Commonly Used Medications in Alcohol & Opioid Detoxification Protocols |
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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 |