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BENZODIAZEPINES

(INCLUDES OTHER SEDATIVE HYPNOTIC AGENTS)

This section is designed to inform professionals.

Use in Pregnancy

  • Many benzodiazepines have been associated with increased risk of malformations especially neural tube and facial. This is probably associated with regular and high dose use.
  • No known intra uterine growth effects
  • No known neuro-behavioural teratogenicity
  • Respiratory depression in neonate may occur if pre delivery dose significant. If mothers use is chronic, withdrawal is also seen.

Use in Lactation

  • Benzodiazepines are considered safe in breastfeeding if the dose is less than the equivalent of diazepam 20mg per 24 hours.
  • Caution is advised in the benzodiazepines with the longest half-life, in premature infants and in long term use.

Dose Equivalents

Below is a table giving the dose equivalents, half-life, and pregnancy and lactation risk categories of several different benzodiazepines:

Approximate dose equivalent for 10mg of Diazepam

Generic Name

Brand Name

Dose Equivalent

Pregnancy
Risk Category

Lactation
Risk Category

Half-Life (adult) in hours

Alprazolam

Xanax

0.5mg

D

L3

12-15

Clonazepam

Rivotril

2mg

C

L3

18-50

Diazepam

Valium

10mg

D

L3

43

Lorazepam

Ativan

1mg

D

L3

12

Nitrazepam

Mogadon

10mg

?

L2

30

Oxazepam

Serepax

20-30mg

D

L3

12

Temazepam

Euhypnos

20-40mg

X

L3

9-13

Triazolam

Halcion

0.25mg

X

L3

1-6

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