Lorazepam

Know the basics

What is lorazepam used for?

Lorazepam is used to treat anxiety. 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).

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by yourhealth care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

If directed by your doctor, this drug may also be used to reduce the symptoms ofalcohol withdrawal, to prevent nausea and vomiting due to chemotherapy, and fortrouble sleeping (insomnia).

How should I take lorazepam?

Take loprazepam by mouth with or without food as directed by your doctor. The dosage is based on your medical condition, age, and response to treatment.

If directed by your doctor, use loprazepam regularly in order to get the most benefit from it. To help you remember, use it at the same time(s) each day.

Loprazepam may cause withdrawal reactions, especially if it has been used regularly for a long time or in high doses (more than 1-4 weeks) or if you have a history of alcoholism, drug abuse, or personality disorder. Withdrawal symptoms (such as seizures, trouble sleeping, mental/mood changes, nausea, vomiting, diarrhea, loss of appetite, stomach pain, hallucinations, numbness/tingling of arms and legs,muscle pain, fast heartbeat, short-term memory loss, very high fever, and increased reactions to noise/touch/light) may occur if you suddenly stop using loprazepam. To prevent withdrawal reactions, your doctor may reduce your dose gradually. Report any withdrawal reactions immediately.

Along with its benefits, loprazepam may rarely cause abnormal drug-seeking behavior (addiction). This risk may be increased if you have abused alcohol or drugs in the past. Take loprazepam exactly as prescribed to lessen the risk of addiction.

Do not suddenly stop using this drug without consulting your doctor. Some conditions may become worse when this drug is abruptly stopped. Your dose may need to be gradually decreased.

When loprazepam is used for a long time, it may not work as well. Talk with your doctor if loprazepam stops working well.

Tell your doctor if your condition persists or worsens.

How do I store lorazepam?

Loprazepam is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store loprazepam in the bathroom or the freezer. There may be different brands of loprazepam that may have different storage needs. 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 loprazepam down the toilet or pour them into a drain unless instructed to do so. 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 taking lorazepam,

• Tell your doctor and pharmacist if you are allergic to lorazepam, alprazolam (Xanax), chlordiazepoxide (Librium, Librax), clonazepam (Klonopin), clorazepate (Tranxene), diazepam (Valium), estazolam (prosom), flurazepam (Dalmane), oxazepam (Serax), prazepam (Centrax), temazepam (Restoril), triazolam (Halcion), any other loprazepams, or any of the ingredients in lorazepam tablets or concentrate. Ask your doctor or pharmacist for a list of the ingredients.
• Tell your doctor and pharmacist what prescription and nonprescription loprazepams, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: antihistamines; digoxin (Lanoxin); levodopa (Larodopa, Sinemet); loprazepams for depression, seizures, pain, Parkinson’s disease, asthma, colds, or allergies; muscle relaxants; oral contraceptives; probenecid (Benemid); rifampin (Rifadin); sedatives; sleeping pills; theophylline (Theo-Dur); tranquilizers; and valproic acid (Depakene).Your doctor may need to change the doses of your loprazepams or monitor you carefully for side effects.
• Tell your doctor if you have or have ever had glaucoma; seizures; or lung, heart, or liver disease.
• Tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking lorazepam, call your doctor immediately.
• Talk to your doctor about the risks and benefits of taking loprazepam if you are 65 years of age or older. Older adults should take lower doses of lorazepam because higher doses may not be more effective and are more likely to cause serious side effects.
• If you are having surgery, including dental surgery, tell the doctor or dentist that you are taking lorazepam.
• You should know that loprazepam may make you drowsy. Do not drive a car or operate machinery until you know how loprazepam affects you.
• Talk to your doctor about the safe use of alcohol during your treatment with lorazepam. Alcohol can make the side effects of loprazepam worse.
• Tell your doctor if you use tobacco products. Cigarette smoking may decrease the effectiveness of loprazepam.

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

There are no adequate studies in women for determining risk when using loprazepam during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking loprazepam. Loprazepam 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?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

• Confusion, depressed mood, thoughts of suicide or hurting yourself;
• Hyperactivity, agitation, hostility;
• Hallucinations;
• Feeling light-headed, fainting.

Less serious side effects may include:

• Drowsiness, dizziness, tiredness;
• Blurred vision;
• Sleep problems (insomnia);
• Muscle weakness, lack of balance or coordination;
• Amnesia or forgetfulness, trouble concentrating;
• Nausea, vomiting, constipation;
• Appetite changes;
• Skin rash.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Know the interactions

What drugs may interact with lorazepam?

Loprazepam 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. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

• A barbiturate such as amobarbital (Amytal), butabarbital (Butisol), mephobarbital (Mebaral), secobarbital (Seconal), or phenobarbital (Luminal, Solfoton);
• An MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate);
• Medicines to treat psychiatric disorders, such as chlorpromazine (Thorazine), haloperidol (Haldol), mesoridazine (Serentil), pimozide (Orap), or thioridazine (Mellaril);
• Narcotic loprazepams such as butorphanol (Stadol), codeine, hydrocodone (Lortab, Vicodin), levorphanol (Levo-Dromoran), meperidine (Demerol), methadone (Dolophine, Methadose), morphine (Kadian, MS Contin, Oramorph), naloxone (Narcan), oxycodone (oxycontin), propoxyphene (Darvon, Darvocet);
• Antidepressants such as amitriptyline (Elavil, Etrafon), amoxapine (Asendin), citalopram (Celexa), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), imipramine (Janimine, Tofranil), nortriptyline (Pamelor), paroxetine (Paxil), protriptyline (Vivactil), sertraline (Zoloft), or trimipramine (Surmontil).

Does food or alcohol interact with lorazepam?

Loprazepam may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with lorazepam?

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

• Glaucoma, acute narrow-angle or
• Lung disease, severe or
• Sleep apnea (temporary stopping of breathing during sleep)—This medicine should not be used in patients with these conditions.
• Kidney disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.
• Lung disease, mild to moderate—Use with caution. May make this condition worse.

Understand the dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using loprazepam.

What is the dose of loprazepam for an adult?

Usual Adult Dose for Intensive Care Unit Agitation:

Intravenous, intermittent:

• Initial dose: 1 to 4 mg Intravenous every 10 to 20 minutes to control acute agitation.
• Maintenance dose: 1 to 4 mg Intravenous every 2 to 6 hours and as needed to maintain desired level of sedation.

Intravenous, continuous infusion:

• to 0.1 mg/kg/hour Intravenous to maintain desired level of sedation.

• high-dose infusions (greater than 18 mg/hour for more than 4 weeks, or greater than 25 mg/hour for several hours or days) have been associated with tubular necrosis, lactic acidosis and hyperosmolality states due to the polyethylene glycol and propylene glycol solvents.

Usual Adult Dose for Anxiety:

Oral:

• Initial dose: 1 mg orally 2 to 3 times a day.
• Maintenance dose: 1 to 2 mg orally 2 to 3 times a day. The daily dosage may vary from 1 to 10 mg/day orally.

Intravenous: Alternatively, an initial intravenous dose of 2 mg or 0.044 mg/kg, whichever is smaller, may be given.

Usual Adult Dose for Insomnia: 2 to 4 mg orally at bedtime

Usual Adult Dose for Light Anesthesia: Preloprazepam for Anesthesia:

• Intramuscular: 0.05 mg/kg up to a maximum of 4 mg.
• Intravenous: 2 mg total, or 0.044 mg/kg, whichever is smaller.
• This dose should not ordinarily be exceeded in patients over 50 years of age.
• Larger doses as high as 0.05 mg/kg up to a total of 4 mg may be administered.

Usual Adult Dose for Nausea/Vomiting: Oral or Intravenous: 0.5 to 2 mg every 4 to 6 hours as needed.

Usual Adult Dose for Status Epilepticus: 4 mg/dose slow Intravenous over 2 to 5 minutes (maximum rate: 2 mg/minute); may repeat in 10 to 15 minutes; usual total maximum dose: 8 mg.

What is the dose of loprazepam for a child?

Usual Pediatric Dose for Nausea/Vomiting – Chemotherapy Induced:

Children: Intravenous: Limited information exists, especially for multiple doses:

• single dose: 0.04 to 0.08 mg/kg/dose prior to chemotherapy (maximum dose: 4 mg).
• multiple doses: some centers use 0.02 to 0.05 mg/kg/dose (maximum dose: 2 mg) every 6 hours as needed.

Usual Pediatric Dose for Anxiety: Infants and Children: Usual: 0.05 mg/kg/dose (maximum dose: 2 mg/dose) every 4 to 8 hours; range: 0.02 to 0.1 mg/kg

Usual Pediatric Dose for Sedation: Sedation (preprocedure): Infants and Children:

• Oral, Intramuscular, Intravenous: Usual: 0.05 mg/kg; range: 0.02 to 0.09 mg/kg.
• Intravenous: May use smaller doses (e.g., 0.01 to 0.03 mg/kg) and repeat every 20 minutes, as needed to titrate to effect.

Usual Pediatric Dose for Status Epilepticus: Infants and Children: 0.05 to 0.1 mg/kg (maximum: 4 mg/dose) slow Intravenous over 2 to 5 minutes (maximum rate: 2 mg/minute); may repeat every 10 to 15 minutes if needed.

Adolescents: 0.07 mg/kg (maximum: 4 mg/dose) slow Intravenous over 2 to 5 minutes (maximum rate: 2 mg/minute); may repeat in 10 to 15 minutes if needed; usual total maximum dose: 8 mg.

 How is loprazepam available?

Loprazepam is available in the following dosage forms and strengths:

• Tablet, Oral: 0.5 mg, 1 mg, 2 mg.
• Solution for intravenous or intramuscular injection.

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

In case of an emergency or an overdose, call your local emergency services (115) or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of loprazepam, 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.