Diazepam and Lorazepam Equivalence and Clinical Considerations

Pharmacokinetics and Metabolism

• The American Gastroenterological Association notes that diazepam has active metabolites with long half-lives, while lorazepam is directly conjugated and eliminated, which affects their metabolism and risk of accumulation 1
• The British Medical Journal recommends considering patient factors such as age, liver function, and concomitant medications when prescribing diazepam or lorazepam, as these factors can affect metabolism of both drugs 2

Safety and Adverse Effects

• The American Academy of Pediatrics warns that both diazepam and lorazepam can cause respiratory depression, especially when combined with other sedatives or opioids, and this risk should be carefully considered when prescribing these medications 3