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NERVOUS SYSTEM › PSYCHOLEPTICS › ANXIOLYTICS › Benzodiazepine derivatives
lorazepam
N05BA06
Forms & Strengths
- Tablet: 0.5 mg, 1 mg, 2 mg
- Oral Concentrate: 2 mg/mL
- Injection: 2 mg/mL, 4 mg/mL
Adult Dosing
- Anxiety: 2 to 3 mg orally daily in divided doses, max 10 mg/day
- Insomnia due to anxiety: 2 to 4 mg orally at bedtime
- Status epilepticus: 4 mg IV slow (over 2 minutes), may repeat once in 10-15 minutes
- Pre-anesthetic: 0.05 mg/kg (up to 4 mg) IM or IV 2 hours before procedure
Pediatric Dosing
- Status epilepticus (pediatric): 0.1 mg/kg IV slow (max single dose 4 mg), may repeat once in 5-10 minutes
- Anxiety/Sedation: Safety and efficacy not established in children < 12 years
Indications
- Management of anxiety disorders
- Short-term relief of anxiety symptoms or anxiety-associated depression
- Status epilepticus
- Pre-anesthetic medication for sedation and amnesia
Mechanism of Action
- Binds to GABA-A receptors in the central nervous system
- Potentiates GABA-mediated chloride ion conductance
- Causes neuronal hyperpolarization, inhibition, and central nervous system depression
Contraindications
- Hypersensitivity to benzodiazepines
- Acute narrow-angle glaucoma
- Severe respiratory insufficiency
- Sleep apnea syndrome
- Severe hepatic impairment
Adverse Reactions
- Sedation, drowsiness, dizziness
- Ataxia, confusion, cognitive impairment
- Respiratory depression, apnea
- Hypotension
- Physical dependence and withdrawal syndrome upon chronic use
Drug Interactions
- CNS depressants (opioids, alcohol, barbiturates): enhanced sedative and respiratory depressant effects
- Opioids: profound sedation, respiratory depression, coma, and death
- CYP enzyme inducers/inhibitors: minimal pharmacokinetic interaction due to primary glucuronidation metabolism
Curated Content: Needs Vetting Before Put to Clinical Use