Benzodiazepine Equivalents

FOR ORAL DRUGS AVAILABLE IN AUSTRALIA

Name Duration of # action Approx dose equiv to 5mg diazepam
0.5 1 mg 3 6 mg 10 15 mg 0.25 0.5 mg 5 mg 1 2 mg 0.5 1 mg 5 15 30 mg 10 20 mg 0.25 mg

Trade names (in MIMS)

Alprax, Kalma,Xanax, Zamhexal Lexotan Frisium Rivotril Antenex, Ducene, Ranzepam, Valium, Valpam Hypnodorm Ativan Alodorm, Mogadon Alepam, Murelax, Serepax Normison, Temaze, Temtabs Halcion

Tablet strengths

No per PBS script

Alprazolam Bromazepam Clobazam Clonazepam Diazepam Flunitrazepam Lorazepam Nitrazepam Oxazepam Temazepam Triazolam Z Drugs Zolpidem Zopiclone

short intermed intermed long long intermed intermed long short short v.short

0.25mg, 0.5mg, 1mg & 2mg 3mg & 6mg 10mg 0.5mg & 2mg 2mg & 5mg 1 mg 1mg & 2.5mg 5mg 15mg & 30mg 10mg 0.125mg

50 Authority Non PBS Non PBS 200 Authority 50 Non PBS Non PBS 25 25 50 Authority 25 Non PBS

v.short v.short

*10 mg *7.5 mg

Dormizol, Somidem, Stildem, Stilnox, Zolpibell Imovane, Imrest

10mg 6.25 & 12.5mg (modified release) 7.5mg

Non PBS Non PBS

# Duration of action (approx.):

Very short Short Intermediate Long

<6 hours <12 hours <24 hours >24hours

Different sources quote a range of varying equivalents figures in bold are recommended as most consistent with references and clinical experience. * Values only available from one reference source (Reference 3).

References 1. 2. 3. Australian Medicines Handbook 2008 Therapeutic Guidelines: Psychotropic 2008 Oxford Specialist Handbook in Addiction Medicine 2009 Latt et al 4. 5. 6. NPS Newsletter 4 June 1999 Alcohol and other drugs: A handbook for health professionals 2004 NCETA consortium Benzodiazepine conversion chart DASC

See PBS website for prescribing details: http://www.pbs.gov.au/html/healthpro/search/results?term=subsidy

Urine drug info: Routine urinalysis (IMVS) will detect the benzodiazepines above (not Z drugs). Where use has been heavy, metabolites may be detected for at least 6-8 weeks. Confirmation urinalysis for specific benzodiazepines may be requested refer to metabolism for interpretation as some benzodiazepines eg oxazepam, temazepam may appear as metabolites of others see metabolism pathway.

Benzodiazepine Metabolism
Diazepam

Temazepam*

Desmethyldiazepam* Alprazolam

hydroxymetabolites* Oxazepam* amino metabolite Nitrazepam Flunitrazepam desmethyl* metabolite Conjugation (glucuronidation) metabolites

Clonazepam

amino metabolite Urinary Excretion

Lorazepam

* = active metabolite