Benzodiazepine Conversion Calculator

Benzodiazepine Conversion Calculator
Source Benzodiazepine
mg
Equivalent Dose: –
–
–
Provides equivalents between different benzodiazepines.

When to Use

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

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) Short 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

Pearls / Pitfalls

Durations of action: Very short acting: <6 hours. Short acting: 6-12 hours (ALPRAZolam, oxazepam, triazolam). Intermediate acting: 12-24 hours (LORazepam, temazepam). Long acting: >24 hours (chlordiazePOXIDE, diazePAM, clonazePAM). 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.

Advice

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

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