Chlordiazepoxide / Amitriptyline

generic

Chlordiazepoxide / Amitriptyline Side Effects

See also Warning section.

Drowsiness, dizziness, dry mouth, blurred vision, constipation, bloating, trouble urinating, and weight gain may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

To reduce the risk of dizziness and fainting, get up slowly when rising from a sitting or lying position.

To relieve dry mouth, suck on (sugarless) hard candy or ice chips, chew (sugarless) gum, drink water, or use a saliva substitute.

To prevent constipation, eat dietary fiber, drink enough water, and exercise. You may also need to take a laxative. Ask your pharmacist which type of laxative is right for you.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if any of these unlikely but serious side effects occur: easy bruising/bleeding, loss of balance, persistent heartburn, mental/mood changes (such as confusion, excitement, memory problems, suicidal thoughts), shaking (tremor), decreased sexual ability/desire, signs of infection (such as fever, persistent sore throat), persistent nausea/vomiting, severe stomach/abdominal pain, dark urine, yellowing eyes/skin.

Get medical help right away if you have any very serious side effects, including: black stools, chest pain, severe dizziness, fainting, fast/irregular heartbeat, seizures, slurred speech, weakness on one side of the body, eye pain/swelling/redness, widened pupils, vision changes (such as seeing rainbows around lights at night), vomit that looks like coffee grounds.

A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
  • hypoglycemic disorder
  • SIADH syndrome
  • purpura
  • agranulocytosis
  • neutropenic disorder
  • eosinophilia
  • blood dyscrasias
  • drug-induced psychosis
  • acute confusion
  • manic disorder
  • hypomania
  • delusional disorder
  • panic disorder
  • suicidal ideation
  • abnormal sexual function
  • libido changes
  • nightmares
  • agitation
  • aggressive behavior
  • hostility
  • parkinsonism
  • serotonin syndrome
  • blurred vision
  • mydriasis
  • tinnitus
  • hypertension
  • acute myocardial infarction
  • heart block
  • abnormal ECG
  • ventricular tachycardia
  • ventricular fibrillation
  • bradycardia
  • prolonged QT interval
  • cardiac arrhythmia
  • cerebrovascular accident
  • hypotension
  • xerostomia
  • constipation
  • erectile dysfunction
  • testicular swelling
  • gynecomastia
  • galactorrhea not associated with childbirth
  • skin photosensitivity
  • allergic dermatitis
  • pruritus of skin
  • alopecia
  • drowsy
  • hallucinations
  • seizure disorder
  • dizziness
  • insomnia
  • hyperhidrosis
  • tremor
  • akathisia
  • dysgeusia
  • skin rash
  • facial edema
  • hyperbilirubinemia
  • anorexia
  • weight gain
  • increased appetite
  • headache disorder
  • palpitations
  • nausea
  • vomiting
  • heartburn
  • diarrhea
  • dysuria
  • hyperglycemia
  • abnormal hepatic function tests
  • nervousness
  • angioedema
  • secondary angle-closure glaucoma
  • paresthesia
  • irritability
  • accidental fall
  • impulse control disorder
  • symptoms of anxiety
  • tachycardia
  • hemolytic anemia
  • aplastic anemia
  • anemia
  • thrombocytopenic disorder
  • agranulocytosis
  • leukopenia
  • neutropenic disorder
  • eosinophilia
  • leukocytosis
  • drug-induced psychosis
  • acute confusion
  • manic disorder
  • paranoid disorder
  • excitement
  • depersonalization
  • suicidal ideation
  • libido changes
  • drug dependence
  • nightmares
  • agitation
  • depression

Drug Interactions

See also Warning section.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this product include:

anticholinergic drugs (such as belladonna alkaloids), other drugs that can cause bleeding/bruising (including antiplatelet drugs such as clopidogrel, NSAIDs such as ibuprofen, "blood thinners" such as warfarin), certain drugs for high blood pressure (drugs that work in the brain such as clonidine, guanabenz), clozapine, thyroid supplements.

Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before and after treatment with this medication. Ask your doctor when to start or stop taking this medication.

Other medications can affect the removal of amitriptyline and chlordiazepoxide from your body, thereby affecting how amitriptyline/chlordiazepoxide works. These drugs include cimetidine, disulfiram, terbinafine, drugs to treat irregular heart rate (such as quinidine/propafenone/flecainide), antidepressants (such as SSRIs like citalopram/fluvoxamine/paroxetine/sertraline). This is not a complete list.

Many drugs besides amitriptyline may affect the heart rhythm (QT prolongation in the EKG), including amiodarone, cisapride, dofetilide, pimozide, procainamide, quinidine, sotalol, macrolide antibiotics (such as erythromycin), among others. Therefore, before using amitriptyline/chlordiazepoxide, report all medications you are currently using to your doctor or pharmacist.

Cigarette smoking decreases blood levels of chlordiazepoxide. Tell your doctor if you smoke or if you have recently stopped smoking.

The risk of serious side effects (such as slow/shallow breathing, severe drowsiness/dizziness) may be increased if this medication is taken with other products that may also cause drowsiness or breathing problems. Tell your doctor or pharmacist if you are taking other products such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).

Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

Aspirin can increase the risk of bleeding when used with this medication. However, if your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually at dosages of 81-325 milligrams a day), you should continue taking it unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.

Amitriptyline is very similar to nortriptyline. Do not use medications containing nortriptyline while using amitriptyline.