Benzodiazepine Equivalence Chart
| BENZODIAZEPINE | COMPARATIVE DOSE | TIME TO PEAK PLASMA LEVEL | HALF-LIFE |
| Alprazolam | .5 | 1 – 2 | 9 – 20 |
| Bromazepam | 3.0 | .5 – 4 | 8 – 30 |
| Chlordiazepoxide | 25 | 1 – 4 | 24 – 100 |
| Clonazepam | .25 | 1 – 4 | 10 – 60 |
Aug 13 2022
What are the alternatives to benzodiazepines?
Some non-addictive alternatives to benzodiazepines for anxiety available by prescription include:
- SSRIs (antidepressants)
- SNRIs (antidepressants)
- Beta-Blockers (blood pressure medications)
- Buspirone (anti-anxiety)
- Hydroxyzine (brand name Vistaril, a prescription antihistamine).
Which benzo has the longest half life?
The various benzodiazepines are listed in order of the shortest acting to the longest acting (by the approximate elimination half-life of the drug), however this time may greatly vary between persons. triazolam (Halcion®) – 2 hours midazolam (Versed®, Hypnovel®) – 3 hours (1.8-6 hours) oxazepam (Serax®) – 4-15 hours
What is the most prescribed benzodiazepine?
- Halcion. Halcion is one of the fastest acting of all Benzos, and it is also processed by the body faster than other Benzos.
- Klonopin. Klonopin is one of the longest acting of all Benzos. …
- Librium. Librium produces a calming effect, which is why the drug is used to treat many anxiety disorders. …
- Rohypnol. …
- Valium. …
- Xanax. …
What are the adverse effects of benzodiazepines?
The most common side effects of benzodiazepines include:
- drowsiness
- light-headedness
- confusion
- unsteadiness (especially in older people, who may fall and experience injuries)
- dizziness
- slurred speech
- muscle weakness
- memory problems
- constipation
- nausea (feeling sick)
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.
What is the equivalent of Ativan to Xanax?
Benzodiazepine equivalency tables state that 0.5mg of alprazolam (Xanax) is approximately equivalent to 1mg lorazepam (Ativan).
What are the most potent benzodiazepines?
Alprazolam is the only high-potency benzodiazepine developed in an XR formulation.
What is the drug of choice for anxiety?
SSRIs and SNRIs are often the first-line treatment for anxiety. Common SSRI brands are Celexa, Lexapro, Luvox, Paxil, and Zoloft, and common SNRI brands are Pristiq, Cymbalta, and Effexor XR. Pros: They are effective for a lot of people and they have a solid safety profile.
What is better than Xanax for anxiety?
Ativan treats more conditions than Xanax. The Food and Drug Administration (FDA) have approved the following uses: Xanax: Treatment of anxiety and panic disorders. Ativan tablets: Treatment of anxiety disorders.
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.
What is the longest lasting benzodiazepine?
Klonopin. Klonopin is one of the longest acting of all Benzos. This means that it takes longer to fully effect the patient, but it also means that it can be more powerful when abused. Klonopin has an extremely high potential for abuse and addiction, and the addiction can be very severe.
What is the least sedating benzodiazepine?
Thus, the nine benzodiazepines tested exhibited different profiles of action in the present study. Alprazolam, oxazepam and diazepam appeared least sedative, while triazolam and lorazepam were most sedative.
Which is stronger Ativan or Xanax?
Is Ativan stronger than Xanax? Neither drug is stronger than the other, but both are dosed differently due to how long they last in the body and how quickly they take effect. Is Ativan a benzo? Yes, Ativan is a benzodiazepine drug.
Does Ativan and Xanax feel the same?
The central difference between Ativan and Xanax is Ativan leaves a person’s system more quickly, reducing the chance of toxicity or side effects. Some side effects of both these drugs include sedation, dizziness, weakness, unsteadiness, and memory problems.
What’s the closest drug to Xanax?
Common benzos include Xanax (alprazolam), Valium (diazepam), and Klonopin (clonazepam ), to name a few.
How long does 1mg Ativan last?
Lorazepam tablets and liquid start to work in around 20 to 30 minutes. The full sedating effect lasts for around 6 to 8 hours. The most common side effect is feeling sleepy (drowsy) during the daytime. It’s not recommended to use lorazepam for longer than 4 weeks.
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 half life of a drug?
“Half-life” is a measure of how long it takes until half of the drug becomes inactivated.
Is Benzo a low dose?
Benzo dosages vary widely. As you can see from the table, taking a “low dose” is meaningless unless you are using a comparative scale, such as the one in the table. For example, Xanax is 10 times more powerful than Valium, and clonazepam is 60 times more powerful than temazepam.
How does the dosage of benzodiazepine vary?
USUAL. The dosage of a benzodiazepine will vary depending on the patient and his or her history of sedative use. Although similar in many ways, the choice of an agent is often based on its pharmacokinetic properties, especially onset of action, half-life, and metabolic pathway.
Why do elderly patients need lower benzodiazepine doses?
Elderly patients often require lower benzodiazepine doses due to slower metabolism of the drugs.
How much Xanax is in a day?
Diazepam (Diastat®, Valium®) 5. Lorazepam (Ativan®) 1. Oxazepam (Serax®) 15-30. Alprazolam (Xanax®): The initial dose is 0.25 mg two to three times a day; the dose can be increased by 0.5-1 mg daily every 3-4 days; the usual therapeutic dose is 2-3 mg total/day, with twice daily or three times a day dosing.
Why are benzodiazepines used?
Benzodiazepines are often used to “bridge” patients who are starting an “antidepressant” for anxiety, since the therapeutic effects may be delayed, and patients may experience stimulating side effects initially. Benzodiazepines may be more effective than antidepressants for social anxiety disorder [9] [10].
What receptors do benzodiazepines use?
Benzodiazepines act through the gamma-aminobutyric acid (GABA) A receptor, which regulates chloride entry into neurons, resulting in neuronal hyperpolarization [1].
What is a sample topic from the Johns Hopkins Psychiatry Guide?
Benzodiazepines is a sample topic from the Johns Hopkins Psychiatry Guide.
How much should chlordiazepoxide be decreased?
Chlordiazepoxide: Patients with renal impairment (CrCl less than 10 mL/min) should have their doses decreased by 50%
