Benzodiazepine Equivalence (Ashton)
Benzodiazepine Equivalence (Ashton) - a deterministic tool in Sophie Well's Medication & Infusion group.
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What this is
Convert between benzodiazepine doses using the Ashton manual equivalence table - diazepam as the 10 mg reference, with conversions for alprazolam, lorazepam, clonazepam, oxazepam, temazepam, chlordiazepoxide, midazolam, and the rest of the commonly prescribed agents. Sophie Well also reports the half-life class (short, intermediate, long) for each agent, which matters more than the equivalent dose when planning a taper because the long-half-life agents (diazepam, clonazepam) are the conventional taper anchors.
When to use it
Use this when planning a benzodiazepine taper that switches a patient off a short-half-life agent (alprazolam, lorazepam) onto a long-half-life agent for a stepwise reduction, when transitioning from an inpatient IV agent to an outpatient oral, or when assessing whether a patient's current daily dose is high enough to require a gradual rather than abrupt discontinuation. Ashton equivalents are reference math; the actual taper schedule and rate are clinical decisions, and abrupt cessation of a long-term benzodiazepine can cause seizures.
References
Ashton CH. Benzodiazepines: How They Work and How to Withdraw (the Ashton Manual).
Source: Ashton benzodiazepine equivalence table (public)
Worked example: 10 mg diazepam ~ 1.0 mg lorazepam (Ashton equivalence).
Sophie Well is a reference and educational tool. Not medical, legal, or financial advice. Does not replace clinician judgment, professional billing review, or legal counsel.