Management of Benzodiazepine Withdrawal – WS DASSA August Benzodiazepine equivalents. Name. Duration of. Action #. Approx dose. Alprazolam. Xanax. Y**. B. Chlordiazepoxide Librium. Y**. B,E. Clonazepam. Klonopin. – N**. A,B,D,E. Diazepam. Valium. This Benzodiazepine Equivalence Table is based on the extensive research and clinical experience of Professor C Heather Ashton, DM, FRCP.
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Squivalency psychometric study based on flicker sensitivity, reaction time and digit symbol substitution test. Because published benzodiazepine dose conversions are based on oral administration, parenteral formulations may not use the same conversion ratio.
This calculator only accounts for differences in bioavailability with midazolam.
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A Comprehensive Study Guide. Due to discrepancies in the literature, many benzodiazepine conversions may have a potential conversion range that is extremely variable eg, by a factor of 10x or greater.
Given the numerous issues with benzodiazepine equivalence, the importance of reasonable clinical judgment, clinical experience, appropriate patient monitoring, and dose titration are of even greater significance.
Can J Hosp Pharm. Br J Clin Pharmacol. Dose equivalence of midazolam and triazolam. Benzodiazepine Equivalents Conversion Calculator.
Home Academy Blog About. Related Bing Images Extra: Handbook of Psychiatric Benzodoazepine. Phenobarbital pharmacokinetics and bioavailability in adults. Search Bing for all related images. The Ashton Manual Online. Benzodiazepines Equivalents Alprazolam Xanax Alprazolam 0. Evaluation of an alcohol withdrawal protocol and a preprinted order set at a tertiary care hospital.
Although access to this website is not restricted, the information found here is intended for use by medical providers. In addition to an overall lack equivalenxy evidence to support specific conversions, there are a number of other limitations that should be recognized:. Although phenobarbital and secobarbital are not benzodiazepines, they are commonly grouped with this drug class and cited within benzodiazepine conversion charts due to their use in alcohol withdrawal.
In fact, most benzodiazepine equivalence estimates are based on expert opinion, uncited tables in published documents, and clinical practice. Unlike nearly all other benzodiazepine conversions, the conversion between intravenous midazolam and lorazepam has been well studied in mechanically ventilated patients.
It should be noted, however, that this conversion is based on chronic administration of continuous intravenous lorazepam or midazolam. The following bioavailabilities are available based on published literature.
Updated June 3, For more information, please view the website disclaimer. Indications Benzodiazepine Withdrawal Barbiturate withdrawal Sedative eqivalency. Absolute bioavailability of oral and intramuscular diazepam: These images are a random sampling from a Bing search on the term “Benzodiazepine Equivalents.
Note how the large variances in oral bioavailability highlight the significant inter-patient variability:. All benzodiazepine conversions used in this calculator are based on published equipotent dose estimates. Accessed December 31, Bsnzodiazepine of withdrawal syndromes and relapse prevention in drug and alcohol dependence. Most benzodiazepines included in this calculator are only available as oral dosage forms.
These wide ranges of confidence highlight the lack of firm, evidence-based literature supporting specific conversion ratios. Click here to start from scratch and enter your own patient data.
Pharmacokinetics of midazolam following intravenous and oral administration in patients with chronic liver disease and in healthy subjects. Miscellaneous Sedative Equivalents References Extra: How they work and equivwlency to withdraw; The Ashton Manual. Lieberman JA, Tasman A. While barbiturates do share similar pharmacology to benzodiazepines, they have a more concerning safety profile with a higher incidence of respiratory depression.
Page Contents Page Contents Related Topics in Chemical Dependency. Barbiturate Abuse Benzodiazepine Abuse. The following guiding principles govern the calculator’s logic:. Effect of age, gender, and obesity on midazolam kinetics.
Related links to equivapency sites from Bing. We’ve benzodiwzepine out some of the form to show you this clinical calculator in action.