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LORAZEPAM (LORAZEPAM)
- Anxiety
- Preoperative anxiety
- Status epilepticus
- Induce anterograde amnesia
- Sedation as adjunct to anesthesia
- Lorazepam Oral Concentrate
- Lorazepam Intensol Oral Concentrate
- Lorazepam Injection Solution
- Ativan Injection Solution
- By Indication
2 mg/mL oral concentrate
- 0.5 milliliter (1 mg) by oral route 3 times per day
2 mg/mL oral concentrate
- 0.5 milliliter (1 mg) by oral route 3 times per day
2 mg/mL injection solution
- Inject 1 milliliter (2 mg) by intravenous route 30 minutes before chemotherapy
4 mg/mL injection solution
- Inject 0.5 milliliter (2 mg) by intravenous route 30 minutes before chemotherapy
2 mg/mL injection solution
- Inject 1 milliliter (2 mg) by intravenous route 30 minutes before chemotherapy
4 mg/mL injection solution
- Inject 0.5 milliliter (2 mg) by intravenous route 30 minutes before chemotherapy
Anxiety
- 0.5 milliliter (1 mg) by oral route 3 times per day
- 1 milliliter (2 mg) by oral route 2 times per day
- 0.75 milliliter (1.5 mg) by oral route 2 times per day
Cancer chemotherapy-induced nausea and vomiting
- Inject 1 milliliter (2 mg) by intravenous route 30 minutes before chemotherapy
- Inject 1 milliliter (2 mg) by intravenous route every 4 hours as needed
- Inject 1.5 - 2 mg/m2 over 5 minute(s) by intravenous route 45 minutesbefore the initiation of chemotherapy up to a max of 3 mg
Induce anterograde amnesia
- Inject 0.05 mg/kg by intramuscular route up to a maximum of 4 mg at least 2 hours prior to surgery
- Inject 0.044 mg/kg by intravenous route up to a maximum of 2 mg 15-20Minutes prior to surgery
- Inject 0.05 mg/kg by intravenous route up to a maximum of 4 mg 15-20 minutes prior to surgery
Insomnia
- 1 milliliter (2 mg) by oral route once daily at bedtime
- 1.5 milliliters (3 mg) by oral route once daily at bedtime
- 2 milliliters (4 mg) by oral route once daily at bedtime
Preoperative anxiety
- Inject 0.05 mg/kg by intramuscular route up to a maximum of 4 mg at least 2 hours prior to surgery
- Inject 0.044 mg/kg by intravenous route up to a maximum of 2 mg 15-20Minutes prior to surgery
- Inject 0.05 mg/kg by intravenous route up to a maximum of 4 mg 15-20 minutes prior to surgery
Sedation as adjunct to anesthesia
- Inject 0.05 mg/kg by intramuscular route up to a maximum of 4 mg at least 2 hours prior to surgery
- Inject 0.044 mg/kg by intravenous route up to a maximum of 2 mg 15-20Minutes prior to surgery
- Inject 0.05 mg/kg by intravenous route up to a maximum of 4 mg 15-20 minutes prior to surgery
Status epilepticus
- Inject 2 milliliters (4 mg) over 2 minute(s) by intravenous route x 1Dose, may be repeated in 10-15 minutes if needed
- sodium oxybate
- Xyrem
Contraindicated
- clozapine
- Clozaril
- Dehydrated Alcohol
- ethanol (ethyl alcohol)
- ethyl alcohol-herbal drugs
- Fazaclo
- Lydia Pinkham Herbal
- olanzapine
- olanzapine pamoate
- Versacloz
- Zyprexa
- Zyprexa Relprevv
Severe
Moderate
- buprenorphine-naloxone
- colchicine-probenecid
- Depacon
- Depakene
- Depakote
- Depakote Er
- Depakote Sprinkles
- divalproex
- isoniazid-rifamp-pyrazinamide
- probenecid
- Rifadin
- Rifamate
- rifampin
- rifampin-isoniazid
- Rifater
- Stavzor
- Suboxone
- valproate sodium
- valproic acid
- valproic acid (as sodium salt)
- Zubsolv
- Acute angle-closure glaucoma
Contraindicated
- Alcohol intoxication
- Hepatic encephalopathy
- Pregnancy
- Severe hepatic disease
Severe
Moderate
- Chronic pulmonary disease
- Disease of liver
- Drug abuse
- Hypoalbuminemia
- Kidney disease with likely reduction in GFR
- Severe renal impairment
- Sleep apnea
- Suicidal ideation
LORAZEPAM (LORAZEPAM)
- Anxiety
- Preoperative anxiety
- Status epilepticus
- Induce anterograde amnesia
- Sedation as adjunct to anesthesia
- Muscle weakness
- Ataxia
- Dizziness
- Drowsy
- Dyspepsia
- Slurred speech
More Frequent
Severe
Less Severe
- Acute confusion
- Behavioral disorders
- CNS depression
- Diarrhea
- Fatigue
- General weakness
Less Frequent
Severe
Less Severe
Rare / Very Rare
Severe
- Abnormal hepatic function tests
- Accidental fall
- Agranulocytosis
- Anaphylaxis
- Anemia
- Angioedema
- Aplastic anemia
- Apnea
- Coma
- Dehydration
- Depression
- Disease of liver
- Drug-induced psychosis
- Eosinophilia
- Hallucinations
- Hemolytic anemia
- Hepatomegaly
- Hostility
- Hypotension
- Jaundice
- Leukocytosis
- Leukopenia
- Manic disorder
- Memory impairment
- Neutropenic disorder
- Respiratory depression
- Seizure disorder
- Skin rash
- Sleep walking disorder
- Suicidal ideation
- Thrombocytopenic disorder
- Urinary retention
Less Severe
- Aggressive behavior
- Agitation
- Alopecia
- Anorexia
- Aphonia
- Blurred vision
- Bronchial congestion
- Complex sleep behavior
- Concentration difficulty
- Conjunctivitis
- Constipation
- Contact dermatitis
- Cramps
- Delirium
- Depersonalization
- Diplopia
- Disturbance in thinking
- Dream disorder
- Drug dependence
- Dry eye
- Dry skin
- Dysarthria
- Dyspnea
- Dysuria
- Excitement
- Eyes vertical deviation
- Facial edema
- Gastritis
- Gingival pain
- Glossitis
- Headache disorder
- Hiccups
- Hirsutism
- Increased appetite
- Irritability
- Libido changes
- Loss of taste
- Lymphadenopathy
- Menstrual disorder
- Myalgias
- Nausea
- Nervousness
- Nightmares
- Nocturia
- Nystagmus
- Orthostatic hypotension
- Palpitations
- Paranoid disorder
- Polydipsia
- Pruritus of skin
- Rhinorrhea
- Sialorrhea
- Sleep disorder
- Sneezing
- Sore tongue
- Stomatitis
- Swelling of ankles or feet
- Syncope
- Tachycardia
- Tremor
- Urinary incontinence
- Urine discoloration
- Vertigo
- Visual changes
- Visual field defect
- Vomiting
- Weight gain
- Weight loss
- Xerostomia
- Yawning
Contraindicated
None
Severe Precaution
Lorazepam (Inj)
Duration of use lasting > 3 hours may affect cognitive development. No demonstrated efficacy in treating status epilepticus. Prolonged t 1/2. Increased CNS effects. May contain benzyl alcohol.
Safety and efficacy not established. Prolonged t 1/2.
Increased CNS effects (prolonged in neonates).
- 1 Day – 364 Days
- Duration of use lasting > 3 hours may affect cognitive development. No demonstrated efficacy in treating status epilepticus. Prolonged t 1/2. Increased CNS effects. May contain benzyl alcohol.
- 30 Days – 12 Years
- Duration of use lasting > 3 hours may affect cognitive development. No demonstrated efficacy in treating status epilepticus. Prolonged t 1/2. Increased CNS effects. May contain benzyl alcohol.
- 1 Day – 29 Days
- Duration of use lasting > 3 hours may affect cognitive development. No demonstrated efficacy in treating status epilepticus. Prolonged t 1/2. Increased CNS effects. May contain benzyl alcohol.
Lorazepam (oral, SL)
Duration of use lasting > 3 hours may affect cognitive development. No demonstrated efficacy in treating status epilepticus. Prolonged t 1/2. Increased CNS effects. May contain benzyl alcohol.
Safety and efficacy not established. Prolonged t 1/2.
Increased CNS effects (prolonged in neonates).
- 1 Day – 364 Days
- Safety and efficacy not established. Prolonged t 1/2.
- 30 Days – 12 Years
- Safety and efficacy not established. Prolonged t 1/2.
- 1 Day – 29 Days
- Safety and efficacy not established. Prolonged t 1/2.
Lorazepam (Oral,SL)
Duration of use lasting > 3 hours may affect cognitive development. No demonstrated efficacy in treating status epilepticus. Prolonged t 1/2. Increased CNS effects. May contain benzyl alcohol.
Safety and efficacy not established. Prolonged t 1/2.
Increased CNS effects (prolonged in neonates).
- 1 Day – 364 Days
- Increased CNS effects (prolonged in neonates).
- 30 Days – 12 Years
- Increased CNS effects (prolonged in neonates).
- 1 Day – 29 Days
- Increased CNS effects (prolonged in neonates).
Management or Monitoring Precaution
Lorazepam (Inj)
Duration of use > 3 hours may affect cognitive development. Prolonged half-life (t 1/2) may increase risk of excitation, agitation, and hallucination age <8 years.
- 1 Years – 18 Years
- Duration of use > 3 hours may affect cognitive development. Prolonged half-life (t 1/2) may increase risk of excitation, agitation, and hallucination age <8 years.
Lorazepam (oral)
- Severity Level:
D
- Additional Notes: No fda category; not recommended; consider alternatives
Lorazepam(inj)
- Severity Level:
D
- Additional Notes:
Contraindicated
None
| General | Excretion Potential | Effect on Infant | Notes |
| None |
Precaution Exists
Lorazepam
Limited data suggest minimal amount excreted
| General | Excretion Potential | Effect on Infant | Notes |
| Evaluate use carefully | Excreted | Not known; no or inclusive data | Limited data suggest minimal amount excreted |
No Known Risk
None
| General | Excretion Potential | Effect on Infant | Notes |
| None |
Contraindicated
None
Precaution Exists
Lorazepam (oral)
Neuro/Psych-Risk of cognitive impairment, delirium, fractures, ataxia, syncope, motor vehicle crashes, and falls. If used, initial dosage of 1mg/day to 2 mg/day in divided doses is recommended, adjusted as needed and tolerated. General-May be appropriate for select indications including alcohol withdrawal and severe generalized anxiety disorder.
| Organ / System | HEP | REN | CARD | ENDO | NEURO / PSYCH | PULM |
| Increased Risk / Adverse Effects | Y | Y | N | Y | N | N |
BEERS: Y HEDIS: Y STOPP: Y
No Known Risk
None
- Taking lorazepam with opioid medications (such as codeine, hydrocodone) may increase your risk of very serious side effects, including death. To lower your risk, your doctor should have you take the smallest dose of lorazepam that works, and take it for the shortest possible time. Get medical help right away if any of these very serious side effects occur: slow/shallow breathing, unusual lightheadedness, severe drowsiness/dizziness, difficulty waking up.
| Anxiety | |
| F06.4 | Anxiety disorder due to known physiological condition |
| F10.180 | Alcohol abuse with alcohol-induced anxiety disorder |
| F10.280 | Alcohol dependence with alcohol-induced anxiety disorder |
| F10.980 | Alcohol use, unspecified with alcohol-induced anxiety disorder |
| F12.180 | Cannabis abuse with cannabis-induced anxiety disorder |
| F12.280 | Cannabis dependence with cannabis-induced anxiety disorder |
| F12.980 | Cannabis use, unspecified with anxiety disorder |
| F14.180 | Cocaine abuse with cocaine-induced anxiety disorder |
| F14.280 | Cocaine dependence with cocaine-induced anxiety disorder |
| F14.980 | Cocaine use, unspecified with cocaine-induced anxiety disorder |
| F15.180 | Other stimulant abuse with stimulant-induced anxiety disorder |
| F15.280 | Other stimulant dependence with stimulant-induced anxiety disorder |
| F15.980 | Other stimulant use, unspecified with stimulant-induced anxiety disorder |
| F16.180 | Hallucinogen abuse with hallucinogen-induced anxiety disorder |
| F16.280 | Hallucinogen dependence with hallucinogen-induced anxiety disorder |
| F16.980 | Hallucinogen use, unspecified with hallucinogen-induced anxiety disorder |
| F18.180 | Inhalant abuse with inhalant-induced anxiety disorder |
| F18.280 | Inhalant dependence with inhalant-induced anxiety disorder |
| F18.980 | Inhalant use, unspecified with inhalant-induced anxiety disorder |
| F19.180 | Other psychoactive substance abuse with psychoactive substance-induced anxiety disorder |
| F19.280 | Other psychoactive substance dependence with psychoactive substance-induced anxiety disorder |
| F19.980 | Other psychoactive substance use, unspecified with psychoactive substance-induced anxiety disorder |
| F40 | Phobic anxiety disorders |
| F40.0 | Agoraphobia |
| F40.00 | Agoraphobia, unspecified |
| F40.01 | Agoraphobia with panic disorder |
| F40.02 | Agoraphobia without panic disorder |
| F40.1 | Social phobias |
| F40.10 | Social phobia, unspecified |
| F40.11 | Social phobia, generalized |
| F40.8 | Other phobic anxiety disorders |
| F40.9 | Phobic anxiety disorder, unspecified |
| F41 | Other anxiety disorders |
| F41.0 | Panic disorder [episodic paroxysmal anxiety] |
| F41.1 | Generalized anxiety disorder |
| F41.3 | Other mixed anxiety disorders |
| F41.8 | Other specified anxiety disorders |
| F41.9 | Anxiety disorder, unspecified |
| F93.0 | Separation anxiety disorder of childhood |
| Preoperative anxiety | |
| R45.0 | Nervousness |
| Status epilepticus | |
| G40.001 | Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, not intractable, with status epilepticus |
| G40.011 | Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, intractable, with status epilepticus |
| G40.101 | Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, with status epilepticus |
| G40.111 | Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, with status epilepticus |
| G40.201 | Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable, with status epilepticus |
| G40.211 | Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, intractable, with status epilepticus |
| G40.301 | Generalized idiopathic epilepsy and epileptic syndromes, not intractable, with status epilepticus |
| G40.311 | Generalized idiopathic epilepsy and epileptic syndromes, intractable, with status epilepticus |
| G40.401 | Other generalized epilepsy and epileptic syndromes, not intractable, with status epilepticus |
| G40.411 | Other generalized epilepsy and epileptic syndromes, intractable, with status epilepticus |
| G40.501 | Epileptic seizures related to external causes, not intractable, with status epilepticus |
| G40.801 | Other epilepsy, not intractable, with status epilepticus |
| G40.803 | Other epilepsy, intractable, with status epilepticus |
| G40.811 | Lennox-gastaut syndrome, not intractable, with status epilepticus |
| G40.813 | Lennox-gastaut syndrome, intractable, with status epilepticus |
| G40.821 | Epileptic spasms, not intractable, with status epilepticus |
| G40.823 | Epileptic spasms, intractable, with status epilepticus |
| G40.901 | Epilepsy, unspecified, not intractable, with status epilepticus |
| G40.911 | Epilepsy, unspecified, intractable, with status epilepticus |
| G40.A01 | Absence epileptic syndrome, not intractable, with status epilepticus |
| G40.A11 | Absence epileptic syndrome, intractable, with status epilepticus |
| G40.B01 | Juvenile myoclonic epilepsy, not intractable, with status epilepticus |
| G40.B11 | Juvenile myoclonic epilepsy, intractable, with status epilepticus |
| 0-9 | A-Z |
|---|---|
| F06.4 | Anxiety disorder due to known physiological condition |
| F10.180 | Alcohol abuse with alcohol-induced anxiety disorder |
| F10.280 | Alcohol dependence with alcohol-induced anxiety disorder |
| F10.980 | Alcohol use, unspecified with alcohol-induced anxiety disorder |
| F12.180 | Cannabis abuse with cannabis-induced anxiety disorder |
| F12.280 | Cannabis dependence with cannabis-induced anxiety disorder |
| F12.980 | Cannabis use, unspecified with anxiety disorder |
| F14.180 | Cocaine abuse with cocaine-induced anxiety disorder |
| F14.280 | Cocaine dependence with cocaine-induced anxiety disorder |
| F14.980 | Cocaine use, unspecified with cocaine-induced anxiety disorder |
| F15.180 | Other stimulant abuse with stimulant-induced anxiety disorder |
| F15.280 | Other stimulant dependence with stimulant-induced anxiety disorder |
| F15.980 | Other stimulant use, unspecified with stimulant-induced anxiety disorder |
| F16.180 | Hallucinogen abuse with hallucinogen-induced anxiety disorder |
| F16.280 | Hallucinogen dependence with hallucinogen-induced anxiety disorder |
| F16.980 | Hallucinogen use, unspecified with hallucinogen-induced anxiety disorder |
| F18.180 | Inhalant abuse with inhalant-induced anxiety disorder |
| F18.280 | Inhalant dependence with inhalant-induced anxiety disorder |
| F18.980 | Inhalant use, unspecified with inhalant-induced anxiety disorder |
| F19.180 | Other psychoactive substance abuse with psychoactive substance-induced anxiety disorder |
| F19.280 | Other psychoactive substance dependence with psychoactive substance-induced anxiety disorder |
| F19.980 | Other psychoactive substance use, unspecified with psychoactive substance-induced anxiety disorder |
| F40 | Phobic anxiety disorders |
| F40.0 | Agoraphobia |
| F40.00 | Agoraphobia, unspecified |
| F40.01 | Agoraphobia with panic disorder |
| F40.02 | Agoraphobia without panic disorder |
| F40.1 | Social phobias |
| F40.10 | Social phobia, unspecified |
| F40.11 | Social phobia, generalized |
| F40.8 | Other phobic anxiety disorders |
| F40.9 | Phobic anxiety disorder, unspecified |
| F41 | Other anxiety disorders |
| F41.0 | Panic disorder [episodic paroxysmal anxiety] |
| F41.1 | Generalized anxiety disorder |
| F41.3 | Other mixed anxiety disorders |
| F41.8 | Other specified anxiety disorders |
| F41.9 | Anxiety disorder, unspecified |
| F93.0 | Separation anxiety disorder of childhood |
| G40.001 | Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, not intractable, with status epilepticus |
| G40.011 | Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, intractable, with status epilepticus |
| G40.101 | Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, with status epilepticus |
| G40.111 | Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, with status epilepticus |
| G40.201 | Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable, with status epilepticus |
| G40.211 | Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, intractable, with status epilepticus |
| G40.301 | Generalized idiopathic epilepsy and epileptic syndromes, not intractable, with status epilepticus |
| G40.311 | Generalized idiopathic epilepsy and epileptic syndromes, intractable, with status epilepticus |
| G40.401 | Other generalized epilepsy and epileptic syndromes, not intractable, with status epilepticus |
| G40.411 | Other generalized epilepsy and epileptic syndromes, intractable, with status epilepticus |
| G40.501 | Epileptic seizures related to external causes, not intractable, with status epilepticus |
| G40.801 | Other epilepsy, not intractable, with status epilepticus |
| G40.803 | Other epilepsy, intractable, with status epilepticus |
| G40.811 | Lennox-gastaut syndrome, not intractable, with status epilepticus |
| G40.813 | Lennox-gastaut syndrome, intractable, with status epilepticus |
| G40.821 | Epileptic spasms, not intractable, with status epilepticus |
| G40.823 | Epileptic spasms, intractable, with status epilepticus |
| G40.901 | Epilepsy, unspecified, not intractable, with status epilepticus |
| G40.911 | Epilepsy, unspecified, intractable, with status epilepticus |
| G40.A01 | Absence epileptic syndrome, not intractable, with status epilepticus |
| G40.A11 | Absence epileptic syndrome, intractable, with status epilepticus |
| G40.B01 | Juvenile myoclonic epilepsy, not intractable, with status epilepticus |
| G40.B11 | Juvenile myoclonic epilepsy, intractable, with status epilepticus |
| R45.0 | Nervousness |
Formulary Reference Tool