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Table 5 Examples of symptom-triggered regimens for alcohol withdrawal*†

From: Care for hospitalized patients with unhealthy alcohol use: a narrative review

Initial oral medication dose Frequency Medication half-life
Diazepam 10 to 20 mg if CIWA-Ar ≥ 8 to 10 Repeat same dose hourly until Long half-life may provide smoother withdrawal, but may accumulate in elderly or those with liver disease.
CIWA-Ar < 10
Chlordiazepoxide 50 mg if CIWA-Ar > 9 Repeat 50 mg hourly until CIWA-Ar < 10 Intermediate half-life may provide smoother withdrawal than lorazepam.
Lorazepam 2 to 4 mg if CIWA-Ar ≥ 8 to 10 Repeat same dose hourly until Short half-life may increase withdrawal symptoms between doses. May be better tolerated in elderly and liver disease patients.
  CIWA-Ar < 10  
  1. *Fixed dose regimens generally consist of the same dose administered every 6 hours for 24 hours followed by half the initial dose every 6 hours for 48 hours. Close monitoring is still critical as adjustments in dose, frequency, and length of taper depend on clinical response.
  2. †Detailed descriptions are found in citations 48 and 53.