lorazepam (Rx)

Brand and Other Names:Ativan, Loreev XR
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablet: Schedule IV

  • 0.5mg
  • 1mg
  • 2mg

capsule, extended-release: Schedule IV

  • 1mg
  • 2mg
  • 3mg

oral concentrate: Schedule IV

  • 2mg/mL

injectable solution: Schedule IV

  • 2mg/mL
  • 4mg/mL

Anxiety Disorders

Indicated for management of anxiety disorders or for the short-term relief of symptoms of anxiety or anxiety associated with depressive symptoms

Anxiety or tension associated with stress of everyday life usually does not require treatment with an anxiolytic

Efficacy in long-term use (ie, >4 months), has not been assessed by systematic clinical studies

Tablets

  • Initial: 2-3 mg PO q8-12hr PRN; not to exceed 10 mg/day
  • Maintenance: 2-6 mg/day PO divided q8-12hr

Extended-release capsules (Loreev XR)

  • Indicated for anxiety disorders in adults who are receiving stable, evenly divided, TID dosing with lorazepam tablets
  • Recommended dose: Administer capsule PO qAM; dose equals the total daily dose of previously administered lorazepam tablets
  • Dosage adjustment: Discontinue Loreev XR and switch to lorazepam tablets to adjust dosage

Short-Term Treatment of Insomnia

Tablets: 2-4 mg PO qHS

Preoperative Sedation, Anxiety Relief, & Anterograde Amnesia

0.05 mg/kg IM for 1 dose; 2 hours before surgery; not to exceed 4 mg (2 mg/dose in elderly), OR  

0.044 mg/kg IV for 1 dose; 15-20 minutes before surgery; not to exceed 4 mg (2 mg/dose in elderly)

Status Epilepticus

Usual 4 mg/dose slow IV at 2 mg/min

If seizure persists after 5-10 min, administer 4 mg IV again

Anxiolytic/Sedation in ICU (Off-label)

Intubated and mechanically ventilated patients

  • 0.02-0.04 mg/kg loading dose IV
  • 0.02-0.06 mg/kg intermittent IV q2-6hr PRN, OR  
  • 0.01-0.1 mg/kg/hr continuous IV; not to exceed 10 mg/hr

Chemotherapy-Induced Nausea/Vomiting (Off-label)

0.5-2 mg PO/IV q6hr; PRN thereafter

Chronic Insomnia (Off-label)

2-4 mg PO qHS

Dosing Modifications

Renal impairment

  • PO: Dose adjustment not necessary
  • IV/IM: Use with caution in mild-to-moderate impairment; not recommended in severe impairment or renal failure
  • IV/IM (prolonged periods or high doses): Monitor; risk of propylene glycol toxicity

Hepatic impairment

  • PO: No dose adjustment recommended in mild-to-moderate impairment; use with caution (may require lower dose) in severe impairment
  • IV/IM: Use with caution in mild-to-moderate impairment; not recommended in severe impairment of hepatic failure

Dosing Considerations

Periodically reassess the usefulness for individual patients

IV: Monitor respirations q5-15min and before each repeated IV dose

Dosage Forms & Strengths

tablet: Schedule IV

  • 0.5mg
  • 1mg
  • 2mg

oral concentrate: Schedule IV

  • 2mg/mL

injectable solution: Schedule IV

  • 2mg/mL
  • 4mg/mL

Status Epilepticus (Off-label)

Infants and children: 0.05-0.1 mg/kg IV over 2-5 minutes; not to exceed 4 mg/dose; may repeat q10-15min PRN  

Alternatively, 0.1 mg/kg at slow IV rate not to exceed rate of 2 mg/min; not to exceed dose of 4 mg

Adolescents: 4 mg slow IV; if seizure persists after 10-15 minutes, administer 4 mg IV again

Anxiolytic/Sedation/Agitation (Off-label)

Children: 0.05 mg/kg/dose PO q4-8hr; not to exceed 2 mg/dose  

Chemotherapy-Induced Nausea/Vomiting (Off-label)

Children >2 years: 0.025-0.05 mg/kg/dose IV q6hr PRN; not to exceed 2 mg/dose  

Dosing Considerations

IV: Monitor respirations q5-15min and before each repeated IV dose

Preferred agent in elderly because short-acting and has inactive metabolite

Anxiety disorders

Lower initial dose recommended; 1-2 mg PO divided q8-12hr

Insomnia

Lower initial dose recommended; 0.5-1 mg PO qHS, increase PRN

To avoid oversedation, initial daily dose should not exceed 2 mg

Dosing considerations

When higher dose indicated, increase evening dose before daytime doses

Next:

Interactions

Interaction Checker

and lorazepam

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              Serious - Use Alternative (8)

              • benzhydrocodone/acetaminophen

                benzhydrocodone/acetaminophen, lorazepam. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

              • calcium/magnesium/potassium/sodium oxybates

                lorazepam, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

              • hydrocodone

                hydrocodone, lorazepam. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

              • metoclopramide intranasal

                lorazepam, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.

              • selinexor

                selinexor, lorazepam. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.

              • sodium oxybate

                lorazepam, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

              • sufentanil SL

                sufentanil SL, lorazepam. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration may result in hypotension, profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

              • valerian

                valerian and lorazepam both increase sedation. Avoid or Use Alternate Drug.

              Monitor Closely (194)

              • albuterol

                lorazepam increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • alfentanil

                lorazepam and alfentanil both increase sedation. Use Caution/Monitor.

              • alprazolam

                alprazolam and lorazepam both increase sedation. Use Caution/Monitor.

              • amitriptyline

                lorazepam and amitriptyline both increase sedation. Use Caution/Monitor.

              • amobarbital

                amobarbital and lorazepam both increase sedation. Use Caution/Monitor.

              • amoxapine

                lorazepam and amoxapine both increase sedation. Use Caution/Monitor.

              • apomorphine

                lorazepam and apomorphine both increase sedation. Use Caution/Monitor.

              • arformoterol

                lorazepam increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • aripiprazole

                lorazepam and aripiprazole both increase sedation. Use Caution/Monitor.

              • armodafinil

                lorazepam increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • azelastine

                azelastine and lorazepam both increase sedation. Use Caution/Monitor.

              • baclofen

                lorazepam and baclofen both increase sedation. Use Caution/Monitor.

              • belladonna and opium

                lorazepam and belladonna and opium both increase sedation. Use Caution/Monitor.

              • benperidol

                lorazepam and benperidol both increase sedation. Use Caution/Monitor.

              • benzphetamine

                lorazepam increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • brexanolone

                brexanolone, lorazepam. Either increases toxicity of the other by sedation. Use Caution/Monitor.

              • brompheniramine

                brompheniramine and lorazepam both increase sedation. Use Caution/Monitor.

              • buprenorphine

                lorazepam and buprenorphine both increase sedation. Use Caution/Monitor.

              • buprenorphine buccal

                lorazepam and buprenorphine buccal both increase sedation. Use Caution/Monitor.

              • buprenorphine subdermal implant

                lorazepam increases toxicity of buprenorphine subdermal implant by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Studies have shown that the combination of benzodiazepines and buprenorphine altered the usual ceiling effect on buprenorphine-induced respiratory depression, making the respiratory effects of buprenorphine appear similar to those of full opioid agonists. There have been postmarketing reports of coma and death with coadministration of buprenorphine and benzodiazepines. In many, but not all of these cases, buprenorphine was misused by self-injection. If a benzodiazepine must be used for an indication other than seizures, lower the benzodiazepine initial dose and cautiously titrate to clinical response.

              • buprenorphine, long-acting injection

                lorazepam increases toxicity of buprenorphine, long-acting injection by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of buprenorphine and benzodiazepines or other CNS depressants increases risk of adverse reactions including overdose, respiratory depression, and death. Cessation of benzodiazepines or other CNS depressants is preferred in most cases. In some cases, monitoring at a higher level of care for tapering CNS depressants may be appropriate. In others, gradually tapering a patient off of a prescribed benzodiazepine or other CNS depressant or decreasing to the lowest effective dose may be appropriate.

              • butabarbital

                butabarbital and lorazepam both increase sedation. Use Caution/Monitor.

              • butalbital

                butalbital and lorazepam both increase sedation. Use Caution/Monitor.

              • butorphanol

                lorazepam and butorphanol both increase sedation. Use Caution/Monitor.

              • caffeine

                lorazepam increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • cannabidiol

                cannabidiol will increase the level or effect of lorazepam by decreasing metabolism. Modify Therapy/Monitor Closely. Cannabidiol may potentially inhibit UGT2B7 activity. Consider reducing the dose when concomitantly using UGT2B7 substrates.

              • carbinoxamine

                carbinoxamine and lorazepam both increase sedation. Use Caution/Monitor.

              • carisoprodol

                lorazepam and carisoprodol both increase sedation. Use Caution/Monitor.

              • cenobamate

                cenobamate, lorazepam. Either increases effects of the other by sedation. Use Caution/Monitor.

              • chloral hydrate

                lorazepam and chloral hydrate both increase sedation. Use Caution/Monitor.

              • chlordiazepoxide

                chlordiazepoxide and lorazepam both increase sedation. Use Caution/Monitor.

              • chlorpheniramine

                chlorpheniramine and lorazepam both increase sedation. Use Caution/Monitor.

              • chlorpromazine

                lorazepam and chlorpromazine both increase sedation. Use Caution/Monitor.

              • chlorzoxazone

                lorazepam and chlorzoxazone both increase sedation. Use Caution/Monitor.

              • cinnarizine

                cinnarizine and lorazepam both increase sedation. Use Caution/Monitor.

              • clemastine

                clemastine and lorazepam both increase sedation. Use Caution/Monitor.

              • clobazam

                lorazepam, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression).

              • clomipramine

                lorazepam and clomipramine both increase sedation. Use Caution/Monitor.

              • clonazepam

                clonazepam and lorazepam both increase sedation. Use Caution/Monitor.

              • clonidine

                clonidine, lorazepam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration enhances CNS depressant effects.

              • clorazepate

                clorazepate and lorazepam both increase sedation. Use Caution/Monitor.

              • clozapine

                lorazepam and clozapine both increase sedation. Use Caution/Monitor.

                lorazepam, clozapine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Possible risk of cardiorespiratory collapse.

              • codeine

                lorazepam and codeine both increase sedation. Use Caution/Monitor.

              • cyclizine

                cyclizine and lorazepam both increase sedation. Use Caution/Monitor.

              • cyclobenzaprine

                lorazepam and cyclobenzaprine both increase sedation. Use Caution/Monitor.

              • cyproheptadine

                cyproheptadine and lorazepam both increase sedation. Use Caution/Monitor.

              • dantrolene

                lorazepam and dantrolene both increase sedation. Use Caution/Monitor.

              • desflurane

                desflurane and lorazepam both increase sedation. Use Caution/Monitor.

              • desipramine

                lorazepam and desipramine both increase sedation. Use Caution/Monitor.

              • deutetrabenazine

                lorazepam and deutetrabenazine both increase sedation. Use Caution/Monitor.

              • dexchlorpheniramine

                dexchlorpheniramine and lorazepam both increase sedation. Use Caution/Monitor.

              • dexfenfluramine

                lorazepam increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • dexmedetomidine

                lorazepam and dexmedetomidine both increase sedation. Use Caution/Monitor.

              • dexmethylphenidate

                lorazepam increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • dextroamphetamine

                lorazepam increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • dextromoramide

                lorazepam and dextromoramide both increase sedation. Use Caution/Monitor.

              • diamorphine

                lorazepam and diamorphine both increase sedation. Use Caution/Monitor.

              • diazepam

                diazepam and lorazepam both increase sedation. Use Caution/Monitor.

              • diazepam intranasal

                diazepam intranasal, lorazepam. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may potentiate the CNS-depressant effects of each drug.

              • dichlorphenamide

                dichlorphenamide, lorazepam. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Both drugs can cause metabolic acidosis.

              • diethylpropion

                lorazepam increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • difenoxin hcl

                lorazepam and difenoxin hcl both increase sedation. Use Caution/Monitor.

              • dimenhydrinate

                dimenhydrinate and lorazepam both increase sedation. Use Caution/Monitor.

              • diphenhydramine

                diphenhydramine and lorazepam both increase sedation. Use Caution/Monitor.

              • diphenoxylate hcl

                lorazepam and diphenoxylate hcl both increase sedation. Use Caution/Monitor.

              • dipipanone

                lorazepam and dipipanone both increase sedation. Use Caution/Monitor.

              • dobutamine

                lorazepam increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • dopamine

                lorazepam increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • dopexamine

                lorazepam increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • dosulepin

                lorazepam and dosulepin both increase sedation. Use Caution/Monitor.

              • doxepin

                lorazepam and doxepin both increase sedation. Use Caution/Monitor.

              • doxylamine

                lorazepam and doxylamine both increase sedation. Use Caution/Monitor.

              • droperidol

                lorazepam and droperidol both increase sedation. Use Caution/Monitor.

              • ephedrine

                lorazepam increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • epinephrine

                lorazepam increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • epinephrine racemic

                lorazepam increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • esketamine intranasal

                esketamine intranasal, lorazepam. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.

              • estazolam

                estazolam and lorazepam both increase sedation. Use Caution/Monitor.

              • ethanol

                lorazepam and ethanol both increase sedation. Use Caution/Monitor.

              • etomidate

                etomidate and lorazepam both increase sedation. Use Caution/Monitor.

              • fenfluramine

                lorazepam increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • flibanserin

                lorazepam and flibanserin both increase sedation. Modify Therapy/Monitor Closely. Risk for sedation increased if flibanserin is coadministration with other CNS depressants.

              • fluphenazine

                lorazepam and fluphenazine both increase sedation. Use Caution/Monitor.

              • flurazepam

                flurazepam and lorazepam both increase sedation. Use Caution/Monitor.

              • formoterol

                lorazepam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • gabapentin

                gabapentin, lorazepam. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

              • gabapentin enacarbil

                gabapentin enacarbil, lorazepam. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

              • haloperidol

                lorazepam and haloperidol both increase sedation. Use Caution/Monitor.

              • hyaluronidase

                hyaluronidase, lorazepam. Other (see comment). Use Caution/Monitor. Comment: Drug combination has been found to be incompatible.

              • hydromorphone

                lorazepam and hydromorphone both increase sedation. Use Caution/Monitor.

              • hydroxyzine

                hydroxyzine and lorazepam both increase sedation. Use Caution/Monitor.

              • iloperidone

                lorazepam and iloperidone both increase sedation. Use Caution/Monitor.

              • imipramine

                lorazepam and imipramine both increase sedation. Use Caution/Monitor.

              • isoproterenol

                lorazepam increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • ketamine

                ketamine and lorazepam both increase sedation. Use Caution/Monitor.

              • ketotifen, ophthalmic

                lorazepam and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.

              • lasmiditan

                lasmiditan, lorazepam. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.

              • lemborexant

                lemborexant, lorazepam. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.

              • levalbuterol

                lorazepam increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • levorphanol

                lorazepam and levorphanol both increase sedation. Use Caution/Monitor.

              • lisdexamfetamine

                lorazepam increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • lofepramine

                lorazepam and lofepramine both increase sedation. Use Caution/Monitor.

              • lofexidine

                lorazepam and lofexidine both increase sedation. Use Caution/Monitor.

              • loprazolam

                loprazolam and lorazepam both increase sedation. Use Caution/Monitor.

              • lormetazepam

                lorazepam and lormetazepam both increase sedation. Use Caution/Monitor.

              • loxapine

                lorazepam and loxapine both increase sedation. Use Caution/Monitor.

                lorazepam, loxapine. Mechanism: unknown. Use Caution/Monitor. Risk of resp. depression, hypotension.

              • loxapine inhaled

                lorazepam and loxapine inhaled both increase sedation. Use Caution/Monitor.

                lorazepam, loxapine inhaled. Mechanism: unknown. Use Caution/Monitor. Risk of resp. depression, hypotension.

              • lurasidone

                lurasidone, lorazepam. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.

              • maprotiline

                lorazepam and maprotiline both increase sedation. Use Caution/Monitor.

              • marijuana

                lorazepam and marijuana both increase sedation. Use Caution/Monitor.

              • melatonin

                lorazepam and melatonin both increase sedation. Use Caution/Monitor.

              • meperidine

                lorazepam and meperidine both increase sedation. Use Caution/Monitor.

              • meprobamate

                lorazepam and meprobamate both increase sedation. Use Caution/Monitor.

              • metaproterenol

                lorazepam increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • metaxalone

                lorazepam and metaxalone both increase sedation. Use Caution/Monitor.

              • methadone

                lorazepam and methadone both increase sedation. Use Caution/Monitor.

              • methamphetamine

                lorazepam increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • methocarbamol

                lorazepam and methocarbamol both increase sedation. Use Caution/Monitor.

              • methylenedioxymethamphetamine

                lorazepam increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • midazolam

                lorazepam and midazolam both increase sedation. Use Caution/Monitor.

              • midazolam intranasal

                midazolam intranasal, lorazepam. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.

              • midodrine

                lorazepam increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • mirtazapine

                lorazepam and mirtazapine both increase sedation. Use Caution/Monitor.

              • modafinil

                lorazepam increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • morphine

                lorazepam and morphine both increase sedation. Use Caution/Monitor.

              • motherwort

                lorazepam and motherwort both increase sedation. Use Caution/Monitor.

              • moxonidine

                lorazepam and moxonidine both increase sedation. Use Caution/Monitor.

              • nabilone

                lorazepam and nabilone both increase sedation. Use Caution/Monitor.

              • nalbuphine

                lorazepam and nalbuphine both increase sedation. Use Caution/Monitor.

              • norepinephrine

                lorazepam increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • nortriptyline

                lorazepam and nortriptyline both increase sedation. Use Caution/Monitor.

              • olanzapine

                lorazepam and olanzapine both increase sedation. Use Caution/Monitor.

              • oliceridine

                oliceridine, lorazepam. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

              • opium tincture

                lorazepam and opium tincture both increase sedation. Use Caution/Monitor.

              • orlistat

                orlistat decreases levels of lorazepam by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Risk of convulsions.

              • orphenadrine

                lorazepam and orphenadrine both increase sedation. Use Caution/Monitor.

              • oxazepam

                lorazepam and oxazepam both increase sedation. Use Caution/Monitor.

              • oxycodone

                lorazepam and oxycodone both increase sedation. Use Caution/Monitor.

              • oxymorphone

                lorazepam and oxymorphone both increase sedation. Use Caution/Monitor.

              • paliperidone

                lorazepam and paliperidone both increase sedation. Use Caution/Monitor.

              • papaveretum

                lorazepam and papaveretum both increase sedation. Use Caution/Monitor.

              • papaverine

                lorazepam and papaverine both increase sedation. Use Caution/Monitor.

              • pentazocine

                lorazepam and pentazocine both increase sedation. Use Caution/Monitor.

              • pentobarbital

                pentobarbital and lorazepam both increase sedation. Use Caution/Monitor.

              • perampanel

                perampanel and lorazepam both increase sedation. Use Caution/Monitor.

              • perphenazine

                lorazepam and perphenazine both increase sedation. Use Caution/Monitor.

              • phendimetrazine

                lorazepam increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • phenobarbital

                phenobarbital and lorazepam both increase sedation. Use Caution/Monitor.

              • phentermine

                lorazepam increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • phenylephrine

                lorazepam increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • phenylephrine PO

                lorazepam increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

              • pholcodine

                lorazepam and pholcodine both increase sedation. Use Caution/Monitor.

              • pimozide

                lorazepam and pimozide both increase sedation. Use Caution/Monitor.

              • pirbuterol

                lorazepam increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • pregabalin

                pregabalin, lorazepam. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

              • primidone

                primidone and lorazepam both increase sedation. Use Caution/Monitor.

              • prochlorperazine

                lorazepam and prochlorperazine both increase sedation. Use Caution/Monitor.

              • promethazine

                promethazine and lorazepam both increase sedation. Use Caution/Monitor.

              • propofol

                propofol and lorazepam both increase sedation. Use Caution/Monitor.

              • propylhexedrine

                lorazepam increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • protriptyline

                lorazepam and protriptyline both increase sedation. Use Caution/Monitor.

              • quazepam

                lorazepam and quazepam both increase sedation. Use Caution/Monitor.

              • quetiapine

                lorazepam and quetiapine both increase sedation. Use Caution/Monitor.

              • ramelteon

                lorazepam and ramelteon both increase sedation. Use Caution/Monitor.

              • remimazolam

                remimazolam, lorazepam. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.

              • risperidone

                lorazepam and risperidone both increase sedation. Use Caution/Monitor.

              • salmeterol

                lorazepam increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • scullcap

                lorazepam and scullcap both increase sedation. Use Caution/Monitor.

              • secobarbital

                secobarbital and lorazepam both increase sedation. Use Caution/Monitor.

              • sevelamer

                sevelamer decreases levels of lorazepam by increasing elimination. Use Caution/Monitor.

              • sevoflurane

                sevoflurane and lorazepam both increase sedation. Use Caution/Monitor.

              • shepherd's purse

                lorazepam and shepherd's purse both increase sedation. Use Caution/Monitor.

              • stiripentol

                stiripentol, lorazepam. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.

              • sufentanil

                lorazepam and sufentanil both increase sedation. Use Caution/Monitor.

              • suvorexant

                suvorexant and lorazepam both increase sedation. Modify Therapy/Monitor Closely. Dosage adjustments of suvorexant and concomitant CNS depressants may be necessary

              • tapentadol

                lorazepam and tapentadol both increase sedation. Use Caution/Monitor.

              • teduglutide

                teduglutide increases levels of lorazepam by Other (see comment). Use Caution/Monitor. Comment: Teduglutide may increase absorption of concomitant PO medications; caution with with drugs requiring titration or those with a narrow therapeutic index; dose adjustment may be necessary.

              • temazepam

                lorazepam and temazepam both increase sedation. Use Caution/Monitor.

              • terbutaline

                lorazepam increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • thioridazine

                lorazepam and thioridazine both increase sedation. Use Caution/Monitor.

              • thiothixene

                lorazepam and thiothixene both increase sedation. Use Caution/Monitor.

              • topiramate

                lorazepam and topiramate both increase sedation. Modify Therapy/Monitor Closely.

              • tramadol

                lorazepam and tramadol both increase sedation. Use Caution/Monitor.

              • trazodone

                lorazepam and trazodone both increase sedation. Use Caution/Monitor.

              • triazolam

                lorazepam and triazolam both increase sedation. Use Caution/Monitor.

              • triclofos

                lorazepam and triclofos both increase sedation. Use Caution/Monitor.

              • trifluoperazine

                lorazepam and trifluoperazine both increase sedation. Use Caution/Monitor.

              • trimipramine

                lorazepam and trimipramine both increase sedation. Use Caution/Monitor.

              • triprolidine

                triprolidine and lorazepam both increase sedation. Use Caution/Monitor.

              • xylometazoline

                lorazepam increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • yohimbine

                lorazepam increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • ziconotide

                lorazepam and ziconotide both increase sedation. Use Caution/Monitor.

              • ziprasidone

                lorazepam and ziprasidone both increase sedation. Use Caution/Monitor.

              • zotepine

                lorazepam and zotepine both increase sedation. Use Caution/Monitor.

              Minor (30)

              • acetaminophen

                lorazepam decreases levels of acetaminophen by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.

              • acetaminophen IV

                lorazepam decreases levels of acetaminophen IV by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.

              • acetaminophen rectal

                lorazepam decreases levels of acetaminophen rectal by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.

              • atracurium

                lorazepam decreases effects of atracurium by pharmacodynamic antagonism. Minor/Significance Unknown.

              • biotin

                lorazepam decreases levels of biotin by unspecified interaction mechanism. Minor/Significance Unknown. Biotin supplementation may be necessary.

              • brimonidine

                brimonidine increases effects of lorazepam by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • cisatracurium

                lorazepam decreases effects of cisatracurium by pharmacodynamic antagonism. Minor/Significance Unknown.

              • cyanocobalamin

                lorazepam decreases levels of cyanocobalamin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • dexmethylphenidate

                dexmethylphenidate increases effects of lorazepam by decreasing metabolism. Minor/Significance Unknown.

              • esomeprazole

                esomeprazole increases levels of lorazepam by decreasing metabolism. Minor/Significance Unknown.

              • eucalyptus

                lorazepam and eucalyptus both increase sedation. Minor/Significance Unknown.

              • fleroxacin

                fleroxacin increases levels of lorazepam by decreasing metabolism. Minor/Significance Unknown.

              • gemifloxacin

                gemifloxacin increases levels of lorazepam by decreasing metabolism. Minor/Significance Unknown.

              • green tea

                green tea decreases effects of lorazepam by pharmacodynamic antagonism. Minor/Significance Unknown. Caffeine component of green tea may decrease sedative effects of benzodiazepines.

              • levocarnitine

                lorazepam decreases levels of levocarnitine by unspecified interaction mechanism. Minor/Significance Unknown.

              • levofloxacin

                levofloxacin increases levels of lorazepam by decreasing metabolism. Minor/Significance Unknown.

              • moxifloxacin

                moxifloxacin increases levels of lorazepam by decreasing metabolism. Minor/Significance Unknown.

              • ofloxacin

                ofloxacin increases levels of lorazepam by decreasing metabolism. Minor/Significance Unknown.

              • omeprazole

                omeprazole increases levels of lorazepam by decreasing metabolism. Minor/Significance Unknown.

              • onabotulinumtoxinA

                lorazepam decreases effects of onabotulinumtoxinA by pharmacodynamic antagonism. Minor/Significance Unknown.

              • pancuronium

                lorazepam decreases effects of pancuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

              • pyrimethamine

                lorazepam, pyrimethamine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive hepatotoxicity.

              • rapacuronium

                lorazepam decreases effects of rapacuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

              • rifabutin

                rifabutin decreases levels of lorazepam by increasing metabolism. Minor/Significance Unknown.

              • rocuronium

                lorazepam decreases effects of rocuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

              • sage

                lorazepam and sage both increase sedation. Minor/Significance Unknown.

                sage decreases effects of lorazepam by pharmacodynamic antagonism. Minor/Significance Unknown. Theoretical interaction; some species of sage may cause convulsions.

              • succinylcholine

                lorazepam decreases effects of succinylcholine by pharmacodynamic antagonism. Minor/Significance Unknown.

              • vecuronium

                lorazepam decreases effects of vecuronium by pharmacodynamic antagonism. Minor/Significance Unknown.

              • vinpocetine

                lorazepam increases effects of vinpocetine by unspecified interaction mechanism. Minor/Significance Unknown. Desirable interaction enhanced memory improvement (based on preliminary trial).

              • zolpidem

                zolpidem, lorazepam. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

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              Adverse Effects

              Frequency Not Defined

              Sedation

              Dizziness

              Unsteadiness

              Weakness

              Fatigue

              Drowsiness

              Amnesia

              Confusion

              Disorientation

              Depression

              Suicidal ideation/attempt

              Vertigo

              Ataxia

              Sleep apnea

              Asthenia

              Extrapyramidal symptoms

              Respiratory depression

              Tremor

              Convulsions/seizures

              Visual disturbances

              Dysarthria

              Hypotension

              Blood dyscrasias

              Change in libido

              Impotence

              Jaundice

              Increased bilirubin

              Increased liver transaminases

              Increase in ALP

              Hypersensitivity reactions

              Nausea

              Constipation

              Change in appetite

              Paradoxical reactions (anxiety, excitation, agitation, hostility, aggression, rage)

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              Warnings

              Black Box Warnings

              Risks From Concomitant Use With Opioids

              • Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death
              • Reserve concomitant prescribing of these drugs for use in patients for whom alternative treatment options are inadequate
              • Limit dosages and durations to the minimum required
              • Follow patients for signs and symptoms of respiratory depression and sedation

              Addiction, abuse, and misuse

              • On September 2020, FDA addressed serious risks of benzodiazepine addiction, abuse, and misuse, which can lead to overdose and death
              • Abuse and misuse of benzodiazepines commonly involve concomitant use of other medications, alcohol, and/or illicit substances, which is associated with an increased frequency of serious adverse outcomes; before prescribing and throughout treatment, assess each patient’s risk for abuse, misuse, and addiction
              • Physical dependence can occur when taken steadily for several days to weeks, even as prescribed
              • Risks of dependence and withdrawal increase with longer treatment duration and higher daily dose; although injection is indicated only for intermittent use, if used more frequently than recommended, abrupt discontinuation or rapid dosage reduction may precipitate acute withdrawal reactions, including seizures, which can be life-threatening; use gradual taper when discontinuing therapy to reduce withdrawal reactions risk
              • Assess each patient’s risk prior to prescribing and monitor regularly for the development of these conditions

              Contraindications

              Documented hypersensitivity

              Acute narrow angle glaucoma

              Intra-arterial administration

              Severe respiratory depression

              Sleep apnea

              Use of injectable dosage form in premature infants (contains benzyl alcohol)

              Cautions

              Concomitant use of benzodiazepines, including lorazepam, and opioids may result in profound sedation, respiratory depression, coma, and death (see BBW)

              Advise both patients and caregivers about the risks of respiratory depression and sedation when lorazepam is used with opioids; advise patients not to drive or operate heavy machinery until the effects of concomitant use with the opioid have been determined

              Use of benzodiazepines, including lorazepam, both used alone and in combination with other CNS depressants, may lead to potentially fatal respiratory depression

              Not recommended for use in patients with primary depressive disorder or psychosis

              Injection contains benzyl alcohol associated with potentially fatal "gasping syndrome" in neonates and an increased incidence of kernicterus, particularly in small preterm infants; if patient requires more than recommended dosages or other medications containing this preservative, practitioner must consider daily metabolic load of benzyl alcohol from combined sources

              Prolonged use may lead to physical and psychological dependence especially in patients with history of alcohol or drug abuse; risk of dependence is decreased with short-term treatment (eg, 2-4 weeks); evaluate need for continued treatment prior to extending therapy duration

              Use of drug, particularly in patients at elevated risk, necessitates counseling about risks and proper use of drug along with monitoring for signs and symptoms of abuse, misuse, and addiction; do not exceed recommended dosing frequency

              Avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (eg, opioid analgesics, stimulants); advise patients on proper disposal of unused drug; if a substance use disorder is suspected, evaluate patient and institute (or refer them for) early treatment, as appropriate

              For patients using treated more frequently than recommended, to reduce risk of withdrawal reactions, use a gradual taper to discontinue therapy (a patient-specific plan should be used to taper the dose)

              Patients at an increased risk of withdrawal adverse reactions after benzodiazepine discontinuation or rapid dosage reduction include those who take higher dosages, and those who have had longer durations of use

              In some cases, benzodiazepine users have developed a protracted withdrawal syndrome with withdrawal symptoms lasting weeks to more than 12 months

              Use caution in patients with history of suicide attempt or drug abuse

              Do not withdraw abruptly after prolonged use; terminate dosage gradually

              Use caution in patients with impaired gag reflex

              May cause CNS depression, impairing physical and mental abilities; caution patients to not operate dangerous machinery or motor vehicles

              Anterograde amnesia reported with use

              Use caution in patients with respiratory disease, including COPD or sleep apnea

              Hyperactive or aggressive behavior and other paradoxical reactions reported with use

              Caution patients that tolerance for alcohol and other CNS depressants will be diminished

              General anesthetics and sedation drugs in young children and pregnant women

              • Brain development
                • Published animal studies demonstrate that administration of anesthetic and sedation drugs that block NMDA receptors and/or potentiate GABA activity increase neuronal apoptosis in developing brain and result in long-term cognitive deficits when used for longer than 3 hours; repeated exposure may also result in negative effects on fetal or young children’s brain development
                • Caution with use during surgeries or procedures in children younger than 3 yr or in pregnant women during their third trimester
                • Assess the risk:benefit ratio in these populations, especially for prolonged procedures (ie, >3 hr) or multiple procedures
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              Pregnancy & Lactation

              Pregnancy category: D

              Lactation: Excreted in human breast milk; not recommended

              Risk of serious adverse effects, including CNS and respiratory depression, exist

              Minor tranquilizers should be avoided in first trimester of pregnancy, due to increased risk of congenital malformations

              Maternal use shortly before delivery is associated with floppy infant syndrome (good and consistent evidence)

              Prenatal benzodiazepine exposure slightly increased oral cleft risk (limited or inconsistent evidence)

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Mechanism of Action

              Sedative hypnotic with short onset of effects and relatively long half-life; by increasing the action of gamma-aminobutyric acid (GABA), which is a major inhibitory neurotransmitter in the brain, lorazepam may depress all levels of the CNS, including limbic and reticular formation

              Absorption

              Bioavailability: 90%

              Onset: 1-3 min (IV in sedation); 15-30 min (IM in hypnosis)

              Duration: Up to 8 hr

              Peak plasma time: 2 hr (tablets); 14 hr (capsules); <3 hr (IM)

              Peak plasma concentration: 41 ng/mL (tablets); 25 ng/mL (capsules

              Trough concentration: 29 ng/mL (tablets); 25 ng/mL (capsules)

              AUC: 765 ng⋅h/mL (tablets); 695 ng⋅h/mL (capsules)

              Steady-state: 5 days (capsules)

              Distribution

              Protein bound: 85-93%

              Vd: 1.9 L/kg (adolescents); 1.3 L/kg (adults); 0.78 L/kg (neonates); 177 L (capsules)

              Metabolism

              Metabolites: Inactive

              Undergoes glucuronic acid conjugation

              Elimination

              Half-life: 18 hr (children 2-12 years); 42 hr (neonates); 28 hr (adolescents); 18 hr (end stage renal disease); 12 hr (tablets, adults); 20.2 hr (capsules, adults)

              Excretion: Urine (88% mainly as inactive metabolites); feces (7%)

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              Administration

              IV Incompatibilities

              Additive: Buprenorphine, dexamethasone sodium phosphate with diphenhydramine and metoclopramide

              Syringe: Sufentanil

              Y-site: Aldesleukin, aztreonam, floxacillin, foscarnet, idarubicin, imipenem/cilastatin, omeprazole, ondansetron, sargramostim, sufentanil

              IV Preparation

              Parenteral admixture stable for 24 hr at room temp (25°C)

              Usually given IVP

              Standard IVP dilution: dilute immediately before use with equal amount of NS or SWI

              Usual dilution for continuous infusion: 1 mg in 100 mL D5W

              Discard if discoloration or precipitate

              IV/IM Administration

              IM administration

              • Administer deep into muscle mass

              IV administration

              • Prior to use, dilute injection solution with an equal amount of compatible diluent (D5W, NS, SWFI)
              • Administer IV injection slowly, directly into a vein or into tubing of a free-flowing, compatible IV infusion (eg, NS, D5W), at no more than 2 mg/min
              • Validate patent venous catheter with repeated aspiration during infusion to visualize venous blood return
              • Inadvertent intra-arterial injection may produce arteriospasm resulting in gangrene, potentially requiring amputation
              • Rapid IV infusion may result in apnea, bradycardia, hypotension, cardiac arrest
              • Continuous infusion solutions should have an in-line filter and should be checked frequently for possible precipitation
              • Emergency resuscitative equipment should be available when administering IV

              Oral Administration

              Capsules

              • May take with or without food
              • Swallow whole, do not crush or chew
              • Unable to swallow capsule
                • Capsule may be opened and entire contents sprinkled onto a tablespoon of applesauce
                • Swallow mixture without chewing
                • Swallow within 2 hours of mixing; do not store mixture for future use
                • Drink a glass of water after swallowing mixture

              Discontinuation

              • Gradually taper dose to reduce risk of withdrawal reactions
              • If withdrawal reactions occur, consider pausing the taper or increasing the dosage to the previous tapered dosage level; subsequently decrease dosage more slowly

              Storage

              IV/IM injection: Refrigerate intact vials at 2-8°C (36-46°F) and protect contents from light

              Tablets: Keep tightly closed; store at 25°C (77°F)

              Oral concentrate: Store at cold temperature; refrigerate at 2-8°C (36-46°F); discard open bottle after 90 days

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              Ativan oral
              -
              1 mg tablet
              Ativan oral
              -
              2 mg tablet
              Ativan oral
              -
              1 mg tablet
              Ativan oral
              -
              0.5 mg tablet
              lorazepam oral
              -
              2 mg/mL liquid
              lorazepam oral
              -
              0.5 mg tablet
              lorazepam oral
              -
              2 mg tablet
              lorazepam oral
              -
              2 mg tablet
              lorazepam oral
              -
              1 mg tablet
              lorazepam oral
              -
              0.5 mg tablet
              lorazepam oral
              -
              2 mg/mL liquid
              lorazepam oral
              -
              1 mg tablet
              lorazepam oral
              -
              0.5 mg tablet
              lorazepam oral
              -
              2 mg tablet
              lorazepam oral
              -
              0.5 mg tablet
              lorazepam oral
              -
              2 mg tablet
              lorazepam oral
              -
              2 mg tablet
              lorazepam oral
              -
              1 mg tablet
              lorazepam oral
              -
              0.5 mg tablet
              lorazepam oral
              -
              2 mg/mL liquid
              lorazepam oral
              -
              1 mg tablet
              lorazepam oral
              -
              1 mg tablet
              Ativan injection
              -
              2 mg/mL vial
              Ativan injection
              -
              4 mg/mL vial
              Ativan injection
              -
              4 mg/mL vial
              Ativan injection
              -
              4 mg/mL vial
              Lorazepam Intensol oral
              -
              2 mg/mL liquid
              lorazepam injection
              -
              2 mg/mL vial
              lorazepam injection
              -
              2 mg/mL vial
              lorazepam injection
              -
              4 mg/mL vial
              lorazepam injection
              -
              2 mg/mL vial
              lorazepam injection
              -
              2 mg/mL vial
              lorazepam injection
              -
              2 mg/mL vial
              lorazepam injection
              -
              2 mg/mL vial
              lorazepam injection
              -
              4 mg/mL vial
              lorazepam injection
              -
              2 mg/mL vial
              lorazepam injection
              -
              4 mg/mL vial
              lorazepam injection
              -
              2 mg/mL solution
              lorazepam injection
              -
              4 mg/mL vial
              lorazepam injection
              -
              2 mg/mL vial
              lorazepam injection
              -
              2 mg/mL vial

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              Select a drug:
              Patient Education
              lorazepam oral

              LORAZEPAM EXTENDED-RELEASE - ORAL

              (lor-AZ-e-pam)

              COMMON BRAND NAME(S): Loreev XR

              WARNING: Lorazepam has a risk for abuse and addiction, which can lead to overdose and death. Taking this medication with alcohol or other drugs that can cause drowsiness or breathing problems (especially opioid medications such as codeine, hydrocodone) may cause very serious side effects, including death. To lower your risk, your doctor should have you take the smallest dose of lorazepam that works, and take it for the shortest possible time. Be sure you know how to take lorazepam and what other drugs you should avoid taking with it. See also Drug Interactions section. Get medical help right away if any of these very serious side effects occur: slow/shallow breathing, unusual lightheadedness, severe drowsiness/dizziness, difficulty waking up.Suddenly stopping this medication may cause serious (possibly fatal) withdrawal, especially if you have used it for a long time or in high doses. To help prevent withdrawal, your doctor may lower your dose slowly. Tell your doctor or pharmacist right away if you have any withdrawal symptoms such as headaches, trouble sleeping, restlessness, hallucinations/confusion, depression, nausea, or seizures. Withdrawal symptoms may sometimes last weeks to months.

              USES: This form of lorazepam is used to treat anxiety in people who are taking lorazepam in a stable, evenly divided dose (usually 3 times a day). Lorazepam belongs to a class of drugs known as benzodiazepines which act on the brain and nerves (central nervous system) to produce a calming effect. This drug works by enhancing the effects of a certain natural chemical in the body (GABA).

              HOW TO USE: See also Warning section.Read the Medication Guide provided by your pharmacist before you start taking lorazepam and each time you get a refill. If you have any questions, ask your doctor or pharmacist.Take this medication by mouth with or without food as directed by your doctor, usually once daily in the morning. Swallow the capsules whole. Do not crush or chew the capsules. Doing so can release all of the drug at once, increasing the risk of side effects. The dosage is based on your medical condition, age, and response to treatment.If you have trouble swallowing the capsule whole, you may open the capsule and sprinkle the contents on a tablespoon of applesauce. Swallow all of the mixture right away without chewing. After swallowing the mixture, drink some water to make sure you have taken all your dose. The mixture should be used within 2 hours. Do not store it for later use.Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day.Do not suddenly stop using this drug without consulting your doctor. Some conditions may become worse when this drug is suddenly stopped. Your doctor may lower your dose slowly.When this medication is used for a long time, it may not work as well. Talk with your doctor if this medication stops working well.Though it helps many people, this medication may sometimes cause addiction. This risk may be higher if you have a substance use disorder (such as overuse of or addiction to drugs/alcohol). Take this medication exactly as prescribed to lower the risk of addiction. Ask your doctor or pharmacist for more details.Tell your doctor if your condition does not get better or if it gets worse.

              SIDE EFFECTS: See also Warning section.Drowsiness, dizziness, loss of coordination, headache, nausea, blurred vision, change in sexual interest/ability, constipation, heartburn, or change in appetite may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: mental/mood changes (such as hallucinations, depression, thoughts of suicide), trouble speaking, vision changes, unusual weakness, trouble walking, memory problems, signs of infection (such as sore throat that doesn't go away, fever, chills).Get medical help right away if you have any very serious side effects, including: yellowing eyes or skin, seizures, slow/shallow breathing.This medication can rarely have the opposite of its usual calming effect. Symptoms of this opposite effect may include agitation, irritability, violent behavior, confusion, restlessness, excitement, and talking more than normal. Tell your doctor right away if you notice any of these effects.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Before taking lorazepam, tell your doctor or pharmacist if you are allergic to it; or to other benzodiazepines (such as alprazolam, clonazepam, diazepam); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney problems, liver problems, glaucoma, lung/breathing problems (such as sleep apnea), mental/mood disorders (such as depression, psychosis, thoughts of suicide), personal or family history of a substance use disorder (such as overuse of or addiction to drugs/alcohol).This drug may make you dizzy or drowsy or cause blurred vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the side effects of this drug, especially loss of coordination and drowsiness. Loss of coordination and drowsiness may increase the risk of falling. Also, lorazepam may have the opposite of its usual calming effect in older adults (see also Side Effects section).Tell your doctor if you are pregnant or plan to become pregnant. You should not become pregnant while using lorazepam. Lorazepam may harm an unborn baby. If you become pregnant, talk to your doctor right away about the risks and benefits of this medication. Tell the doctor right away if you notice symptoms in your newborn baby such as slowed breathing, feeding problems, or constant crying. Consult your doctor for more details.This drug passes into breast milk. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: See also Warning section.Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug are: clozapine, kava, sodium oxybate (also known as gamma hydroxybutyrate or GHB).The risk of serious side effects (such as slow/shallow breathing, severe drowsiness/dizziness) may be increased if this medication is taken with other products that may also cause drowsiness or breathing problems. Tell your doctor or pharmacist if you are taking other products such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), other drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: confusion, slow reflexes, clumsiness, deep sleep, and loss of consciousness.

              NOTES: Do not share this medication with others. Sharing it is against the law.Lifestyle changes such as a stress reduction program may increase the effectiveness of this medication. Talk to your doctor or pharmacist about lifestyle changes that might benefit you.Lab and/or medical tests (such as blood counts, liver function) should be done while you are taking this medication. Keep all medical and lab appointments.

              MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

              STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

              MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).

              Information last revised September 2021. Copyright(c) 2021 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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              Formulary

              FormularyPatient Discounts

              Adding plans allows you to compare formulary status to other drugs in the same class.

              To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

              Adding plans allows you to:

              • View the formulary and any restrictions for each plan.
              • Manage and view all your plans together – even plans in different states.
              • Compare formulary status to other drugs in the same class.
              • Access your plan list on any device – mobile or desktop.

              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
              PA Prior Authorization
              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
              QL Quantity Limits
              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
              ST Step Therapy
              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.