Benzodiazepine Equivalency
Evidence-based information on benzodiazepine equivalency is limited, and different sources may disagree; hence the use of dose ranges in this table. Even so, the data listed in this table are estimates, and their use requires clinical judgement.
Particularly when tapering a dose, a very gradual reduction with attention to patient response is required. This is particularly the case for patients who have been taking benzodiazepines for an extended period of time. When escalating a dose, it is preferable to err on the side of caution, to avoid overshooting and causing respiratory depression.
Table 1. Benzodiazepine Equivalency [1, 2, 3, 4] (Open Table in a new window)
|
Approximately Equivalent Oral Doses, mg |
Time to Peak Level, hours |
Half-life, hours |
Alprazolam (Xanax) |
0.5–1 |
1-2 |
12 |
Bromazepam (Lexotan)* |
3–6 |
1-4 |
20 |
Chlordiazepoxide (Librium) |
10–25 |
1-4 |
100 |
Clonazepam (Klonopin) |
0.25–0.5 |
1-4 |
34 |
Clorazepate (Tranxene) |
7.5–15 |
0.5-2 |
100 |
Diazepam (Valium) |
5–10 |
1-2 |
100 |
Flurazepam (Dalmane) |
15–30 |
0.5-1 |
100 |
Lorazepam (Ativan) |
1–2 |
1-4 |
15 |
Nitrazepam (Mogadon)* |
2.5–10 |
0.5-2 |
30 |
Oxazepam (Serax) |
15–30 |
1-4 |
8 |
Quazepam (Doral) |
10–20 |
1.5 |
25-41 |
Temazepam (Restoril) |
10–20 |
2-3 |
11 |
Triazolam (Halcion) |
0.25–0.5 |
1-2 |
2 |
*Not available in the United States |