| Anxiety disorders / short-term relief of anxiety symptoms; adjunctive therapy in partial seizures; and symptomatic relief of acute alcohol withdrawal (label; product-dependent). View labelExact | Anxiety: administered in divided doses; usual daily dose is 30 mg, adjusted gradually within 15–60 mg/day based on response (label). | Benzodiazepine prodrug; positive allosteric modulator of GABA-A receptors (via nordiazepam). | Hepatic metabolism (prodrug → nordiazepam) | Single-dose range 40–50 h | No | | - Daytime sedation, driving safety, falls, and cognitive impairment, especially during dose changes.
- Substance use risk, opioid co-prescribing, alcohol use, and other sedative co-prescriptions.
- Withdrawal monitoring when tapering or discontinuing after prolonged use.
- Mood/behavior changes when used as seizure adjunct therapy (AED class warning).
| No | 2026-02-23 |
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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 |
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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 |
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| 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 |
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