Lorazepam: Side effects, Uses an Dosage

 

Lorazepam side effects

What is lorazepam and its side effects?

Lorazepam is a benzodiazepine (ben-zoe-dye-AZE-eh-peen) It is thought that benzodiazepines work by enhancing the activity of certain neurotransmitters in the brain.

Lorazepam is used to treat anxiety disorders, insomnia, and seizures.

It is dangerous to purchase lorazepam on the Internet or outside the United States. The sale and distribution of medicines outside the U.S. does not comply with safe-use regulations of the Food and Drug Administration (FDA). These medications may contain dangerous ingredients, or may not be distributed by a licensed pharmacy.

Warnings

Lorazepam can slow or stop your breathing, especially if you have recently used an opioid medication, alcohol, or other drugs that can slow your breathing. These effects can be fatal.

MISUSE OF LORAZEPAM CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep this medicine where others cannot get to it.

Lorazepam may be habit-forming and should be used only by the person it was prescribed for. This medicine should never be shared with another person, especially someone who has a history of drug abuse or addiction.

Do not stop using lorazepam without asking your doctor. You may have life-threatening withdrawal symptoms if you stop using the medicine suddenly after long-term use. Some withdrawal symptoms may last up to 12 months or longer.

Get medical help right away if you stop using lorazepam and have symptoms such as: unusual muscle movements, being more active or talkative, sudden and severe changes in mood or behavior, confusion, hallucinations, seizures, or thoughts about suicide.

Do not use lorazepam if you are pregnant. This medicine can cause birth defects or life-threatening withdrawal symptoms in a newborn.

You should not use this medicine if you have narrow-angle glaucoma, severe respiratory insufficiency, myasthenia gravis, or if you are allergic to Valium or a similar medicine.

Before taking this medicine

You should not use lorazepam if you have:

  • narrow-angle glaucoma; or

  • a history of allergic reaction to any benzodiazepine (lorazepam, alprazolam, diazepam, Valium, Xanax, Versed, Klonopin, and others).

To make sure lorazepam is safe for you, tell your doctor if you have ever had:

Tell your doctor if you are pregnant or plan to become pregnant. If you use lorazepam during pregnancy, your baby could be born with life-threatening withdrawal symptoms, and may need medical treatment for several weeks.

You should not breastfeed while you are taking lorazepam.

If you do breastfeed, tell your doctor if you notice drowsiness, feeding problems, or slow weight gain in the nursing baby.

Lorazepam is not approved for use by anyone younger than 12 years old. Extended-release lorazepam should not be used by anyone younger than 18 years old.

How should I take lorazepam?

Take lorazepam exactly as prescribed by your doctor. Follow the directions on your prescription label and read all medication guides or instruction sheets. Never use lorazepam in larger amounts, or for longer than prescribed. Tell your doctor if you feel an increased urge to use more of lorazepam.

Never share this medicine with another person, especially someone with a history of drug abuse or addiction. MISUSE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medication in a place where others cannot get to it. Selling or giving away this medicine is against the law.

Measure the oral concentrate (liquid) with the supplied measuring device (not a kitchen spoon). Mix the liquid with water, juice, soda, or soft food such as applesauce or pudding. Swallow this mixture right away.

Swallow the extended-release capsule whole and do not crush, chew, break, or open it.

If you cannot swallow a capsule whole, open it and mix the medicine with applesauce. Swallow the mixture right away without chewing. Then drink a glass of water.

Do not stop using lorazepam without asking your doctor. You may have life-threatening withdrawal symptoms if you stop using the medicine suddenly after long-term use.

Store tightly closed at room temperature, away from moisture and heat.

Store the liquid form of lorazepam in the refrigerator. Throw away any liquid not used within 90 days.

Keep your medicine in a place where no one can use it improperly.

Dosing information

Usual Adult Dose for Anxiety:

ORAL:
Initial dose: 2 to 3 mg orally per day, given 2 to 3 times per day
Maintenance dose: 1 to 2 mg orally 2 to 3 times a day.

Usual Adult Dose for Light Anesthesia:

INJECTION:
IM: 0.05 mg/kg IM ONCE
-Maximum dose: 4 mg

IV: 2 mg total OR 0.044 mg/kg IV ONCE, whichever is smaller

Comments:
-Doses of other injectable central-nervous-system depressant drugs should be reduced.
-Narcotic analgesics should be administered at their usual preoperative time.
-IV: The recommended dose of 2 mg (OR 0.44 mg/kg, whichever is smaller) should not ordinarily be exceeded in patients over 50 years of age.
-IV: Doses up to 0.05 mg/kg (4 mg maximum) may be administered.
-IM: For optimum effect, this route should be administered at least 2 hours before the anticipated operative procedure.
-IV: For optimum effect, this route should be administered 15 to 20 minutes before the anticipated operative procedure.

Use: As a preanesthetic medication to produce sedation (sleepiness or drowsiness), relieve anxiety, and decrease the ability to recall events related to the day of surgery

Usual Adult Dose for Status Epilepticus:

INJECTION: 4 mg IV given at a rate of 2 mg/min; may repeat the dose in 10 to 15 minutes
-Maximum total dose: 8 mg

Comments :
-Vital signs should be monitored, an unobstructed airway should be maintained, and artificial ventilation equipment should be available.
-When an intravenous port is not available, the IM route may prove useful.

Use: Treatment of status epilepticus

Usual Adult Dose for Insomnia:

ORAL: 2 to 4 mg orally once a day at bedtime

Comments:
-The dosage should be increased gradually when needed to help avoid adverse effects.
-Clinical studies have not evaluated this drug for efficacy in long-term treatment (e.g., greater than 4 months).

Use: Management of insomnia due to anxiety of transient situational stress

Usual Geriatric Dose for Anxiety:

ORAL:
Older or debilitated patients:
-Initial dose: 1 to 2 mg orally per day, given in divided doses

Comments:
-The dosage should be increased gradually when needed to help avoid adverse effects.

Usual Pediatric Dose for Anxiety:

ORAL:
12 years or older:
-Initial dose: 2 to 3 mg orally per day, given 2 to 3 times per 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.
-The dosage 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.
-Use of anxiolytic agents is typically not needed to treat anxiety/tension associated with the stress of everyday life.
-Clinical studies have not evaluated this drug for efficacy in long-term treatment (e.g., greater than 4 months).

Uses:
-Management of anxiety disorders
-Short-term relief of the symptoms of anxiety or anxiety associated with depressive symptoms

Usual Pediatric Dose for Insomnia:

ORAL:
12 years or older: 2 to 4 mg orally once a day at bedtime

Comments:
-For debilitated patients, an initial dosage of 1 to 2 mg/day in divided doses is recommended.
-The dosage should be increased gradually when needed to help avoid adverse effects.
-Clinical studies have not evaluated this drug for efficacy in long-term treatment (e.g., greater than 4 months).

Use: Management of insomnia.

  Detailed Lorazepam dosage information

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of lorazepam can be fatal if you take it with alcohol, opioid medicine, or other drugs that cause drowsiness or slow your breathing.

Overdose symptoms may include severe drowsiness, confusion, slurred speech, feeling restless, muscle weakness, loss of balance or coordination, feeling light-headed, slow heartbeats, weak or shallow breathing, or coma.

What should I avoid while taking lorazepam?

Avoid drinking alcohol. Dangerous side effects or death could occur. Lorazepam Lorazepam and alcohol (more detail)

Avoid driving or hazardous activity until you know how lorazepam will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.

Lorazepam side effects

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

Lorazepam can slow or stop your breathing, especially if you have recently used an opioid medication or alcohol. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up.

Call your doctor at once if you have:

  • severe drowsiness;

  • unusual changes in mood or behavior, being agitated or talkative;

  • sudden restless feeling or excitement;

  • thoughts of suicide or hurting yourself;

  • confusion, aggression, hallucinations;

  • sleep problems;

  • vision changes; or

  • dark urine, or jaundice (yellowing of the skin or eyes).

Drowsiness or dizziness may last longer in older adults. Use caution to avoid falling or accidental injury.

Common lorazepam side effects may include:

  • dizziness, drowsiness;

  • weakness; or

  • feeling unsteady.

After you stop using lorazepam, get medical help right away if you have symptoms such as: unusual muscle movements, being more active or talkative, sudden and severe changes in mood or behavior, confusion, hallucinations, seizures, suicidal thoughts or actions.

Some withdrawal symptoms may last up to 12 months or longer after stopping this medicine suddenly. Tell your doctor if you have ongoing anxiety, depression, problems with memory or thinking, trouble sleeping, ringing in your ears, a burning or prickly feeling, or a crawling sensation under your skin.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. Lorazepam side effects 

What other drugs will affect lorazepam?

Taking lorazepam with other drugs that make you sleepy or slow your breathing can cause dangerous side effects or death. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.

Tell your doctor about all your other medicines, especially:

  • probenecid, aminophylline, or theophylline;

  • medicine to treat mental illness; or

  • medicine that contains an antihistamine (such as sleep medicine, cold or allergy medicine).

This list is not complete. Other drugs may interact with lorazepam, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here. Lorazepam drug interactions 

Important information about lorazepam

Generic name: lorazepam (oral) [ lor-A-ze-pam ]
Brand names: Ativan, Lorazepam Intensol, Loreev XR
Dosage forms: oral capsule, extended release (1 mg; 2 mg; 3 mg); oral concentrate (2 mg/mL); oral tablet (0.5 mg; 1 mg; 2 mg)
Drug classes: Benzodiazepine anticonvulsantsBenzodiazepinesMiscellaneous antiemetics

Drugs Side Effects 101