chlordiazepoxide (Rx)

Anxiety

Mild/moderate: 5-10 mg PO q6-8hr

Severe: 20-25 mg PO q6-8hr

Preoperative Apprehension & Anxiety

5-10 mg PO q6-8hr

Dosing Modifications

Renal impairment

• CrCl <10 mL/min: 50% of recommended dose
• CrCl >10 mL/min: Dose adjustment not necessary (monitor)

Hepatic impairment

• Not studied

Anxiety

<6 years: Safety and efficacy not established

>6 years: 5 mg PO BID/QID; may increase dose to 10 mg PO BID/TID if necessary

Anxiety

Lower initial dose: 5 mg PO q6-12hr; adjust gradually based on response and incidence of adverse effects

Dosing Considerations

Adjust for renal impairment; administer 50% of recommended dose if CrCl <10 mL/min

Not drug of choice in elderly because of prolonged sedation and increased risk of falls/fractures

Contraindicated (0)

Serious - Use Alternative (22)

• abametapir

  abametapir will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. If not feasible, avoid use of abametapir.

• apalutamide

  apalutamide will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.

• benzhydrocodone/acetaminophen

  benzhydrocodone/acetaminophen, chlordiazepoxide. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
  
  benzhydrocodone/acetaminophen and chlordiazepoxide both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate

• buprenorphine subdermal implant

  buprenorphine subdermal implant and chlordiazepoxide both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate

• calcium/magnesium/potassium/sodium oxybates

  chlordiazepoxide, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

• conivaptan

  conivaptan will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• dacomitinib

  dacomitinib will increase the level or effect of chlordiazepoxide by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid use with CYP2D6 substrates where minimal increases in concentration of the CYP2D6 substrate may lead to serious or life-threatening toxicities.

• enzalutamide

  enzalutamide will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• fexinidazole

  fexinidazole will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Fexinidazole inhibits CYP3A4. Coadministration may increase risk for adverse effects of CYP3A4 substrates.

• hydrocodone

  hydrocodone, chlordiazepoxide. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

• idelalisib

  idelalisib will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Idelalisib is a strong CYP3A inhibitor; avoid coadministration with sensitive CYP3A substrates

• ivosidenib

  ivosidenib will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternate therapies. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs.

• lonafarnib

  lonafarnib will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration with sensitive CYP3A substrates. If coadministration unavoidable, monitor for adverse reactions and reduce CYP3A substrate dose in accordance with product labeling.

• metoclopramide intranasal

  chlordiazepoxide, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.

• nefazodone

  nefazodone will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• olopatadine intranasal

  chlordiazepoxide and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.

• selinexor

  selinexor, chlordiazepoxide. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.

• sodium oxybate

  chlordiazepoxide, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

• sufentanil SL

  sufentanil SL, chlordiazepoxide. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration may result in hypotension, profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

• tucatinib

  tucatinib will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If unavoidable, reduce CYP3A substrate dose according to product labeling.

• valerian

  valerian and chlordiazepoxide both increase sedation. Avoid or Use Alternate Drug.

• voxelotor

  voxelotor will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid.

Monitor Closely (247)

• abiraterone

  abiraterone increases levels of chlordiazepoxide by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Avoid coadministration of abiraterone with substrates of CYP2D6. If alternative therapy cannot be used, exercise caution and consider a dose reduction of the CYP2D6 substrate.

• acrivastine

  acrivastine and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• albuterol

  chlordiazepoxide increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• alfentanil

  chlordiazepoxide and alfentanil both increase sedation. Use Caution/Monitor.

• alprazolam

  alprazolam and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• amisulpride

  amisulpride and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• amitriptyline

  chlordiazepoxide and amitriptyline both increase sedation. Use Caution/Monitor.

• amobarbital

  amobarbital and chlordiazepoxide both increase sedation. Use Caution/Monitor.
  
  amobarbital will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• amoxapine

  chlordiazepoxide and amoxapine both increase sedation. Use Caution/Monitor.

• apomorphine

  chlordiazepoxide and apomorphine both increase sedation. Use Caution/Monitor.

• arformoterol

  chlordiazepoxide increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• aripiprazole

  chlordiazepoxide and aripiprazole both increase sedation. Use Caution/Monitor.

• armodafinil

  chlordiazepoxide increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• asenapine

  asenapine and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• asenapine transdermal

  asenapine transdermal and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• atazanavir

  atazanavir increases levels of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Potential for increased toxicity. Use alternatives if available. Consider lowering benzodiazepine dose.

• avapritinib

  avapritinib and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• azelastine

  azelastine and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• baclofen

  chlordiazepoxide and baclofen both increase sedation. Use Caution/Monitor.

• belladonna and opium

  chlordiazepoxide and belladonna and opium both increase sedation. Use Caution/Monitor.

• belzutifan

  belzutifan will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. If unable to avoid coadministration of belzutifan with sensitive CYP3A4 substrates, consider increasing the sensitive CYP3A4 substrate dose in accordance with its prescribing information.

• benperidol

  chlordiazepoxide and benperidol both increase sedation. Use Caution/Monitor.

• benzphetamine

  chlordiazepoxide increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• bosentan

  bosentan will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• brexanolone

  brexanolone, chlordiazepoxide. Either increases toxicity of the other by sedation. Use Caution/Monitor.

• brexpiprazole

  brexpiprazole and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• brimonidine

  brimonidine and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• brivaracetam

  brivaracetam and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• brompheniramine

  brompheniramine and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• buprenorphine

  chlordiazepoxide and buprenorphine both increase sedation. Use Caution/Monitor.

• buprenorphine buccal

  chlordiazepoxide and buprenorphine buccal both increase sedation. Use Caution/Monitor.

• buprenorphine subdermal implant

  chlordiazepoxide increases toxicity of buprenorphine subdermal implant by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Studies have shown that the combination of benzodiazepines and buprenorphine altered the usual ceiling effect on buprenorphine-induced respiratory depression, making the respiratory effects of buprenorphine appear similar to those of full opioid agonists. There have been postmarketing reports of coma and death with coadministration of buprenorphine and benzodiazepines. In many, but not all of these cases, buprenorphine was misused by self-injection. If a benzodiazepine must be used for an indication other than seizures, lower the benzodiazepine initial dose and cautiously titrate to clinical response.

• buprenorphine, long-acting injection

  chlordiazepoxide increases toxicity of buprenorphine, long-acting injection by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of buprenorphine and benzodiazepines or other CNS depressants increases risk of adverse reactions including overdose, respiratory depression, and death. Cessation of benzodiazepines or other CNS depressants is preferred in most cases. In some cases, monitoring at a higher level of care for tapering CNS depressants may be appropriate. In others, gradually tapering a patient off of a prescribed benzodiazepine or other CNS depressant or decreasing to the lowest effective dose may be appropriate.

• butabarbital

  butabarbital and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• butalbital

  butalbital and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• butorphanol

  chlordiazepoxide and butorphanol both increase sedation. Use Caution/Monitor.

• caffeine

  chlordiazepoxide increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• carbamazepine

  carbamazepine will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• carbinoxamine

  carbinoxamine and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• carisoprodol

  chlordiazepoxide and carisoprodol both increase sedation. Use Caution/Monitor.

• cenobamate

  cenobamate, chlordiazepoxide. Either increases effects of the other by sedation. Use Caution/Monitor.

• ceritinib

  ceritinib will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• chloral hydrate

  chlordiazepoxide and chloral hydrate both increase sedation. Use Caution/Monitor.

• chlorpheniramine

  chlorpheniramine and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• chlorpromazine

  chlordiazepoxide and chlorpromazine both increase sedation. Use Caution/Monitor.

• chlorzoxazone

  chlordiazepoxide and chlorzoxazone both increase sedation. Use Caution/Monitor.

• cimetidine

  cimetidine increases levels of chlordiazepoxide by decreasing metabolism. Use Caution/Monitor.

• cinnarizine

  cinnarizine and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• clarithromycin

  clarithromycin will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• clemastine

  clemastine and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• clobazam

  chlordiazepoxide, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression).

• clomipramine

  chlordiazepoxide and clomipramine both increase sedation. Use Caution/Monitor.

• clonazepam

  chlordiazepoxide and clonazepam both increase sedation. Use Caution/Monitor.

• clonidine

  clonidine, chlordiazepoxide. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration enhances CNS depressant effects.

• clorazepate

  chlordiazepoxide and clorazepate both increase sedation. Use Caution/Monitor.

• clozapine

  chlordiazepoxide and clozapine both increase sedation. Use Caution/Monitor.

• cobicistat

  cobicistat will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• codeine

  chlordiazepoxide and codeine both increase sedation. Use Caution/Monitor.

• crofelemer

  crofelemer increases levels of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Crofelemer has the potential to inhibit CYP3A4 at concentrations expected in the gut; unlikely to inhibit systemically because minimally absorbed.

• cyclizine

  cyclizine and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• cyclobenzaprine

  chlordiazepoxide and cyclobenzaprine both increase sedation. Use Caution/Monitor.

• cyproheptadine

  cyproheptadine and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• dabrafenib

  dabrafenib will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

• dantrolene

  chlordiazepoxide and dantrolene both increase sedation. Use Caution/Monitor.

• daridorexant

  chlordiazepoxide and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.

• darunavir

  darunavir increases levels of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Potential for increased toxicity. Use alternatives if available. Consider lowering benzodiazepine dose.

• desflurane

  desflurane and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• desipramine

  chlordiazepoxide and desipramine both increase sedation. Use Caution/Monitor.

• deutetrabenazine

  chlordiazepoxide and deutetrabenazine both increase sedation. Use Caution/Monitor.

• dexchlorpheniramine

  dexchlorpheniramine and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• dexfenfluramine

  chlordiazepoxide increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• dexmedetomidine

  chlordiazepoxide and dexmedetomidine both increase sedation. Use Caution/Monitor.

• dexmethylphenidate

  chlordiazepoxide increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• dextroamphetamine

  chlordiazepoxide increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• dextromoramide

  chlordiazepoxide and dextromoramide both increase sedation. Use Caution/Monitor.

• diamorphine

  chlordiazepoxide and diamorphine both increase sedation. Use Caution/Monitor.

• diazepam

  chlordiazepoxide and diazepam both increase sedation. Use Caution/Monitor.

• diazepam intranasal

  diazepam intranasal, chlordiazepoxide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may potentiate the CNS-depressant effects of each drug.

• diethylpropion

  chlordiazepoxide increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• difelikefalin

  difelikefalin and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• difenoxin hcl

  chlordiazepoxide and difenoxin hcl both increase sedation. Use Caution/Monitor.

• dimenhydrinate

  dimenhydrinate and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• diphenhydramine

  diphenhydramine and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• diphenoxylate hcl

  chlordiazepoxide and diphenoxylate hcl both increase sedation. Use Caution/Monitor.

• dipipanone

  chlordiazepoxide and dipipanone both increase sedation. Use Caution/Monitor.

• dobutamine

  chlordiazepoxide increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• dopamine

  chlordiazepoxide increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• dopexamine

  chlordiazepoxide increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• dosulepin

  chlordiazepoxide and dosulepin both increase sedation. Use Caution/Monitor.

• doxepin

  chlordiazepoxide and doxepin both increase sedation. Use Caution/Monitor.

• doxylamine

  chlordiazepoxide and doxylamine both increase sedation. Use Caution/Monitor.

• droperidol

  chlordiazepoxide and droperidol both increase sedation. Use Caution/Monitor.

• duvelisib

  duvelisib will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. will increase the level or effect of

• efavirenz

  efavirenz will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• elagolix

  elagolix will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Elagolix is a weak-to-moderate CYP3A4 inducer. Monitor CYP3A substrates if coadministered. Consider increasing CYP3A substrate dose if needed.

• eliglustat

  eliglustat increases levels of chlordiazepoxide by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Monitor therapeutic drug concentrations, as indicated, or consider reducing the dosage of the concomitant drug and titrate to clinical effect.

• elvitegravir/cobicistat/emtricitabine/tenofovir DF

  elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Cobicistat is a CYP3A4 inhibitor; consider benzodiazepine dose reduction.

• encorafenib

  encorafenib, chlordiazepoxide. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. Coadministration of encorafenib with sensitive CYP3A4 substrates may result in increased toxicity or decreased efficacy of these agents.

• ephedrine

  chlordiazepoxide increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• epinephrine

  chlordiazepoxide increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• epinephrine racemic

  chlordiazepoxide increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• esketamine intranasal

  esketamine intranasal, chlordiazepoxide. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.

• estazolam

  chlordiazepoxide and estazolam both increase sedation. Use Caution/Monitor.

• ethanol

  chlordiazepoxide and ethanol both increase sedation. Use Caution/Monitor.

• etomidate

  etomidate and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• etravirine

  etravirine will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• fedratinib

  fedratinib will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP3A4 substrates as necessary.

• fenfluramine

  chlordiazepoxide increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• flibanserin

  chlordiazepoxide and flibanserin both increase sedation. Modify Therapy/Monitor Closely. Risk for sedation increased if flibanserin is coadministration with other CNS depressants.

• fluphenazine

  chlordiazepoxide and fluphenazine both increase sedation. Use Caution/Monitor.

• flurazepam

  chlordiazepoxide and flurazepam both increase sedation. Use Caution/Monitor.

• formoterol

  chlordiazepoxide increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• fosamprenavir

  fosamprenavir increases levels of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Potential for increased toxicity. Use alternatives if available. Consider lowering benzodiazepine dose.

• fosphenytoin

  fosphenytoin will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

• gabapentin

  gabapentin, chlordiazepoxide. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

• gabapentin enacarbil

  gabapentin enacarbil, chlordiazepoxide. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

• ganaxolone

  chlordiazepoxide and ganaxolone both increase sedation. Use Caution/Monitor.

• haloperidol

  chlordiazepoxide and haloperidol both increase sedation. Use Caution/Monitor.

• hydromorphone

  chlordiazepoxide and hydromorphone both increase sedation. Use Caution/Monitor.

• hydroxyzine

  hydroxyzine and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• iloperidone

  chlordiazepoxide and iloperidone both increase sedation. Use Caution/Monitor.
  
  iloperidone increases levels of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Iloperidone is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4.

• imipramine

  chlordiazepoxide and imipramine both increase sedation. Use Caution/Monitor.

• indinavir

  indinavir increases levels of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Potential for increased toxicity. Use alternatives if available. Consider lowering benzodiazepine dose.

• isoproterenol

  chlordiazepoxide increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• istradefylline

  istradefylline will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. This effect was not observed with istradefylline 20 mg/day. Consider dose reduction of sensitive CYP3A4 substrates.

• itraconazole

  itraconazole will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• ketamine

  ketamine and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• ketoconazole

  ketoconazole will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• ketotifen, ophthalmic

  chlordiazepoxide and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.

• lasmiditan

  lasmiditan, chlordiazepoxide. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.

• lemborexant

  lemborexant, chlordiazepoxide. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.

• letermovir

  letermovir increases levels of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• levalbuterol

  chlordiazepoxide increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• levoketoconazole

  levoketoconazole will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• levorphanol

  chlordiazepoxide and levorphanol both increase sedation. Use Caution/Monitor.

• lisdexamfetamine

  chlordiazepoxide increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• lofepramine

  chlordiazepoxide and lofepramine both increase sedation. Use Caution/Monitor.

• lofexidine

  chlordiazepoxide and lofexidine both increase sedation. Use Caution/Monitor.

• lopinavir

  lopinavir increases levels of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Use alternatives if available. Consider lowering benzodiazepine dose.

• loprazolam

  chlordiazepoxide and loprazolam both increase sedation. Use Caution/Monitor.

• lorazepam

  chlordiazepoxide and lorazepam both increase sedation. Use Caution/Monitor.

• lorlatinib

  lorlatinib will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• lormetazepam

  chlordiazepoxide and lormetazepam both increase sedation. Use Caution/Monitor.

• loxapine

  chlordiazepoxide and loxapine both increase sedation. Use Caution/Monitor.

• loxapine inhaled

  chlordiazepoxide and loxapine inhaled both increase sedation. Use Caution/Monitor.

• lurasidone

  lurasidone, chlordiazepoxide. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.

• maprotiline

  chlordiazepoxide and maprotiline both increase sedation. Use Caution/Monitor.

• marijuana

  chlordiazepoxide and marijuana both increase sedation. Use Caution/Monitor.

• melatonin

  chlordiazepoxide and melatonin both increase sedation. Use Caution/Monitor.

• meperidine

  chlordiazepoxide and meperidine both increase sedation. Use Caution/Monitor.

• meprobamate

  chlordiazepoxide and meprobamate both increase sedation. Use Caution/Monitor.

• metaproterenol

  chlordiazepoxide increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• metaxalone

  chlordiazepoxide and metaxalone both increase sedation. Use Caution/Monitor.

• methadone

  chlordiazepoxide and methadone both increase sedation. Use Caution/Monitor.

• methamphetamine

  chlordiazepoxide increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• methocarbamol

  chlordiazepoxide and methocarbamol both increase sedation. Use Caution/Monitor.

• methylenedioxymethamphetamine

  chlordiazepoxide increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• midazolam

  chlordiazepoxide and midazolam both increase sedation. Use Caution/Monitor.

• midazolam intranasal

  midazolam intranasal, chlordiazepoxide. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.

• midodrine

  chlordiazepoxide increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• mirtazapine

  chlordiazepoxide and mirtazapine both increase sedation. Use Caution/Monitor.

• mitotane

  mitotane decreases levels of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments.

• modafinil

  chlordiazepoxide increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• morphine

  chlordiazepoxide and morphine both increase sedation. Use Caution/Monitor.

• motherwort

  chlordiazepoxide and motherwort both increase sedation. Use Caution/Monitor.

• moxonidine

  chlordiazepoxide and moxonidine both increase sedation. Use Caution/Monitor.

• nabilone

  chlordiazepoxide and nabilone both increase sedation. Use Caution/Monitor.

• nafcillin

  nafcillin will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• nalbuphine

  chlordiazepoxide and nalbuphine both increase sedation. Use Caution/Monitor.

• nelfinavir

  nelfinavir increases levels of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Potential for increased toxicity. Use alternatives if available. Consider lowering benzodiazepine dose.

• norepinephrine

  chlordiazepoxide increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• nortriptyline

  chlordiazepoxide and nortriptyline both increase sedation. Use Caution/Monitor.

• olanzapine

  chlordiazepoxide and olanzapine both increase sedation. Use Caution/Monitor.

• oliceridine

  oliceridine, chlordiazepoxide. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

• opium tincture

  chlordiazepoxide and opium tincture both increase sedation. Use Caution/Monitor.

• orphenadrine

  chlordiazepoxide and orphenadrine both increase sedation. Use Caution/Monitor.

• oxazepam

  chlordiazepoxide and oxazepam both increase sedation. Use Caution/Monitor.

• oxycodone

  chlordiazepoxide and oxycodone both increase sedation. Use Caution/Monitor.

• oxymorphone

  chlordiazepoxide and oxymorphone both increase sedation. Use Caution/Monitor.

• paliperidone

  chlordiazepoxide and paliperidone both increase sedation. Use Caution/Monitor.

• papaveretum

  chlordiazepoxide and papaveretum both increase sedation. Use Caution/Monitor.

• papaverine

  chlordiazepoxide and papaverine both increase sedation. Use Caution/Monitor.

• pentazocine

  chlordiazepoxide and pentazocine both increase sedation. Use Caution/Monitor.

• pentobarbital

  pentobarbital and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• perampanel

  perampanel and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• perphenazine

  chlordiazepoxide and perphenazine both increase sedation. Use Caution/Monitor.

• phendimetrazine

  chlordiazepoxide increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• phenobarbital

  phenobarbital and chlordiazepoxide both increase sedation. Use Caution/Monitor.
  
  phenobarbital will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• phentermine

  chlordiazepoxide increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• phenylephrine

  chlordiazepoxide increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• phenylephrine PO

  chlordiazepoxide increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• phenytoin

  phenytoin will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

• pholcodine

  chlordiazepoxide and pholcodine both increase sedation. Use Caution/Monitor.

• pimozide

  chlordiazepoxide and pimozide both increase sedation. Use Caution/Monitor.

• pirbuterol

  chlordiazepoxide increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• posaconazole

  posaconazole will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• pregabalin

  pregabalin, chlordiazepoxide. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

• primidone

  primidone and chlordiazepoxide both increase sedation. Use Caution/Monitor.
  
  primidone will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• prochlorperazine

  chlordiazepoxide and prochlorperazine both increase sedation. Use Caution/Monitor.

• promethazine

  promethazine and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• propofol

  propofol and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• propylhexedrine

  chlordiazepoxide increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• protriptyline

  chlordiazepoxide and protriptyline both increase sedation. Use Caution/Monitor.

• quazepam

  chlordiazepoxide and quazepam both increase sedation. Use Caution/Monitor.

• quetiapine

  chlordiazepoxide and quetiapine both increase sedation. Use Caution/Monitor.

• ramelteon

  chlordiazepoxide and ramelteon both increase sedation. Use Caution/Monitor.

• remimazolam

  remimazolam, chlordiazepoxide. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.

• ribociclib

  ribociclib will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• rifabutin

  rifabutin will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• rifampin

  rifampin will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• risperidone

  chlordiazepoxide and risperidone both increase sedation. Use Caution/Monitor.

• ritonavir

  ritonavir increases levels of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Use alternatives if available. Potential for increased toxicity. Consider lowering benzodiazepine dose.

• rolapitant

  rolapitant will increase the level or effect of chlordiazepoxide by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Rolapitant may increase plasma concentrations of CYP2D6 substrates for at least 28 days following rolapitant administration.

• rucaparib

  rucaparib will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP3A4 substrates, if clinically indicated.

• salmeterol

  chlordiazepoxide increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• saquinavir

  saquinavir increases levels of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Use alternatives if available. Consider lowering benzodiazepine dose.

• scullcap

  chlordiazepoxide and scullcap both increase sedation. Use Caution/Monitor.

• secobarbital

  secobarbital and chlordiazepoxide both increase sedation. Use Caution/Monitor.
  
  secobarbital will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. May also enhance CNS depressant effect of chlordiazepoxide

• sevoflurane

  sevoflurane and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• shepherd's purse

  chlordiazepoxide and shepherd's purse both increase sedation. Use Caution/Monitor.

• stiripentol

  stiripentol, chlordiazepoxide. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP3A4 inhibitor and inducer. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. CYP3A4 substrates may require dosage adjustment.
  
  stiripentol, chlordiazepoxide. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.

• sufentanil

  chlordiazepoxide and sufentanil both increase sedation. Use Caution/Monitor.

• suvorexant

  suvorexant and chlordiazepoxide both increase sedation. Modify Therapy/Monitor Closely. Dosage adjustments of suvorexant and concomitant CNS depressants may be necessary

• tapentadol

  chlordiazepoxide and tapentadol both increase sedation. Use Caution/Monitor.

• tazemetostat

  tazemetostat will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• tecovirimat

  tecovirimat will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Tecovirimat is a weak CYP3A4 inducer. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered.

• teduglutide

  teduglutide increases levels of chlordiazepoxide by Other (see comment). Use Caution/Monitor. Comment: Teduglutide may increase absorption of concomitant PO medications; caution with with drugs requiring titration or those with a narrow therapeutic index; dose adjustment may be necessary.

• temazepam

  chlordiazepoxide and temazepam both increase sedation. Use Caution/Monitor.

• terbinafine

  terbinafine will increase the level or effect of chlordiazepoxide by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Assess need to reduce dose of CYP2D6-metabolized drug.

• terbutaline

  chlordiazepoxide increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• thioridazine

  chlordiazepoxide and thioridazine both increase sedation. Use Caution/Monitor.

• thiothixene

  chlordiazepoxide and thiothixene both increase sedation. Use Caution/Monitor.

• tipranavir

  tipranavir increases levels of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Use alternatives if available. Consider lowering benzodiazepine dose.

• topiramate

  chlordiazepoxide and topiramate both increase sedation. Modify Therapy/Monitor Closely.

• tramadol

  chlordiazepoxide and tramadol both increase sedation. Use Caution/Monitor.

• trazodone

  chlordiazepoxide and trazodone both increase sedation. Use Caution/Monitor.

• triazolam

  chlordiazepoxide and triazolam both increase sedation. Use Caution/Monitor.

• triclofos

  chlordiazepoxide and triclofos both increase sedation. Use Caution/Monitor.

• trifluoperazine

  chlordiazepoxide and trifluoperazine both increase sedation. Use Caution/Monitor.

• trimipramine

  chlordiazepoxide and trimipramine both increase sedation. Use Caution/Monitor.

• triprolidine

  triprolidine and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• voriconazole

  voriconazole will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• xylometazoline

  chlordiazepoxide increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• yohimbine

  chlordiazepoxide increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• ziconotide

  chlordiazepoxide and ziconotide both increase sedation. Use Caution/Monitor.

• ziprasidone

  chlordiazepoxide and ziprasidone both increase sedation. Use Caution/Monitor.

• zotepine

  chlordiazepoxide and zotepine both increase sedation. Use Caution/Monitor.

Minor (29)

• acetazolamide

  acetazolamide will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• anastrozole

  anastrozole will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• brimonidine

  brimonidine increases effects of chlordiazepoxide by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

• ciprofloxacin

  ciprofloxacin increases levels of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.

• clotrimazole

  clotrimazole increases levels of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.

• cyclophosphamide

  cyclophosphamide will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• disulfiram

  disulfiram increases levels of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.

• esomeprazole

  esomeprazole will increase the level or effect of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.

• eucalyptus

  chlordiazepoxide and eucalyptus both increase sedation. Minor/Significance Unknown.

• fleroxacin

  fleroxacin increases levels of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.

• fluconazole

  fluconazole increases levels of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.

• gemifloxacin

  gemifloxacin increases levels of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.

• green tea

  green tea decreases effects of chlordiazepoxide by pharmacodynamic antagonism. Minor/Significance Unknown. Caffeine component of green tea may decrease sedative effects of benzodiazepines.

• ketoconazole

  ketoconazole increases levels of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.

• larotrectinib

  larotrectinib will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• levofloxacin

  levofloxacin increases levels of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.

• levoketoconazole

  levoketoconazole increases levels of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.

• metyrapone

  chlordiazepoxide decreases effects of metyrapone by unspecified interaction mechanism. Minor/Significance Unknown.

• miconazole vaginal

  miconazole vaginal increases levels of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.

• moxifloxacin

  moxifloxacin increases levels of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.

• ofloxacin

  ofloxacin increases levels of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.

• omeprazole

  omeprazole increases levels of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.

• posaconazole

  posaconazole increases levels of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.

• rifabutin

  rifabutin decreases levels of chlordiazepoxide by increasing metabolism. Minor/Significance Unknown.

• rifampin

  rifampin decreases levels of chlordiazepoxide by increasing metabolism. Minor/Significance Unknown.

• sage

  chlordiazepoxide and sage both increase sedation. Minor/Significance Unknown.

• vinpocetine

  chlordiazepoxide increases effects of vinpocetine by unspecified interaction mechanism. Minor/Significance Unknown. Desirable interaction enhanced memory improvement (based on preliminary trial).

• voriconazole

  voriconazole increases levels of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.

• zolpidem

  zolpidem, chlordiazepoxide. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

• abametapir

  Serious - Use Alternative (1)abametapir will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. If not feasible, avoid use of abametapir.

• abiraterone

  Monitor Closely (1)abiraterone increases levels of chlordiazepoxide by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Avoid coadministration of abiraterone with substrates of CYP2D6. If alternative therapy cannot be used, exercise caution and consider a dose reduction of the CYP2D6 substrate.

• acetazolamide

  Minor (1)acetazolamide will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• acrivastine

  Monitor Closely (1)acrivastine and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• albuterol

  Monitor Closely (1)chlordiazepoxide increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• alfentanil

  Monitor Closely (1)chlordiazepoxide and alfentanil both increase sedation. Use Caution/Monitor.

• alprazolam

  Monitor Closely (1)alprazolam and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• amisulpride

  Monitor Closely (1)amisulpride and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• amitriptyline

  Monitor Closely (1)chlordiazepoxide and amitriptyline both increase sedation. Use Caution/Monitor.

• amobarbital

  Monitor Closely (2)amobarbital and chlordiazepoxide both increase sedation. Use Caution/Monitor.
  
  amobarbital will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• amoxapine

  Monitor Closely (1)chlordiazepoxide and amoxapine both increase sedation. Use Caution/Monitor.

• anastrozole

  Minor (1)anastrozole will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• apalutamide

  Serious - Use Alternative (1)apalutamide will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.

• apomorphine

  Monitor Closely (1)chlordiazepoxide and apomorphine both increase sedation. Use Caution/Monitor.

• arformoterol

  Monitor Closely (1)chlordiazepoxide increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• aripiprazole

  Monitor Closely (1)chlordiazepoxide and aripiprazole both increase sedation. Use Caution/Monitor.

• armodafinil

  Monitor Closely (1)chlordiazepoxide increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• asenapine

  Monitor Closely (1)asenapine and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• asenapine transdermal

  Monitor Closely (1)asenapine transdermal and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• atazanavir

  Monitor Closely (1)atazanavir increases levels of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Potential for increased toxicity. Use alternatives if available. Consider lowering benzodiazepine dose.

• avapritinib

  Monitor Closely (1)avapritinib and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• azelastine

  Monitor Closely (1)azelastine and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• baclofen

  Monitor Closely (1)chlordiazepoxide and baclofen both increase sedation. Use Caution/Monitor.

• belladonna and opium

  Monitor Closely (1)chlordiazepoxide and belladonna and opium both increase sedation. Use Caution/Monitor.

• belzutifan

  Monitor Closely (1)belzutifan will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. If unable to avoid coadministration of belzutifan with sensitive CYP3A4 substrates, consider increasing the sensitive CYP3A4 substrate dose in accordance with its prescribing information.

• benperidol

  Monitor Closely (1)chlordiazepoxide and benperidol both increase sedation. Use Caution/Monitor.

• benzhydrocodone/acetaminophen

  Serious - Use Alternative (2)benzhydrocodone/acetaminophen, chlordiazepoxide. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
  
  benzhydrocodone/acetaminophen and chlordiazepoxide both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate

• benzphetamine

  Monitor Closely (1)chlordiazepoxide increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• bosentan

  Monitor Closely (1)bosentan will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• brexanolone

  Monitor Closely (1)brexanolone, chlordiazepoxide. Either increases toxicity of the other by sedation. Use Caution/Monitor.

• brexpiprazole

  Monitor Closely (1)brexpiprazole and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• brimonidine

  Monitor Closely (1)brimonidine and chlordiazepoxide both increase sedation. Use Caution/Monitor.Minor (1)brimonidine increases effects of chlordiazepoxide by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

• brivaracetam

  Monitor Closely (1)brivaracetam and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• brompheniramine

  Monitor Closely (1)brompheniramine and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• buprenorphine

  Monitor Closely (1)chlordiazepoxide and buprenorphine both increase sedation. Use Caution/Monitor.

• buprenorphine buccal

  Monitor Closely (1)chlordiazepoxide and buprenorphine buccal both increase sedation. Use Caution/Monitor.

• buprenorphine subdermal implant

  Monitor Closely (1)chlordiazepoxide increases toxicity of buprenorphine subdermal implant by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Studies have shown that the combination of benzodiazepines and buprenorphine altered the usual ceiling effect on buprenorphine-induced respiratory depression, making the respiratory effects of buprenorphine appear similar to those of full opioid agonists. There have been postmarketing reports of coma and death with coadministration of buprenorphine and benzodiazepines. In many, but not all of these cases, buprenorphine was misused by self-injection. If a benzodiazepine must be used for an indication other than seizures, lower the benzodiazepine initial dose and cautiously titrate to clinical response.Serious - Use Alternative (1)buprenorphine subdermal implant and chlordiazepoxide both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate

• buprenorphine, long-acting injection

  Monitor Closely (1)chlordiazepoxide increases toxicity of buprenorphine, long-acting injection by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of buprenorphine and benzodiazepines or other CNS depressants increases risk of adverse reactions including overdose, respiratory depression, and death. Cessation of benzodiazepines or other CNS depressants is preferred in most cases. In some cases, monitoring at a higher level of care for tapering CNS depressants may be appropriate. In others, gradually tapering a patient off of a prescribed benzodiazepine or other CNS depressant or decreasing to the lowest effective dose may be appropriate.

• butabarbital

  Monitor Closely (1)butabarbital and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• butalbital

  Monitor Closely (1)butalbital and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• butorphanol

  Monitor Closely (1)chlordiazepoxide and butorphanol both increase sedation. Use Caution/Monitor.

• caffeine

  Monitor Closely (1)chlordiazepoxide increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• calcium/magnesium/potassium/sodium oxybates

  Serious - Use Alternative (1)chlordiazepoxide, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

• carbamazepine

  Monitor Closely (1)carbamazepine will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• carbinoxamine

  Monitor Closely (1)carbinoxamine and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• carisoprodol

  Monitor Closely (1)chlordiazepoxide and carisoprodol both increase sedation. Use Caution/Monitor.

• cenobamate

  Monitor Closely (1)cenobamate, chlordiazepoxide. Either increases effects of the other by sedation. Use Caution/Monitor.

• ceritinib

  Monitor Closely (1)ceritinib will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• chloral hydrate

  Monitor Closely (1)chlordiazepoxide and chloral hydrate both increase sedation. Use Caution/Monitor.

• chlorpheniramine

  Monitor Closely (1)chlorpheniramine and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• chlorpromazine

  Monitor Closely (1)chlordiazepoxide and chlorpromazine both increase sedation. Use Caution/Monitor.

• chlorzoxazone

  Monitor Closely (1)chlordiazepoxide and chlorzoxazone both increase sedation. Use Caution/Monitor.

• cimetidine

  Monitor Closely (1)cimetidine increases levels of chlordiazepoxide by decreasing metabolism. Use Caution/Monitor.

• cinnarizine

  Monitor Closely (1)cinnarizine and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• ciprofloxacin

  Minor (1)ciprofloxacin increases levels of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.

• clarithromycin

  Monitor Closely (1)clarithromycin will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• clemastine

  Monitor Closely (1)clemastine and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• clobazam

  Monitor Closely (1)chlordiazepoxide, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression).

• clomipramine

  Monitor Closely (1)chlordiazepoxide and clomipramine both increase sedation. Use Caution/Monitor.

• clonazepam

  Monitor Closely (1)chlordiazepoxide and clonazepam both increase sedation. Use Caution/Monitor.

• clonidine

  Monitor Closely (1)clonidine, chlordiazepoxide. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration enhances CNS depressant effects.

• clorazepate

  Monitor Closely (1)chlordiazepoxide and clorazepate both increase sedation. Use Caution/Monitor.

• clotrimazole

  Minor (1)clotrimazole increases levels of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.

• clozapine

  Monitor Closely (1)chlordiazepoxide and clozapine both increase sedation. Use Caution/Monitor.

• cobicistat

  Monitor Closely (1)cobicistat will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• codeine

  Monitor Closely (1)chlordiazepoxide and codeine both increase sedation. Use Caution/Monitor.

• conivaptan

  Serious - Use Alternative (1)conivaptan will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• crofelemer

  Monitor Closely (1)crofelemer increases levels of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Crofelemer has the potential to inhibit CYP3A4 at concentrations expected in the gut; unlikely to inhibit systemically because minimally absorbed.

• cyclizine

  Monitor Closely (1)cyclizine and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• cyclobenzaprine

  Monitor Closely (1)chlordiazepoxide and cyclobenzaprine both increase sedation. Use Caution/Monitor.

• cyclophosphamide

  Minor (1)cyclophosphamide will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• cyproheptadine

  Monitor Closely (1)cyproheptadine and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• dabrafenib

  Monitor Closely (1)dabrafenib will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

• dacomitinib

  Serious - Use Alternative (1)dacomitinib will increase the level or effect of chlordiazepoxide by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid use with CYP2D6 substrates where minimal increases in concentration of the CYP2D6 substrate may lead to serious or life-threatening toxicities.

• dantrolene

  Monitor Closely (1)chlordiazepoxide and dantrolene both increase sedation. Use Caution/Monitor.

• daridorexant

  Monitor Closely (1)chlordiazepoxide and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.

• darunavir

  Monitor Closely (1)darunavir increases levels of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Potential for increased toxicity. Use alternatives if available. Consider lowering benzodiazepine dose.

• desflurane

  Monitor Closely (1)desflurane and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• desipramine

  Monitor Closely (1)chlordiazepoxide and desipramine both increase sedation. Use Caution/Monitor.

• deutetrabenazine

  Monitor Closely (1)chlordiazepoxide and deutetrabenazine both increase sedation. Use Caution/Monitor.

• dexchlorpheniramine

  Monitor Closely (1)dexchlorpheniramine and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• dexfenfluramine

  Monitor Closely (1)chlordiazepoxide increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• dexmedetomidine

  Monitor Closely (1)chlordiazepoxide and dexmedetomidine both increase sedation. Use Caution/Monitor.

• dexmethylphenidate

  Monitor Closely (1)chlordiazepoxide increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• dextroamphetamine

  Monitor Closely (1)chlordiazepoxide increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• dextromoramide

  Monitor Closely (1)chlordiazepoxide and dextromoramide both increase sedation. Use Caution/Monitor.

• diamorphine

  Monitor Closely (1)chlordiazepoxide and diamorphine both increase sedation. Use Caution/Monitor.

• diazepam

  Monitor Closely (1)chlordiazepoxide and diazepam both increase sedation. Use Caution/Monitor.

• diazepam intranasal

  Monitor Closely (1)diazepam intranasal, chlordiazepoxide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may potentiate the CNS-depressant effects of each drug.

• diethylpropion

  Monitor Closely (1)chlordiazepoxide increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• difelikefalin

  Monitor Closely (1)difelikefalin and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• difenoxin hcl

  Monitor Closely (1)chlordiazepoxide and difenoxin hcl both increase sedation. Use Caution/Monitor.

• dimenhydrinate

  Monitor Closely (1)dimenhydrinate and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• diphenhydramine

  Monitor Closely (1)diphenhydramine and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• diphenoxylate hcl

  Monitor Closely (1)chlordiazepoxide and diphenoxylate hcl both increase sedation. Use Caution/Monitor.

• dipipanone

  Monitor Closely (1)chlordiazepoxide and dipipanone both increase sedation. Use Caution/Monitor.

• disulfiram

  Minor (1)disulfiram increases levels of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.

• dobutamine

  Monitor Closely (1)chlordiazepoxide increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• dopamine

  Monitor Closely (1)chlordiazepoxide increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• dopexamine

  Monitor Closely (1)chlordiazepoxide increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• dosulepin

  Monitor Closely (1)chlordiazepoxide and dosulepin both increase sedation. Use Caution/Monitor.

• doxepin

  Monitor Closely (1)chlordiazepoxide and doxepin both increase sedation. Use Caution/Monitor.

• doxylamine

  Monitor Closely (1)chlordiazepoxide and doxylamine both increase sedation. Use Caution/Monitor.

• droperidol

  Monitor Closely (1)chlordiazepoxide and droperidol both increase sedation. Use Caution/Monitor.

• duvelisib

  Monitor Closely (1)duvelisib will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. will increase the level or effect of

• efavirenz

  Monitor Closely (1)efavirenz will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• elagolix

  Monitor Closely (1)elagolix will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Elagolix is a weak-to-moderate CYP3A4 inducer. Monitor CYP3A substrates if coadministered. Consider increasing CYP3A substrate dose if needed.

• eliglustat

  Monitor Closely (1)eliglustat increases levels of chlordiazepoxide by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Monitor therapeutic drug concentrations, as indicated, or consider reducing the dosage of the concomitant drug and titrate to clinical effect.

• elvitegravir/cobicistat/emtricitabine/tenofovir DF

  Monitor Closely (1)elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Cobicistat is a CYP3A4 inhibitor; consider benzodiazepine dose reduction.

• encorafenib

  Monitor Closely (1)encorafenib, chlordiazepoxide. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. Coadministration of encorafenib with sensitive CYP3A4 substrates may result in increased toxicity or decreased efficacy of these agents.

• enzalutamide

  Serious - Use Alternative (1)enzalutamide will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• ephedrine

  Monitor Closely (1)chlordiazepoxide increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• epinephrine

  Monitor Closely (1)chlordiazepoxide increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• epinephrine racemic

  Monitor Closely (1)chlordiazepoxide increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• esketamine intranasal

  Monitor Closely (1)esketamine intranasal, chlordiazepoxide. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.

• esomeprazole

  Minor (1)esomeprazole will increase the level or effect of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.

• estazolam

  Monitor Closely (1)chlordiazepoxide and estazolam both increase sedation. Use Caution/Monitor.

• ethanol

  Monitor Closely (1)chlordiazepoxide and ethanol both increase sedation. Use Caution/Monitor.

• etomidate

  Monitor Closely (1)etomidate and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• etravirine

  Monitor Closely (1)etravirine will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• eucalyptus

  Minor (1)chlordiazepoxide and eucalyptus both increase sedation. Minor/Significance Unknown.

• fedratinib

  Monitor Closely (1)fedratinib will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP3A4 substrates as necessary.

• fenfluramine

  Monitor Closely (1)chlordiazepoxide increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• fexinidazole

  Serious - Use Alternative (1)fexinidazole will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Fexinidazole inhibits CYP3A4. Coadministration may increase risk for adverse effects of CYP3A4 substrates.

• fleroxacin

  Minor (1)fleroxacin increases levels of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.

• flibanserin

  Monitor Closely (1)chlordiazepoxide and flibanserin both increase sedation. Modify Therapy/Monitor Closely. Risk for sedation increased if flibanserin is coadministration with other CNS depressants.

• fluconazole

  Minor (1)fluconazole increases levels of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.

• fluphenazine

  Monitor Closely (1)chlordiazepoxide and fluphenazine both increase sedation. Use Caution/Monitor.

• flurazepam

  Monitor Closely (1)chlordiazepoxide and flurazepam both increase sedation. Use Caution/Monitor.

• formoterol

  Monitor Closely (1)chlordiazepoxide increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• fosamprenavir

  Monitor Closely (1)fosamprenavir increases levels of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Potential for increased toxicity. Use alternatives if available. Consider lowering benzodiazepine dose.

• fosphenytoin

  Monitor Closely (1)fosphenytoin will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

• gabapentin

  Monitor Closely (1)gabapentin, chlordiazepoxide. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

• gabapentin enacarbil

  Monitor Closely (1)gabapentin enacarbil, chlordiazepoxide. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

• ganaxolone

  Monitor Closely (1)chlordiazepoxide and ganaxolone both increase sedation. Use Caution/Monitor.

• gemifloxacin

  Minor (1)gemifloxacin increases levels of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.

• green tea

  Minor (1)green tea decreases effects of chlordiazepoxide by pharmacodynamic antagonism. Minor/Significance Unknown. Caffeine component of green tea may decrease sedative effects of benzodiazepines.

• haloperidol

  Monitor Closely (1)chlordiazepoxide and haloperidol both increase sedation. Use Caution/Monitor.

• hydrocodone

  Serious - Use Alternative (1)hydrocodone, chlordiazepoxide. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

• hydromorphone

  Monitor Closely (1)chlordiazepoxide and hydromorphone both increase sedation. Use Caution/Monitor.

• hydroxyzine

  Monitor Closely (1)hydroxyzine and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• idelalisib

  Serious - Use Alternative (1)idelalisib will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Idelalisib is a strong CYP3A inhibitor; avoid coadministration with sensitive CYP3A substrates

• iloperidone

  Monitor Closely (2)chlordiazepoxide and iloperidone both increase sedation. Use Caution/Monitor.
  
  iloperidone increases levels of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Iloperidone is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4.

• imipramine

  Monitor Closely (1)chlordiazepoxide and imipramine both increase sedation. Use Caution/Monitor.

• indinavir

  Monitor Closely (1)indinavir increases levels of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Potential for increased toxicity. Use alternatives if available. Consider lowering benzodiazepine dose.

• isoproterenol

  Monitor Closely (1)chlordiazepoxide increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• istradefylline

  Monitor Closely (1)istradefylline will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. This effect was not observed with istradefylline 20 mg/day. Consider dose reduction of sensitive CYP3A4 substrates.

• itraconazole

  Monitor Closely (1)itraconazole will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• ivosidenib

  Serious - Use Alternative (1)ivosidenib will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternate therapies. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs.

• ketamine

  Monitor Closely (1)ketamine and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• ketoconazole

  Monitor Closely (1)ketoconazole will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Minor (1)ketoconazole increases levels of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.

• ketotifen, ophthalmic

  Monitor Closely (1)chlordiazepoxide and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.

• larotrectinib

  Minor (1)larotrectinib will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• lasmiditan

  Monitor Closely (1)lasmiditan, chlordiazepoxide. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.

• lemborexant

  Monitor Closely (1)lemborexant, chlordiazepoxide. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.

• letermovir

  Monitor Closely (1)letermovir increases levels of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• levalbuterol

  Monitor Closely (1)chlordiazepoxide increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• levofloxacin

  Minor (1)levofloxacin increases levels of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.

• levoketoconazole

  Monitor Closely (1)levoketoconazole will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Minor (1)levoketoconazole increases levels of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.

• levorphanol

  Monitor Closely (1)chlordiazepoxide and levorphanol both increase sedation. Use Caution/Monitor.

• lisdexamfetamine

  Monitor Closely (1)chlordiazepoxide increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• lofepramine

  Monitor Closely (1)chlordiazepoxide and lofepramine both increase sedation. Use Caution/Monitor.

• lofexidine

  Monitor Closely (1)chlordiazepoxide and lofexidine both increase sedation. Use Caution/Monitor.

• lonafarnib

  Serious - Use Alternative (1)lonafarnib will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration with sensitive CYP3A substrates. If coadministration unavoidable, monitor for adverse reactions and reduce CYP3A substrate dose in accordance with product labeling.

• lopinavir

  Monitor Closely (1)lopinavir increases levels of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Use alternatives if available. Consider lowering benzodiazepine dose.

• loprazolam

  Monitor Closely (1)chlordiazepoxide and loprazolam both increase sedation. Use Caution/Monitor.

• lorazepam

  Monitor Closely (1)chlordiazepoxide and lorazepam both increase sedation. Use Caution/Monitor.

• lorlatinib

  Monitor Closely (1)lorlatinib will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• lormetazepam

  Monitor Closely (1)chlordiazepoxide and lormetazepam both increase sedation. Use Caution/Monitor.

• loxapine

  Monitor Closely (1)chlordiazepoxide and loxapine both increase sedation. Use Caution/Monitor.

• loxapine inhaled

  Monitor Closely (1)chlordiazepoxide and loxapine inhaled both increase sedation. Use Caution/Monitor.

• lurasidone

  Monitor Closely (1)lurasidone, chlordiazepoxide. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.

• maprotiline

  Monitor Closely (1)chlordiazepoxide and maprotiline both increase sedation. Use Caution/Monitor.

• marijuana

  Monitor Closely (1)chlordiazepoxide and marijuana both increase sedation. Use Caution/Monitor.

• melatonin

  Monitor Closely (1)chlordiazepoxide and melatonin both increase sedation. Use Caution/Monitor.

• meperidine

  Monitor Closely (1)chlordiazepoxide and meperidine both increase sedation. Use Caution/Monitor.

• meprobamate

  Monitor Closely (1)chlordiazepoxide and meprobamate both increase sedation. Use Caution/Monitor.

• metaproterenol

  Monitor Closely (1)chlordiazepoxide increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• metaxalone

  Monitor Closely (1)chlordiazepoxide and metaxalone both increase sedation. Use Caution/Monitor.

• methadone

  Monitor Closely (1)chlordiazepoxide and methadone both increase sedation. Use Caution/Monitor.

• methamphetamine

  Monitor Closely (1)chlordiazepoxide increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• methocarbamol

  Monitor Closely (1)chlordiazepoxide and methocarbamol both increase sedation. Use Caution/Monitor.

• methylenedioxymethamphetamine

  Monitor Closely (1)chlordiazepoxide increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• metoclopramide intranasal

  Serious - Use Alternative (1)chlordiazepoxide, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.

• metyrapone

  Minor (1)chlordiazepoxide decreases effects of metyrapone by unspecified interaction mechanism. Minor/Significance Unknown.

• miconazole vaginal

  Minor (1)miconazole vaginal increases levels of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.

• midazolam

  Monitor Closely (1)chlordiazepoxide and midazolam both increase sedation. Use Caution/Monitor.

• midazolam intranasal

  Monitor Closely (1)midazolam intranasal, chlordiazepoxide. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.

• midodrine

  Monitor Closely (1)chlordiazepoxide increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• mirtazapine

  Monitor Closely (1)chlordiazepoxide and mirtazapine both increase sedation. Use Caution/Monitor.

• mitotane

  Monitor Closely (1)mitotane decreases levels of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments.

• modafinil

  Monitor Closely (1)chlordiazepoxide increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• morphine

  Monitor Closely (1)chlordiazepoxide and morphine both increase sedation. Use Caution/Monitor.

• motherwort

  Monitor Closely (1)chlordiazepoxide and motherwort both increase sedation. Use Caution/Monitor.

• moxifloxacin

  Minor (1)moxifloxacin increases levels of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.

• moxonidine

  Monitor Closely (1)chlordiazepoxide and moxonidine both increase sedation. Use Caution/Monitor.

• nabilone

  Monitor Closely (1)chlordiazepoxide and nabilone both increase sedation. Use Caution/Monitor.

• nafcillin

  Monitor Closely (1)nafcillin will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• nalbuphine

  Monitor Closely (1)chlordiazepoxide and nalbuphine both increase sedation. Use Caution/Monitor.

• nefazodone

  Serious - Use Alternative (1)nefazodone will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• nelfinavir

  Monitor Closely (1)nelfinavir increases levels of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Potential for increased toxicity. Use alternatives if available. Consider lowering benzodiazepine dose.

• norepinephrine

  Monitor Closely (1)chlordiazepoxide increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• nortriptyline

  Monitor Closely (1)chlordiazepoxide and nortriptyline both increase sedation. Use Caution/Monitor.

• ofloxacin

  Minor (1)ofloxacin increases levels of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.

• olanzapine

  Monitor Closely (1)chlordiazepoxide and olanzapine both increase sedation. Use Caution/Monitor.

• oliceridine

  Monitor Closely (1)oliceridine, chlordiazepoxide. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

• olopatadine intranasal

  Serious - Use Alternative (1)chlordiazepoxide and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.

• omeprazole

  Minor (1)omeprazole increases levels of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.

• opium tincture

  Monitor Closely (1)chlordiazepoxide and opium tincture both increase sedation. Use Caution/Monitor.

• orphenadrine

  Monitor Closely (1)chlordiazepoxide and orphenadrine both increase sedation. Use Caution/Monitor.

• oxazepam

  Monitor Closely (1)chlordiazepoxide and oxazepam both increase sedation. Use Caution/Monitor.

• oxycodone

  Monitor Closely (1)chlordiazepoxide and oxycodone both increase sedation. Use Caution/Monitor.

• oxymorphone

  Monitor Closely (1)chlordiazepoxide and oxymorphone both increase sedation. Use Caution/Monitor.

• paliperidone

  Monitor Closely (1)chlordiazepoxide and paliperidone both increase sedation. Use Caution/Monitor.

• papaveretum

  Monitor Closely (1)chlordiazepoxide and papaveretum both increase sedation. Use Caution/Monitor.

• papaverine

  Monitor Closely (1)chlordiazepoxide and papaverine both increase sedation. Use Caution/Monitor.

• pentazocine

  Monitor Closely (1)chlordiazepoxide and pentazocine both increase sedation. Use Caution/Monitor.

• pentobarbital

  Monitor Closely (1)pentobarbital and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• perampanel

  Monitor Closely (1)perampanel and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• perphenazine

  Monitor Closely (1)chlordiazepoxide and perphenazine both increase sedation. Use Caution/Monitor.

• phendimetrazine

  Monitor Closely (1)chlordiazepoxide increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• phenobarbital

  Monitor Closely (2)phenobarbital and chlordiazepoxide both increase sedation. Use Caution/Monitor.
  
  phenobarbital will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• phentermine

  Monitor Closely (1)chlordiazepoxide increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• phenylephrine

  Monitor Closely (1)chlordiazepoxide increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• phenylephrine PO

  Monitor Closely (1)chlordiazepoxide increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• phenytoin

  Monitor Closely (1)phenytoin will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

• pholcodine

  Monitor Closely (1)chlordiazepoxide and pholcodine both increase sedation. Use Caution/Monitor.

• pimozide

  Monitor Closely (1)chlordiazepoxide and pimozide both increase sedation. Use Caution/Monitor.

• pirbuterol

  Monitor Closely (1)chlordiazepoxide increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• posaconazole

  Monitor Closely (1)posaconazole will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Minor (1)posaconazole increases levels of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.

• pregabalin

  Monitor Closely (1)pregabalin, chlordiazepoxide. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

• primidone

  Monitor Closely (2)primidone will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  primidone and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• prochlorperazine

  Monitor Closely (1)chlordiazepoxide and prochlorperazine both increase sedation. Use Caution/Monitor.

• promethazine

  Monitor Closely (1)promethazine and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• propofol

  Monitor Closely (1)propofol and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• propylhexedrine

  Monitor Closely (1)chlordiazepoxide increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• protriptyline

  Monitor Closely (1)chlordiazepoxide and protriptyline both increase sedation. Use Caution/Monitor.

• quazepam

  Monitor Closely (1)chlordiazepoxide and quazepam both increase sedation. Use Caution/Monitor.

• quetiapine

  Monitor Closely (1)chlordiazepoxide and quetiapine both increase sedation. Use Caution/Monitor.

• ramelteon

  Monitor Closely (1)chlordiazepoxide and ramelteon both increase sedation. Use Caution/Monitor.

• remimazolam

  Monitor Closely (1)remimazolam, chlordiazepoxide. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.

• ribociclib

  Monitor Closely (1)ribociclib will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• rifabutin

  Monitor Closely (1)rifabutin will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Minor (1)rifabutin decreases levels of chlordiazepoxide by increasing metabolism. Minor/Significance Unknown.

• rifampin

  Monitor Closely (1)rifampin will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Minor (1)rifampin decreases levels of chlordiazepoxide by increasing metabolism. Minor/Significance Unknown.

• risperidone

  Monitor Closely (1)chlordiazepoxide and risperidone both increase sedation. Use Caution/Monitor.

• ritonavir

  Monitor Closely (1)ritonavir increases levels of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Use alternatives if available. Potential for increased toxicity. Consider lowering benzodiazepine dose.

• rolapitant

  Monitor Closely (1)rolapitant will increase the level or effect of chlordiazepoxide by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Rolapitant may increase plasma concentrations of CYP2D6 substrates for at least 28 days following rolapitant administration.

• rucaparib

  Monitor Closely (1)rucaparib will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP3A4 substrates, if clinically indicated.

• sage

  Minor (1)chlordiazepoxide and sage both increase sedation. Minor/Significance Unknown.

• salmeterol

  Monitor Closely (1)chlordiazepoxide increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• saquinavir

  Monitor Closely (1)saquinavir increases levels of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Use alternatives if available. Consider lowering benzodiazepine dose.

• scullcap

  Monitor Closely (1)chlordiazepoxide and scullcap both increase sedation. Use Caution/Monitor.

• secobarbital

  Monitor Closely (2)secobarbital will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. May also enhance CNS depressant effect of chlordiazepoxide
  
  secobarbital and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• selinexor

  Serious - Use Alternative (1)selinexor, chlordiazepoxide. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.

• sevoflurane

  Monitor Closely (1)sevoflurane and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• shepherd's purse

  Monitor Closely (1)chlordiazepoxide and shepherd's purse both increase sedation. Use Caution/Monitor.

• sodium oxybate

  Serious - Use Alternative (1)chlordiazepoxide, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

• stiripentol

  Monitor Closely (2)stiripentol, chlordiazepoxide. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.
  
  stiripentol, chlordiazepoxide. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP3A4 inhibitor and inducer. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. CYP3A4 substrates may require dosage adjustment.

• sufentanil

  Monitor Closely (1)chlordiazepoxide and sufentanil both increase sedation. Use Caution/Monitor.

• sufentanil SL

  Serious - Use Alternative (1)sufentanil SL, chlordiazepoxide. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration may result in hypotension, profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

• suvorexant

  Monitor Closely (1)suvorexant and chlordiazepoxide both increase sedation. Modify Therapy/Monitor Closely. Dosage adjustments of suvorexant and concomitant CNS depressants may be necessary

• tapentadol

  Monitor Closely (1)chlordiazepoxide and tapentadol both increase sedation. Use Caution/Monitor.

• tazemetostat

  Monitor Closely (1)tazemetostat will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• tecovirimat

  Monitor Closely (1)tecovirimat will decrease the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Tecovirimat is a weak CYP3A4 inducer. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered.

• teduglutide

  Monitor Closely (1)teduglutide increases levels of chlordiazepoxide by Other (see comment). Use Caution/Monitor. Comment: Teduglutide may increase absorption of concomitant PO medications; caution with with drugs requiring titration or those with a narrow therapeutic index; dose adjustment may be necessary.

• temazepam

  Monitor Closely (1)chlordiazepoxide and temazepam both increase sedation. Use Caution/Monitor.

• terbinafine

  Monitor Closely (1)terbinafine will increase the level or effect of chlordiazepoxide by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Assess need to reduce dose of CYP2D6-metabolized drug.

• terbutaline

  Monitor Closely (1)chlordiazepoxide increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• thioridazine

  Monitor Closely (1)chlordiazepoxide and thioridazine both increase sedation. Use Caution/Monitor.

• thiothixene

  Monitor Closely (1)chlordiazepoxide and thiothixene both increase sedation. Use Caution/Monitor.

• tipranavir

  Monitor Closely (1)tipranavir increases levels of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Use alternatives if available. Consider lowering benzodiazepine dose.

• topiramate

  Monitor Closely (1)chlordiazepoxide and topiramate both increase sedation. Modify Therapy/Monitor Closely.

• tramadol

  Monitor Closely (1)chlordiazepoxide and tramadol both increase sedation. Use Caution/Monitor.

• trazodone

  Monitor Closely (1)chlordiazepoxide and trazodone both increase sedation. Use Caution/Monitor.

• triazolam

  Monitor Closely (1)chlordiazepoxide and triazolam both increase sedation. Use Caution/Monitor.

• triclofos

  Monitor Closely (1)chlordiazepoxide and triclofos both increase sedation. Use Caution/Monitor.

• trifluoperazine

  Monitor Closely (1)chlordiazepoxide and trifluoperazine both increase sedation. Use Caution/Monitor.

• trimipramine

  Monitor Closely (1)chlordiazepoxide and trimipramine both increase sedation. Use Caution/Monitor.

• triprolidine

  Monitor Closely (1)triprolidine and chlordiazepoxide both increase sedation. Use Caution/Monitor.

• tucatinib

  Serious - Use Alternative (1)tucatinib will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If unavoidable, reduce CYP3A substrate dose according to product labeling.

• valerian

  Serious - Use Alternative (1)valerian and chlordiazepoxide both increase sedation. Avoid or Use Alternate Drug.

• vinpocetine

  Minor (1)chlordiazepoxide increases effects of vinpocetine by unspecified interaction mechanism. Minor/Significance Unknown. Desirable interaction enhanced memory improvement (based on preliminary trial).

• voriconazole

  Monitor Closely (1)voriconazole will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Minor (1)voriconazole increases levels of chlordiazepoxide by decreasing metabolism. Minor/Significance Unknown.

• voxelotor

  Serious - Use Alternative (1)voxelotor will increase the level or effect of chlordiazepoxide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid.

• xylometazoline

  Monitor Closely (1)chlordiazepoxide increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• yohimbine

  Monitor Closely (1)chlordiazepoxide increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• ziconotide

  Monitor Closely (1)chlordiazepoxide and ziconotide both increase sedation. Use Caution/Monitor.

• ziprasidone

  Monitor Closely (1)chlordiazepoxide and ziprasidone both increase sedation. Use Caution/Monitor.

• zolpidem

  Minor (1)zolpidem, chlordiazepoxide. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

• zotepine

  Monitor Closely (1)chlordiazepoxide and zotepine both increase sedation. Use Caution/Monitor.