Benzodiazepine Equivalent

Aka: Benzodiazepine Equivalent, Barbiturate Equivalent, Sedative Equivalent

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II. Indications

  1. Benzodiazepine Withdrawal
  2. Barbiturate withdrawal
  3. Sedative withdrawal

III. Preparations: Benzodiazepines Equivalents

  1. Background
    1. Equivalents are estimated based on 2 sources (VA/DOD and Ashton Manual) and noted when discrepant
    2. VA/DOD estimations are used by American Society of addiction medicine
  2. Alprazolam (Xanax)
    1. Alprazolam 1 mg (Ashton 0.5 mg) is equivalent to 10 mg Diazepam
    2. Diazepam= Alprazolam Dose x10 (Asthton x20)
    3. Phenobarbital = Dose x30
  3. Chlordiazepoxide (Librium, Limbitrol)
    1. Chlordiazepoxide 25 mg is equivalent to 10 mg Diazepam
    2. Diazepam= Chlordiazepoxide Dose x0.4
    3. Phenobarbital = Dose x1.2
  4. Clonazepam (Klonopin)
    1. Clonazepam 1 mg (Ashton 0.5 mg) is equivalent to 10 mg Diazepam
    2. Diazepam= Clonazepam Dose x10 (Asthton x20)
    3. Phenobarbital = Dose x7.5
  5. Lorazepam (Ativan)
    1. Lorazepam 2 mg (Ashton 1 mg) is equivalent to 10 mg Diazepam
    2. Diazepam= Lorazepam Dose x5 (Ashton x10)
    3. Phenobarbital = Dose x15.0
  6. Oxazepam (Serax) 60 mg
    1. Oxazepam 30 mg (Ashton 20 mg) is equivalent to 10 mg Diazepam
    2. Diazepam= Oxazepam Dose x0.33 (Ashton x0.5)
    3. Phenobarbital = Dose x3.0
  7. Temazepam (Restoril)
    1. Temazepam 15 mg (Ashton 20 mg) is equivalent to 10 mg Diazepam
    2. Diazepam= Temazepam Dose x0.66 (Ashton x0.5)
    3. Phenobarbital = Dose x3.0
  8. Flurazepam (Dalmane)
    1. Flurazepam 15-30 mg is equivalent to 10 mg Diazepam
    2. Diazepam= Dose x0.33
    3. Phenobarbital = Dose x2.0
  9. Halazepam (Paxipam)
    1. Halazepam 20 mg is equivalent to 10 mg Diazepam
    2. Diazepam= Dose x0.5
    3. Phenobarbital = Dose x0.75

IV. Preparations: Barbiturate Equivalents

  1. Butabarbital (Butisol)
    1. Valium = Dose x0.1
    2. Phenobarbital = Dose x0.3
  2. Pentobarbital (Nembutal)
    1. Valium = Dose x0.1
    2. Phenobarbital = Dose x0.3
  3. Secobarbital (Seconal)
    1. Valium = Dose x0.1
    2. Phenobarbital = Dose x0.3
  4. Phenobarbital
    1. Valium = Dose x0.33

V. Preparations: Miscellaneous Sedative Equivalents

  1. Glycerol: Meprobamate (Equanil)
    1. Valium= Dose x0.025
    2. Phenobarbital = Dose x0.075
  2. Piperidinedione: Glutethimide (Doriden)
    1. Valium = Dose x0.04
    2. Phenobarbital = Dose x0.12
  3. Quinazoline: Methaqualone
    1. Valium = Dose x0.03
    2. Phenobarbital = Dose x0.1

VI. References

  1. Ashton (2005) Curr Opin Psychiatry 18:249-55 [PubMed]
  2. Butler (2026) Am Fam Physician 113(6): 611-4 [PubMed]
  3. Tauseef (2012) BJMP 5(1): a501 [PubMed]

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