Indicated for the management of anxiety disorders or for the short-term relief of the symptoms of anxiety or anxiety associated with depressive symptoms. Anxiety or tension associated with the stress of everyday life usually does not require treatment with an anxiolytic.
Benzodiazepine; Anxiolytic
Lorazepam is a short-acting tranquilizer of the benzodiazepine group. It is an agonist at benzodiazepine receptors in the CNS. It exerts a depressant action on the CNS, which may be mediated by potentiating the inhibitory actions of GABA (gamma amino butyric acid) in the CNS. This will result in diminution of the ascending activating systems, particularly the serotonergic and noradrenergic pathway from brain stem or the mid-brain to the cerebral cortex.
ORAL Anxiety: Adult: Usual dose: 1-6 mg daily in 2 or 3 divided doses. Largest dose taken at night. Up to 10 mg daily has been used. Elderly: Initial dose of 1-2 mg daily in 2 or 3 divided doses. Adjust as necessary. Insomnia associated w/ anxiety: Adult: 1-4 mg as a single dose given at bedtime, Elderly: 1-2 mg initially, adjust as needed. Prophylaxis of nausea & vomiting associated w/ cytotoxic therapy: Adult: For moderately emetogenic chemotherapy: May add 1-2 mg to the antiemetic therapy w/ domperidone or metoclopramide. INTRAVENOUS Status epilepticus: Adult: 4 mg injected slowly, may repeat once after 10 mins If seizures recur. Dose should be given at a rate not >2 mg/minute into a large vein. Child: Neonates & child up to 12 yr: 0.1 mg/kg (max: 4 mg) as a single dose, may repeat once after 10 mins if needed. Sedation In critical care: Adult: 0.02- 0.06 mg/kg every 2-6 hr as inj or 0.01 -0.1 mg/kg/ hr as continuous IV infusion. Child: 2 mth: 0.025-0.05 mg/kg (max 2 mg) every 2-4 hr as intermitlent IV infusion or 0.025 mg/ kg/hr (to a max of 2 mg/hr) as continuous IV infusion. PARENTERAL Acute anxiety: Adult: 25-30 mcg/kg repeated every 6 hr if necessary. Dose may be given via IV or IM inj. Give IV inj at a rate of not >2 mg/minute into a large vein. Child: Usual: 50 mcg/kg every 4-8 hr.
Lorazepam may potentiate the central depressant effect when combined with other drugs with central depressant action. Such drugs include alcohol, general anesthetics, tricyclic antidepressants and monoamine oxidase inhibitors.
Severe hepatic impairment; resp depression; acute narrow-angle glaucoma; pregnancy & lactation. Hepatic & renal dysfunction; pulmonary insufficiency; myasthenia gravis; may impair ability to drive or operate machinery; elderly or debilitated patients.
Drowsiness, headache, dizziness, confusion; blurred vision; nausea; weakness; unsteadiness. Respiratory depression.
according to some studies, increase the risk of several problems in the baby. Lorazepam has low levels in breastmilk, a short half-life relative to many other benzodiazepines, and is safely administered directly to infants. Evidence from nursing mothers indicates that lorazepam does not cause any adverse effects in breastfed infants with usual maternal dosages.
Overdosage of Lorazepam is usually manifested by varying degrees of central nervous system depression ranging from drowsiness to coma. In mild cases, symptoms include drowsiness, mental confusion and lethargy. In more serious cases and especially when other drugs or alcohol were ingested, symptoms may include ataxia, hypotonia, hypotension, hypnotic states (stages I to III), coma.
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