From the Research
When converting from Valium (diazepam) to Ativan (lorazepam), the general equivalence ratio is 10 mg of diazepam equals approximately 1-2 mg of lorazepam, as supported by the most recent study 1. This means that 5 mg of diazepam would be roughly equivalent to 0.5-1 mg of lorazepam. The conversion should be individualized based on the patient's clinical response, as sensitivity to benzodiazepines varies between patients. When making this conversion, it's essential to consider that lorazepam has a shorter half-life (10-20 hours) compared to diazepam (20-100 hours), which may necessitate more frequent dosing with lorazepam. Additionally, lorazepam is more potent on a milligram-per-milligram basis than diazepam. Patients should be monitored closely during conversion for signs of either over-sedation or withdrawal symptoms, and dosages should be adjusted accordingly. The conversion should ideally be done gradually, particularly in patients who have been on long-term diazepam therapy, to minimize withdrawal effects.
Some key points to consider during the conversion process include:
- The patient's medical history and current health status
- The reason for the conversion (e.g., side effects, efficacy, or dosage convenience)
- The potential for drug interactions with other medications the patient is taking
- The need for close monitoring and follow-up to adjust the dosage as needed
It's also important to note that the conversion ratio may vary depending on the individual patient and the specific clinical context, as highlighted in earlier studies 2, 3, 4, 5. However, the most recent study 1 provides the most up-to-date guidance on this topic. By following these guidelines and considering the individual patient's needs, healthcare providers can ensure a safe and effective conversion from diazepam to lorazepam.