Before Using This Medicine

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

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to benzodiazepines such as alprazolam [e.g., Xanax], bromazepam [e.g., Lectopam], chlordiazepoxide [e.g., Librium], clonazepam [e.g., Klonopin], clorazepate [e.g., Tranxene], diazepam [e.g., Valium], flurazepam [e.g., Dalmane], halazepam [e.g., Paxipam], ketazolam [e.g., Loftran], lorazepam [e.g., Ativan], midazolam [e.g., Versed], nitrazepam [e.g., Mogadon], oxazepam [e.g., Serax], prazepam [e.g., Centrax], temazepam [e.g., Restoril], or triazolam [e.g., Halcion], or to clidinium or any of the belladonna alkaloids (atropine, belladonna, hyoscyamine, and scopolamine). Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Clidinium (contained in this combination) has not been studied in pregnant women. However, clidinium has not been shown to cause birth defects or other problems in animal studies. Chlordiazepoxide (contained also in this combination) may cause birth defects if taken during the first 3 months of pregnancy. In addition, too much use of this medicine during pregnancy may cause the baby to become dependent on the medicine. This may lead to withdrawal side effects after birth. Make sure your doctor knows if you are pregnant or if you may become pregnant before taking chlordiazepoxide and clidinium.

Breast-feeding—Chlordiazepoxide may pass into the breast milk and cause unwanted effects, such as excessive drowsiness, in nursing babies. Also, because clidinium tends to decrease the secretions of the body, it is possible that the flow of breast milk may be reduced in some patients.

Children—There is no specific information comparing use of chlordiazepoxide and clidinium in children with use in other age groups. However, children are especially sensitive to the effects of chlordiazepoxide and clidinium. Therefore, this may increase the chance of side effects during treatment.

Older adults—Confusion or memory loss; constipation; difficult urination; drowsiness; dryness of mouth, nose, throat, or skin; and unusual excitement or agitation may be more likely to occur in the elderly, who are usually more sensitive than younger adults to the effects of chlordiazepoxide and clidinium.

Other medicines—Although certain medicines should not be used together at all, in other cases 2 different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking chlordiazepoxide and clidinium it is especially important that your health care professional know if you are taking any of the following:

• Antacids or
• Diarrhea medicine containing kaolin or attapulgite—These medicines may reduce the blood levels of chlordiazepoxide and clidinium, which may decrease their effects; they should be taken at least 2 to 3 hours before or after the chlordiazepoxide and clidinium combination

• Central nervous system (CNS) depressants (medicines that cause drowsiness) or
• Other anticholinergics (medicines for abdominal or stomach spasms or cramps)—Use with chlordiazepoxide and clidinium may increase the side effects of either medicine

• Ketoconazole (e.g., Nizoral)—Chlordiazepoxide and clidinium may reduce the blood level of ketoconazole, which may decrease its effects; therefore, chlordiazepoxide and clidinium should be taken at least 2 hours after ketoconazole

• Potassium chloride (e.g., Kay Ciel)—Use of chlordiazepoxide and clidinium may worsen or cause sores of the stomach or intestine

Other medical problems—The presence of other medical problems may affect the use of chlordiazepoxide and clidinium. Make sure you tell your doctor if you have any other medical problems, especially:

• Difficult urination or
• Dryness of mouth (severe and continuing) or
• Emphysema, asthma, bronchitis, or other chronic lung disease or
• Enlarged prostate or
• Glaucoma or
• Hiatal hernia or
• High blood pressure (hypertension) or
• Intestinal blockage or
• Mental depression or
• Mental illness (severe) or
• Myasthenia gravis or
• Ulcerative colitis (severe)—Use of chlordiazepoxide and clidinium may make these conditions worse

• Drug abuse or dependence—Taking chlordiazepoxide (contained in this combination) may become habit-forming, causing mental or physical dependence

• Kidney disease or
• Liver disease—Higher blood levels of chlordiazepoxide and clidinium may result, possibly increasing the chance of side effects

• Overactive thyroid—Use of chlordiazepoxide and clidinium may further increase the heart rate