This tool is based on the national Quality prescribing guide for benzodiazepines and z-drugs , from the Scottish Government Effective Prescribing and Therapeutics Division.

It provides examples of drug switching and reduction schedule to inform and support the prescriber. It is not intended to provide definitive drug dosage schedules. The prescriber needs to apply professional judgement and shared decision-making approaches to define a schedule tailored to the needs of the individual patient.

For guidance on calculating diazepam dose equivalents, go to this section of the Quality prescribing guidance.

For guidance on tapering schedules go to this section.

Other examples of drug reduction schedules are provided within the national Quality prescribing guidance and in the Ashton manual.

Approximate dose equivalents and switching considerations:
  • Due to inter-patient variability and differing drug half-lives this means switching to diazepam is based on approximate dose equivalents, not exact equivalence.
  • Inter-patient variability may be due a range of effects, e.g. liver impairment reducing/slowing drug excretion, which can increase B-Z half-lives and increase the risk of accumulation and drug effects.
  • The drug and dose equivalents can never be exact, and should be interpreted considering your clinical knowledge and the individual patient's needs. Such as older adults and/or frail people may experience next day sedation due to diazepam's long-half life.
  • Drug interactions and drug-disease interactions.
  • Dose equivalents vary between authors, they are based on clinical experience but may vary between individuals.

Date from which tapering schedule starts

For example, 27 3 2007

Starting drug

Please select which drug(s) you are currently taking

Guidance

Please refer to dose equivalence table

Is switch to diazepam required? *

Guidance

Where the decision is not to convert to diazepam:

  • Reduce current B-Z.
  • Review progress at 5-7 days, or sooner. Reviews should be frequent to detect and manage problems early and to provide advice and encouragement during and after the drug withdrawal. If a person does not succeed on their first attempt, they should be encouraged to try again.
  • Consider: Review and reducing dose every 2 to 4 weeks as per reducing schedules. Size of reduction dose varies with starting dose, see Reduction schedules.

Refer to flowchart

Please choose from the medication you selected and enter a dose. Note that this tool uses mg as the prescribing unit. So if you are prescribing 500 mcg, check that you enter it as 0.5 mg (e.g. for Clonazepam and Lorazepam).

Preferred timepoint to start reducing *

Interval between each step

Your new schedule & daily dosage

Check your answers

Step / DateApproximate equivalent dose

A PDF will open in a new window/tab. Please ensure that you have not blocked pop-ups in your browser.

Your answers

Please note: If information is incorrect you can click on the edit links associated to the area you wish to edit.

Tapering start date - Edit tapering start date

Starting drugs - Edit starting drugs

Switch to diazepam? - Edit switch to diazepam?

Current schedule and doses - Edit current schedule and doses

Total dose as Diazepam

0mg

View diazepam conversion guidance table

Following information provides guidance to converting doses for diazepam

Drug Approximate equivalent dose
Diazepam 5mg
Chlordiazepoxide 12.5mg
Clobazam 10mg
Clonazepam 0.25mg (250mcg)
Lorazepam 0.5mg (500mcg)
Oxazepam 10mg
Nitrazepam 5mg
Temazepam 10mg
Zolpidem 10mg
Zopiclone 7.5mg