Drug interactions
Butalbital + Chlordiazepoxide
Severity: Major
Butalbital and Chlordiazepoxide: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Butalbital is a barbiturate that adds to benzodiazepine sedation and respiratory depression, with greater concern at higher doses or with other depressants. Enzyme induction by the barbiturate may also modestly alter benzodiazepine levels.
What this interaction means in plain words
Butalbital and Chlordiazepoxide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive GABA-A mediated CNS depression, with possible hepatic enzyme induction.
What to do
Avoid concurrent use if possible; otherwise use the lowest doses and monitor sedation and breathing, advising against driving.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Chlordiazepoxide
Frequently asked questions
Can I take Butalbital with Chlordiazepoxide?
MediHelp rates the interaction as major. Butalbital and Chlordiazepoxide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Butalbital is a barbiturate that adds to benzodiazepine sedation and respiratory depression, with greater concern at higher doses or with other depressants. Enzyme induction by the barbiturate may also modestly alter benzodiazepine levels.
How serious is the interaction between Butalbital and Chlordiazepoxide?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concurrent use if possible; otherwise use the lowest doses and monitor sedation and breathing, advising against driving.
What other medicines interact with Chlordiazepoxide?
MediHelp also lists interactions of Chlordiazepoxide with, for example, Alfentanil, Alprazolam, Amobarbital. The full list is on the Chlordiazepoxide page.
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