Drug Interactions between Librax and nefazodone
This report displays the potential drug interactions for the following 2 drugs:
- Librax (chlordiazepoxide/clidinium)
- nefazodone
Interactions between your drugs
chlordiazePOXIDE nefazodone
Applies to: Librax (chlordiazepoxide / clidinium) and nefazodone
MONITOR: Nefazodone, when administered with alprazolam or triazolam, has been reported to increase their half-life, area under the plasma concentration-time curve, and peak plasma concentrations. Increased sedation and altered psychomotor performance have resulted. The mechanism appears to be inhibition of the CYP450 3A4 enzyme by nefazodone. This interaction may occur with all benzodiazepines that undergo oxidative metabolism, although it has been reported only with alprazolam and triazolam.
MANAGEMENT: Patients receiving this combination should be monitored for excessive and prolonged sedation. It may be necessary to adjust benzodiazepine dosage when nefazodone is started or stopped. Lorazepam, oxazepam, and temazepam undergo conjugative metabolism and may be suitable alternatives.
References (5)
- (2001) "Product Information. Serzone (nefazodone)." Bristol-Myers Squibb
- Kroboth PD, Mcauley JW, Derry CL (1995) "Time-dependent sensitization to triazolam? An observation in three studies." J Clin Psychopharmacol, 15, p. 192-6
- Barbhaiya RH, Shukla UA, Kroboth PD, Greene DS (1995) "Coadministration of nefazodone and benzodiazepines: 2. a pharmacokinetic interaction study with triazolam." J Clin Psychopharmacol, 15, p. 320-6
- Riesenman C (1995) "Antidepressant drug interactions and the cytochrome p450 system: a critical appraisal." Pharmacotherapy, 15, s84-99
- Greene DS, Salazar DE, Dockens RC, Kroboth P, Barbhaiya RH (1995) "Coadministration of nefazodone and benzodiazepines: 3. a pharmacokinetic interaction study with alprazolam." J Clin Psychopharmacol, 15, p. 399-408
Drug and food interactions
chlordiazePOXIDE food
Applies to: Librax (chlordiazepoxide / clidinium)
GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.
MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.
References (4)
- Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
- Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.
- (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
- (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc
nefazodone food
Applies to: nefazodone
GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.
MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.
References (4)
- Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
- Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.
- (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
- (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc
clidinium food
Applies to: Librax (chlordiazepoxide / clidinium)
GENERALLY AVOID: Use of anticholinergic agents with alcohol may result in sufficient impairment of attention so as to render driving and operating machinery more hazardous. In addition, the potential for abuse may be increased with the combination. The mechanism of interaction is not established but may involve additive depressant effects on the central nervous system. No effect of oral propantheline or atropine on blood alcohol levels was observed in healthy volunteers when administered before ingestion of a standard ethanol load. However, one study found impairment of attention in subjects given atropine 0.5 mg or glycopyrrolate 1 mg in combination with alcohol.
MANAGEMENT: Alcohol should generally be avoided during therapy with anticholinergic agents. Patients should be counseled to avoid activities requiring mental alertness until they know how these agents affect them.
References (1)
- Linnoila M (1973) "Drug effects on psychomotor skills related to driving: interaction of atropine, glycopyrrhonium and alcohol." Eur J Clin Pharmacol, 6, p. 107-12
Therapeutic duplication warnings
No warnings were found for your selected drugs.
Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
See also
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
No interaction information available. |
Further information
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