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All about: Limbitrol

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Generic Name: amitriptyline and chlordiazepoxide (a mi TRIP ti leen and klor dye az e POX ide)
Brand Names: Limbitrol

What is Limbitrol (amitriptyline and chlordiazepoxide)?

Amitriptyline is in a group of drugs called tricyclic antidepressants. Amitriptyline affects chemicals in the brain that may become unbalanced.

Chlordiazepoxide is in a group of drugs called benzodiazepines (ben-zoe-dye-AZE-eh-peens). Chlordiazepoxide affects chemicals in the brain that may become unbalanced and cause anxiety.

Amitriptyline and chlordiazepoxide is used to treat depression and anxiety.

Amitriptyline and chlordiazepoxide may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about Limbitrol (amitriptyline and chlordiazepoxide)?

Do not use this medication if you are allergic to amitriptyline (Elavil) or chlordiazepoxide (Librium), or to other benzodiazepines, such as alprazolam (Xanax), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), or oxazepam (Serax). Do not use amitriptyline and chlordiazepoxide if you have taken an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. This medication can cause birth defects in an unborn baby. Do not use amitriptyline and chlordiazepoxide if you are pregnant.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself. Do not drink alcohol while taking amitriptyline and chlordiazepoxide. Chlordiazepoxide can increase the effects of alcohol.

What should I discuss with my healthcare provider before taking Limbitrol (amitriptyline and chlordiazepoxide)?

Do not use this medication if you are allergic to amitriptyline (Elavil) or chlordiazepoxide (Librium), or to other benzodiazepines, such as alprazolam (Xanax), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), or oxazepam (Serax). Do not use this medication if you have recently had a heart attack. Do not use amitriptyline and chlordiazepoxide if you have taken an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take amitriptyline and chlordiazepoxide before the MAO inhibitor has cleared from your body.

Before taking amitriptyline and chlordiazepoxide, tell your doctor if you are allergic to any drugs, or if you have:

  • kidney or liver disease;

  • heart disease, or a history of heart attack or stroke;

  • epilepsy or other seizure disorder;

  • bipolar disorder (manic-depression), schizophrenia or other mental illness;

  • a history of suicidal thoughts or behavior;

  • history of drug or alcohol addiction;

  • a thyroid disorder;

  • glaucoma; or

  • problems with urination.

If you have any of these conditions, you may not be able to use amitriptyline and chlordiazepoxide, or you may need a dosage adjustment or special tests during treatment.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Chlordiazepoxide can cause birth defects in an unborn baby. Do not use amitriptyline and chlordiazepoxide without your doctor's consent if you are pregnant. Tell your doctor if you become pregnant during treatment. Use an effective form of birth control while you are using this medication. Amitriptyline and chlordiazepoxide may pass into breast milk and could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Drowsiness caused by chlordiazepoxide may last longer in older adults. Accidental falls are common in elderly patients who take benzodiazepines. Use caution to avoid falling or accidental injury while you are taking amitriptyline and chlordiazepoxide.

Do not give this medication to anyone under 18 years old without the advice of a doctor.

How should I take Limbitrol (amitriptyline and chlordiazepoxide)?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

It may take up to 4 weeks of using this medicine before your symptoms improve. For best results, keep using the medication as directed. Talk with your doctor if your symptoms do not improve after 4 weeks of treatment.

To be sure this medication is not causing harmful effects, your blood will need to be tested on a regular basis. Do not miss any scheduled visits to your doctor.

If you need to have any type of surgery, tell the surgeon ahead of time that you are taking amitriptyline and chlordiazepoxide. You may need to stop using the medicine for a short time.

You may have unpleasant withdrawal symptoms when you stop using amitriptyline and chlordiazepoxide after using it over a long period of time. Do not stop using it suddenly without first talking to your doctor. You may need to use less and less before you stop completely. Chlordiazepoxide may be habit-forming and should be used only by the person it was prescribed for. Chlordiazepoxide should never be shared with another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it. Store amitriptyline and chlordiazepoxide at room temperature away from moisture and heat.

Keep track of how many pills have been used from each new bottle of this medicine. Benzodiazepines are drugs of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of amitriptyline and chlordiazepoxide can be fatal.

Symptoms of an overdose may include uneven heartbeats, extreme drowsiness, confusion, agitation, hallucinations, vomiting, feeling hot or cold, sweating, muscle stiffness, feeling light-headed, fainting, seizure (convulsions), or coma.

What should I avoid while taking Limbitrol (amitriptyline and chlordiazepoxide)?

Do not drink alcohol while taking amitriptyline and chlordiazepoxide. This medication can increase the effects of alcohol. Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by amitriptyline and chlordiazepoxide. Tell your doctor if you need to use any of these other medicines together with amitriptyline and chlordiazepoxide. Amitriptyline and chlordiazepoxide can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Limbitrol (amitriptyline and chlordiazepoxide) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have any of these serious side effects:
  • fast, pounding, or uneven heart rate, chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;

  • sudden numbness or weakness (especially on one side of the body), headache, confusion, problems with vision, speech, or balance;

  • hallucinations, or seizures (convulsions), feeling light-headed, fainting;

  • easy bruising or bleeding;

  • jaundice (yellowing of your skin or eyes); or

  • urinating less than usual or not at all.

Less serious side effects may be more likely to occur, such as:

  • feeling dizzy, drowsy, or tired;

  • blurred vision, trouble concentrating;

  • dry mouth, unusual or unpleasant taste;

  • loss of appetite, nausea, vomiting, stomach pain, constipation;

  • weight changes;

  • strange dreams or nightmares;

  • breast or testicle swelling in men; or

  • decreased sex drive, impotence, or difficulty having an orgasm.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Limbitrol (amitriptyline and chlordiazepoxide)?

Before taking amitriptyline and chlordiazepoxide, tell your doctor if you have used an "SSRI" antidepressant in the past 5 weeks, such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), or sertraline (Zoloft).

Before taking amitriptyline and chlordiazepoxide, tell your doctor if you are currently using cimetidine (Tagamet), guanethidine (Ismelin), or a heart rhythm medicine such as flecainide (Tambocor), propafenone (Rhythmol), or quinidine (Quinidex, Quinaglute). You may not be able to use amitriptyline and chlordiazepoxide, or you may need dosage adjustments or special tests during treatment.

There are many other medicines that can interact with amitriptyline and chlordiazepoxide. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

Where can I get more information?

  • Your pharmacist has information about amitriptyline and chlordiazepoxide written for health professionals that you may read.

What does my medication look like?

Amitriptyline and chlordiazepoxide is available with a prescription generically and under the brand names Limbitrol and Limbitrol DS. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2006 Cerner Multum, Inc. Version: 4.03. Revision Date: 06/04/2007 1:29:35 PM.

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