Daily Dose Thresholds for Sedative-Hypnotics

DAILY DOSE THRESHOLDS FOR SEDATIVE-HYPNOTICS
 
Generic Brand (Manufacturer) Usual Maximum
Daily Dose
Max Daily Dose
for LTC Patients
Chloral hydrate* (various) 2000mg  500mg
Diphenhydramine* Benadryl (McNeil)   50mg   25mg
Estazolam (various)    2mg   0.5mg
Eszopiclone Lunesta (Sunovion)    3mg    1mg
Flurazepam* (various)   30mg   15mg
Hydroxyzine* Vistaril (Pfizer)  100mg   50mg
Lorazepam Ativan (Biovail)    4mg    1mg
Oxazepam (various)   30mg   15mg
Quazepam* Doral (Questcor)   15mg   7.5mg
Ramelteon Rozerem (Takeda)    8mg    8mg
Temazepam Restoril (Mallinckrodt)   30mg   15mg
Triazolam* Halcion (Pfizer)   0.5mg 0.125mg
Zaleplon Sonata (King)   20mg    5mg
Zolpidem IR Ambien (Sanofi Aventis)   10mg    5mg
Zolpidem CR Ambien CR (Sanofi Aventis) 12.5mg  6.25mg
Zolpidem SL** Intermezzo (Purdue) 1.75mg (female)
3.5mg    (male)
 1.75mg
NOTES

*Not recommended for management of insomnia, especially in elderly.
**SL = sublingual
Adapted from the CMS State Operations Manual: Appendix PP - Guidance to Surveyors for Long Term Care Facilities.
Available at: cms.hhs.gov/manuals/Downloads/som107ap_pp_guidelines_ltcf.pdf. Accessed 9/2010.

(Rev. 6/2012)

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