Intermediate Acting:
Alprazolam (Xanax) 0.5 mg OP
- Peak: 1-2 hrs
- Half-life: 6-12hrs
- Use: anxiolytic
Lorazepam (Ativan) 1 mg PO
- Peak: 2 hrs
- Half-life: 12 hrs
- Use: anxiolytic, anticonvulsant, hypnotic
Clonazepam (Klonopin) 0.5 mg PO
- Peak: 1-4 hrs
- Half-life: 30-40 hrs
- Use: anxiolytic, anticonvulsant
Temazepam (Restoril) 10 mg PO
- Peak: 1-2 hrs
- Half-life: 8-10 hrs
- Use: anxiolytic, hypnotic
Long Acting:
Diazepam (valium) 5 mg PO
- Peak: 1-1.5 hrs
- Half-life: 48-100 hrs (active metabolite up to 200 hrs)
- Use: anxiolytic, muscle relaxant, anticonvulsant
Chlordiazepoxide (Librium) 25 mg PO
- Peak: 2- 4 hrs
- Half-life: 24-48 hrs. (active metabolite up to 200 hrs)
- Use: anxiolytic, alcohol withdrawal
Notes:
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Hypnotics are used to induce sleep
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There is considerable variability in the reported ranges for peak concentration and half-life. Wherever possible, data is extracted from package inserts.
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Long acting benzodiazepines have active metabolites.
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Dosing listed above is for equivalence in ORAL administration only.
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Careful consideration should be given to patient age, liver function, and co-ingestion of metabolic inhibitors or other non-benzodiazepine sedative medications (opioids, alcohol, etc).
References:
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Benzodiazepines: How They Work And How To Withdraw (aka The Ashton Manual), Chapter : The Benzodiazepines, What They Do In The Body; Online Manual
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DailyMed, Official Provider Of FDA Label Information; Website
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Medscape Benzodiazepine Equivalence Table; July 2018; Table
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Management Of Benzodiazepine Withdrawal; Government Of South Australia; SA Health; WS2.4 Handout