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lorazepam
Apo-Lorazepam†, Ativan, Lorazepam Intensol, Novo-Lorazem†, Nu-Loraz†OTC

Controlled Substance Schedule IV

Pregnancy Risk Category D

How supplied
Tablets:
0.5 mg, 1 mg, 2 mg
Tablets (S.L.):
0.5 mg†, 1 mg†, 2 mg
Oral solution (concentrated):
2 mg/ml
Injection:
2 mg/ml, 4 mg/ml

Action
Unknown. A benzodiazepine that probably potentiates the effects of gamma-aminobutyric acid, an inhibitory neurotransmitter, and depresses the CNS at the limbic and subcortical levels of the brain.

Indications & dosage
Anxiety--

Adults:
2 to 6 mg P.O. daily in divided doses. Maximum dose is 10 mg daily.
Elderly:
initially, 1 to 2 mg daily.
Insomnia due to anxiety--

Adults:
2 to 4 mg P.O. h.s.
Preoperative sedation--

Adults:
0.05 mg/kg I.M. 2 hours before procedure. Total dose shouldn't exceed 4 mg. Or, 2 mg I.V. total or 0.044 mg/kg I.V., whichever is smaller. Larger doses up to 0.05 mg/kg I.V., to total of 4 mg, may be needed.

Adverse reactions
CNS:
drowsiness, amnesia, insomnia, agitation, sedation, dizziness, weakness, unsteadiness, disorientation, depression, headache.
CV:
hypotension.
EENT:
visual disturbances.
GI:
abdominal discomfort, nausea, change in appetite.
Hepatic:
elevated liver function tests.
Other:
acute withdrawal syndrome following sudden discontinuation in physically dependent persons.

Interactions
Drug-drug.
CNS depressants: increased CNS depression. Avoid concomitant use.
Digoxin:
may increase serum digoxin levels and risk of toxicity. Monitor patient closely.
Drug-lifestyle.
Alcohol use: increased CNS depression. Avoid concomitant use.
Smoking:
decreased effectiveness of benzodiazepines. Monitor patient closely.

Effects on diagnostic tests
None reported.

Contraindications
Contraindicated in patients with hypersensitivity to drug, other benzodiazepines, or its vehicle (used in parenteral dosage form); also contraindicated in those with acute angle-closure glaucoma.

Nursing considerations

I.V. administration

Patient teaching

*Liquid contains alcohol. **May contain tartrazine.  †Canada  ‡Australia  §U.K.  OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING

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