Commonly Used Medications in Alcohol & Opioid Detoxification Protocols
|
| Drug |
Medication |
Dose |
Mechanism of action |
Special considerations |
| Alcohol |
Chlordiazepoxide |
50-100 mg IV/IM (may repeat in 2-4 hours) |
Benzodiazepine |
For use in acute withdrawal only given potential for dual benzo/alcohol dependence |
|
Clonazepam |
0.25 mg PO BID (max 4 mg/day) |
Benzodiazepine |
For use in acute withdrawal only given potential for dual benzo/alcohol dependence |
|
Diazepam |
10 mg IV/IM, then 5-10 mg in 3-4 hours prn |
Benzodiazepine |
For use in acute withdrawal only given potential for dual benzo/alcohol dependence |
|
Oxazepam |
15-30 mg PO TID-QID |
Benzodiazepine |
For use in acute withdrawal only given potential for dual benzo/alcohol dependence |
|
Lorazepam |
0.05 mg/kg IM;2 mg or 0.044 mg/kg IV;2-3 mg PO BID |
Benzodiazepine |
For use in acute withdrawal only given potential for dual benzo/alcohol dependence |
|
Carbamazepine |
200 mg PO BID (max 1200 mg/day) |
Anticonvulsant |
Used for seizure prevention in acute withdrawal period |
|
Valproate |
15 mg/kg/day PO (max 60 mg/kg/day) |
Anticonvulsant |
Used for seizure prevention in acute withdrawal period |
| Opiates |
Methadone |
30-100 mg PO daily (initial doses 15-20 mg/day);>100 mg/day in persistent heroin abuse or comorbid conditions |
Mu receptor agonist |
Protracted withdrawal syndrome associated with cessation so most often used for maintenance therapy rather than detox |
|
Naltrexone |
50 mg PO; depot available for extended release (used for relapse prevention) |
Nonspecific opioid antagonist |
If used for acute withdrawal, addition of clonidine reduces severity of acute opioid withdrawal during detox |
|
Clonidine |
0.05-0.1 mg PO TID |
Alpha agonist |
Used for treatment of reactive hypertension in acute withdrawal period |
|
Nonsteroidal antiinflammatories |
Multiple medications at usual prescription treatment doses |
Analgesic; antipyretic |
Caution in patients with HTN, upper GI problems, renal dysfunction |
|
Immodium |
4 mg PO BID |
Anti-diarrheal |
|
|
Compazine |
5-10 mg PO BID |
Anti-emetic |
Used for nausea/vomiting |
|
Hydroxyzine |
100 mg PO QHS |
Antihistamine |
Used for treatment of insomnia |