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lorazepam (injection)

Pronunciation

Generic Name: lorazepam (injection) (lor A ze pam)
Brand Name: Ativan

What is lorazepam injection?

Lorazepam is a benzodiazepine (ben-zoe-dye-AZE-eh-peen). Lorazepam affects chemicals in the brain that may be unbalanced in people with certain conditions.

Lorazepam injection is used to treat a seizure emergency called status epilepticus. Lorazepam injection is also used as a sedative to help you relax before having surgery.

Lorazepam injection may also be used for purposes not listed in this medication guide.

What is the most important information I should know about lorazepam injection?

Before you are treated with lorazepam injection, tell your doctor about all your medical conditions or allergies, and all the medicines you are using. Also make sure your doctor knows if you are pregnant or breast-feeding. In some cases, you may not be able to use lorazepam, or you may need a dose adjustment or special precautions.

In an emergency situation it may not be possible to tell your caregivers about your health conditions. Make sure any doctor caring for you afterward knows you have received this medicine.

What should I discuss with my healthcare provider before using lorazepam injection?

If possible before you receive lorazepam injection, tell your doctor if you are allergic to any drugs, or if you have:

  • narrow-angle glaucoma;

  • sleep apnea or severe breathing problem; or

  • a known allergy to polyethylene glycol, propylene glycol, benzyl alcohol, or to other benzodiazepines (alprazolam, Xanax, Valium, or others).

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

  • a history of seizures;

  • asthma or other breathing disorder;

  • kidney disease; or

  • liver disease.

Lorazepam can cause birth defects in an unborn baby, and generally should not be used during pregnancy. However, status epilepticus is a life-threatening condition and the benefit of receiving lorazepam to treat it may outweigh any risk to the unborn baby.

It is not known whether lorazepam injection passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

In an emergency situation, it may not be possible before you are treated with lorazepam to tell your caregivers if you are pregnant or breast feeding. Make sure any doctor caring for your pregnancy or your baby knows you have received this medication.

How is lorazepam injection given?

Lorazepam is injected into a vein through an IV. You will receive this injection in an emergency or surgical setting.

You may need to receive only one dose of lorazepam if your condition improves after the medicine is given.

After treatment with lorazepam injection, you will be watched to make sure the medication is working and does not cause harmful side effects.

Your breathing, blood pressure, oxygen levels, and other vital signs will be watched closely while you are in surgery.

Lorazepam can make you very drowsy, dizzy, or light-headed. These effects may last longer in older adults. Use caution to avoid falling or accidental injury after you have received lorazepam injection. You may need help getting out of bed for at least the first 8 hours.

What happens if I miss a dose?

Since lorazepam injection is given by a healthcare professional in an emergency setting, you are not likely to miss a dose.

What happens if I overdose?

Since this medication is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

What should I avoid after receiving lorazepam injection?

Lorazepam injection can cause extreme drowsiness that may last for 24 to 48 hours after you have received the medication. Older adults may feel sleepy for even longer.

Avoid driving or doing anything that requires you to be awake and alert until the effects of lorazepam have worn off completely.

Do not drink alcohol within the first 1 or 2 days after you receive lorazepam injection. This medication can increase the effects of alcohol.

Lorazepam injection side effects

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

Tell your caregivers right away if you have:

  • weak or shallow breathing;

  • restlessness, feeling agitated or irritable;

  • unusual thoughts, hallucinations; or

  • a light-headed feeling, like you might pass out.

Common side effects may include:

  • nausea, vomiting;

  • drowsiness, dizziness, confusion;

  • blurred vision; or

  • pain, redness, or burning where the medicine was injected.

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.

See also: Side effects (in more detail)

Lorazepam dosing information

Usual Adult Dose for Anxiety:

Tablets:
Initial dose: 2 to 3 mg orally per day administered 2 to 3 times per day
Maintenance dose: 1 to 2 mg orally 2 to 3 times a day
Parenteral:
IV: 2 mg total, or 0.044 mg/kg, whichever is smaller

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 up to a maximum of 4 mg
IV: 2 mg total, or 0.044 mg/kg, 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:

0.1 mg/kg IV up to 4 mg per dose; may repeat in 5 to 10 minutes
Maximum 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 at bedtime

Comments:
-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

Comments:
-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 administered 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 elderly or 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

What other drugs will affect lorazepam injection?

Shortly after you are treated with this medicine, taking other drugs that make you sleepy or slow your breathing can cause dangerous side effects. Tell your doctor if you regularly use a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • any other benzodiazepines (such as alprazolam, diazepam, Valium, Xanax, and others);

  • probenecid;

  • valproate or other seizure medication;

  • birth control pills; or

  • medicine to treat mental illness.

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 interactions are listed in this medication guide.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about lorazepam injection.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 3.01. Revision Date: 2016-03-07, 6:54:44 AM.

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