Amitriptyline; Chlordiazepoxide

Brand names: Limbitrol®, Limbitrol® DS

Chemical formula:

Drug Forms:
• Amitriptyline; Chlordiazepoxide tablets (below)
• Amitriptyline Hydrochloride, Chlordiazepoxide Hydrochloride Oral tablet
• Amitriptyline Hydrochloride, Chlordiazepoxide Oral tablet

Espa�ol:
• Clorhidrato de Amitriptilina, Clorhidrato de Clordiacepóxido, Tableta oral
• Clorhidrato de Amitriptilina; Clordiacepóxido, Tableta oral

Amitriptyline; Chlordiazepoxide tablets

What are Amitriptyline; Chlordiazepoxide tablets?

AMITRIPTYLINE; CHLORDIAZEPOXIDE (Limbitrol®, Limbitrol® DS) is a combination tricyclic antidepressant and benzodiazepine used to treat depression. This medicine can lift your spirits by treating your depression, especially if it is associated with anxiety. Federal law prohibits the transfer of this medicine to any person other than the patient for whom it was prescribed. Do not share this medicine with anyone else. Generic amitriptyline; chlordiazepoxide tablets are available.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:
• an alcohol or drug abuse problem
• asthma, or other lung disease, such as chronic obstructive pulmonary disease (COPD), sleep apnea or other breathing difficulties
• bipolar disorder or a family history of bipolar, depression, psychosis or other mental health condition
• blood disorders or disease
• diabetes
• difficulty passing urine, prostate trouble
• glaucoma
• having intramuscular injections
• heart disease or previous heart attack
• liver disease
• kidney disease
• myasthenia gravis
• over active thyroid
• Parkinson's disease
• porphyria
• schizophrenia
• seizures (convulsions) or a history of seizures
• stomach disease
• thoughts or plans of suicide; a previous suicide attempt or family history of suicide attempt
• an unusual reaction to Amitriptyline or Chlordiazepoxide, other medicines called tricyclic antidepressants or benzodiazepines; other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should this medicine be used?

Take this medicine by mouth. Follow the directions on the prescription label. Swallow the tablets with a drink of water. If this medicine upsets your stomach, take it with food or milk. Take your doses at regular intervals. Do not take your medicine more often than directed. Do not stop taking except on your prescriber's advice.

Generally this medication is not used in children. Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed.

Elderly patients over 65 years old may have a stronger reaction to this medicine and need smaller doses.

What drug(s) may interact with Amitriptyline; Chlordiazepoxide?

Amitriptyline can interact with many other medicines. Some interactions can be very important. Make sure your prescriber or health care professional knows about all other medicines you are taking. Many important interactions are listed below:

Do not take amitriptyline; chlordiazepoxide with any of the following medications:
• astemizole (Hismanal®)
• cisapride (Propulsid®)
• probucol
• terfenadine (Seldane®)
• thioridazine (Mellaril®)
• medicines called MAO inhibitors-phenelzine (Nardil®), tranylcypromine (Parnate®), isocarboxazid (Marplan®), selegiline (Eldepryl®)
• other medicines for mental depression (may be duplicate therapies or cause additive side effects)

Amitriptyline; chlordiazepoxide may also interact with any of the following medications:
• alcohol
• antacids
• atropine and related drugs like hyoscyamine, scopolamine, tolterodine and others
• barbiturate medicines for inducing sleep or treating seizures (convulsions), such as phenobarbital
• blood thinners, such as warfarin
• bosentan
• bupropion
• cimetidine
• clonidine
• cocaine
• disulfiram
• donepezil
• drugs for treating HIV infection or AIDS
• female hormones, including contraceptive or birth control pills and estrogen
• galantamine
• herbs and dietary supplements like ephedra (Ma huang), kava kava, SAM-e, St. John's wort, valerian, melatonin, St. John's Wort or others
• imatinib, STI-571
• isoniazid
• labetalol
• levodopa and other medicines for movement problems like Parkinson's disease
• lithium
• medicines for anxiety or sleeping problems, such as alprazolam, diazepam, lorazepam or triazolam
• medicines for cold or flu symptoms (like pseudoephedrine, a decongestant)
• medicines for fungal infections (such as fluconazole, itraconazole, ketoconazole, voriconazole)
• medicines for hay fever or allergies (antihistamines)
• medicines for mental problems or psychiatric disturbances
• medicines for weight loss or appetite control
• medicines used to regulate abnormal heartbeat or to treat high blood pressure or other heart conditions (examples: amiodarone, bepridil, diltiazem, verapamil, disopyramide, dofetilide, flecainide, ibutilide, mibefradil, procainamide, propafenone, quinidine, and others)
• nicardipine
• other medicines for mental or mood problems and psychotic disturbances
• prescription pain medications like morphine, codeine, tramadol and others
• probenecid
• procarbazine
• rifampin, rifapentine, or rifabutin
• seizure (convulsion) or epilepsy medicine such as carbamazepine or phenytoin
• stimulants like dexmethylphenidate or methylphenidate
• some antibiotics (examples: clarithromycin, erythromycin, gatifloxacin, levofloxacin, linezolid, moxifloxacin, sparfloxacin, troleandomycin)
• some medicines for seizures (carbamazepine, phenobarbital, phenytoin, primidone)
• tacrine
• theophylline
• thyroid hormones such as levothyroxine
• warfarin
• zafirlukast
• zileuton

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What should I watch for while taking Amitriptyline; Chlordiazepoxide?

Visit your prescriber or health care professional for regular checks on your progress. It can take one to several weeks before you feel the full effect of this medicine. A Medication Guide About Using Antidepressants in Children and Teenagers is available from your health care professional and should be read by the patients and their family or caregivers. Discuss this Medication Guide with the health care provider if this drug is being used in a child or adolescent.

If you have been taking this medicine regularly for some time, do not suddenly stop taking it. You must gradually reduce the dose or you may get severe side effects. Ask your prescriber or health care professional for advice. Even after you stop taking this medicine it can still affect your body for several days.

If you notice any unusual effects, such as restlessness, worsening of depression, agitation, difficulty sleeping, irritability, anger, acting on dangerous impulses, or suicide thoughts or attempts, you should call your health care provider immediately.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may increase dizziness and drowsiness. Avoid alcoholic drinks.

Do not treat yourself for coughs, colds or allergies without asking your prescriber or health care professional for advice. Some ingredients can increase possible side effects.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water will help.

This medicine may cause dry eyes and blurred vision. If you wear contact lenses you may feel some discomfort. Lubricating drops may help. See your ophthalmologist if the problem does not go away or is severe.

This medicine may make your skin more sensitive to the sun. Keep out of the sun, or wear protective clothing outdoors and use a sunscreen. Do not use sun lamps or sun tanning beds or booths.

This medicine can affect blood glucose (sugar) levels. If you are a diabetic, check your blood sugar more often than usual, especially during the first few weeks of treatment. Call your prescriber or health care professional for advice if you notice a change in the results of blood or urine glucose tests.

If you are going to have surgery or will need an x-ray procedure that uses contrast agents, tell your prescriber or health care professional that you are taking this medicine.

What side effects may I notice from receiving Amitriptyline; Chlordiazepoxide?

Side effects that you should report to your prescriber or health care professional as soon as possible:
• abnormal production of milk in females
• anxiety, agitation, panic attacks, inability to sleep, irritability, hostility or extreme anger, aggressiveness, engaging in unusual or dangerous activities, restlessness or inability to sit still, extreme elation or feeling of happiness that may switch back and forth with a depressed or sad mood
• blurred vision or eye pain
• breast enlargement in both males and females
• confusion, hallucinations (seeing or hearing things that are not really there)
• difficulty breathing
• lightheadedness or fainting spells
• fever with increased sweating
• irregular or fast pounding heartbeat, palpitations
• movement difficulty, muscle stiffness, muscle cramps or spasms
• pain or difficulty passing urine, loss of bladder control
• seizures (convulsions)
• sexual difficulties (decreased sexual ability or desire, difficulty ejaculating)
• stomach pain
• swelling of the testicles
• tingling, pain, or numbness in the feet or hands
• tremors
• unusual weakness or tiredness
• worsening depression
• yellowing of the eyes or skin

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):
• anxiety
• constipation or diarrhea
• drowsiness or dizziness
• dry mouth
• increased sensitivity of the skin to sun or ultraviolet light
• loss of appetite
• menstrual period changes
• nausea, vomiting
• skin rash or itching
• temporary loss of sexual desire
• weight gain or loss

Where can I keep my medicine?

Keep out of the reach of children in a container that small children cannot open.

Store at room temperature between 15—30 degrees C (59—86 degrees F). Store in a dry place.

Last updated: 7/1/2002

Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.