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    Benzodiazepine Conversion Calculator

    Provides equivalents between different benzodiazepines.
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    IMPORTANT

    This calculator should be used as a reference for oral benzodiazepine conversions. Equipotent benzodiazepine doses are reported as ranges due to paucity of literature supporting exact conversions, thus reported ranges are based on expert opinion and clinical experience published in psychiatric literature.

    INSTRUCTIONS

    Do not use to calculate initial dose for a benzo-naïve patient.

    When to Use
    Pearls/Pitfalls

    Intended for use when interchanging benzodiazepines and should not be used to help calculate an initial dose for a benzodiazepine naïve patient.

    • Durations of action:

      • Very short acting: <6 hours.

      • Short acting: 6-12 hours (alprazolam, oxazepam).

      • Intermediate acting: 12-24 hours (lorazepam, temazepam).

      • Long acting: >24 hours (chlordiazepoxide, diazepam, clonazepam, triazolam).

    • This calculator does not account for age, organ function, and inter-patient variability that may alter the pharmacokinetics, peak effect, and duration of action.

    • Selecting doses on the lower end of the reported range may result in lower risk of unwanted oversedation.

    • Dosing conversions may not be adequate when treating such conditions as status epilepticus or alcohol withdrawal. Disease-state specific guidelines should be utilized.  

    Alprazolam (Xanax)
    Chlordiazepoxide (Librium)
    Diazepam (Valium)
    Clonazepam (Klonopin)
    Lorazepam (Ativan)
    Oxazepam (Serax)
    Temazepam (Restoril)
    Triazolam (Halcion)
    mg
    Alprazolam (Xanax)
    Chlordiazepoxide (Librium)
    Diazepam (Valium)
    Clonazepam (Klonopin)
    Lorazepam (Ativan)
    Oxazepam (Serax)
    Temazepam (Restoril)
    Triazolam (Halcion)

    Result:

    Please fill out required fields.

    Next Steps
    Evidence

    Advice

    Abrupt discontinuation of benzodiazepines should be avoided as this can precipitate withdrawal symptoms, including severe agitation and seizure activity.

    Formula

    Benzodiazepine

    Duration of action

    Alprazolam (Xanax)

    Short

    Chlordiazepoxide (Librium)

    Long

    Diazepam (Valium)

    Long

    Clonazepam (Klonopin)

    Long

    Lorazepam (Ativan)

    Intermediate

    Oxazepam (Serax)

    Short

    Temazepam (Restoril)

    Intermediate

    Triazolam (Halcion)

    Long

     

    Conversion factors (highlighted cell is used for example below):

    Example (highlighted cell):

    To convert 1 mg Xanax to Librium, multiply 1 mg x 25. For a range of equipotent doses, multiply by 15 and 50.

    • 1 mg Xanax ≈ 25 mg Librium

    • 15-50 mg ≈ range of Librium dose equipotent to 1 mg Xanax

    Literature

    Original/Primary Reference

    Research PaperGelenberg AJ, Bassuk, EL. Practitioner's Guide to Psychoactive Drugs. 4th Edition. Springer, 1997. Research PaperAshton H. Benzodiazepines: How they work and how to withdraw. The Ashton Manual, 2002.Research PaperGitlow S. Practical Guides in Psychiatry: Substance Use Disorders, 2nd Edition. Lippincott Williams & Wilkins, 2006.Research PaperTyrer PJ, Silk KR. Cambridge Textbook of Effective Treatments in Psychiatry. Cambridge University Press, 2008.Research PaperLatt N, Conigrave K, Saunders JB, Marshall EJ, Nutt D. Addition Medicine, 2nd Edition. Oxford Specialist Handbooks, 2009.Research PaperLabatte LA, Fava M, Rosenbaum JF, Arana GW. Handbook of Psychiatric Drug Therapy, 6th Edition. Lippincott Williams & Wilkins, 2010.Research PaperLorazepam [package insert]. Corona (CA): Watson Laboratories, 2010.Research PaperDiazepam [package insert]. San Francisco (CA): Genentech Laboratories, 2016.Research PaperProcyshyn RM, Bezchlibnyk-Butler KZ, Jeffries JJ. Clinical Handbook of Psychotropic Drugs, 22nd Edition. Hogrefe, 2017.
    Content Contributors
    • Jenny L. Koehl, PharmD
    Reviewed By
    • Bryan D. Hayes, PharmD
    Content Contributors
    • Jenny L. Koehl, PharmD
    Reviewed By
    • Bryan D. Hayes, PharmD