Class: Benzodiazepine, Short or Intermediate Acting. C-IV
Dosage Forms. Tablet: 0.5 mg, 1 mg, 2 mg; Solution: 2 mg/mL
Common FDA Label Indication, Dosing, and Titration.
1. Anxiety: Adults: 1 mg po bid-tid
2. Insomnia, due to anxiety or situational stress: Adults and Children >12 y: 2-4 mg po hs
Off-Label Uses.
1. Alcohol withdrawal syndrome: Initial, 2 mg po qid, then 1 mg qid × 8 doses
MOA. Enhance the postsynaptic effect of the inhibitory neurotransmitter, gamma-aminobutyric acid (GABA).
Drug Characteristics: Lorazepam
Medication Safety Issues: Lorazepam
Drug Interactions: Lorazepam
Adverse Reactions: Lorazepam
Efficacy Monitoring Parameters. Reduction of anxiety symptoms, alcohol withdrawal symptoms, onset of sleep.
Toxicity Monitoring Parameters. Seek medical attention if severe drowsiness, thoughts of suicide, or seizures; monitor BP, heart rate.
Key Patient Counseling Points. May cause drowsiness; avoid driving or other tasks requiring motor coordination. Avoid alcohol.
Clinical Pearls. May be benzodiazepine of choice in impaired liver function and for nursing mothers. Use caution in elderly, appear more sensitive to the effects; dose reductions of 50% have been recommended. Avoid abrupt discontinuation after chronic use, may cause seizures. Not approved in children <12 y of age.