From the Guidelines
Chlordiazepoxide (Librium) should be administered at a dose of 25-100 mg orally every 4-6 hours for the management of ethanol (ETOH) withdrawal. This dosage is based on the most recent and highest quality study available, which provides guidelines for the management of alcohol withdrawal syndrome (AWS) 1. The study recommends a dose range of 25-100 mg every 4-6 hours for chlordiazepoxide, which is a benzodiazepine commonly used for the treatment of AWS.
Key Considerations
- The dose of chlordiazepoxide should be adjusted based on the severity of withdrawal symptoms and the patient's response to treatment.
- Patients with liver impairment may require lower doses due to decreased metabolism.
- Chlordiazepoxide should be administered in a monitored setting for severe withdrawal, and vital signs should be regularly checked.
- Adequate hydration, thiamine supplementation, and electrolyte replacement are also essential components of alcohol withdrawal management.
Management of Alcohol Withdrawal
- The goal of treatment is to prevent serious complications like seizures and delirium tremens while managing withdrawal symptoms.
- A validated assessment tool like the CIWA-Ar scale (Clinical Institute Withdrawal Assessment for Alcohol) can be used to assess the severity of withdrawal symptoms and adjust the dose of chlordiazepoxide accordingly.
- Other medications like thiamine, diazepam, and lorazepam may also be used in the management of AWS, depending on the severity of symptoms and the patient's response to treatment 1.
From the FDA Drug Label
For the relief of withdrawal symptoms of acute alcoholism, the parenteral form* is usually used initially. If the drug is administered orally, the suggested initial dose is 50 to 100 mg, to be followed by repeated doses as needed until agitation is controlled — up to 300 mg per day Dosage should then be reduced to maintenance levels.
The dose of Librium (chlordiazepoxide) for ethanol (ETOH) withdrawal is 50 to 100 mg orally, followed by repeated doses as needed, up to 300 mg per day. The dosage should then be reduced to maintenance levels 2.
From the Research
Dose of Librium (Chlordiazepoxide) for Ethanol (ETOH) Withdrawal
- The provided studies do not specify the exact dose of Librium (chlordiazepoxide) for ethanol (ETOH) withdrawal 3, 4, 5, 6, 7.
- However, the studies suggest that benzodiazepines, including chlordiazepoxide, are effective in treating alcohol withdrawal symptoms, particularly seizures 5, 6.
- The studies also mention that the treatment protocols for alcohol withdrawal often involve symptom-triggered or fixed-schedule dosing of benzodiazepines, but the exact dose of chlordiazepoxide is not specified 4, 6, 7.
- One study mentions that chlordiazepoxide performed better when comparing different benzodiazepines, but the results did not reach statistical significance 6.
- Another study discusses the use of the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) scoring system for assessing alcohol withdrawal, but does not provide information on the dose of chlordiazepoxide 7.