Clonazepam 2 mg to Lorazepam Equivalent Dose
Clonazepam 2 mg is approximately equivalent to lorazepam 2-2.5 mg based on sedative potency.
Benzodiazepine Equivalency
The standard conversion ratio is approximately 1:1 to 1:1.25 (clonazepam:lorazepam), meaning 2 mg of clonazepam equals roughly 2-2.5 mg of lorazepam for sedative effects 1.
This equivalency is based on comparative sedative potency studies, though it's important to recognize that clonazepam and lorazepam differ significantly in their pharmacokinetic profiles beyond just potency 1.
Critical Pharmacokinetic Differences
While the doses may appear equivalent, these medications behave very differently in clinical practice:
Clonazepam has a much longer elimination half-life (30-40 hours) compared to lorazepam, which affects dosing frequency and withdrawal risk 2.
Lorazepam has a duration of action of 1-24 hours, which is considerably shorter than clonazepam's sustained effect 3.
Clonazepam reaches maximum plasma concentrations within 1-4 hours after oral administration with 90% bioavailability 2.
Important Clinical Considerations When Converting
Do not perform abrupt substitution. When switching between these benzodiazepines:
Clonazepam should be tapered gradually by 0.25 mg per week when discontinuing after intermediate-term use to avoid withdrawal symptoms including anxiety, tremor, insomnia, nausea, sweating, tachycardia, headache, and muscle aches 4.
Lorazepam withdrawal can cause marked rebound insomnia and significant increases in tension and anxiety, particularly on the third night after discontinuation 5.
The longer half-life of clonazepam means withdrawal symptoms may be delayed compared to lorazepam 2, 5.
Common Pitfalls to Avoid
Do not assume equivalent dosing means equivalent clinical effect - clonazepam's longer duration may provide more sustained coverage, while lorazepam requires more frequent dosing 3, 1.
Be aware that both medications can cause significant side effects including morning sedation, confusion, memory dysfunction, and motor incoordination, with clonazepam potentially causing these effects for longer periods due to its extended half-life 2, 5.
In elderly patients, reduce lorazepam doses by 20% or more due to reduced clearance 3.
Monitor for respiratory depression risk, especially when combined with other CNS depressants or in patients with underlying respiratory disease 3.