Limbitrol

Generic Name: Chlordiazepoxide and amitriptyline

  • What is Limbitrol?

    Limbitrol is a combination of an antianxiety drug (chlordiazepoxide) and an antidepressant (amitriptyline). It is used to treat moderate to severe depression associated with moderate to severe anxiety.
  • What is the most important information I should know about Limbitrol?

    Children, teenagers, and young adults who take Limbitrol may be at an increased risk for suicidal thoughts or actions. The patient's family and/or caregiver should closely observe the individual who is on Limbitrol. Contact the doctor at the onset of new, worsened, or sudden symptoms such as depressed mood; anxious, restless, or irritable behavior; panic attacks; or any unusual change in mood or behavior occur.

    Contact the doctor right away if any signs of suicidal thoughts or actions occur. The risk of suicidal actions may be especially high in patients with bipolar disorder (also called manic-depressive illness), a family history of bipolar disorder, and a personal or family history of suicide attempt. After starting your child on an antidepressant, regular visits with your doctor should be set up.

    When using Limbitrol for long periods of time or at high doses, tolerance may develop; you may require higher doses to obtain the same effect as when you first started taking this drug. Talk with your doctor if Limbitrol stops working well. Do not take more than prescribed.

    Some people who use Limbitrol over an extended period of time may develop dependence or a need to continue taking it. If you stop taking Limbitrol suddenly, you may have withdrawal symptoms which may include convulsions, tremor, stomach and muscle cramps, vomiting, or sweating. Contact your doctor if you experience any of these symptoms or if you wish to alter your Limbitrol dose; do not change your dose independently.

    Do not drive or perform other possibly unsafe tasks until you know how you react to Limbitrol; this drug may cause dizziness, drowsiness, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines.

    Do not drink alcohol or use medicines that may cause drowsiness (such as sleep aids and muscle relaxers) while you are using Limbitrol; it may add to their effects.

    Limbitrol may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.

    Limbitrol may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.

    Limbitrol may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Limbitrol. Use sunscreen or wear protective clothing if you must be outside for more than a short time.

    Do not become overheated in hot weather or while you are being active; heatstroke may occur.

    Separate Limbitrol and monoamine oxidase inhibitors (MAOIs by a minimum of 14 days. Do not start Limbitrol therapy if you are currently on an MAOI.

    If your symptoms do not get better within 4 weeks or if they get worse, check with your doctor.

    This drug should be used with caution in patients with a history of seizures.

    Close supervision is required when Limbitrol is given to patients with an overactive thyroid or those on thyroid medication.

    Tell your doctor or dentist that you take Limbitrol before you receive any medical or dental care, emergency care, or surgery.

  • Who should not take Limbitrol?

    Limbitrol should not be used in patients with hypersensitivity to either benzodiazepines or tricyclic antidepressants, both components of Limbitrol.

    Limbitrol should not be given concomitantly with an MAOI due to serious side effects that may occur. Limbitrol and MAOIs must be separated by a minimum of 14 days.

    Limbitrol should not be used during the acute recovery phase following myocardial infarction (heart attack).

  • What should I tell my doctor before I take the first dose of Limbitrol?

    Tell your doctor about all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with Limbitrol. Also, talk to your doctor about your complete medical history, especially if you have any of the following: a history of bipolar disorder, suicidal thoughts or actions, a history of alcohol or other substance abuse or dependence, an irregular heartbeat, heart disease, chest pain, liver or kidney problems, thyroid disease, lung or breathing problems, muscle problems (myasthenia gravis), glaucoma, seizures, blood problems, or if you unable to urinate (urinary retention).
  • What is the usual dosage?

    The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

    Optimum dosage varies with the severity of the symptoms and the response of the individual patient. When a satisfactory response is obtained, dosage should be reduced to the smallest amount needed to maintain the remission. The larger portion of the total daily dose may be taken at bedtime. In some patients, a single dose at bedtime may be sufficient. In general, lower dosages are recommended for elderly patients.

    Adults: Limbitrol tablets contain 5 milligrams (mg) chlordiazepoxide and 12.5 mg amitriptyline. The recommended starting dose of Limbitrol tablets is 3 or 4 tablets taken daily in divided doses may be satisfactory in patients who do not tolerate higher doses.

    Limbitrol DS (double strength) tablets contain 10 mg chlordiazepoxide and 25 mg amitriptyline. The recommended starting dose is 3 or 4 tablets taken daily in divided doses. This may increase to 6 tablets daily if required. Some patients may respond to smaller doses and can be maintained on 2 tablets daily.

  • How should I take Limbitrol?

    Limbitrol can be swallowed with or without food daily. Withdrawal symptoms may occur if you decrease your dose or suddenly stop taking Limbitrol. Talk with your doctor about any changes to your dose.

    Do not eat grapefruit or drink grapefruit juice while using Limbitrol without first contacting your doctor.

  • What should I avoid while taking Limbitrol?

    Do not start Limbitrol therapy if you are currently on an MAOI.

    Do not take more than prescribed or suddenly stop taking Limbitrol.

    Do not drive or perform other possibly unsafe tasks until you know how you react to Limbitrol; this drug may cause dizziness, drowsiness, or blurred vision.

    Do not drink alcohol or use medicines that may cause drowsiness (such as sleep aids and muscle relaxers) while you are using Limbitrol; it may add to their effects.

    Avoid sitting or standing up too quickly, especially in the morning and when you start treatment with Limbitrol. Sit or lie down at the first sign of any dizziness or lightheadedness.

    Avoid the sun, sunlamps, or tanning booths until you know how you react to Limbitrol. Use sunscreen or wear protective clothing if you must be outside for more than a short time. Limbitrol may cause you to become sunburned more easily.

    Do not become overheated in hot weather or while you are being active; heatstroke may occur.

    Do not eat grapefruit or drink grapefruit juice while using Limbitrol without first contacting your doctor.

  • What are possible food and drug interactions associated with Limbitrol?

    If Limbitrol is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Limbitrol with the following: antiarrhythmics, anticholinergics such as scopolamine, anticoagulants/blood thinners, antifungals, antidepressants (including MAOIs, SSRIs, and SNRIs), bupropion, carbamazepine, cimetidine, clonidine, clozapine, disulfiram, fluconazole, guanethidine, guanfacine, H1 antagonists such as astemizole and terfenadine, ketolide antibiotics, macrolide antibiotics, MAOIs such as phenelzine and selegiline, omeprazole, phenothiazines such as chlorpromazine, pimozide, rifampin, sodium oxybate GHB, quinupristin/dalfopristin, sympathomimetics such as albuterol and pseudoephedrine, terbinafine, and valproic acid.
  • What are the possible side effects of Limbitrol?

    Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

    Side effects may include: abnormal skin sensations, bloating, blurred vision, constipation, diarrhea, disturbed concentration, dizziness, drowsiness, dry mouth, headache, loss of appetite, nausea, restlessness, tiredness, upset stomach, vomiting, weakness, weight gain or loss, chest pain, confusion, decreased sexual ability, delusions, disorientation, decreased or increased urination, fast or irregular heartbeat, fever, chills, persistent sore throat, involuntary movements of the tongue, face, mouth, or jaw (such as protrusion of tongue, puffing of cheeks, puckering of mouth, chewing movements), involuntary movements of the arms and legs

  • Can I receive Limbitrol if I am pregnant or breastfeeding?

    Limbitrol has been shown to cause fetal harm. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Limbitrol while you are pregnant.

    Limbitrol is found in breast milk. Do not breastfeed while taking Limbitrol.

  • What should I do if I miss a dose of Limbitrol?

    If you miss a dose of Limbitrol, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take two doses at once.
  • How should I store Limbitrol?

    Store at room temperature in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom.