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Lorazepam (Oral route)

Pronunciation:

lor-AZ-e-pam

Brand Names:

  • Ativan
  • Lorazepam Intensol

Dosage Forms:

  • Tablet
  • Solution

Classifications:

Therapeutic—

Antianxiety

Pharmacologic—

Benzodiazepine, Short or Intermediate Acting

Uses of This Medicine:

Lorazepam is used to treat anxiety. This medicine is a benzodiazepine. Benzodiazepines belong to the group of medicines called central nervous system (CNS) depressants, which are medicines that slow down the nervous system.

This medicine is available only with your doctor's prescription.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies have not been performed on the relationship of age to the effects of lorazepam in children under 12 years of age. Safety and efficacy have not been established.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of lorazepam in the elderly. However, severe drowsiness or unsteadiness are more likely to occur in the elderly, who are usually more sensitive than younger adults to the effects of lorazepam. Elderly patients may require a lower dose to help reduce unwanted effects.

Pregnancy—

Pregnancy CategoryExplanation
All TrimestersDStudies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.

Breast-feeding—

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Alfentanil
  • Amobarbital
  • Anileridine
  • Aprobarbital
  • Buprenorphine
  • Butabarbital
  • Butalbital
  • Carbinoxamine
  • Carisoprodol
  • Chloral Hydrate
  • Chlorzoxazone
  • Codeine
  • Dantrolene
  • Ethchlorvynol
  • Fentanyl
  • Fospropofol
  • Hydrocodone
  • Hydromorphone
  • Levorphanol
  • Meclizine
  • Meperidine
  • Mephenesin
  • Mephobarbital
  • Meprobamate
  • Metaxalone
  • Methadone
  • Methocarbamol
  • Methohexital
  • Mirtazapine
  • Morphine
  • Morphine Sulfate Liposome
  • Orlistat
  • Oxycodone
  • Oxymorphone
  • Pentobarbital
  • Phenobarbital
  • Primidone
  • Propoxyphene
  • Remifentanil
  • Secobarbital
  • Sodium Oxybate
  • Sufentanil
  • Suvorexant
  • Tapentadol
  • Thiopental
  • Zolpidem

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Perampanel
  • Posaconazole
  • Probenecid
  • Pyrimethamine
  • St John's Wort
  • Theophylline
  • Valproic Acid

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Glaucoma, acute narrow-angle—Should not be used in patients with this condition.
  • Kidney disease or
  • Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.
  • Lung diseases (e.g., COPD, sleep apnea syndrome) or
  • Seizures—Use with caution. May make these conditions worse.

Proper Use of This Medicine:

Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

To use the oral solution:

This medicine is to be taken by mouth. Measure the oral liquid with the provided medicine dropper. Dilute each dose with water, juice, soda, applesauce and puddings.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage forms (tablets or solution):
    • For anxiety:
      • Adults or teenagers—2 to 6 milligrams (mg) in divided doses per day. Your doctor may adjust your dose as needed.
      • Older adults—At first, 1 to 2 mg in divided doses per day. Your doctor may adjust your dose as needed.
      • Children younger than 12 years of age—Use and dose must be determined by your doctor.

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using This Medicine:

It is very important that your doctor check your progress at regular visits to allow for changes in your dose and to check for any unwanted effects. Blood tests may be needed to check for any unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.

This medicine may cause drowsiness, trouble with thinking, trouble with controlling movements, or trouble with seeing clearly. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert or able to think or see well.

Do not stop taking it without checking with your doctor first. Your doctor may want you to gradually reduce the amount you are using before stopping it completely. This may help prevent a worsening of your condition and reduce the possibility of withdrawal symptoms, such as convulsions (seizures), hallucinations, stomach or muscle cramps, tremors, or unusual behavior.

This medicine will add to the effects of alcohol and other central nervous system (CNS) depressants. CNS depressants are medicines that slow down the nervous system, which may cause drowsiness or make you less alert. Some examples of CNS depressants are antihistamines or medicine for hay fever, allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates (used for seizures); muscle relaxants; or anesthetics (numbing medicines), including some dental anesthetics. This effect may last for a few days after you stop taking this medicine. Check with your doctor before taking any of the above while you are using this medicine.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common
Drowsiness
relaxed and calm
sleepiness
Incidence not known
Abdominal or stomach pain
aggressive, angry
agitation
anxiety
attack, assault, or force
black, tarry stools
bleeding gums
blood in urine or stools
bluish lips or skin
blurred vision
change in consciousness
chills
coma
confusion
confusion about identity, place, and time
convulsions
cough or hoarseness
dark urine
decreased urine output
difficulty in breathing and/or swallowing
difficulty in speaking
discouragement
dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
drooling
dry mouth
excitation
false or unusual sense of well-being
fast or irregular heartbeat
fear or nervousness
feeling sad or empty
fever with or without chills
general feeling of tiredness or weakness
headache
hives
hyperventilation
increased thirst
irregular, fast or slow, or shallow breathing
irritability
itching
loss of appetite
loss of balance control
loss of consciousness
loss of interest or pleasure
loss of memory
lower back or side pain
muscle pain or cramps
muscle trembling, jerking, or stiffness
nausea or vomiting
not breathing
painful or difficult urination
pale or blue lips, fingernails, or skin
pinpoint red spots on skin
problems with memory
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
rash
reddening of the skin, especially around ears
restlessness
seeing, hearing, or feeling things that are not there
seizures
shaking
shortness of breath
shuffling walk
sleeplessness
sore throat
sores, ulcers, or white spots on lips or in mouth
stiffness of limbs
sweating
swelling of eyes or inside of nose
swelling of face, ankles, or hands
swollen glands
thoughts or attempts at killing oneself
tightness in chest
trouble concentrating
trouble sleeping
twisting movements of body
unable to sleep
uncontrolled movements, especially of face, neck, and back
unexplained bleeding or bruising
unpleasant breath odor
unusual bleeding or bruising
unusual tiredness or weakness
vomiting of blood
wheezing
yellow eyes or skin

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose
Changes in patterns and rhythms of speech
increased sweating
loss of strength or energy
low blood pressure
nightmares
shakiness and unsteady walk
slurred speech
trouble in speaking
unsteadiness, trembling, or other problems with muscle control or coordination
unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
unusual excitement, nervousness, restlessness, or irritability
unusual paleness unusual weak feeling

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known
Being forgetful
clumsiness
constipation
decreased interest in sexual intercourse
disturbed color perception
dizziness or lightheadedness
double vision
drowsiness
feeling of constant movement of self or surroundings
hair loss, thinning of hair
halos around lights
hostility
inability to have or keep an erection
increased in sexual ability, desire, drive, or performance
increased interest in sexual intercourse
lack or loss of self-control
lethargy
loss in sexual ability, desire, drive, or performance
low body temperature
muscle aches
muscle twitching
muscle weakness
night blindness
overbright appearance of lights
rapid weight gain
sensation of spinning
shakiness in legs, arms, hands, or feet
shivering
sleepiness
stupor
trembling or shaking of hands or feet
tunnel vision
weak or feeble pulse

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 11/4/2014

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