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Librax: What is the Cost and Dosage?

If you’ve never heard of irritable bowel syndrome (IBS), you’re not alone, but you almost certainly know someone who is affected by the condition. An estimated 10 and 15 percent of the adult population in the United States suffers from IBS, which is a common, chronic gastrointestinal condition, but only about 5 to 7 percent of adults have actually been diagnosed. Researchers aren’t clear on exactly what causes IBS, but we do know that women are about twice as likely to suffer from the condition as men. People with IBS regularly experience abdominal pain and discomfort along with altered bowel habits that can make the condition unpleasant and embarrassing. Librax is a prescription medication that can help ease the symptoms of IBS for some patients. It should be stored at room temperature and kept out of the reach of children. 

What is Librax?

Librax is a prescription medication that is comprised of two drugs: chlordiazepoxide and clidinium. Chlordiazepoxide belongs to a class of drugs known as benzodiazepines, while clidinium belongs to a class of drugs called anticholinergics/antispasmodics. The U.S. Food and Drug Administration (FDA) first approved the use of Librax for the treatment of gastrointestinal disorders in 1966. The medication works in two ways: chlordiazepoxide reduces anxiety by working on chemicals in the brain to produce a calming effect, while clidinium reduces the production of stomach acid and decreases intestinal spasms that are often associated with irritable bowel syndrome.

What is Librax Used to Treat?

Librax is used to treat several different gastrointestinal disorders, including stomach ulcers, treatment of peptic ulcer, irritable bowel syndrome, acute enterocolitis, and some bowel infections, when used with other medications.

Stomach Ulcers

Stomach ulcers, often called peptic or gastric ulcers, are open sores that develop on the stomach lining or the upper portion of the small intestine. Stomach ulcers can be caused by a number of different factors, including an infection with a type of bacteria called H. pylori or use of nonsteroidal anti-inflammatory drugs (NSAIDs) like naproxen sodium or ibuprofen for a prolonged period of time. Contrary to popular belief, factors like stress or consumption of spicy or highly acidic foods do not cause stomach ulcers, but they can make them worse. Common symptoms of stomach ulcers include belching, bloating, burning pain in the stomach, a feeling of fullness,  heartburn, intolerance of fatty foods, and nausea. In severe cases, people with ulcers may vomit blood or have blood present in their stools. 

Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a common, chronic gastrointestinal condition that predominantly impacts the large intestine. There are many symptoms of IBS, and they typically occur concurrently; some people are more likely to experience constipation with IBS, while others are more likely to experience diarrhea.  Diagnostic criteria for IBS indicates that patients must typically experience symptoms a minimum of at least three days per month for at least three months. Symptoms associated with IBS include:

  • Cramping
  • Constipation
  • Diarrhea
  • Abdominal pain
  • Bloating and gas

Some people with IBS experience only constipation or only diarrhea, while others experience symptoms of both. Women are twice as likely as men to be affected by IBS, and scientists do not entirely understand what causes the condition.  

How Much Does Librax Cost?

Librax is available as both a brand name medication and in a generic form of the drug known as chlordiazepoxide/clidinium. As is so often the case with medications, the brand name version of Librax costs substantially more than the generic version of the drug.  Purchasing 30 capsules of Librax will cost about 1,400 dollars, while purchasing the same quantity of the generic version of the medication will cost approximately 58 dollars. Most forms of commercial insurance, Medicare, and Medicaid offer coverage for the generic version of the drug, but finding coverage for the brand name version is much more challenging. However,  regardless of a patient’s insured status, they are able to use a pharmacy discount card to  receive substantial savings on the medication. Pharmacy discount cards offer discounts on all generic and brand name FDA-approved medications.

Brand name medications like Librax can sometimes be prohibitively expensive for patients, particularly when compared to the generic form of the drug. However, some patients prefer to purchase the brand name version of a medication because they have concerns regarding the quality and safety of generic drugs. Fortunately, these concerns are unfounded. The FDA requires generic drugs to undergo the same rigorous quality and safety testing as brand name medications, and generic drugs are equally as effective as the brand name drugs because they use the same active ingredients. The main difference between generic and brand name drugs is in the inactive ingredients that affect cosmetic qualities like the color,  taste, shape, and size of the medications.  

What Dose of Librax Should I Take?

Both the brand name form of Librax and the generic version is dispensed in the form of capsules that are available in a strength of 5 mg of chlordiazepoxide and 2.5 mg of clidinium. Librax is taken orally and is typically taken three to four times a day by adults who are using the medication for the treatment of ulcers or IBS. Librax is typically taken approximately 30 to 60 minutes before meals, and one to two capsules are taken at a time. Older adults may have difficulty processing the medication and will typically take a reduced dose of two capsules per day in order to avoid side effects. 

What are the Side Effects of Librax?

Common side effects of Librax generally do not require medical advice to be sought, while others can be serious and should receive medical attention immediately. Common side effects of Librax that do not usually require medical attention include:

  • Dry mouth
  • Constipation
  • Drowsiness
  • Swelling
  • Blurred vision
  • Nausea
  • Urination problems
  • Rash
  • Irregular menstrual periods
  • Increased or decreased interest in sex

Other side effects of Librax are serious and require immediate medical attention. Side effects requiring immediate medical attention include:

  • Confusion
  • Liver problems, commonly seen as jaundice (yellowing of the skin or eyes)
  • Light-headed feeling, like you might pass out
  • Anger
  • Unusual Excitement
  • Feeling restless
  • Painful or difficult urination
  • Fever or sore throat
  • Severe drowsiness
  • Severe constipation
  • Restless muscle movements in your eyes, jaw, tongue, or neck
  • Problems with balance or coordination
  • Allergic reaction to Librax, as indicated by:
    • Hives
    • Swelling of the face, tongue, lips, or throat
    • Difficulty breathing

Withdrawal symptoms are also possible if you suddenly stop taking Librax, and may include muscle cramps, seizures, shaking, sweating, and vomiting. 

Are There Any Risks Associated With Librax?

The FDA has issued a black box warning, its highest warning level, for Librax due to the possibility of serious side effects or death when the medication is taken with opioids or if there is drug abuse involved due to its habit-forming nature. Concomitant use of central nervous system depressants like benzodiazepines, such as chlordiazepoxide and diazepam, along with opioids, such as Vicodin, can cause respiratory depression, severe breathing problems, profound sedative effects, coma, and even death. The best way to avoid these potentially serious and deadly side effects is to use alternatives to opioid medications when taking Librax. Patients who have no other options and must take the medications concurrently should take the lowest possible dosage at the longest possible intervals in order to control their symptoms, and the patients should be closely monitored. 

Benzodiazepines like chlordiazepoxide are also associated with an increased risk of suicidal thoughts and behaviors, and these side effects are especially likely to occur in patients with a history of depression. Patients and their loved ones should watch out for any unusual changes in mood or behavior and signs of emerging or worsening depression and should pay particular attention to the presence of suicidal thoughts, behaviors, and thoughts about self harm.

Benzodiazepines like chlordiazepoxide are capable of causing increased drowsiness, dizziness, and reduced mental alertness, especially in older adults or those who may have difficulty processing the medication. Until you know how Librax affects you, do not drive a car or operate dangerous machinery while taking the medication. People should also avoid the use of alcohol or other drugs with a sedative effect while taking Librax.

Is it Possible to Overdose on Librax?

Patients should use caution when taking Librax, as It is possible to overdose on the medication. Patients should never take more than the amount of the drug prescribed by their doctor and should only take it as frequently as prescribed. Seek emergency medical help right away if you notice any of the following signs of a Librax overdose:

  • Blurred vision
  • Lack of coordination
  • Sleepiness or unusual drowsiness
  • Dry mouth
  • Loss of consciousness
  • Difficulty having a bowel movement (constipation)
  • Change in consciousness

Who Should Not Take Librax?

Librax can be dangerous for people with certain medical conditions, and some people cannot take the medication safely. Librax is not typically needed for medical emergencies, so it must be avoided by people with any of the following conditions:

  • Allergies to chlordiazepoxide or clidinium
  • Enlarged prostate
  • Problems with urination
  • Glaucoma
  • Bladder obstruction
  • Currently pregnant or breastfeeding as the drug may pass to the unborn baby or into breast milk
  • Possible drug interactions include phenothiazines, MAO inhibitors (MAOIs), barbiturates, antihistamines (over the counter or prescription), and more. Make sure to always let your healthcare provider know about any medications or supplements you may be taking so they can properly assess drug information and potential risk of interactions. 

It’s important to give your doctor a complete medical history, as people with certain medical conditions may need to use caution while taking Librax. Make sure to tell your doctor if you have:

  • A history of suicidal thoughts or behavior
  • A history of depression
  • Liver disease
  • Kidney disease
  • A current prescription for opioids
  • A history of using illegal narcotics/opioids
  • A history of drug or alcohol addiction

Sources:

https://www.webmd.com/drugs/2/drug-15881/librax-with-clidinium-oral/details 

https://www.drugs.com/librax.html 

https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=f99ebf66-f207-4a97-9666-4da1d72b061c 

https://www.mayoclinic.org/diseases-conditions/peptic-ulcer/symptoms-causes/syc-20354223 

https://www.healthline.com/health/irritable-bowel-syndrome 

https://gi.org/topics/irritable-bowel-syndrome/

Published October 1st, 2020 by Bridget Reed
Fact Checked by Chris Riley

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