Norvalette Tablet: Complete Medicine Guide
Clinical Reference Standards: CDSCO (Central Drugs Standard Control Organisation), Indian Pharmacopoeia (IP) & WHO | Last Updated: September 2026
When to Call Your Doctor IMMEDIATELY
- High fever with severe muscle stiffness, confusion, or sweating
- Unusual facial movements, tongue protrusion, or lip smacking
- Fever, sore throat, mouth ulcers, or unusual bruising or bleeding
- Yellowing of the skin or eyes, dark urine, or severe abdominal pain
- Difficulty breathing, swelling of the face, lips, or throat
- Chest pain, palpitations, or fainting
- Seizures or loss of consciousness
- Severe dizziness or inability to stand
If experiencing severe symptoms, call emergency services immediately.
What is norvalette tablet used for?
This medicine is a combination of chlordiazepoxide 0.5 mg and trifluoperazine 5 mg used for short-term treatment of severe anxiety with agitation. It works by enhancing GABA activity and blocking dopamine receptors. It can cause drowsiness and dizziness, and should not be combined with alcohol. It is available only by prescription and must be used under medical supervision.
- Generic Name: Chlordiazepoxide (0.5mg) + Trifluoperazine (5mg)
- Manufacturer: A N Pharmacia
- Form: Allopathy
- Pregnancy Category: Consult doctor
- Prescription Required: Yes
🇮🇳 norvalette tablet के बारे में (Hindi Summary)
उपयोग: यह दवा क्लोरडायजेपॉक्साइड 0.5 मिलीग्राम और ट्राइफ्लुओपेराज़ीन 5 मिलीग्राम का संयोजन है। इसका उपयोग गंभीर चिंता, तनाव और बेचैनी के अल्पकालिक इलाज के लिए किया जाता है, खासकर जब मरीज में व्यवहार संबंधी गड़बड़ी या मानसिक विकार के लक्षण भी हों। यह दवा दिमाग में GABA नामक रसायन को बढ़ाकर और डोपामिन रिसेप्टर को रोककर काम करती है। यह केवल डॉक्टर की सलाह पर ही लेनी चाहिए और इसका सेवन शराब के साथ बिल्कुल नहीं करना चाहिए। इस दवा को अचानक बंद नहीं करना चाहिए क्योंकि इससे withdrawal के लक्षण हो सकते हैं।
साइड इफेक्ट्स: इस दवा के सामान्य दुष्प्रभावों में नींद आना, चक्कर आना, मुँह सूखना, धुंधली दृष्टि, कब्ज और पेशाब में कठिनाई शामिल हैं। कुछ मरीजों में हाथ-पैर कांपना, बेचैनी या मांसपेशियों में अकड़न हो सकती है। दुर्लभ मामलों में चेहरे, जीभ या होंठों की अनैच्छिक हरकतें, तेज बुखार के साथ मांसपेशियों में अकड़न, या खून की बीमारी हो सकती है। अगर आपको कोई भी गंभीर या लगातार परेशानी हो, तो तुरंत डॉक्टर से संपर्क करें।
सुरक्षा सलाह: इस दवा को डॉक्टर के बताए अनुसार ही लें, अपनी मर्जी से डोज न बढ़ाएं या घटाएं। दवा लेने के बाद नींद और चक्कर आ सकते हैं, इसलिए गाड़ी चलाने या मशीन चलाने से बचें। शराब का सेवन बिल्कुल न करें। अगर आपको ग्लूकोमा, प्रोस्टेट की समस्या, लीवर या किडनी की बीमारी, या पार्किंसन रोग है, तो डॉक्टर को जरूर बताएं। लंबे समय तक दवा लेने के बाद अचानक बंद न करें; डॉक्टर की सलाह से धीरे-धीरे कम करें। गर्भावस्था या स्तनपान के दौरान डॉक्टर से सलाह लें।
💊 norvalette tablet Uses & Benefits
[{"condition":"Severe anxiety with agitation","description":"Short-term relief of intense anxiety, tension, and restlessness when a benzodiazepine alone is not sufficient.","evidence":"Established for short-term use"},{"condition":"Psychotic disorders with anxiety","description":"Used as an adjunct to reduce agitation and anxiety in conditions such as schizophrenia or other psychotic disorders.","evidence":"Limited to short-term adjunctive use"},{"condition":"Acute behavioural disturbance","description":"May be used in hospital or specialist settings for rapid calming in selected patients.","evidence":"Restricted to specialist supervision"}]
Off-label uses: [{"condition":"Refractory nausea and vomiting","description":"Trifluoperazine has antiemetic properties, but this combination is not a first-line treatment for nausea.","evidence":"Limited"},{"condition":"Severe premenstrual tension","description":"Occasionally used for short-term symptom control when other measures have failed.","evidence":"Limited"}]
Primary treatment for: Severe anxiety with agitation
Also treats: Psychotic disorders with anxiety, Acute behavioural disturbance
📋 Drug Information
| Generic Name(s) | Chlordiazepoxide (0.5mg) + Trifluoperazine (5mg) |
| Brand Name | norvalette tablet |
| Manufacturer | A N Pharmacia |
| Packaging / Form | Varies by brand (Allopathy) |
| Therapeutic Class | NEURO CNS |
| Action Class | |
| Route of Administration | Oral |
| Storage | Store at room temperature between 15°C and 30°C, in a dry place, away from direct sunlight and moisture. Keep the tablets in their original container with the lid tightly closed. Do not remove the desiccant packet if one is present. Keep out of reach of children and pets. |
| Shelf Life | 24 months from the date of manufacture, or as printed on the pack. Do not use after the expiry date. |
| WHO Guideline | Not established from the available information. The World Health Organization does not have a specific guideline for this fixed-dose combination. Treatment should follow local psychiatric guidelines and specialist advice. |
| ICMR Guideline | Not established from the available information. The Indian Council of Medical Research does not have a specific guideline for this fixed-dose combination. Prescribers should follow national mental health guidelines and institutional protocols. |
👨⚕️ Doctor's Practical Tips
Evidence-based practical advice from experienced clinicians
🔍 Is This Medicine Right for Your Symptom?
Educational reference. Always consult a doctor for diagnosis.
🔬 How This Medicine Works (Pharmacology)
Pharmacokinetics
How It Works
This medicine combines two active ingredients with different but complementary actions. Chlordiazepoxide binds to a specific site on the GABA-A receptor complex and increases the frequency of chloride channel opening, which enhances the inhibitory effect of GABA in the brain and produces anxiolytic, sedative, and muscle-relaxant effects. Trifluoperazine blocks dopamine D2 receptors in the mesolimbic and mesocortical pathways, which reduces psychotic symptoms and agitation; it also has anticholinergic, antihistaminic, and alpha-adrenergic blocking effects that contribute to its calming action and side-effect profile. The combination is intended to provide rapid control of anxiety and agitation while the antipsychotic component addresses underlying psychotic or severe behavioural symptoms.
Mechanism Steps
💡 How to Take norvalette tablet
Strength: Each tablet contains chlordiazepoxide 0.5 mg and trifluoperazine 5 mg.
Dosage Information
| Adult Dosage | The dose of this medicine must be individualized by a qualified clinician based on the indication, severity of symptoms, age, weight, renal and hepatic function, and response to treatment. A typical starting dose for adults is one tablet taken once or twice daily, but the exact dose and frequency will be determined by your doctor. Do not adjust the dose without medical advice. Treatment is usually short-term, and the need for continued use should be reviewed regularly. |
| Pediatric Dosage | Pediatric dosing is not established from available information. Consult a pediatrician. |
| Elderly Dosage | Elderly patients are more sensitive to the sedative, anticholinergic, and extrapyramidal effects of this medicine. A lower starting dose and slower titration are recommended. Regular monitoring for falls, confusion, and abnormal movements is essential. The dose must be individualized by a qualified clinician. |
| Renal Impairment | Dose reduction may be necessary in patients with renal impairment because both ingredients are excreted by the kidneys. The exact adjustment must be determined by a qualified clinician based on the degree of renal impairment and clinical response. |
| Hepatic Impairment | Dose reduction and careful monitoring are recommended in patients with hepatic impairment because both ingredients are metabolised in the liver. The exact adjustment must be determined by a qualified clinician based on liver function tests and clinical response. |
| Maximum Daily Dose | The maximum daily dose must be determined by a qualified clinician based on the individual patient's condition and response. Do not exceed the prescribed dose. |
Dosage Timeline
🍽️ Food Timing Guide
⏰ What to Do If You Miss a Dose
⚠️ Side Effects of norvalette tablet
✅ Common Side Effects
🚨 Serious Side Effects
⚠️ Rare Side Effects
Consult your doctor if you experience any unusual symptoms.
🔬 Drug Interactions
| Drug | Severity | Effect |
|---|---|---|
| Alcohol | Major | |
| Opioid analgesics | Major | |
| MAOIs | Major | |
| CYP3A4 inhibitors | Major | |
| Antihypertensives | Moderate | |
| Anticholinergics | Moderate | |
| Levodopa | Moderate | |
| CYP1A2 inhibitors | Moderate | |
| Thyroid hormones | Moderate | |
| Antacids | Minor |
🚨 Major Interactions
- Alcohol
- Opioid analgesics
- Other benzodiazepines or sedative-hypnotics
- Monoamine oxidase inhibitors (MAOIs)
- CYP3A4 inhibitors (e.g., ketoconazole, ritonavir)
⚡ Moderate Interactions
- Antihypertensive drugs
- Anticholinergic drugs (e.g., trihexyphenidyl, benztropine)
- Levodopa
- CYP1A2 inhibitors (e.g., fluvoxamine, ciprofloxacin)
- Thyroid hormones
🍷 Alcohol Interaction
Alcohol must be completely avoided while taking this medicine. Alcohol increases the sedative and respiratory-depressant effects of chlordiazepoxide and adds to the central nervous system depression caused by trifluoperazine. This combination can lead to severe drowsiness, impaired coordination, dangerous falls, and life-threatening breathing difficulty. Alcohol can also worsen the underlying anxiety and interfere with the effectiveness of treatment.
🔎 Check Your Other Medicines
Educational tool. Always confirm with your doctor or pharmacist.
🛡️ Safety & Warnings
🚫 Contraindications
["Known hypersensitivity to chlordiazepoxide, trifluoperazine, or any component of the formulation","Narrow-angle glaucoma","Severe liver disease","Severe kidney disease","Parkinson's disease","Blood dyscrasias or history of bone marrow depression","Coma or severe central nervous system depression","Myasthenia gravis","Acute porphyria","Children under 18 years of age (unless specifically prescribed by a specialist)","Pregnancy and breastfeeding (unless specialist advises otherwise)"]
⚠️ Warnings & Precautions
["This medicine can cause severe drowsiness and impair coordination; avoid driving and operating machinery until you know how it affects you.","Do not drink alcohol while taking this medicine.","Do not stop this medicine suddenly after prolonged use; withdrawal symptoms may occur.","Use with caution in elderly patients, who are more sensitive to sedation, confusion, and falls.","Use with caution in patients with liver or kidney disease; dose adjustment may be needed.","Trifluoperazine can cause tardive dyskinesia, which may be irreversible; report any abnormal movements immediately.","This medicine can lower the seizure threshold; use with caution in patients with epilepsy.","Avoid exposure to extreme heat or cold, as this medicine may affect temperature regulation.","Tell your doctor if you have glaucoma, enlarged prostate, or difficulty passing urine.","Keep all follow-up appointments for monitoring of blood counts, liver function, and mental status."]
🤱 Lactation Safety
Chlordiazepoxide and trifluoperazine are excreted in breast milk. Because of the potential for sedation, poor feeding, and developmental effects in the infant, this medicine is generally not recommended during breastfeeding. If treatment is essential, the lowest effective dose should be used, and the infant should be monitored for drowsiness, feeding difficulties, and weight gain. Consult a doctor before breastfeeding while taking this medicine.
💊 Overdose Management
Overdose of this medicine can cause severe drowsiness, confusion, coma, respiratory depression, hypotension, tachycardia, and extrapyramidal symptoms. If overdose is suspected, seek emergency medical care immediately. Treatment is supportive and may include airway management, oxygen, intravenous fluids, and monitoring in an intensive care setting. Flumazenil, a benzodiazepine antagonist, may be used with extreme caution in selected cases, but it can precipitate seizures in patients dependent on benzodiazepines. There is no specific antidote for trifluoperazine; management is symptomatic and supportive. Activated charcoal may be considered if the patient presents early and the airway is protected.
⏰ Missed Dose
If you miss a dose of this medicine, take it as soon as you remember if less than half the dosing interval has passed. If more than half the dosing interval has passed, skip the missed dose and continue with your regular schedule. Do not take a double dose to make up for a missed one. If you are unsure what to do, contact your doctor or pharmacist for advice.
Additional Safety Advice
Take this medicine exactly as prescribed by your doctor and never increase or decrease the dose on your own. Swallow the tablet whole with a glass of water; do not crush or chew it unless your doctor advises otherwise. Because this medicine can make you sleepy and slow your reactions, do not drive, cycle, or operate heavy machinery until you are sure how it affects you. Avoid alcohol completely while taking this medicine, as it can dangerously increase sedation and breathing difficulty. Do not use other sedatives, sleeping pills, opioid painkillers, or recreational drugs without checking with your prescriber. Tell your doctor if you have glaucoma, an enlarged prostate, liver or kidney problems, Parkinson's disease, or a history of blood disorders, as this medicine may not be suitable for you. If you have been taking this medicine for more than a few weeks, do not stop it suddenly; your doctor will reduce the dose gradually to prevent withdrawal symptoms. Keep all follow-up appointments so that your doctor can monitor your response, check for side effects, and adjust the dose if needed. Store this medicine in its original container, away from children and direct sunlight. If you become pregnant, suspect pregnancy, or plan to breastfeed, contact your doctor immediately before continuing this medicine.
👴 Special Considerations for Elderly
💡 For Patients Above 65
Elderly patients are more sensitive to the sedative, anticholinergic, and extrapyramidal effects of this medicine. They are at higher risk of falls, confusion, and cognitive impairment. A lower starting dose and slower titration are recommended, with regular monitoring for side effects. The dose must be individualized by a qualified clinician.
🤰 Pregnancy Planning (TTC)
If you are planning to become pregnant, consult your doctor before continuing this medicine. Both ingredients can affect the developing baby, and this medicine is generally not recommended during pregnancy unless clearly necessary under specialist supervision. Your doctor may consider alternative treatments or a gradual taper before conception.
🏥 Post-Surgery Considerations
Inform your surgeon and anaesthetist that you are taking this medicine before any surgery. It can interact with anaesthetic agents and increase sedation and respiratory depression. Your doctor may advise you to stop or adjust the dose before surgery. Do not stop the medicine on your own.
🦷 Dental Procedures
Tell your dentist that you are taking this medicine before any dental procedure. It can cause dry mouth, which may increase the risk of dental problems, and can interact with sedatives used in dentistry. Your dentist may recommend additional precautions or adjustments.
💚 Lifestyle Tips for Better Results
🏋️ Exercise Considerations
This medicine can cause drowsiness, dizziness, and impaired coordination. Avoid strenuous exercise, heavy lifting, or activities that require balance until you know how the medicine affects you. Gentle walking or stretching may be safe, but consult your doctor before starting any new exercise routine.
🥗 Diet Recommendations
💼 Impact on Daily Work & Life
This medicine can cause significant drowsiness and slow your reaction time, which may affect your ability to work, drive, or operate machinery. Avoid driving or operating heavy machinery until you know how it affects you. Inform your employer if your job involves safety-sensitive tasks. Discuss with your doctor if you need adjustments to your work schedule or duties.
🛑 When to Stop This Medicine
Do not stop this medicine without consulting your doctor. If you have been taking it for more than a few weeks, your doctor will gradually reduce the dose to prevent withdrawal symptoms. Seek immediate medical advice if you experience severe side effects such as abnormal movements, high fever with muscle rigidity, or signs of an allergic reaction.
📅 Long-Term Use Effects
Long-term use of this medicine can lead to dependence on the benzodiazepine component, tolerance, and withdrawal symptoms on discontinuation. Prolonged use of trifluoperazine can cause tardive dyskinesia, which may be irreversible, and metabolic or hormonal changes such as raised prolactin levels. Regular monitoring of mental status, movement disorders, blood counts, liver function, and cardiac status is recommended. The need for continued treatment should be reassessed periodically, and the dose should be tapered gradually when stopping.
🌿 Non-Medicine Approaches
These can complement medicine but do not replace prescribed treatment.
Can help manage anxiety and reduce the need for long-term medicine.
Evidence: Well-establishedDeep breathing, meditation, and yoga can complement medical treatment.
Evidence: ModerateRegular exercise, good sleep, and stress management can improve symptoms.
Evidence: Moderate💉 Vaccination Considerations
💉 If You're Getting Vaccinated
Not established from the available information. There are no known specific interactions between this medicine and vaccines. However, if you are unwell with a fever or infection, consult your doctor before receiving any vaccine.
📦 Storage Guide
✅ DO
Store at room temperature (15–30°C)
❌ DON'T
Do not refrigerate unless specified
✅ DO
Keep in original container
❌ DON'T
Do not transfer to unmarked containers
✅ DO
Keep away from direct sunlight
❌ DON'T
Do not store in bathroom cabinet
✅ DO
Keep out of reach of children
❌ DON'T
Do not use after expiry date
✈️ Traveling with This Medicine
When travelling, carry this medicine in its original packaging with the prescription label clearly visible. Bring a copy of your prescription and a letter from your doctor if you are carrying more than a personal supply. Keep the medicine in your hand luggage to avoid loss or temperature extremes. Store it at room temperature and away from direct sunlight. If crossing time zones, continue taking the medicine at the same intervals as prescribed; consult your doctor if you need help adjusting the schedule. Check local customs regulations before travelling internationally, as some countries have strict rules about controlled medicines.
💰 Cost Analysis & Savings
👥 Real Patient Stories
Educational, anonymized scenarios. Individual results may vary.
💬 Questions Patients Often Ask
A: The calming and sedative effects usually begin within 30–60 minutes, but the full antipsychotic effect may take several days to weeks.
A: No. Stopping suddenly after prolonged use can cause withdrawal symptoms. Your doctor will reduce the dose gradually.
A: Yes, the chlordiazepoxide component can cause dependence, especially with long-term use. It should be used only under medical supervision.
A: No. Alcohol can dangerously increase sedation and breathing problems. Avoid alcohol completely.
A: If less than half the dosing interval has passed, take it as soon as you remember. If more, skip the missed dose and continue your regular schedule. Do not double dose.
🤔 Common Patient Concerns
🛑 Myths vs. Facts
- Myth: This medicine is a harmless sleeping pill.
Fact: This medicine contains a benzodiazepine and an antipsychotic. It can cause dependence and serious side effects, and must be used only under medical supervision. - Myth: You can stop this medicine whenever you want.
Fact: Stopping suddenly after prolonged use can cause withdrawal symptoms. Always consult your doctor before stopping. - Myth: It is safe to drink alcohol with this medicine.
Fact: Alcohol can dangerously increase sedation and breathing problems. It must be avoided completely. - Myth: This medicine can be taken for everyday stress.
Fact: This medicine is for severe anxiety and agitation under specialist care. It is not meant for routine stress or mild anxiety.
🔄 Alternative Options
Generic Alternatives
- Chlordiazepoxide and trifluoperazine combination (generic)
Brand Alternatives
- Norvalette Tablet