Commonly Used Medications in Alcohol & Opioid Detoxification Protocols

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

 

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