Last update July 2, 2022

Chlordiazepoxide

Low Risk

Possibly safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.

Long-acting benzodiazepine with properties similar to diazepam. Indicated in anxiety and insomnia disorders. Intravenous and intramuscular administration in a single dose or orally three to four times a day. Complete oral bioavailability. (Greenblatt 1978)

Since the last update we have not found any published data on its excretion in breast milk.

Its pharmacokinetic data (low molecular weight, prolonged elimination time and being highly lipophilic) makes transfer to milk possible in amounts which could be significant, but its high protein binding and high volume of distribution would make it difficult.

Its main metabolite is desmethyldiazepam, with an average elimination time of several days.

In low doses and used in a judicious manner, benzodiazepines are compatible with breastfeeding. (Kelly 2012, Rubin 2004, Iqbal 2002, Hägg 2000, McElhatton 1994, Lee 1993, Kanto 1982)

It is advisable to choose short acting benzodiazepines given at the lowest effective doses (Rowe 2013), specially during the neonatal period and in the case of prematurity since during chronic use it might accumulate in the infant. (Sachs 2013)

It is advisable to watch for somnolence and adequate feeding behaviour in the lactating infant. Bedsharing is not advisable due to an increased risk of SIDS (Sudden infant death syndrome) and asphyxia in lactating infants of mothers taking this medication. (ABM 2020, UNICEF 2018, 2017, 2014 y 2013, Landa 2012, ABM 2008, UNICEF 2006)


See below the information of this related product:

  • Nordazepam ( Poorly safe. Evaluate carefully. Use safer alternative or interrupt breastfeeding 3 to 7 T ½ (elimination half-lives). Read the Comment.)

Alternatives

  • Lorazepam ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Oxazepam ( Safe. Compatible. Minimal risk for breastfeeding and infant.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Chlordiazepoxide is also known as


Chlordiazepoxide in other languages or writings:

Group

Chlordiazepoxide belongs to this group or family:

Tradenames

Main tradenames from several countries containing Chlordiazepoxide in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 100 %
Molecular weight 300 daltons
Protein Binding 85 - 96 %
VD 0.3 l/Kg
pKa 4.8 -
Tmax 0.5 - 2 hours
24 - 48 (Metab: 100) hours

References

  1. AEMPS. Clordiazepóxido (Huberplex). Ficha técnica. 2021 Full text (in our servers)
  2. Mylan. Chlordiazepoxide. Drug Summary. 2020 Full text (in our servers)
  3. (ABM): Blair PS, Ball HL, McKenna JJ, Feldman-Winter L, Marinelli KA, Bartick MC; Academy of Breastfeeding Medicine.. Bedsharing and Breastfeeding: The Academy of Breastfeeding Medicine Protocol #6, Revision 2019. Breastfeed Med. 2020 Jan;15(1):5-16. Abstract Full text (link to original source) Full text (in our servers)
  4. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Abstract
  5. Sachs HC; Committee On Drugs. The transfer of drugs and therapeutics into human breast milk: an update on selected topics. Pediatrics. 2013 Sep;132(3):e796-809. Abstract Full text (link to original source) Full text (in our servers)
  6. Kelly LE, Poon S, Madadi P, Koren G. Neonatal benzodiazepines exposure during breastfeeding. J Pediatr. 2012 Sep;161(3):448-51. Abstract
  7. Rubin ET, Lee A, Ito S. When breastfeeding mothers need CNS-acting drugs. Can J Clin Pharmacol. 2004 Fall;11(2):e257-66. Epub 2004 Dec 8. Abstract
  8. Iqbal MM, Sobhan T, Ryals T. Effects of commonly used benzodiazepines on the fetus, the neonate, and the nursing infant. Psychiatr Serv. 2002 Jan;53(1):39-49. Review. Abstract Full text (in our servers)
  9. Hägg S, Spigset O. Anticonvulsant use during lactation. Drug Saf. 2000 Jun;22(6):425-40. Review. Abstract
  10. McElhatton PR. The effects of benzodiazepine use during pregnancy and lactation. Reprod Toxicol. 1994 Nov-Dec;8(6):461-75. Review. Abstract
  11. Lee JJ, Rubin AP. Breast feeding and anaesthesia. Anaesthesia. 1993 Jul;48(7):616-25. Review. Abstract Full text (link to original source) Full text (in our servers)
  12. Kanto JH. Use of benzodiazepines during pregnancy, labour and lactation, with particular reference to pharmacokinetic considerations. Drugs. 1982 May;23(5):354-80. Review. Abstract
  13. Greenblatt DJ, Shader RI, MacLeod SM, Sellers EM. Clinical pharmacokinetics of chlordiazepoxide. Clin Pharmacokinet. 1978 Sep-Oct;3(5):381-94. Review. Abstract

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