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Amitriptyline and chlordiazepoxide

Generic Name: amitriptyline and chlordiazepoxide (AM i TRIP ti leen and KLOR dye AZ e POX ide)
Brand Name: Limbitrol, Limbitrol DS

Medically reviewed on January 29, 2018

What is amitriptyline and chlordiazepoxide?

Amitriptyline is a tricyclic antidepressant. Chlordiazepoxide is a benzodiazepine (ben-zoe-dye-AZE-eh-peen). These medicines affect chemicals in the brain that may be unbalanced in people with depression.

Amitriptyline and chlordiazepoxide is a combination medicine used to treat moderate to severe depression and anxiety.

Amitriptyline and chlordiazepoxide may also be used for purposes not listed in this medication guide.

Important Information

You should not use this medicine if you have recently had a heart attack.

Do not use this medicine if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

Before taking this medicine

You should not use this medicine if you are allergic to amitriptyline or chlordiazepoxide, or:

Do not use this medicine if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

To make sure amitriptyline and chlordiazepoxide is safe for you, tell your doctor if you have:

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

This medicine can harm an unborn baby or cause birth defects. Do not use if you are pregnant, and tell your doctor right away if you become pregnant while taking amitriptyline and chlordiazepoxide.

This medicine can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using amitriptyline and chlordiazepoxide.

Do not give this medicine to a child without medical advice.

How should I take amitriptyline and chlordiazepoxide?

Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Amitriptyline and chlordiazepoxide may be habit-forming. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it. Selling or giving away this medicine is against the law.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

It may take up to 4 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve.

If you need surgery, tell the surgeon ahead of time that you are using amitriptyline and chlordiazepoxide. You may need to stop using the medicine for a short time.

Do not stop using amitriptyline and chlordiazepoxide suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using amitriptyline and chlordiazepoxide.

Your doctor will need to check your progress while you are using amitriptyline and chlordiazepoxide. If you use this medicine long-term, you may need frequent medical tests.

Store at room temperature away from moisture and heat.

Keep track of the amount of medicine used from each new bottle. Amitriptyline and chlordiazepoxide is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of amitriptyline and chlordiazepoxide can be fatal, especially if taken with alcohol.

Overdose symptoms may include irregular heartbeats, extreme drowsiness, overactive reflexes, stiff muscles, dilated pupils, vomiting, feeling hot or cold, feeling like you might pass out, or seizure (convulsions).

What should I avoid while taking amitriptyline and chlordiazepoxide?

Do not drink alcohol. Dangerous side effects can occur when alcohol is combined with amitriptyline and chlordiazepoxide.

Amitriptyline and chlordiazepoxide may impair your thinking or reactions. Avoid driving or operating machinery until you know how this medicine will affect you. Dizziness or severe drowsiness can cause falls or other accidents.

Amitriptyline and chlordiazepoxide side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

  • confusion, hallucinations, unusual thoughts or behavior;

  • chest pain or heavy feeling, pain spreading to the jaw or shoulder;

  • pounding heartbeats or fluttering in your chest;

  • a light-headed feeling, like you might pass out;

  • severe constipation; or

  • little or no urination.

The sedative effects of this medicine may last longer in older adults. Accidental falls are common in elderly patients who take benzodiazepines. Use caution to avoid falling or accidental injury while you are taking amitriptyline and chlordiazepoxide.

Common side effects may include:

  • dizziness, drowsiness, feeling weak or tired;

  • restlessness;

  • blurred vision;

  • constipation, bloating, loss of appetite; or

  • dry mouth.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Amitriptyline and chlordiazepoxide dosing information

Usual Adult Dose for Anxiety:

Amitriptyline 25 mg-chlordiazepoxide 10 mg tablets:
-Initial dose: 3 to 4 tablets orally per day, given in divided doses
-Maintenance dose: 2 to 6 tablets orally per day, given in divided doses
Maximum dose: 6 tablets/day

Comments:
-Doses should be reduced to the lowest effective amount once a satisfactory response is obtained.
-The larger portion of the total dose may be given at bedtime.
-A single daily dose (given at bedtime) may be sufficient for some patients.

Use: Treatment of patients with moderate to severe depression associated with moderate to severe anxiety

Usual Adult Dose for Depression:

Amitriptyline 25 mg-chlordiazepoxide 10 mg tablets:
-Initial dose: 3 to 4 tablets orally per day, given in divided doses
-Maintenance dose: 2 to 6 tablets orally per day, given in divided doses
Maximum dose: 6 tablets/day

Comments:
-Doses should be reduced to the lowest effective amount once a satisfactory response is obtained.
-The larger portion of the total dose may be given at bedtime.
-A single daily dose (given at bedtime) may be sufficient for some patients.

Use: Treatment of patients with moderate to severe depression associated with moderate to severe anxiety

What other drugs will affect amitriptyline and chlordiazepoxide?

Taking this medicine with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking amitriptyline and chlordiazepoxide with a cold or allergy medicine, sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Before taking amitriptyline and chlordiazepoxide, tell your doctor if you have used an "SSRI" antidepressant in the past 5 weeks, such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), or sertraline (Zoloft).

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • any other antidepressants;

  • heart or blood pressure medication; or

  • medicine to treat mental illness.

This list is not complete. Other drugs may interact with amitriptyline and chlordiazepoxide, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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