19
Table 7. Benzodiazepine Approximate Dose Equivalents to
10 mg Oral Diazepam
a
Benzodiazepine
Anatomical Therapeutic
Chemical classification
system (ATC)
Therapeutic Class
US Department of
Veterans Affairs (VA)/US
Department of Defense
(DoD) SUD CPG (2021)
Ashton
Manual
(2002)
b
Alprazolam Anxiolytic 1 0.5
Chlordiazepoxide Anxiolytic 25 25
Clonazepam Antiepileptic 1 0.5
Clorazepate Anxiolytic 15 15
Diazepam Anxiolytic 10 10
Estazolam Sedative–Hypnotic 1 1–2
Flurazepam Sedative–Hypnotic 15 15–30
Lorazepam Anxiolytic 2 1
Oxazepam Anxiolytic 30 20
Quazepam Sedative–Hypnotic 10 20
Temazepam Sedative–Hypnotic 15 20
Triazolam Sedative–Hypnotic 0.25 0.5
a
ese doses are intended for guidance only. Clinical decisions on dose should be
individualized based on the patient response.
b
Same equivalents in Ashton, H. Benzodiazepine Equivalence Table [Online]. Revised
April 2007. https://www.benzo.org.uk/bzequiv.htm and Ashton CH. e diagnosis and
management of benzodiazepine dependence. Curr Opin Psychiatry. 2005;18(3):249–255.
doi:10.1097/01.yco.0000165594.60434.84.
Conversion to diazepam equivalents is not straightforward and depends
on patient factors such as age, metabolism, and other medications.
Some patients may require higher doses than the reported equivalent,
while others may require lower doses. Transition to an alternative BZD
may be more successful if the doses are slowly transitioned over 1–2
weeks rather than 1–2 days.
Determining an equivalent BZD dose to begin tapering is complicated
when patients are taking BZDs from the illicit drug market. In general,
clinicians should titrate the BZD dose to the minimum dose necessary to
control a patient's withdrawal symptoms and taper from that point.
Benzodiazepine Dose Equivalents
