Generic name | Trade name | Usual single adult dose (oral) | Oral peak (hours) | Half-life (hours) parent | Metabolite activity* | CYP3A4 interactions¶ |
Benzodiazepines | ||||||
Short-acting (<12 hours) | ||||||
Midazolam | Versed | 0.25 to 0.5 mg/kg; maximum 20 mg (oral formulation not used in adults; dosing is for pediatric sedation) | <1 to 2.5 | 1.5 to 3 | Active | Yes |
Triazolam | Halcion | 0.125 to 0.25 mg | 0.7 to 2 | 2 to 3 | Inactive | Yes |
Intermediate-acting (12 to 24 hours) | ||||||
Alprazolam | Xanax | 0.25 to 0.5 mg | 1 to 2 | 6 to 27 | Inactive | Yes |
BromazepamΔ | Lexotan, Lexotanil | 2 to 6 mg | 1 to 2 | 8 to 20 | Inactive | Limited |
Estazolam | Prosom | 0.5 to 2 mg | 0.5 to 6 | 10 to 24 | Inactive | Limited |
EtizolamΔ◊ | Depas, Etilaam, Etizola | 0.5 to 1 mg | 0.5 to 3 | 3 to 6 | Active (half-life 8 hours) | Yes |
Lorazepam | Ativan | 0.5 to 3 mg | 2 to 4 | 10 to 20 | Inactive | No |
Oxazepam | Serax | 10 to 30 mg | 2 to 4 | 5 to 20 | Inactive | No |
Temazepam | Restoril | 7.5 to 30 mg | 1 to 2 | 3 to 19 | Inactive | No |
Long-acting (>24 hours) | ||||||
Chlordiazepoxide | Librium | 5 to 25 mg | 0.5 to 4 | 5 to 30 | Active | Yes (CYP3A4 inhibitors); limited (CYP3A4 inducers) |
Clobazam | Onfi | 10 to 20 mg | 0.5 to 4 | 36 to 42 | Active (half-life 71 to 82 hours) | Limited (interacts via CYP2C19) |
Clonazepam | Klonopin | 0.25 to 0.5 mg | 1 to 2 | 18 to 50 | Inactive | Limited |
Clorazepate | Tranxene | 7.5 to 15 mg | 1 to 2 | Prodrug | Active (half-life 20 to 160 hours) | Limited |
Diazepam | Valium | 2 to 10 mg | 0.5 to 1 | 20 to 50 | Active | Yes (also interacts via CYP2C19) |
FlunitrazepamΔ | Rohypnol | 0.5 to 2 mg | 1 to 2 | 16 to 35 | Active | Limited |
Flurazepam | Dalmane | 15 to 30 mg | 0.5 to 1 | 2 to 4 | Active | Limited |
Nonbenzodiazepine hypnotics | ||||||
Eszopiclone | Lunesta | 1 to 3 mg | 1 | 6 to 9 | Active (less than parent) | Yes |
Zaleplon | Sonata | 5 to 15 mg | 1 | 1 | Inactive | Yes (CYP3A4 inducers); limited (CYP3A4 inhibitors) |
Zolpidem | Ambien, Edluar, Zolpimist | 5 to 10 mg | 1 to 2 | 1.5 to 8.4 | Inactive | Yes |
ZopicloneΔ | Imovane | 3.75 to 7.5 mg | <2 | 5 to 7 | Active (less than parent) | Yes |
* Half-life of active metabolite(s) may exceed 50-100 hours.
¶ A list of strong and moderate CYP3A inhibitors and inducers is provided in a separate table within UpToDate. When initiating or altering drug therapy, use of a drug interactions database such as the drug interactions program is advised.
Δ Not available in United States.
◊ Etizolam is a thienodiazepine derivative and benzodiazepine receptor agonist; its pharmacologic effects are similar to those of classical benzodiazepines (eg, diazepam).[1]Do you want to add Medilib to your home screen?