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Librium Side Effects

Generic Name: chlordiazepoxide

Note: This page contains information about the side effects of chlordiazepoxide. Some of the dosage forms included on this document may not apply to the brand name Librium.

Not all side effects for Librium may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

For the Consumer

Applies to chlordiazepoxide: oral capsule, oral tablet

In addition to its needed effects, some unwanted effects may be caused by chlordiazepoxide (the active ingredient contained in Librium). In the event that any of these side effects do occur, they may require medical attention.

You should check with your doctor immediately if any of these side effects occur when taking chlordiazepoxide:

  • Fainting
  • mood or mental changes
  • shakiness and unsteady walk
  • unsteadiness, trembling, or other problems with muscle control or coordination
Incidence not known
  • Abdominal and muscle cramps
  • chills
  • clay-colored stools
  • convulsions
  • cough or hoarseness
  • dark urine
  • difficulty in speaking
  • dizziness
  • drooling
  • fever with or without chills
  • general feeling of tiredness or weakness
  • headache
  • itching
  • light-colored stools
  • loss of appetite
  • loss of balance control
  • lower back or side pain
  • muscle trembling, jerking, or stiffness
  • nausea and vomiting
  • painful or difficult urination
  • pale skin
  • rash
  • restlessness
  • shakiness in the legs, arms, hands, or feet
  • shuffling walk
  • sleeplessness
  • sore throat
  • sores, ulcers, or white spots on the lips or in the mouth
  • stiffness of the limbs
  • stomach pain
  • sweating
  • swelling
  • trouble sleeping
  • twisting movements of the body
  • unable to sleep
  • uncontrolled movements, especially of the face, neck, and back
  • unpleasant breath odor
  • unusual bruising or bleeding
  • unusual tiredness or weakness
  • vomiting of blood
  • yellow eyes or skin

If any of the following symptoms of overdose occur while taking chlordiazepoxide, get emergency help immediately:

Symptoms of overdose
  • Change in consciousness
  • lack of coordination
  • loss of consciousness
  • sleepiness or unusual drowsiness

Some of the side effects that can occur with chlordiazepoxide may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

Incidence not known
  • Decreased interest in sexual intercourse
  • difficulty having a bowel movement (stool)
  • inability to have or keep an erection
  • increased in sexual ability, desire, drive, or performance
  • increased interest in sexual intercourse
  • loss in sexual ability, desire, drive, or performance
  • menstrual changes
  • skin blisters

For Healthcare Professionals

Applies to chlordiazepoxide: injectable powder for injection, oral capsule, oral tablet

Nervous system

Nervous system side effects are common and most often have included drowsiness, ataxia, and dizziness.[Ref]

Chlordiazepoxide may impair the psychomotor skills necessary for driving. Persistent electroencephalographic changes (involving a decrease in the mean energy content and an increase in the variability of the EEG) have been reported rarely.[Ref]


Respiratory side effects have included respiratory depression which may be clinically important in patients with underlying respiratory disease.[Ref]


Other side effects have included withdrawal symptoms and case reports of hiccups.[Ref]

Withdrawal symptoms after abrupt cessation of chlordiazepoxide may include agitation, restlessness, anxiety, insomnia, convulsions, tremor, abdominal cramps, vomiting, and sweating.[Ref]


Psychiatric side effects have included hallucinations, vivid dreaming, agitation, and behavioral disinhibition.[Ref]


Local side effects have included reactions at the site of parenteral injection (pain, burning, local irritation and swelling).[Ref]


The manufacturer recommends periodic monitoring of blood counts during protracted treatment with chlordiazepoxide (the active ingredient contained in Librium)

One case of non-thrombocytopenic purpura has also been reported.[Ref]

Hematologic side effects including blood dyscrasias such as agranulocytosis and thrombocytopenia have been reported rarely.[Ref]


The manufacturer recommends periodic monitoring of liver function tests during protracted treatment with chlordiazepoxide (the active ingredient contained in Librium) [Ref]

Hepatic side effects including cholestatic jaundice have been reported rarely. Mild transient increases in liver function tests have also been reported.[Ref]


Endocrine side effects have included depression of iodine 131 uptake, galactorrhea, and potential aggravation of hyperglycemia in diabetic patients.[Ref]


Dermatologic side effects have included fixed drug eruptions and drug-induced photosensitivity.[Ref]


Cardiovascular side effects have rarely included syncope, tachycardia, hypotension, and edema.[Ref]


1. Palva ES, Linnoila M "Effect of active metabolites of chlordiazepoxide and diazepam, alone or in combination with alcohol, on psychomotor skills related to driving." Eur J Clin Pharmacol 13 (1978): 345-50

2. Downing RW, Rickels K "Coffee consumption, cigarette smoking and reporting of drowsiness in anxious patients treated with benzodiazepines or placebo." Acta Psychiatr Scand 64 (1981): 398-408

3. Lipman RS, Covi L, Rickels K, McNair DM, Downing R, Kahn RJ, Lasseter VK, Faden V "Imipramine and chlordiazepoxide in depressive and anxiety disorders. I. Efficacy in depressed outpatients." Arch Gen Psychiatry 43 (1986): 68-77

4. Clark TO, Arrowsmith R "Persistent EEG. changes in chlordiazepoxide toxic state. A case report." Can Psychiatr Assoc J 13 (1968): 279-80

5. Benor D "Side effect of chlordiazepoxide." J Clin Pharmacol J New Drugs 7 (1967): 180

6. Hollister LE "Editorial: Psychotherapeutic drugs and driving." Ann Intern Med 80 (1974): 413

7. Model DG, Berry DJ "Effects of chlordiazepoxide in respiratory failure due to chronic bronchitis." Lancet 2 (1974): 869-70

8. Ryan GP, Boisse NR "Experimental induction of benzodiazepine tolerance and physical dependence." J Pharmacol Exp Ther 226 (1983): 100-7

9. Petursson H, Lader MH "Benzodiazepine dependence." Br J Addict 76 (1981): 133-45

10. Finer MJ "Habituation to chlordiazepoxide in an alcoholic population." JAMA 213 (1970): 1342

11. Viscott DS "Chlordiazepoxide and hallucinations. Report of cases." Arch Gen Psychiatry 19 (1968): 370-6

12. "Product Information. Librium (chlordiazepoxide)." Roche Laboratories, Nutley, NJ.

13. Celada A, Herreros V, Rudolf H "Thrombocytopenic purpura during treatment with Librax." Br Med J 1 (1977): 268

14. Copperman IJ "Purpura in a patient taking chlordiazepoxide." Br Med J 4 (1967): 485-6

15. Lo KJ, Eastwood IR, Eidelman S "Cholestatic jaundice associated with chlordiazepoxide hydrochloride (Librium) therapy. Report of a case and review of the literature." Am J Dig Dis 12 (1967): 845-9

16. Lampe WT, 2d "Lactation following psychotropic agents." Metabolism 16 (1967): 257-8

17. Zumoff B, Hellman L "Aggravation of diabetic hyperglycemia by chlordiazepoxide." JAMA 237 (1977): 1960-1

18. Harvey RF "Drugs and thyroid-function tests." Br Med J 2 (1967): 52

19. Savin JA "Current causes of fixed drug eruptions." Br J Dermatol 83 (1970): 546-9

20. Blair HM, 3d "Letter: Fixed drug eruption from chlordiazepoxide." Arch Dermatol 109 (1974): 914

21. Sakai H, Fukami Y, Ibe M, Hashimoto Y, Iizuka H "A case of a fixed drug eruption presenting with a butterfly rash-like exanthem in a patient with Sjogren's syndrome." Int J Dermatol 44 (2005): 260-2

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