| Anxiety disorders / short-term relief of anxiety symptoms; withdrawal symptoms of acute alcoholism; and preoperative apprehension/anxiety (label). View labelExact | Dosing varies by indication and severity; use the lowest effective dose for the shortest feasible duration, with frequent reassessment (label).
Alcohol withdrawal should follow a structured taper strategy with frequent monitoring rather than indefinite continuation (guidelines). | Benzodiazepine; positive allosteric modulator of GABA-A receptors. | Hepatic metabolism | Single-dose range 24–48 h | No | | - Alcohol withdrawal: use a structured protocol (vitals, withdrawal scoring) and taper as symptoms resolve.
- Screening for opioid co-prescribing, alcohol use, sleep apnea/COPD, and fall risk is important before prescribing.
- Monitoring focuses on oversedation, ataxia, confusion, and next-day impairment—especially in older adults.
- If use extends beyond a short course, documenting a gradual taper plan and monitoring for withdrawal is typical.
| No | 2026-02-23 |
|---|
diazepamAdjunctive therapyBrands: VALIUM | Anxiety disorders (label); also used for alcohol withdrawal, muscle spasm, and seizures (label varies by product). View labelExact | Anxiety (label ranges vary): the lowest effective dose is typically used in divided doses; dose escalation is generally avoided without a clear, time-limited plan.
Alcohol withdrawal and seizure protocols vary by setting; coordination with medical teams and close monitoring of vitals and sedation are typical. | Benzodiazepine; positive allosteric modulator of GABA-A receptors. | CYP3A4, CYP2C19 | Single-dose range 20–48 h | No | | - Functional benefit and safety at each renewal; open-ended continuation without documented goals is generally avoided.
- Sedation, falls, and driving impairment—especially in older adults and when other CNS depressants are present.
- Screening for substance use disorders and prescription monitoring data review; aligning on a single prescriber and pharmacy is common.
- If discontinuing after more than brief use, tapering is gradual with monitoring for withdrawal symptoms and rebound anxiety.
| No | 2026-02-20 |
|---|
lorazepamAdjunctive therapyBrands: ATIVAN, LOREEV XR | Anxiety disorders; insomnia due to anxiety/stress (label varies by product). View labelExact | Anxiety (label ranges vary): typically 1–3 mg/day in divided doses; titration is typically cautious based on sedation and fall risk. | Benzodiazepine; positive allosteric modulator of GABA-A receptors. | Glucuronidation | Single-dose mean 12 h | No | | - Functional benefit and safety are reassessed at each renewal; open-ended continuation without documented goals is generally avoided.
- Sedation, falls, and driving impairment are monitored—especially in older adults and when other CNS depressants are present.
- For catatonia, follow-up is often frequent, with coordinated escalation pathways (medical evaluation and ECT readiness when response is incomplete).
- If discontinuing after more than brief use, gradual tapering and monitoring for withdrawal symptoms and rebound anxiety are typical.
| No | 2026-02-20 |
|---|
| Management of anxiety disorders / short-term relief of anxiety symptoms; and alcohol withdrawal symptoms (label). View labelExact | Dosing is divided and varies by indication and symptom severity; lowest-effective dosing for the shortest feasible duration is typical (label).
Older patients require cautious dosing to reduce oversedation and falls (label). | Benzodiazepine; GABA-A receptor positive allosteric modulator. | Glucuronidation | Single-dose mean 8.2 h; Single-dose range 5.7–10.9 h | No | | - Reassess indication and symptom trajectory at each renewal; avoid chronic maintenance without a clear goal.
- Screen for opioid co-prescribing, alcohol use, sleep apnea/COPD, and fall risk before prescribing.
- Monitor for oversedation, confusion, and impaired coordination; adjust dose or discontinue if harms outweigh benefit.
- If used beyond a short course, document a gradual taper plan and monitor for withdrawal.
| No | 2026-02-20 |
|---|