Lorazepam Side Effects

Brand Names: Ativan

Please note - some side effects for Lorazepam may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

Side Effects of Lorazepam - for the Consumer

Lorazepam

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Lorazepam:

Clumsiness; dizziness; drowsiness; headache; lightheadedness; unsteadiness; weakness.

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); memory loss; mood or mental changes (eg, depression).

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

Lorazepam Solution

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Lorazepam Solution:

Clumsiness; dizziness; drowsiness; headache; lightheadedness; unsteadiness; weakness.

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); memory loss.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

Lorazepam Side Effects - for the Professional

Lorazepam

Most adverse reactions to benzodiazepines, including CNS effects and respiratory depression, are dose dependent, with more severe effects occurring with high doses.

In a sample of about 3500 patients treated for anxiety, the most frequent adverse reaction to Lorazepam was sedation (15.9%), followed by dizziness (6.9%), weakness (4.2%), and unsteadiness (3.4%). The incidence of sedation and unsteadiness increased with age.

Other adverse reactions to benzodiazepines, including Lorazepam are fatigue, drowsiness, amnesia, memory impairment, confusion, disorientation, depression, unmasking of depression, disinhibition, euphoria, suicidal ideation/attempt, ataxia, asthenia, extrapyramidal symptoms, convulsions/seizures tremor, vertigo, eye-function/visual disturbance (including diplopia and blurred vision), dysarthria/slurred speech, change in libido, impotence, decreased orgasm; headache, coma; respiratory depression, apnea, worsening of sleep apnea, worsening of obstructive pulmonary disease; gastrointestinal symptoms including nausea, change in appetite, constipation, jaundice, increase in bilirubin, increase in liver transaminases, increase in alkaline phosphatase; hypersensitivity reactions, anaphylactic/oid reactions; dermatological symptoms, allergic skin reactions, alopecia; SIADH, hyponatremia; thrombocytopenia, agranulocytosis, pancytopenia; hypothermia; and autonomic manifestations.

Paradoxical reactions, including anxiety, excitation, agitation, hostility, aggression, rage, sleep disturbances/insomnia, sexual arousal, and hallucinations may occur. Small decreases in blood pressure and hypotension may occur but are usually not clinically significant, probably being related to the relief of anxiety produced by Lorazepam.

Side Effects by Body System - for Healthcare Professionals

Nervous system

Nervous system side effects have been common and have included drowsiness, fatigue, confusion, impaired cognition, daytime anxiety, asthenia, amnesia, headache, dizziness, and ataxia. Orofacial dyskinesias have been observed rarely.

One study has suggested that the amnestic effects of lorazepam may be increased in patients who consume a large amount of ethanol.

The manufacturer has stated that elderly patients may be associated with a greater incidence of central nervous system depression.

Respiratory

Respiratory side effects including depression have been observed rarely with parenteral administration of lorazepam.

Equipment for resuscitation should be immediately available when parenteral lorazepam is used.

The manufacturer has stated that elderly patients may be associated with more respiratory depression.

Other

Other side effects have included withdrawal symptoms after abrupt cessation of lorazepam. Withdrawal symptoms have included agitation, restlessness, anxiety, insomnia, convulsions, tremor, abdominal cramps, vomiting, and sweating. Mania and delusional depression have also been observed rarely.

Local

The vehicle for the injectable form of lorazepam is propylene glycol, which can cause hyperlactatemia and elevated osmolar gaps. Propylene glycol may also interfere with renal tubular function and may blunt renal compensation for respiratory acidosis. While some guidelines seem to indicate that propylene glycol toxicity occurs at high dose (>18 mg/hr) lorazepam infusions, multiple instances of propylene glycol toxicity from far lower dose (4 to 6 mg/hr) lorazepam infusions have also been reported.

Local side effects at the site of intramuscular injection (pain, burning, local irritation and swelling) occur in about 8% of patients. Rarely, vascular impairment after inadvertent intra-arterial injection has occurred, sometimes with severe consequences.

Hematologic

Hematologic side effects including hemolytic anemia, pancytopenia, neutropenia, and aplastic anemia have been reported.

Endocrine

Endocrine side effects including the syndrome of inappropriate secretion of ADH have been reported rarely in association with lorazepam use.

Musculoskeletal

Musculoskeletal side effects including myopathy and one case of rhabdomyolysis have been reported.

Renal

Renal side effects have been reported including a case of hyperlactatemia, increased osmolar gap, and renal dysfunction during continuous lorazepam infusion.

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