Benzodiazepine Conversion Calculator
Converts equivalent doses between benzodiazepines based on diazepam equivalency. Used for cross-tapering, dose reduction, and management of benzodiazepine dependence. All values expressed as diazepam 5 mg equivalents. Note: equivalencies are approximate and require clinical judgement.
Score interpretation
Diazepam equivalent ≤30 mg/day — low dose range
→ Low dose range: confirm calculated equivalent is clinically appropriate; consider starting with 75–90% of calculated equivalent when switching; titrate based on response; educate patient on difference in onset and duration between agents; avoid abrupt discontinuation
Diazepam equivalent 31–60 mg/day — moderate dose range
→ Moderate dose: supervise switch carefully; start at 50–75% of calculated equivalent; titrate up over 1–2 weeks; monitor for breakthrough anxiety or sedation; if reducing for dependence — consider Ashton Manual protocol (10% reduction every 2–4 weeks); liaise with substance misuse team or psychiatry; document informed consent for cross-tapering
Diazepam equivalent >60 mg/day — high dose; specialist involvement required
→ High-dose benzodiazepine: psychiatry or addiction medicine specialist input; do not switch abruptly — risk of withdrawal seizures; if detoxification: supervised inpatient setting recommended; slow taper (weeks to months); seizure risk with rapid reduction — warn patient; monitor LFT, respiratory function; consider adding SSRIs for underlying anxiety; safeguarding if dependence in context of substance misuse
Interpretation bands for the Benzodiazepine Conversion. Apply clinical judgement and local guidance.
References
- Ashton H. Benzodiazepines: How They Work and How to Withdraw. The Ashton Manual. 2002. Newcastle University.
- Benzodiazepine equivalence — standard conversion references.
Related
Curated clinical cross-links plus same-class fallbacks.
- Falls Assessment in Older Adults · NICE CG161 2013
- Anaemia Investigation · BSH / NICE
- Lower Respiratory Tract Infection (Primary Care) · NICE NG138 / NICE antimicrobial guidance
- Hypertension Management · NICE NG136 2019
- Acute Behavioural Disturbance / Rapid Tranquillisation · RCEM 2022; RCPsych 2022; NICE NG10
- Self-Harm Presentation · NICE NG225 (2022)
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.