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Lorazepam Dosage

Medically reviewed on March 9, 2017.

Applies to the following strengths: 1 mg; 2 mg; 0.5 mg; 4 mg/mL; 2 mg/mL; 1 mg/mL-NaCl 0.9%; 1 mg/mL-D5%

Usual Adult Dose for:

Usual Geriatric Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Anxiety

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

Comments:
-The daily dosage may vary from 1 to 10 mg per 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: Management of anxiety disorders or for the short-term relief of the symptoms of anxiety or anxiety associated with depressive symptoms

Usual Adult Dose for Light Anesthesia

IM: 0.05 mg/kg IM once
-Maximum total 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.
-For optimum effect, intramuscular drug should be administered at least 2 hours before the anticipated operative procedure.
-Narcotic analgesics should be administered at their usual preoperative time.
-IV: This dose should not ordinarily be exceeded in patients over 50 years of age.
-IV: Larger doses as high as 0.05 mg/kg up to a total of 4 mg may be administered.
-For optimum effect, intravenous drug should be administered 15 to 20 minutes before the anticipated operative procedure.

Use: Preanesthetic medication for adult patients, producing sedation (sleepiness or drowsiness), relief of anxiety, and a decreased ability to recall events related to the day of surgery

Usual Adult Dose for Status Epilepticus

4 mg IV given at a rate of 2 mg/min; may repeat the dose in 5 to 10 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

2 to 4 mg orally administered once a day at bedtime

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

Use: Management of insomnia

Usual Geriatric Dose for Anxiety

Elderly or debilitated patients: 1 to 2 mg orally per day in divided doses

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

Use: Management of anxiety disorders or for the short-term relief of the symptoms of anxiety or anxiety associated with depressive symptoms

Usual Pediatric Dose for Anxiety

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

Comments:
-The daily dosage may vary from 1 to 10 mg per 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: Management of anxiety disorders or for the short-term relief of the symptoms of anxiety or anxiety associated with depressive symptoms

Usual Pediatric Dose for Insomnia

12 years or older: 2 to 4 mg orally administered 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.

Use: Management of insomnia

Renal Dose Adjustments

Oral:
-Renal dysfunction: Use with caution
-Renal failure: Not recommended.

Parenteral:
-Frequent doses given over a relatively short period of time: Use with caution
-Infrequent doses and/or doses given over a long period of time: No adjustment recommended.

Liver Dose Adjustments

Oral:
Mild to moderate liver dysfunction: Use with caution
Liver failure: Not recommended.

Parenteral: No adjustment recommended.

Dose Adjustments

Doses should be reduced by 50% when coadministered with probenecid or valproate.

Parenteral: It may be necessary to increase the dose in female patients who are concomitantly taking oral contraceptives.

Precautions

US BOXED WARNINGS:
RISKS FROM CONCOMITANT USE WITH OPIOIDS:
-Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death.
-Monitor patients for respiratory depression and sedation.

Safety and efficacy of oral solution and tablet formulations have not been established in patients younger than 12 years.
Safety and efficacy of injection formulations have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

US Controlled Substance: Schedule IV

Dialysis

Data not available

Other Comments

Administration advice:
-Oral concentrates: Solutions may be mixed with liquid or semi-solid foods.

Storage requirements:
-Injection: Protect from light; store in a refrigerator at 2 to 8 C (36 to 46 F)
-Oral Concentrate: Store in a refrigerator at 2 to 8 C; discard after 90 days of opening
-Oral Solution: Store in a refrigerator at 2 to 8 C; protect from light
-Tablets: Store in a cool, dry place

Reconstitution/preparation techniques:
-The manufacturer product information should be consulted.

IV compatibility:
-The manufacturer product information should be consulted.

General:
-This drug has not been shown to treat cardiovascular and/or gastrointestinal components of anxiety.

Monitoring:
-Respiratory function, especially in status epilepticus
-Renal function, especially in elderly patients with decreased renal function
-Periodic blood counts, especially in patients on long-term therapy
-Periodic liver function tests, especially in patients on long-term therapy
-Sedation, especially within 1 hour of administration AND when given a parenteral formulation

Patient advice:
-This medicine may increase the risk of suicidal thoughts and behavior. Patients should be alert for the emergence or worsening of symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts, behavior, or thoughts about self-harm. Patients should report any behavior of concern to their healthcare provider as soon as possible.
-This drug may cause drowsiness, dizziness, and reduced alertness. Patients should not drive a car or operate dangerous machinery until they know how this drug affects them.
-Patients should avoid drinking alcohol or taking other drugs that may cause sleepiness or dizziness while taking this drug until they talk to their healthcare provider.
-Patients should be told to avoid contact their healthcare provider before increasing/decreasing the dose or discontinuing treatment.
-Advise patients to speak to their healthcare provider if they become pregnant, intend to become pregnant, or are breastfeeding.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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