Table 22Examples of symptom-triggered and front-loaded dosing regimens for treating alcohol withdrawal with chlordiazepoxide

Dosing regimenDay 1Day 2Day 3Day 4
Symptom triggered20 to 30 mg as needed up to hourly, based on symptoms1
Front loaded2100mg every 2 to 4 hours until sedation is achieved; then 50 to 100mg every 4 to 6 hours as needed50 to 100 mg every 4 to 6 hours as needed50 to 100mg every 4 to 6 hours as neededNone

Note.

1

These symptoms include pulse rate greater than 90 beats per minute, diastolic blood pressure greater than 90 mm Hg or signs of withdrawal.

2

Frequently, very little additional medication is necessary after initial loading.

These symptoms include pulse rate greater than 90 beats per minute, diastolic blood pressure greater than 90 mm Hg or signs of withdrawal.

Frequently, very little additional medication is necessary after initial loading.

From: 5, ORGANISATION AND DELIVERY OF CARE

Cover of Alcohol-Use Disorders
Alcohol-Use Disorders: Diagnosis, Assessment and Management of Harmful Drinking and Alcohol Dependence.
NICE Clinical Guidelines, No. 115.
National Collaborating Centre for Mental Health (UK).
Leicester (UK): British Psychological Society; 2011.
Copyright © 2011, The British Psychological Society & The Royal College of Psychiatrists.

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