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.