TABLE 3

Symptomatic management of opioid withdrawal

SymptomDrugDose
AnxietyHydroxyzine25–100 mg orally every 6–8 hours as needed (maximum 400 mg/day)
Lorazepam1 mg every 4–6 hours as needed (maximum 6 mg/day)
Hypertension, tachycardiaClonidine0.1–0.2 mg every 6–8 hours, taper if given for > 7 days
DiarrheaLoperamide4 mg initial dose followed by 2 mg after each loose stool (maximum 16 mg/day)
Myalgias, arthralgiasAcetaminophen1,000 mg every 6–8 hours
Ibuprofen600 mg every 6 hours for up to 7 days (maximum 2,400 mg/day)
Nausea, vomitingOndansetron4 mg every 6 hours as needed (maximum 16 mg/day)
InsomniaTrazodone25–100 mg nightly (maximum 300 mg)
Muscle crampsCyclobenzaprine5–10 mg every 8 hours as needed (maximum 30 mg/day)
Gastrointestinal crampsDicyclomine10–20 mg every 6–8 hours as needed (maximum 160 mg/day)
  • Based on information in references 36, 39, and 40.