Web Content Directory Isle of Man: Limbitrol DS

Generic Name: chlordiazepoxide and amitriptyline (Oral route)

klor-dye-az-e-POX-ide, am-i-TRIP-ti-leen hye-droe-KLOR-ide

Oral route(Tablet)

Antidepressants increased the risk of suicidal thinking and behavior in children, adolescents, and young adults in short-term studies with major depressive disorder (MDD) and other psychiatric disorders. Short term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24, and there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. This risk must be balanced with the clinical need. Monitor patients closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Not approved for use in pediatric patients .

Commonly used brand name(s)

In the U.S.

Limbitrol

Limbitrol DS

Available Dosage Forms:

Tablet

Therapeutic Class: Tricyclic Antidepressant/Benzodiazepine Combination

Pharmacologic Class: Benzodiazepine, Long Acting

Uses For Limbitrol DS

Chlordiazepoxide and amitriptyline combination is used to treat mental depression that occurs with anxiety or nervous tension.

This medicine is available only with your doctor's prescription.

Before Using Limbitrol DS

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated any benefit to using chlordiazepoxide and amitriptyline combination in children with depression. Studies have shown that some children, teenagers, and young adults think about suicide or attempt suicide when taking the medicine. Because of this toxicity, use in children is not recommended .

Geriatric

Appropriate studies performed to date have not demonstrated geriatrics-specific problems that would limit the usefulness of chlordiazepoxide and amitriptyline combination in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require an adjustment in the dose for patients receiving chlordiazepoxide and amitriptyline combination .

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Bepridil

Cisapride

Clorgyline

Dronedarone

Furazolidone

Grepafloxacin

Iproniazid

Isocarboxazid

Levomethadyl

Linezolid

Mesoridazine

Methylene Blue

Metoclopramide

Moclobemide

Nialamide

Pargyline

Phenelzine

Pimozide

Procarbazine

Ranolazine

Selegiline

Sparfloxacin

Terfenadine

Thioridazine

Toloxatone

Tranylcypromine

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Acecainide

Alfentanil

Alfuzosin

Amiodarone

Amisulpride

Amobarbital

Amoxapine

Amprenavir

Anileridine

Apomorphine

Aprindine

Aprobarbital

Arsenic Trioxide

Asenapine

Astemizole

Atazanavir

Azimilide

Azithromycin

Bretylium

Butabarbital

Butalbital

Carisoprodol

Chloral Hydrate

Chloroquine

Chlorpromazine

Chlorzoxazone

Ciprofloxacin

Citalopram

Clarithromycin

Clomipramine

Clonidine

Clozapine

Codeine

Crizotinib

Dantrolene

Dasatinib

Desipramine

Dextromethorphan

Disopyramide

Dofetilide

Dolasetron

Droperidol

Enflurane

Epinephrine

Erythromycin

Ethchlorvynol

Etilefrine

Fentanyl

Flecainide

Fluconazole

Fluoxetine

Foscarnet

Fospropofol

Gatifloxacin

Gemifloxacin

Halofantrine

Haloperidol

Halothane

Hydrocodone

Hydromorphone

Ibutilide

Iloperidone

Imipramine

Indacaterol

Isoflurane

Isradipine

Lapatinib

Levofloxacin

Levorphanol

Lidoflazine

Lopinavir

Lorcainide

Lumefantrine

Mefloquine

Meperidine

Mephenesin

Mephobarbital

Meprobamate

Metaxalone

Methadone

Methocarbamol

Methohexital

Methoxamine

Midodrine

Moricizine

Morphine

Morphine Sulfate Liposome

Moxifloxacin

Nefazodone

Nefopam

Nilotinib

Norepinephrine

Norfloxacin

Nortriptyline

Octreotide

Ofloxacin

Ondansetron

Oxilofrine

Oxycodone

Oxymorphone

Paliperidone

Pazopanib

Pentamidine

Pentobarbital

Perflutren Lipid Microsphere

Phenobarbital

Phenylephrine

Posaconazole

Primidone

Procainamide

Prochlorperazine

Promethazine

Propafenone

Propoxyphene

Protriptyline

Quetiapine

Quinidine

Quinine

Rasagiline

Remifentanil

Risperidone

Saquinavir

Secobarbital

Sematilide

Sertindole

Sertraline

Sodium Oxybate

Sodium Phosphate

Sodium Phosphate, Dibasic

Sodium Phosphate, Monobasic

Solifenacin

Sorafenib

Sotalol

Spiramycin

Sufentanil

Sulfamethoxazole

Sultopride

Sunitinib

Tapentadol

Tedisamil

Telavancin

Telithromycin

Tetrabenazine

Thiopental

Toremifene

Tramadol

Trazodone

Trifluoperazine

Trimethoprim

Trimipramine

Vandetanib

Vardenafil

Vasopressin

Vemurafenib

Venlafaxine

Voriconazole

Ziprasidone

Zolmitriptan

Zolpidem

Zotepine

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Acenocoumarol

Arbutamine

Atomoxetine

Bethanidine

Carbamazepine

Cimetidine

Cinacalcet

Diazepam

Dicumarol

Fluvoxamine

Galantamine

Guanethidine

Ketoconazole

Paroxetine

Phenprocoumon

Phenytoin

Rifapentine

Ritonavir

S-Adenosylmethionine

St John's Wort

Theophylline

Topiramate

Warfarin

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

Ethanol

Proper Use of chlordiazepoxide and amitriptyline

This section provides information on the proper use of a number of products that contain chlordiazepoxide and amitriptyline. It may not be specific to Limbitrol DS. Please read with care.

To reduce stomach upset, take this medicine immediately after meals or with food unless your doctor has told you to take it on an empty stomach.

Sometimes this medicine must be taken for several weeks before you begin to feel better. Your doctor should check your progress at regular visits.

Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer period of time than your doctor ordered. If too much is taken, it may increase unwanted effects or become habit-forming (causing mental or physical dependence).

If you think this medicine is not working properly after you have taken it for a few weeks, do not increase the dose. Instead, check with your doctor.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For oral dosage form (tablets):
- For depression:
  - Adults—At first, 5 milligrams (mg) of chlordiazepoxide and 12.5 milligrams (mg) of amitriptyline or 10 mg of chlordiazepoxide and 25 mg of amitriptyline, taken three or four times a day. The doctor may adjust your dose if needed. However, the dose is usually not greater than 10 mg of chlordiazepoxide and 25 mg of amitriptyline taken six times a day.
  - Children—Use and dose must be determined by your doctor .

Missed Dose

If you miss a dose of this medicine, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using Limbitrol DS

It is very important that your doctor check your progress at regular visits to allow dose adjustments and help reduce side effects.

Do not take chlordiazepoxide and amitriptyline combination with or within 14 days of taking a drug with monoamine oxidase (MAO) inhibitor activity (e.g., isocarboxazid [Marplan®], phenelzine [Nardil®], procarbazine [Matulane®], selegiline [Eldepryl®], or tranylcypromine [Parnate®]). Do not take an MAO inhibitor within 14 days of taking chlordiazepoxide and amitriptyline combination. If you do, you may develop extremely high blood pressure or convulsions (seizures) .

Do not stop taking this medicine without first checking with your doctor. Your doctor may want you to reduce gradually the amount you are using before stopping completely. This may help prevent a possible worsening of your condition and reduce the possibility of withdrawal symptoms such as headache, nausea, and/or an overall feeling of discomfort.

This medicine will add to the effects of alcohol and other CNS depressants (medicines that slow down the nervous system, possibly causing drowsiness). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates; medicine for seizures; muscle relaxants; or anesthetics, including some dental anesthetics. This effect may last for a few days after you stop taking this medicine. Check with your doctor before taking any of the above while you are using this medicine.

For diabetic patients:

This medicine may affect blood sugar levels. If you notice a change in the results of your blood or urine sugar tests or if you have any questions, check with your doctor.

Before you have any medical tests, tell the medical doctor in charge that you are taking this medicine. The results of the metyrapone test may be affected by this medicine.

Chlordiazepoxide and amitriptyline combination may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. If you, your child, or your caregiver notice any of these side effects, tell your doctor right away .

Before having any surgery, any dental treatment, or emergency treatment, tell the medical doctor or dentist in charge that you are using this medicine. Taking chlordiazepoxide and amitriptyline combination together with medicines that are used during surgery or dental or emergency treatments may increase the CNS depressant effects.

This medicine may cause some people to become dizzy, lightheaded, drowsy, or less alert than they are normally. Even if taken at bedtime, it may cause some people to feel drowsy or less alert on arising. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert.

Dizziness, lightheadedness, or fainting may occur when you get up from a lying or sitting position. Getting up slowly may help. If this problem continues or gets worse, check with your doctor.

Chlordiazepoxide and amitriptyline combination may cause dryness of the mouth. For temporary relief, use sugarless candy or gum, melt bits of ice in your mouth, or use a saliva substitute. However, if your mouth continues to feel dry for more than 2 weeks, check with your medical doctor or dentist. Continuing dryness of the mouth may increase the chance of dental disease, including tooth decay, gum disease, and fungus infections.

Chlordiazepoxide and amitriptyline combination may cause your skin to be more sensitive to sunlight than it is normally. Exposure to sunlight, even for brief periods of time, may cause a skin rash, itching, redness or other discoloration of the skin, or a severe sunburn. When you begin taking this medicine:

Stay out of direct sunlight, especially between the hours of 10:00 a.m. and 3:00 p.m., if possible.

Wear protective clothing, including a hat. Also, wear sunglasses.

Apply a sun block product that has a skin protection factor (SPF) of at least 15. Some patients may require a product with a higher SPF number, especially if they have a fair complexion. If you have any questions about this, check with your health care professional.

Apply a sun block lipstick that has an SPF of at least 15 to protect your lips.

Do not use a sunlamp or tanning bed or booth.

If you have a severe reaction from the sun, check with your doctor.

Limbitrol DS Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

Less common

Blurred vision or other changes in vision

confusion or hallucinations (seeing, hearing, or feeling things that are not there)

constipation

difficulty in urinating

eye pain

fainting

irregular heartbeat

mental depression

shakiness

trouble in sleeping

unusual excitement, nervousness, or irritability

Rare

Convulsions (seizures)

increased sensitivity to sunlight

skin rash and itching

sore throat and fever

yellow eyes or skin

Symptoms of overdose

Agitation

confusion

convulsions (seizures)

dizziness or lightheadedness (severe)

drowsiness (severe)

enlarged pupils

fast or irregular heartbeat

fever

hallucinations

muscle stiffness or rigidity

vomiting (severe)

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Bloating

clumsiness or unsteadiness

dizziness or lightheadedness

drowsiness

dryness of mouth or unpleasant taste

headache

weight gain

Less common

Diarrhea

nausea or vomiting

unusual tiredness or weakness

After you stop using this medicine, it may still produce some side effects that need attention. During this period of time, check with your doctor immediately if you notice the following side effects:

Convulsions (seizures)

headache

increased sweating

irritability or restlessness

muscle cramps

nausea or vomiting

stomach cramps

trembling

trouble with sleeping, and vivid dreams

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Limbitrol DS side effects (in more detail)

The information contained in the Thomson Reuters Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

The use of the Thomson Reuters Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Reuters Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON REUTERS HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Reuters Healthcare does not assume any responsibility or risk for your use of the Thomson Reuters Healthcare products.

More Limbitrol DS resources

Limbitrol DS Side Effects (in more detail)
Limbitrol DS Use in Pregnancy & Breastfeeding
Drug Images
Limbitrol DS Drug Interactions
Limbitrol DS Support Group
3 Reviews for Limbitrol DS - Add your own review/rating

Limbitrol DS MedFacts Consumer Leaflet (Wolters Kluwer)

Limbitrol DS Concise Consumer Information (Cerner Multum)

Limbitrol Prescribing Information (FDA)

Compare Limbitrol DS with other medications

Anxiety
Depression

Web Content Directory Isle of Man

Friday, September 30, 2016

Limbitrol DS