Switching from alprazolam to clonazepam

    • [PDF File]Benzodiazepine and Z-Drug Safety Guideline - Kaiser Permanente


      • Long-acting (half-life greater than 24 hours), such as diazepam, clonazepam, clorazepate, chlordiazepoxide, and flurazepam. Z-drugs ... • Dependence: Potent benzodiazepines with short or intermediate half-lives (e.g., alprazolam, lorazepam) appear to carry the highest risk of causing problems with dependence. Psychological

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      Clonazepam (Rivotril) 20 mg Clorazepate (Tranxene) 1 mg Chlordiazepoxide (Librium) ¾ mg ... Loprazolam (Dormonoct) 8 mg Lormetazepam (Noctamid) 8 mg Clobazam (Frisium) ¾ mg Alprazolam (Xanax) 12 mg Bromazepam (Lexotan) 2 mg Zopiclone (Zimivane, Zilese)* ¾ mg ** Zolpidem ... This means switching to 5mg nitrazepam tablets rather than 10mg, to ...

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    • [PDF File]Effective Treatments for PTSD: Helping Patients Taper from Benzodiazepines


      Consider admission due to greater medical risks Consider switching to long half-life drug (diazepam or clonazepam) Reduce dose initially by 25-30% Then reduce dose by approximately 5-10% daily to weekly Consider anticonvulsant for high dose withdrawal Therapeutic Doses – Bedtime Dosing (Qhs) Reduce by approximately 25% weekly

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    • [PDF File]Recommendations for Tapering Benzodiazepines - Superior HealthPlan


      Discontinue the current benzodiazepine treatment and switch to diazepam 2 mg BID x 2 days, followed by 2 mg every day x 2 days, then stop. For high doses, may begin with 5 mg BID x 2 days and then continue as described. Use adjuvant medications as mentioned above for rebound anxiety and other symptoms. BASIC PRINCIPLES

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    • [PDF File]Effective Treatments for PTSD: Helping Patients Taper ... Home


      • Consider switching to long half-life drug (diazepamor clonazepam) • Reduce dose initially by 25-30% ... • CBT concurrent with slow alprazolam taper showed no difference in success of taper, however, at 6-month follow up, 50% of non-CBT group and none of CBT group had

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    • [PDF File]Reducing from Benzodiazepines & Recovery from Withdrawal


      Reduction 4 1mg Alprazolam 1mg Alprazolam 1mg Alprazolam 3mg Alprazolam Reduction 5 .75mg Alprazolam 1mg Alprazolam 1mg Alprazolam 2.75mg Alprazolam Reduction 6 .75mg Alprazolam .75mg Alprazolam 1mg Alprazolam 2.5mg Alprazolam Reduction 7 .75mg Alprazolam .75mg Alprazolam .75mg Alprazolam 2.25mg Alprazolam Transfer 1 0.5mg Alprazolam

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    • [PDF File]Calculating equivalent doses of oral benzodiazepines


      switching benzodiazepines may be advantageous for a variety of reasons, e.g. to a drug with a different half-life pre-discontinuation (4) or in the event of non-availability of a specific benzodiazepine. with relatively short-acting benzodiazepines such as alprazolam and lorazepam, it is not possible to achieve a smooth decline in blood and …

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    • [PDF File]Pharmacist Toolkit: Benzodiazepine Taper - CLOUD


      but switching to an alternative agent may be helpful for some patients.46 Equivalent doses of benzodiazepines are included in the table below. Of note, high doses of alprazolam may not have complete cross-tolerance with other agents, so a gradual switch to a longer-acting agent, such as clonazepam, may be necessary.

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    • [PDF File]Clinical Guidelines for Tapering Benzodiazepines - CBH


      Changing to a longer-acting agent can help prevent rebound anxiety and withdrawal symptoms. In the example below, a tapering plan for an individual originally taking 1mg QID (4mg total daily dose) of alprazolam (equivalent to 40mg diazepam) is shown.

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    • [PDF File]Calculating equivalent doses of oral benzodiazepines


      For people withdrawing from these potent, short-acting drugs it has been advised that they switch to an equivalent dose of a benzodiazepine with a long half life such as diazepam (5). Diazepam is available as 2mg tablets which can be halved to give 1mg doses. This means the dose can be reduced in stages of 1mg every 1-4 weeks or more.

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    • [PDF File]Benzodiazepine Tapering Flow Sheet


      Alprazolam Clonazepam (Klonopin) Oxazepam (Se rak) Triazolam (Halcion) Phenobarbital (ba rbituate) Half-life (hrs) 5—30 h 20-50 h 6—20 h 18-39 h 10-20 h 3—21 h 1.6—5.5h 53-118 h . Title Nebraska Pain Management Guidance Document v3.2 Author: areynol Created Date:

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    • [PDF File]Benzodiazepine withdrawal


      from zopiclone 7.5 mg per day or less: reduce the daily dose by half of a 3.75 mg tablet (1.875 mg) every 2 weeks. the target dose for when to stop is when the person is taking only half of a 3.75 mg tablet. if stopping is not possible at the target dose, one option is to convert to diazepam to complete the withdrawal, although this is …

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    • [PDF File]Recommend Deprescribing Continue BZRA


      Switching from a short-acting BZRA to a long-acting one has been recommended in the past but has not been shown to be more effective than . slowly lowering the dose of a short-acting drug. Pottie K, Thompson W, Davies S, Grenier J, Sadowski C, Welch V, Holbrook A, Boyd C, Swenson JR, Ma A, Farrell B (2016). Evidence-based

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      Switch to alprazolam XR Take largest dose at bedtime to avoid sedative effects during the day Switch to another agent Administer flumazenil if side effects are severe or life-threatening Best Augmenting Agents for SideEffects Many side effects cannot be improved with an augmenting agent DOSING AND USE Usual Dosage Range

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    • [PDF File]Benzodiazepines: Withdrawal and Tapering - CHI St. Gabriel's Health


      2. Lower prescription to Alprazolam 1 MG #60 for one month, then #30 the next month, then 0.5 MG #30 then discontinue 3. Switch to clonazepam 1 mg TID for two weeks, then 0.5 mg TID two weeks, then 0.25 TID two weeks, then discontinue 4. Phenobarbload and taper over 10 weeks, 10% per week Binge benzo use

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    • [PDF File]Managing Benzodiazepine Use in Older Adults


      For those who have been taking a long half-life benzodiazepine for only a short-term (e.g. up to 4 weeks of clorazepate or clonazepam), taper over 1 week Alprazolam For doses

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    • [PDF File]Management of Benzodiazepine Use


      a) Choose the agent: Consider switching from a shorter-acting agent (alprazolam, lorazepam) to a longer-acting agent (diazepam, clonazepam) during BZD taper. This step is not mandatory, but a long-acting agent provides slower onset of withdrawal symptoms, and therefore a smoother taper.

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      Diazepam initially 1-2 mg TDS (titrating to maximum of 5-10mg TDS) OR In hepatic impairment / elderly - lorazepam 500 micrograms – 1 mg daily in divided doses (max 2-4mg daily in divided doses) For severe anxiety AND insomnia: Diazepam initially 2.5mg – 5mg ON (titrate up to 5mg– 15mg ON) For panic disorder [unlicensed indication]

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    • [PDF File]Re-evaluating the Use of Benzodiazepines - Veterans Affairs


      high dose alprazolam may not have complete cross tolerance, a gradual switch to clonazepam or diazepam before taper may be appropriate; in geriatric patients consider tapering the short acting agent until withdrawal symptoms are seen then switch to a longer acting agent; other treatment modalities

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