Examples of symptom-triggered dosing and CIWA-Ar scores
| CIWA-Ar score | Chlordiazepoxide dose (oral)a | Lorazepam dose (oral or intravenous)a | Reassess CIWA-Ar and vital signs, and redose |
|---|---|---|---|
| 0–7 | No medication necessary | No medication necessary | Every 2 hours |
| 8–10 | 25–50 mg | 1–2 mg | Every 2 hours |
| 11–15 | 50–75 mg | 2–3 mg | Every 1–2 hours |
| 16–19 | 75–100 mg | 3–4 mg | Every 1–2 hours |
| 20 or greater | Evaluation for patient transfer to intensive care unit | ||
| CIWA-Ar < 8 for three consecutive checks | Reassess or redose to every 4 hours. If score remains < 8 every 4 hours on three checks, reassess or redose every 8 hours. If CIWA-Ar score is < 8 for 48 hours, discontinue monitoring. | ||
↵a Patients with liver failure and elderly patients should be started on lower doses. CIWA-Ar = revised Clinical Institute Withdrawal Assessment for Alcohol scale (Table 1)
Based on references 15, 16, and 19.