Pharmacology · Benzodiazepines
Chlordiazepoxide !
A long-acting, self-tapering benzodiazepine (active metabolites) used for anxiety and to prevent the dangers of alcohol withdrawal.
Updated 2026-11-01
The figure shows diazepam, a benzodiazepine that occupies the same site, bound to the human GABA-A receptor (α1β2γ2) with GABA; no structure with chlordiazepoxide is available.
Mechanism of action
Chlordiazepoxide binds the benzodiazepine site of the GABA-A receptor and makes GABA open the chloride channel more often. Its long action smooths out the drop in GABA activity when a heavy drinker stops alcohol, preventing tremor, seizures and delirium.
- Binds the benzodiazepine site of the GABA-A receptor
- Replaces the GABA boost that alcohol used to give
- Withdrawal tremor, seizures and delirium are prevented
Pharmacokinetics
- Absorption
- Given by mouth
- Elimination
- In the urine, very little unchanged
- Half-life
- 24 to 48 hours
Indications
- Withdrawal symptoms of acute alcoholism Alcohol withdrawal and delirium tremens →
- Anxiety disorders and short-term relief of anxiety Generalized anxiety disorder →
- Anxiety before surgery
Adverse effects
Common
- Drowsiness
- Unsteadiness (ataxia) and oversedation, especially in older adults
Contraindications
- Hypersensitivity to chlordiazepoxide
Key interactions
- Opioids
- Profound sedation, respiratory depression, coma and death
- Alcohol and other central nervous system depressants
- Additive sedation and breathing depression
- MAO inhibitors and phenothiazines
- Stronger effects; combinations are generally avoided
- Oral anticoagulants
- Rare variable effects on clotting
What is monitored
- Withdrawal signs and sedation level with a withdrawal scale
- Breathing and alertness
- Liver and kidney function, which slow clearance
Administration and safety
- Given by mouth (capsules)
- Controlled medicine; tapered when stopped
Nursing care
- Before each dose, check level of alertness, breathing rate and oxygen saturation
- Ask about opioids, alcohol and other sedatives
- Prevent falls, especially in older adults (unsteadiness, confusion)
- Teach not to drive or drink alcohol and not to stop the medicine suddenly
Pregnancy and breastfeeding
Use late in pregnancy can cause sedation and withdrawal symptoms in the newborn, who is watched after birth.
Test yourself
Think of the answer, then tap the question to see it.
Why are long-acting benzodiazepines used in alcohol withdrawal?
They give a smooth, self-tapering GABA effect that prevents seizures and delirium tremens.
Besides alcohol withdrawal, what are the labelled uses of chlordiazepoxide?
Anxiety disorders and anxiety before surgery.
What is the half-life range of chlordiazepoxide?
Between 24 and 48 hours.
Related drugs
Related conditions
← Back to the class: Benzodiazepines
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: DailyMed - CHLORDIAZEPOXIDE HYDROCHLORIDE capsule (DailyMed (U.S. National Library of Medicine), 2026); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 22 (McGraw Hill, 2023).
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Representative model, for educational purposes only.