lorazepam

Lorazepam is used for the management of anxiety disorders, the short-term relief of symptoms of anxiety or anxiety associated with depression.

• Lorazepam is effective for panic attacks, short-term and long-term treatment of insomnia and is used in combination with other medications to prevent nausea and vomiting resulting from chemotherapy.
• Lorazepam also is administered before anesthesia for sedation and used for prevention and treatment of alcohol withdrawal.
• It also is used for treating seizures (status epilepticus)

Excessive activity of nerves in the brain may cause anxiety and other psychological disorders. Gamma-aminobutyric acid (GABA) is a neurotransmitter, a chemical that nerves in the brain use to send messages to one another that reduces the activity of nerves in the brain.

It is thought that lorazepam and other benzodiazepines may act by enhancing the effects of GABA in the brain to reduce activity. Because lorazepam is removed from the blood more rapidly than many other benzodiazepines, there is less chance that lorazepam concentrations in blood will reach high levels and become toxic. Lorazepam also has fewer interactions with other medications than most of the other benzodiazepines.

Lorazepam belongs to the benzodiazepine family of drugs, the same family that includes:

• diazepam (Valium)
• alprazolam (Xanax)
• clonazepam (Klonopin)
• flurazepam (Dalmane)
• Other medications

• Do not drive or operate heavy machinery until you know how taking lorazepam affects you.
• Like all benzodiazepines, lorazepam can cause physical dependence. Suddenly stopping therapy after a few months of daily therapy may be associated with a feeling of loss of self-worth, agitation, and insomnia.
• If lorazepam is taken continuously for longer than a few months, stopping therapy suddenly may produce seizures, tremors, muscle cramping, vomiting, and sweating.

The most common side effects of lorazepam are:

• Sedation
• Dizziness
• Weakness
• Unsteadiness

Other side effects of lorazepam include:

• A feeling of depression
• Amnesia
• Loss of orientation
• Headaches
• Sleep disturbances
• Low blood pressure (hypotension)
• Impotence (erectile dysfunction, ED)
• Changes in appetite
• Sleep apnea

Possible serious side effects of lorazepam include:

• Extrapyramidal symptoms
• Respiratory depression
• Suicidal ideation/attempt
• Seizures
• Depression

• The dose of lorazepam is tailored to the patient's needs.
• The usual dose for treating anxiety is 2-6 mg orally every 8 to 12 hours as needed.
• Insomnia is treated with 2-4 mg given at bedtime.

• Lorazepam is a benzodiazepine medicine. Taking benzodiazepines with opioid medicines, alcohol, or other central nervous system depressants (including street drugs) can cause severe drowsiness, breathing problems (respiratory depression), coma and death. Get emergency help right away if any of the following happens:
  • shallow or slowed breathing
  • breathing stops (which may lead to the heart stopping)
  • excessive sleepiness (sedation)
• Risk of abuse, misuse, and addiction. There is a risk of abuse, misuse, and addiction with benzodiazepines including Lorazepam, which can lead to overdose and serious side effects including coma and death.
  • Serious side effects including coma and death have happened in people who have abused or misused benzodiazepines, including Lorazepam. These serious side effects may also include delirium, paranoia, suicidal thoughts or actions, seizures, and difficulty breathing. Call your healthcare provider or go to the nearest hospital emergency room right away if you get any of these serious side effects.
  • You can develop an addiction even if you take Lorazepam exactly as prescribed by your healthcare provider.
  • Take Lorazepam exactly as your healthcare provider prescribed.
  • Do not share your Lorazepam with other people.
  • Keep Lorazepam in a safe place and away from children.
• Physical dependence and withdrawal reactions. Lorazepam can cause physical dependence and withdrawal reactions.
  • Do not suddenly stop taking Lorazepam. Stopping Lorazepam suddenly can cause serious and life-threatening side effects, including, unusual movements, responses or expressions, seizures, sudden and severe mental or nervous system changes, depression, seeing or hearing things that others do not see or hear, an extreme increase in activity or talking, losing touch with reality, and suicidal thoughts or actions. Call your healthcare provider or go to the nearest hospital emergency room right away if you get any of these symptoms.
  • Some people who suddenly stop benzodiazepines have symptoms that can last for several weeks to more than 12 months, including anxiety, trouble remembering, learning, or concentrating, depression, problems sleeping, feeling like insects are crawling under your skin, weakness, shaking, muscle twitching, burning or prickling feeling in your hands, arms, legs or feet, and ringing in your ears.
  • Physical dependence is not the same as drug addiction. Your healthcare provider can tell you more about the differences between physical dependence and drug addiction.
• Do not take more Lorazepam than prescribed or take Lorazepam for longer than prescribed.

Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor's recommendation.

Lorazepam and all benzodiazepines accentuate the effects of other drugs that slow the brain's processes such as alcohol, barbiturates, narcotics, and tranquilizers, and the combination of lorazepam and these drugs may lead to excessive sedation.

There have been cases of marked sedation when lorazepam was given to patients taking the tranquilizer loxapine (Loxitane); it is unclear if there is a drug interaction, but caution should be used if lorazepam and loxapine are used together.

Severe Interactions of lorazepam include:

• sodium oxybate

Serious Interactions of lorazepam include:

• valerian

Lorazepam has moderate interactions with at least 191 different drugs.

Lorazepam has mild interactions with at least 36 different drugs.

The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.

It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or health care provider if you have any questions about the medication. 

• Lorazepam and other benzodiazepines have been associated with fetal damage, including congenital malformations, when taken by pregnant women in their first trimester.
• Lorazepam is best avoided if at all possible in the first trimester and probably throughout pregnancy.
• Lorazepam is excreted in human milk and should be avoided during pregnancy.