Chlorazepate

Anxiety Disorder
1. Start 3.75 mg to 15 mg orally twice daily (or 7.5 mg to 15 mg orally once at bedtime)
2. Typical dose: 15 mg orally twice daily
3. Maximum Total Daily Dose: 60 mg in divided doses (15 mg maximum dose in elderly)
Alcohol Withdrawal
1. Day 1: 30 mg orally once, then give additional 30 to 60 mg/day divided in 3 to 4 doses
2. Day 2: 45 to 90 mg/day divided in 3 to 4 doses
3. Day 3: 22.5 to 45 mg/day divided in 3 to 4 doses
4. Day 4: 15 to 30 mg/day divided in 3 to 4 doses
5. Gradually taper and discontinue once patient stable on 7.5 mg once daily
6. Maximum total daily dose: 90 mg/day divided
Partial Seizures (adjunct, age >13 years)
1. Start 7.5 mg orally 2 to 3 times daily
2. May increase by no more than 7.5 mg/dose each week as needed
3. Maximum total daily dose: 90 mg/day divided

Partial Seizures (adjunct, age 9 to 12 years old)
1. Start 7.5 mg orally twice daily
2. May increase by no more than 7.5 mg/dose each week as needed
3. Maximum total daily dose: 60 mg/day divided

Chlorazepate is decarboxylated first in the Gastrointestinal Tract to the active agent desmethyldiazepam, and then absorbed
Desmethyldiazepam is then metabolized to Oxazepam via CYP3A4 and CYP2C19