From the Guidelines
The equivalent dose of temazepam for a patient taking lorazepam (Ativan) 1mg is approximately 15mg, as indicated by the recommended dosages for benzodiazepines in the treatment of insomnia. When switching between benzodiazepines, it's crucial to use appropriate conversion ratios to maintain therapeutic effect while avoiding withdrawal or excessive sedation. According to the clinical guideline for the evaluation and management of chronic insomnia in adults 1, lorazepam and temazepam are both benzodiazepines used for the treatment of insomnia, but they have different potencies and durations of action. The recommended dosage for temazepam is 15-30 mg hs, with 7.5 mg hs recommended for elderly or debilitated patients, suggesting that temazepam is less potent than lorazepam on a milligram-per-milligram basis.
- Key considerations when switching from lorazepam to temazepam include:
- Starting at the lower end of the equivalent range (15mg) and adjusting as needed based on patient response
- Gradually transitioning, especially if the patient has been on lorazepam long-term, to minimize withdrawal symptoms
- Monitoring for signs of excessive sedation or withdrawal
- Advising patients about the potential for adverse effects, such as disruptive sleep-related behaviors, and the importance of allowing appropriate sleep time, using only prescribed doses, and avoiding the combination of benzodiazepines with alcohol, other sedatives, and sleep restriction, as recommended by the FDA and outlined in the clinical guideline 1.
- It's also important to note that benzodiazepines should be used with caution in certain populations, such as the elderly, debilitated, or those with compromised respiratory function, and that rapid dose decrease or abrupt discontinuance can produce withdrawal symptoms, including rebound insomnia 1.
From the Research
Equivalent Dose of Temazepam for Lorazepam 1mg
To determine the equivalent dose of temazepam for a patient taking lorazepam 1mg, we need to consider the pharmacological properties and therapeutic efficacy of both drugs.
- Lorazepam is a benzodiazepine with a short to intermediate half-life, commonly used for anxiety and insomnia 2.
- Temazepam is also a benzodiazepine, specifically marketed for the treatment of insomnia, with a half-life of around 10 to 15 hours 3, 4.
Comparison of Lorazepam and Temazepam
Studies have compared the efficacy of lorazepam and temazepam as sleeping aids.
- One study found that 2 mg of lorazepam and 20 mg of temazepam were efficacious in maintaining sleep in psychogeriatric inpatients, with no significant difference in reducing initial sleep latency 5.
- Another study compared the efficacy of temazepam with other benzodiazepines, including lorazepam, and found that temazepam had a favorable profile for treating insomnia 6.
Equivalent Dose
Based on the available evidence, the equivalent dose of temazepam for lorazepam 1mg is not directly stated. However, considering the study that compared 2 mg of lorazepam with 20 mg of temazepam 5, we can estimate that the equivalent dose of temazepam for lorazepam 1mg might be around 10 mg of temazepam.