LORAZEPAM (lorazepam)

There are 1 contraindications. Absolute contraindication.

Contraindication List
Acute angle-closure glaucoma

There are 4 severe contraindications. Adequate patient monitoring is recommended for safer drug use.

Severe List
Alcohol intoxication
Hepatic encephalopathy
Pregnancy
Severe hepatic disease

There are 8 moderate contraindications. Clinically significant contraindication, where the condition can be managed or treated before the drug may be given safely.

Moderate List
Asthma
Chronic obstructive pulmonary disease
Disease of liver
Drug abuse
Hypoalbuminemia
Kidney disease with likely reduction in glomerular filtration rate (GFr)
Sleep apnea
Suicidal ideation

There are 35 severe adverse reactions.

More Frequent	Less Frequent
Muscle weakness	Acute cognitive impairment Behavioral disorders CNS depression

Rare/Very Rare

Abnormal hepatic function tests Accidental fall Agranulocytosis Anaphylaxis Anemia Angioedema Aplastic anemia Apnea Coma Depression Drug dependence Drug-induced psychosis Dyspnea Eosinophilia Hallucinations Hemolytic anemia 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

There are 52 less severe adverse reactions.

More Frequent	Less Frequent
Ataxia Dizziness Drowsy Dyspepsia Sedation Slurred speech	Diarrhea Fatigue General weakness

Rare/Very Rare

Aggressive behavior Agitation Alopecia Anorexia Anticholinergic toxicity Blurred vision Complex sleep behavior Concentration difficulty Conjunctivitis Constipation Cramps Delirium Depersonalization Diplopia Disturbance in thinking Dream disorder Dysarthria Dysuria Excitement Glossitis Headache disorder Hiccups Irritability Libido changes Menstrual disorder Nausea Nervousness Nightmares Nystagmus Paranoid disorder Polydipsia Pruritus of skin Sialorrhea Sleep disorder Stomatitis Syncope Tachycardia Tremor Urinary incontinence Vertigo Visual changes Xerostomia Yawning

Lorazepam may cause fetal toxicity when administered to pregnant women. An increased risk of congenital malformations associated with use of anxiolytic agents (i.e., chlordiazepoxide, diazepam, and/or meprobamate) during the first trimester of pregnancy has been suggested by several human studies. In humans, lorazepam and its glucuronide have been shown to cross the placenta (as determined from samples of umbilical cord blood).

The drug has also been shown to cause various adverse fetal effects during reproduction studies in animals. Lorazepam injection should not be used during pregnancy. In addition, the manufacturer does not recommend preoperative use of the injection for obstetric procedures (e.g., cesarean section) or during labor and delivery, since safety of the injection has not been established in such procedures.

Oral or injectable lorazepam should be used during pregnancy only in life-threatening situations or severe disease (e.g., status epilepticus) for which safer drugs cannot be used or are ineffective. The possibility that a woman of childbearing potential may be pregnant at the time lorazepam is initiated should be considered. When lorazepam is administered during pregnancy or if the patient becomes pregnant while receiving the drug, the patient should be advised of the potential hazard to the fetus and about the desirability of discontinuing lorazepam.

Based on animal data, repeated or prolonged use of general anesthetics and sedation drugs, including lorazepam, during the third trimester of pregnancy may result in adverse neurodevelopmental effects in the fetus. The clinical relevance of these animal findings to humans is not known; the potential risk of adverse neurodevelopmental effects should be considered and discussed with pregnant women undergoing procedures requiring general anesthetics and sedation drugs. (See Cautions: Pediatric Precautions.)

Lorazepam is distributed into milk. The potential exists that lorazepam can cause sedation or other adverse effects in nursing infants. The manufacturer of oral lorazepam states that the drug should not be administered to nursing women unless the potential benefits to the woman outweigh the possible risk to the infant.

Nursing infants receiving oral lorazepam should be monitored for adverse effects (e.g., sedation, irritability). The manufacturer of lorazepam injection states that the drug should not be administered to nursing women because of possible adverse effects (e.g., sedation).

No enhanced Geriatric Use information available for this drug.