- Tablets: 0.5 mg, 1 mg, and 2 mg
- 05 mg/kg IV (up to 7 mg) which can be repeated in 5 min
- 2 to 3 mg/day given bid. or tid.
- a single daily dose of 2 to 4 mg may be given, usually at bedtime.
For elderly or debilitated patients:
- Initial dosage of 1 to 2 mg/day in divided doses is recommended, to be adjusted as needed and tolerated.
The dosage of Ativan (lorazepam) should be increased gradually when needed to help avoid adverse effects.
When higher dosage is indicated, the evening dose should be increased before the daytime doses.
Causes sedation if used with CNS depressants such as
- narcotic analgesics
- sedative antihistamines
Concomitant use of clozapine and lorazepam may produce
- marked sedation
- excessive salivation
- respiratory arrest
Concurrent administration of lorazepam with valproate results in
- increased plasma concentrations and reduced clearance of lorazepam.
- Lorazepam dosage should be reduced to approximately 50% when coadministered with valproate.
Concurrent administration of lorazepam with probenecid may result in
- a more rapid onset or prolonged effect of lorazepam due to increased half-life and decreased total clearance.
- Lorazepam dosage needs to be reduced by approximately 50% when coadministered with probenecid.
- The effects of probenecid and valproate on lorazepam may be due to inhibition of glucuronidation.
Administration of theophylline or aminophylline
- may reduce the sedative effects of benzodiazepines, including lorazepam
- Blurred vision
- Hypersensitivity reactions,
- Anaphylactic reactions
- Respiratory depression and partial airway obstruction, especially when combined with narcotics
- Respiratory depression
- Worsening of sleep apnea
- paradoxical reactions (irritability, excitability);
- may make depression or psychosis worse
- unmasking of depression
- suicidal ideation/attempt
- extrapyramidal symptoms
- convulsions/seizures tremor
- dysarthria/slurred speech
- change in appetite,
- increase in bilirubin,
- increase in liver transaminases,
- increase in alkaline phosphatase;
- change in libido
- decreased orgasm
- dermatological symptoms
- allergic skin reactions
- Avoid using during nursing
Sign and symptoms of toxicity:
- CNS depression ranging from drowsiness to
- Cardiovascular depression
- Respiratory depression,
- Hypnotic state
- When there is a risk of aspiration, induction of emesis is not recommended.
- Gastric lavage may be indicated if performed soon after ingestion or in symptomatic patients.
- Administration of activated charcoal may also limit drug absorption.
- Hypotension, though unlikely, usually may be controlled with norepinephrine bitartrate injection.
- Lorazepam is poorly dialyzable. Lorazepam glucuronide, the inactive metabolite, may be highly dialyzable