Hyperacidity, GERD, and ulcers:
Indications for LIBRAX:
Adjunct in peptic ulcer. Irritable bowel syndrome. Acute enterocolitis.
Individualize. Usually 1–2 caps 3–4 times daily before meals and at bedtime. Elderly or debilitated: max 2 caps daily initially, then may increase gradually.
Glaucoma. GI or GU obstruction.
Risks from concomitant use with opioids; see Interactions. Monitor for paradoxical reactions. Depression. Suicidal tendencies (monitor). Hepatic and renal impairment. Obtain LFTs and blood counts periodically in prolonged use. Drug or alcohol abuse. Write ℞ for smallest practical amount. Avoid abrupt cessation. Elderly. Debilitated. Pregnancy; avoid during the first trimester. Nursing mothers: not recommended.
Benzodiazepine + anticholinergic.
Increased sedation, respiratory depression, coma, and death with concomitant opioids; reserve use in those for whom alternative treatment options are inadequate; if needed, limit dosages/durations to minimum and monitor. Additive CNS depressant effects with alcohol or other CNS depressants. Concomitant other psychotropic agents (eg, MAOIs, phenothiazines): not recommended. Increased constipation with concomitant other spasmolytic agents and/or a low residue diet. May rarely interfere with oral anticoagulants.
Drowsiness, anticholinergic effects (eg, dry mouth, blurred vision, urinary hesitancy, constipation), ataxia, confusion; rare: jaundice, blood dyscrasias.