Benzodiazepine equivalency table


Benzodiazepine Equivalency Table Generic Brand Example Peak Onset (Hours)1-6 Approximate Half-Life (may include active metabolites)1-9 Approximate Equivalent Dose*1-4,7-9 Dosage form Alprazolam Xanax® 0.5-1.5 6-27 hours 0.25-1 mg Tablet Chlordiazepoxide Librium® 1-4 3-120 hours 10-25 mg Capsule


Does benzodiazepine increase blood pressure?

Unexpectedly, benzodiazepine use may also increase your blood pressure in certain circumstances. In 2019, a study found that people that experience insomnia and sleep alterations had a higher risk for high blood pressure. Mixing Xanax with Other Drugs

Do you take both opioids and benzodiazepines?

correctly, taking opioids and benzodiazepines together can cause an overdose. Ask your provider what your risks are. Ask if there are other medications that may be safer for you. 2. False. Any patient taking an opioid with a benzodiazepine has a risk of an overdose. Remember, it is the medication combination that is dangerous, not the person who takes it. 3.

How to switch benzodiazepines?

Switching Benzodiazepines

  1. Incorrect equivalent dose – the values quoted by Ashton, et. al. …
  2. Poorly planned or too short a period for the exchange from another benzodiazepine to diazepam. …
  3. Failure to maximize accumulation of diazepam used and its metabolites – it takes about four weeks to achieve 90% accumulation, i.e. four weeks after exchange.
  4. Tapering too fast. …

What is the equivalent of Valium to Xanax?

Valium is a brand name for the drug diazepam and Xanax is a brand name for the drug alprazolam. Both Valium and Xanax are in similar drug class and both of them have most of the equivalent interactions with other substances and drugs as well.


What is equivalent to 10mg diazepam?

Oxazepam. Oxazepam 10mg is approximately equivalent to diazepam 5mg. Oxazepam is used short-term for severe anxiety and associated insomnia.

Can I switch from lorazepam to diazepam?

When making the switch it is important to do it gradually, replacing one dose at a time and at approximately weekly intervals and making allowance for the difference in potency. For example, if you are taking lorazepam 1mg three times daily, first change the night dose to 10mg diazepam.

Which Benzo is best for long term use?

With sustained levels of anxiety, long-acting benzodiazepines such as diazepam and clorazepate are usually preferred, while episodic anxiety normally responds best to shorter-acting drugs such as oxazepam or lorazepam.

How much diazepam is equivalent to 1mg lorazepam?

As a sedative, diazepam 10 mg is equivalent to lorazepam 2-2.5 mg.

Can you switch from one benzo to another?

For people withdrawing from these potent, short-acting drugs it has been advised that they switch to an equivalent dose of a benzodiazepine with a long half-life such as diazepam (5). Diazepam is available as 2mg tablets which can be halved to give 1mg doses.

Can you take lorazepam and diazepam at the same time?

How dangerous is it to mix Ativan and Valium? Benzodiazepines should not be mixed. Taking Ativan and Valium together can lead to overdose. This can then lead to severe respiratory depression, coma, and/or death.

Why is lorazepam preferred diazepam?

Abstract. Background: Previous trials have suggested lorazepam may be superior to diazepam as first-line treatment of convulsive status epilepticus (CSE), with improved seizure outcome, and a lower incidence of side-effects. Many published guidelines however still recommend diazepam.

How much diazepam should I take to sleep?

The benzodiazepines have a limited role in insomnia and diazepam is used for the short-term management of insomnia associated with anxiety. The BNF recommends a dose of 5 to 15 mg by mouth at bedtime.

When equivalence discrepancies exist in the literature, a reasonable dose range is provided to emphasize?

When equivalence discrepancies exist in the literature, a reasonable dose range is provided to emphasize the lack of confidence in the conversions

Does the FDA require benzodiazepines to be listed on the package insert?

Lack of FDA oversight – Unlike opioid conversions, the FDA does not require manufacturers to describe equivalent dose or potency of benzodiazepines within the package insert.

Do benzodiazepines have a therapeutic window?

Benzodiazepines have a narrow therapeutic window – dose adjustments should be made by an experienced clinician. This calculator is not a substitute for clinical experience and must be used in conjunction with reasonable clinical judgment. For more information, please view the website disclaimer .

Is benzodiazepine conversion single or multiple dose?

In addition to an overall lack of evidence to support specific conversions, there are a number of other limitations that should be recognized: Varying durations of action – Due to differences in half-life, active metabolites, and drug accumulation, benzodiazepine conversions should account for single-dose versus multiple-dose situations.

Do parenteral formulations have the same conversion ratio?

Because published benzodiazepine dose conversions are based on oral administration, parenteral formulations may not use the same conversion ratio. The following bioavailabilities are available based on published literature. Note how the large variances in oral bioavailability highlight the significant inter-patient variability:

Is phenobarbital a benzodiazepine?

Although phenobarbital and se cobarbital are not benzodiazepines, they are commonly grouped with this drug class and cited within benzodiazepine conversion charts due to their use in alcohol withdrawal. While barbiturates do share similar pharmacology to benzodiazepines, they have a more concerning safety profile with a higher incidence of respiratory depression.

What is the equivalency of benzodiazepines?

Benzodiazepine Equivalency Info and Comparison. Benzodiazepines are the most commonly prescribed drugs for fighting anxiety. While different benzodiazepines might have unique properties, they have more similarities than differences. A benzodiazepine equivalency chart helps you determine how strong different benzos are compared to one another.

Why Bother Learning Benzodiazepine Equivalency?

Everyone responds differently to drugs. As such, not everybody is going to get the same benefits from different benzos.

How long does diazepam stay in your system?

The standard dose of diazepam is 10mg, making an easy comparison. The half-life – the time it takes for half the dose to leave your body- is between 20-100 hours. The following info shows the benzodiazepine equivalency in comparison to 10mg diazepam.

How long does a dose of loprazolam last?

Loprazolam (Dormonoct) has a half-life of 6-12 hours and the equivalent dose is 1-2 mg.

How long does Xanax last?

Alprazolam (Xanax, Xanor) has a half-life of 6-12 hours and the equivalent dose is 0.5 mg. Bromazepam (Lexotan) has a half-life of 10-20 hours and the equivalent dose is 5-6 mg. Chloridiazepoxide (Librium) has a half-life of 5-30 hours and the equivalent dose is 25 mg.

How long does nitrazepam last?

Nitrazepam (Mogadon) has a half-life of 15-38 hours and the equivalent dose is 10 mg. Temazepam (Restoril) has a half-life of 8-22 mg and the equivalent dose is 20 mg. Triazolam (Halcion) has a half-life of 2 hours and the equivalent dose is 0.5 mg. Zolpidem (Ambien) and Zaleplon (Sonata) are benzodiazepine-like drugs.

How long does Zolpidem last?

Zolpidem (Ambien) and Zaleplon (Sonata) are benzodiazepine-like drugs. They both have a half-life of 2 hours with equivalent dosages of 20 mg. While this info shows you equivalent benzo doses, remember that the effects aren’t always the same.

How long can you take benzodiazepines?

The UK’s House of Commons has attempted to get a two to four week limit mandate for prescribing benzodiazepines to replace the two to four week benzodiazepine prescribing guidelines, which are merely recommended.

What does R mean in benzodiazepines?

List of benzodiazepines. The core structure of benzodiazepines. “R” labels denote common locations of side chains, which give different benzodiazepines their unique properties. The below tables contain a sample list of benzodiazepines and benzodiazepine analogs that are commonly prescribed, with their basic pharmacological characteristics, …

What is the best medication for alcohol withdrawal?

Long-acting benzodiazepines with long-acting active metabolites, such as diazepam and chlordiazepoxide, are often prescribed for benzodiazepine or alcohol withdrawal as well as for anxiety if constant dose levels are required throughout the day.

Why do people take benzodiazepines for insomnia?

Shorter-acting benzodiazepines are often preferred for insomnia due to their lesser hangover effect. It is fairly important to note that elimination half-life of diazepam and chlordiazepoxide, as well as other long half-life benzodiazepines, is twice as long in the elderly compared to younger individuals.

Is tifluadom a benzodiazepine core?

Finally, note that the benzodiazepine core is a privileged scaffold, which has been used to derive drugs with diverse activity that is not limited to the GABA A modulatory action of the classical benzodiazepines, such as devazepide and tifluadom, however these have not been included in the list below. 2,3-benzodiazepines such as tofisopam are also not listed, as these act primarily as AMPA receptor modulators, and are inactive at GABA A receptors.

Can you adjust benzodiazepine dosage for elderly?

Many doctors make the mistake of not adjusting benzodiaze pine dosage according to age in elderly patients. Thus, the approximate equivalent of doses below may need to be adjusted accordingly in individuals on short acting benzodiazepines who metabolize long-acting benzodiazepines more slowly and vice versa.

Is benzodiazepine a research chemical?

Pharmacokinetic properties of various benzodiazepines. Data in the table below is taken from the Ashton “Benzodiazepine Equivalency Table”. Often sold as a research chemical, but is approved for human use in many countries. Controlled substance in some US states, Canada, Germany, Austria, and others.


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