Which class of benzodiazepines is primarily cleared by the kidneys and has minimal CYP450 interactions?

The correct answer is the class of benzodiazepines that includes Lorazepam, Oxazepam, and Temazepam, often referred to as the LOT group. These medications are primarily cleared by the kidneys rather than the liver, which makes them particularly suitable for individuals who may have compromised liver function. This renal clearance also results in minimal interactions with the CYP450 enzyme system, reducing the complexity of managing potential drug-drug interactions for patients taking multiple medications. As a result, the LOT medications are often preferred in various clinical settings, especially in elderly patients or those with liver impairment, where minimizing adverse effects and ensuring safety is paramount.

Other classes of benzodiazepines may either rely more heavily on liver metabolism or involve longer clearance times, leading to a greater potential for drug interactions and accumulation in the body, especially in at-risk populations.