Benzodiazepine Conversion Calculator (Diazepam Equivalents)
Convert between common oral benzodiazepines using approximate diazepam equivalents, compare regimens, and generate an example cross‑taper schedule. For educational use only – not a prescribing tool.
Equivalences are approximate and based on commonly cited clinical tables (e.g., Ashton manual, guideline summaries). Individual response varies widely.
Critical safety notice
- This tool does not provide medical advice or prescriptions.
- Use only as a rough educational guide to relative potency.
- Never start, stop, or change benzodiazepines without a qualified prescriber.
- High doses, long‑term use, older age, liver disease, pregnancy, and co‑medications require specialist input.
Interactive benzodiazepine conversion
1. Current regimen
2. Target regimen (optional)
If you select a target drug, the calculator will estimate an equipotent total daily dose based on the same diazepam equivalent.
Results (approximate)
Example cross‑taper schedule (educational)
This simple tool illustrates a linear cross‑taper from your current benzodiazepine to the target benzodiazepine using the calculated equipotent doses. It is not a recommended regimen and may be too fast or too slow for many patients.
Each step reduces the current drug and increases the target drug by the same diazepam‑equivalent amount. Real‑world tapers are often slower at lower doses and adjusted based on symptoms.
| Step | Week range | Current drug (mg/day) | Target drug (mg/day) | Total diazepam‑equiv (mg/day) |
|---|
Approximate benzodiazepine equivalence table
The table below summarizes commonly cited approximate oral dose equivalences to 10 mg diazepam. Values are rounded and synthesized from multiple sources (e.g., Ashton manual, guideline tables, clinical reviews).
| Drug | Example brand | Approx. dose ≈ 10 mg diazepam | Diazepam‑equiv factor* | Half‑life (approx.) |
|---|
*Diazepam‑equiv factor = diazepam mg per 1 mg of the listed drug. For example, factor 20 means 1 mg of that drug ≈ 20 mg diazepam. All values are approximate and for oral dosing in adults.
How this benzodiazepine conversion calculator works
Benzodiazepines differ in potency, half‑life, and active metabolites. To compare regimens, clinicians often convert doses to a common reference, usually diazepam equivalents. This calculator:
- Uses a curated table of approximate oral dose equivalences to 10 mg diazepam.
- Converts your current total daily dose to a diazepam‑equivalent dose.
- Back‑calculates an equipotent dose of a selected target benzodiazepine.
- Optionally generates a simple linear cross‑taper schedule for discussion with a prescriber.
Core formula
diazepam_equiv_mg = current_dose_mg × factor_current
target_dose_mg = diazepam_equiv_mg ÷ factor_target
Where factor_current and
factor_target are the diazepam‑equivalent factors
from the table (diazepam mg per 1 mg of the drug).
Clinical caveats and limitations
Benzodiazepine equivalence is an approximation, not an exact science. Published tables and calculators differ because:
- Studies use different endpoints (e.g., anxiolytic vs. hypnotic effect, seizure control).
- Patient populations vary in age, comorbidities, and prior exposure.
- Some drugs have active metabolites with long half‑lives (e.g., diazepam, flurazepam).
- Cross‑tolerance and receptor adaptations develop with chronic use.
For these reasons, clinical judgment overrides any calculator. Many clinicians start with a conservative equivalent dose and adjust based on response and adverse effects.
When extra caution is needed
- High total daily doses or long‑term use (>3–6 months).
- Older adults, frailty, falls risk, cognitive impairment.
- Respiratory disease, sleep apnea, liver impairment.
- Concomitant opioids, alcohol, or other CNS depressants.
- History of substance use disorder or complicated withdrawal.
- Pregnancy or breastfeeding.
Principles of benzodiazepine tapering
Tapering benzodiazepines is highly individualized. Common expert recommendations include:
- Consider switching to a longer‑acting agent (e.g., diazepam) before tapering in some cases.
- Reduce by about 5–10% of the dose every 1–2 weeks, slowing further at lower doses.
- Monitor for withdrawal symptoms (anxiety, insomnia, tremor, perceptual changes, seizures).
- Pause or slow the taper if significant symptoms emerge.
- Combine with non‑pharmacologic supports (CBT, sleep hygiene, psychoeducation).
The example cross‑taper generated by this tool is a simple linear model and is often more aggressive than real‑world schedules used in complex or long‑term cases.
Data sources and methodology
The equivalence factors used here are synthesized from multiple open clinical sources, including:
- Commonly cited benzodiazepine equivalence tables (e.g., Ashton manual‑style tables).
- Guideline summaries and review articles on benzodiazepine switching and tapering.
- Hospital and health‑system conversion charts (where publicly available).
Where sources disagreed, mid‑range values were chosen and rounded to practical doses. This inevitably introduces uncertainty, which is why the tool is clearly labeled as educational only.
Important disclaimer
This calculator does not establish a doctor–patient relationship and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, psychiatrist, or pharmacist with any questions you may have regarding a medical condition or medication. Never disregard professional medical advice or delay seeking it because of something you have read here.
Frequently asked questions
Is this benzodiazepine conversion calculator a prescribing tool?
No. It is designed for education and rough comparison only. Benzodiazepine switching and tapering must always be individualized and supervised by a qualified prescriber. Do not change your medication based on this tool alone.
What is meant by diazepam equivalent dose?
Diazepam equivalent dose is a way of expressing the strength of different benzodiazepines on a common scale. For example, 0.5 mg of alprazolam is often considered roughly equivalent to 10 mg of diazepam. These equivalences are approximate and vary between sources and patients.
Why do different equivalence tables give different numbers?
Equivalence data come from small studies, clinical experience, and sometimes receptor‑binding data. Different authors use different methods and patient populations, so their suggested equivalent doses can differ. All tables, including this one, should be treated as approximate guides only.
Can I use this to design my own taper schedule?
The taper tool can illustrate a simple linear cross‑taper, but it cannot account for your medical history, comorbidities, or withdrawal risk. Taper schedules should always be created and adjusted by a clinician who knows you, often with slower reductions than the example shown here.
Which benzodiazepines are included?
The calculator includes commonly used oral benzodiazepines such as alprazolam, clonazepam, diazepam, lorazepam, oxazepam, temazepam, chlordiazepoxide, nitrazepam, flurazepam, triazolam, and a few others. It does not cover every brand or formulation, and injectable or IV doses are not included.