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Lorazepam (benzodiazepine, anxiolytic)

Know the basics|Know the precautions & warnings|Know the side effects|Know the interactions|Understand the dosage

Lorazepam is a benzodiazepine drug. Benzodiazepines are CNS depressants that treat anxiety, epilepsy, insomnia, and as premedication in surgery.

In the Philippines, lorazepam is a dangerous drug assigned to schedule IV. This means only physicians with a S-2 license can prescribe this drug.

Know the basics

What is lorazepam used for?

  • Insomnia
  • Anxiety
  • Status epilepticus
  • Premedication for surgery and dental procedures

How should I take lorazepam?

Read the directions on the packaging for complete information. Check the label and expiration date.

For oral dosage forms, swallow it whole without chewing, crushing, or dissolving it in liquid.

For parenteral dosage forms, only a licensed healthcare professional should administer it.

How do I store lorazepam?

Store this product at room temperature away from direct light and moisture. To prevent drug damage, you should not store it in the bathroom or the freezer.

There may be different brands of this drug that may have different storage needs. So, it is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush this product down the toilet or pour them into a drain unless instructed to do so. Additionally, it is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Know the precautions & warnings

What should I know before using lorazepam?

Before using this drug, tell your doctor if you are/have:

  • Pregnant or breastfeeding.
  • Taking any other medicines. This includes any prescription, OTC, and herbal remedies.
  • An allergy to any of the ingredients of this product.
  • Any other illnesses, disorders, or medical conditions.

Is it safe to take lorazepam during pregnancy or breast-feeding?

This drug is not recommended for use during pregnancy. There is evidence that suggests that lorazepam can increase the risk of fetal harm and withdrawal symptoms, especially during the first trimester. Please always consult with your doctor to weigh the potential benefits and risks before taking any medication.

This medication is pregnancy risk category D according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A= No risk
  • B= No risk in some studies
  • C= There may be some risk
  • D= Positive evidence of risk
  • X= Contraindicated
  • N= Unknown

Know the side effects

What are the side effects of lorazepam?

Like all drugs, this product may have side effects. If they occur, side effects are generally mild and resolve once treatment is finished or the dose is lowered. Some reported side effects include:

  • Pain and redness at the injection site
  • Drowsiness
  • Hypotension
  • Confusion
  • Dizziness
  • Hallucinations
  • Delirium
  • Depression
  • Asthenia
  • Coma
  • Apnea
  • Respiratory failure

However, not everyone experiences these side effects. In addition, some people may experience other side effects. So, if you have any concerns about a side effect, please consult your doctor or pharmacist.

Know the interactions

What drugs may interact with lorazepam?

This medication may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects.

To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist.

Drugs with known interactions:

  • Anesthetics
  • Barbiturates
  • Antihypertensive agents
  • MAOIs
  • Antipsychotics
  • Antidepressants
  • Antiepileptic drugs
  • HIV-protease inhibitors
  • Cisapride
  • CYP450 inhibitors
  • Levodopa
  • Theophylline, aminophylline
  • Scopolamine
  • Antacids
  • Narcotics, opioids *potentially fatal

If you experience an adverse drug interaction, inform your doctor immediately to reevaluate your treatment plan. Approaches include dose adjustment, drug substitution, or ending therapy.

Does food or alcohol interact with lorazepam?

This drug may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Do not consume alcohol while taking this medication. Avoid consuming grapefruit and caffeinated products. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with lorazepam?

This drug may interact with underlying conditions. This interaction may worsen your health condition or alter the way the drug works. Therefore, it is important to always let your doctor and pharmacist know all the health conditions you currently have, especially:

  • Glaucoma
  • Lung disease
  • Sleep apnea
  • Kidney impairment
  • Liver impairment

Understand the dosage

The information provided is not a substitute for any medical advice. Therefore, you should always consult with your doctor or pharmacist before using any medication.

What is the dose for an adult?

Status epilepticus

IV: Administer 4 mg of lorazepam as a single dose, may be repeated once after 10-15 minutes if seizure continues or recurs.

Prior to surgery

IV: Administer 0.05 mg/kg given 30-45 minutes before surgery via IV or 60-90 minutes before surgery via IM.

Oral: Take 2 t0 3 mg given the night before the operation followed by 2-4 mg 1-2 hours before the procedure.

Acute anxiety

IV/IM: Administer 0.025 to 0.03 mg/kg, may be repeated 6 hourly, if necessary. The injection rate should not be more than 2 mg/minute.

Oral: Take 1 to 4 mg daily in divided doses for 2 to 4 weeks.

Insomnia

Oral: Take 1-2 mg at bedtime.

Dose adjustment for elderly

Reduce the dose to half the normal adult dose.

What is the dose for a child?

Status epilepticus

IV: Administer 2 mg of lorazepam as a single dose, may be repeated once after 10-15 minutes if seizure continues or recurs.

Prior to surgery

Age 5 to 13 years: Give 0.5 to 2.5 mg at 0.05 mg/kg to the nearest 0.5 mg based on weight, not less than 1 hour before operation.

How is loprazepam available?

Loprazepam is available in the following dosage forms and strengths:

  • Tablet: 0.5 mg, 1 mg, 2 mg
  • Solution for injection: 2 mg/mL, 4 mg/mL

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to the nearest emergency room.

What should I do if I miss a dose?

If you miss a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Lorazepam https://www.mims.com/philippines/drug/info/lorazepam?mtype=generic Accessed July 27, 2021

Lorazepam https://www.nhs.uk/medicines/lorazepam/ Accessed July 27, 2021

Lorazepam https://www.ncbi.nlm.nih.gov/books/NBK532890/ Accessed July 27, 2021

Lorazepam (Oral Route) https://www.mayoclinic.org/drugs-supplements/lorazepam-oral-route/description/drg-20072296 Accessed July 27, 2021

LORazepam. Lexi-Drugs. Lexicomp. Wolters Kluwer Health, Inc. Riverwoods, IL. Accessed July 27, 2021. http://online.lexi.com

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Written by Ruby Fernandez Updated 2 days ago
Expertly reviewed by Stephanie Nicole Nera, RPh, PharmD
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