharmacist if you are taking other products that cause drowsiness or slow/shallow breathing including:

• Alcohol
• antihistamines (such as cetirizine, diphenhydramine)
• drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem)
• kava
• drugs to treat mental/mood conditions
• muscle relaxants
• narcotic pain relievers (such as codeine)

Check the labels on all your medicines (such as allergy or cough-and-cold products, diet aids) because they may contain ingredients that cause drowsiness or a fast heartbeat.

This medication may interfere with certain laboratory tests, possibly causing false test results.

This document does not contain all possible drug interactions.

Overdose

If overdose is suspected, contact a poison control center or emergency room immediately. Symptoms of overdose may include: severe drowsiness, hot/dry skin, fever, severe dizziness, severe thirst, mental/mood changes (such as confusion, unusual excitement), fast/irregular heartbeat, muscle weakness, inability to move (paralysis), slowed breathing, fainting, seizures.

Notes

Do not share this medication with others.

Management of digestive disorders may include lifestyle changes such as stress reduction programs, exercise, stopping smoking, and dietary changes, in addition to medication. Talk to your doctor or pharmacist about lifestyle changes that might benefit you.

If this medication is used for an extended period of time, laboratory and/or medical tests (such as blood counts, liver function tests) may be performed periodically to check for side effects. Consult your doctor for more details.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Storage

Store at room temperature between 59-86 degrees F (15-30 degrees C) away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

Brands:

There are no brands containing this molecule.