TABLE 3

Pharmacokinetic characteristics of benzodiazepines

	Chlordiazepoxide	Diazepam	Lorazepam	Oxazepam
Dosage forms	Oral	Oral, gel, intramuscular, intravenous	Oral, intramuscular, intravenous	Oral
Equivalent dosages	25 mg	5 mg	1 mg	15 mg
Half-life	5–15 hours with active metabolites > 100 hours	30–60 hours with active metabolites >100 hours	10–20 hours	5–20 hours
Active metabolites	Desmethylchlordiazepoxide, desmoxepam, desmethyldiazepam	Desmethyldiazepam	None None
Lipid solubility	Less lipophilic than diazepam; slower onset of action	Highly lipophilic; quick onset of action	Less lipophilic than diazepam; slower onset of action	Less lipophilic than diazepam; slower onset of action
Effect of hepatic disease	Half-life increases in patients with cirrhosis	Half-life increases in patients with cirrhosis, acute viral hepatitis, chronic active hepatitis	Half-life increases in patients with cirrhosis	Half-life increases in patients with cirrhosis
Effect of renal disease	No effect	Decreases protein binding	Half-life increases; impaired elimination	No effect
Effect of older age	Slower absorption; half-life increases	Half-life increases; decreased protein binding	No effect on half-life; decreased protein binding	No effect on half-life; decreased protein binding

Bird RD, Makela EH. Alcohol withdrawal: what is the benzodiazepine of choice? Ann Pharmacother 1994; 28:67–71. Copyright 1994, Annals of Pharmacotherapy; Reproduced and adapted with permission from SAGE Publications, Inc.