Benzodiazepine Conversion Calculator
Clinical tool for safe benzodiazepine conversions based on lorazepam equivalents
⚠️ Clinical Warning: These conversions are estimates only. Individual patient factors, tolerance, age, hepatic function, and concurrent medications significantly affect conversion ratios. Always start with conservative doses (typically 25-50% of calculated equivalent) and titrate based on clinical response. Consider tapering schedules for chronic users to prevent withdrawal.
Convert From:
Convert To:
Quick Conversions:
💡 Clinical Pearls:
- • Half-life considerations: Long-acting benzos (diazepam, clonazepam) may require less frequent dosing
- • Hepatic impairment: Prefer oxazepam, lorazepam, or temazepam (no active metabolites)
- • Elderly patients: Start with 25-50% of calculated dose due to increased sensitivity
- • Cross-tolerance: May not be complete - monitor closely during transitions
- • Withdrawal risk: Rapid conversion without tapering can precipitate withdrawal in chronic users
Lorazepam Equivalency Reference
| Medication | Equivalent to 1mg Lorazepam | Half-life (hours) | Onset | Clinical Notes |
|---|---|---|---|---|
| Alprazolam (Xanax) | 0.5 mg | 11-15 | Fast | High potency, dependence risk |
| Clonazepam (Klonopin) | 0.5 mg | 18-50 | Intermediate | Long-acting, good for anxiety |
| Diazepam (Valium) | 10 mg | 20-100 | Fast | Very long-acting, active metabolites |
| Lorazepam (Ativan) | 1 mg | 8-25 | Intermediate | Reference standard, no active metabolites |
| Chlordiazepoxide (Librium) | 25 mg | 5-30 | Intermediate | First benzodiazepine, alcohol withdrawal |
| Oxazepam (Serax) | 15 mg | 4-15 | Slow | Safe in liver disease, elderly |
| Temazepam (Restoril) | 15 mg | 3-18 | Intermediate | Primarily for sleep, no active metabolites |
| Triazolam (Halcion) | 0.25 mg | 1.5-5 | Fast | Ultra-short acting, amnesia risk |
| Midazolam (Versed) | 2 mg (IV/IM) | 1-4 | Very fast | Procedural sedation, ICU use |
| Clorazepate (Tranxene) | 15 mg | 20-100 | Fast | Prodrug converted to nordiazepam |
📋 Tapering Guidelines:
Short-term use (<4 weeks):
- • Reduce by 25-50% every 1-3 days
- • Monitor for rebound anxiety/insomnia
- • May discontinue more rapidly if tolerated
Long-term use (>4 weeks):
- • Reduce by 10-25% every 1-2 weeks
- • Consider switching to long-acting agent first
- • Monitor for withdrawal symptoms
- • May take several months for complete taper
⚖️ Disclaimer: This calculator is for educational purposes only and should not replace clinical judgment. Always consider individual patient factors, contraindications, and drug interactions. Consult current prescribing information and clinical guidelines. Use the lowest effective dose for the shortest duration possible.