Lorazepam is in a group of drugs called benzodiazepines (ben-zoe-dye-AZE-eh-peens). It affects chemicals in the brain that may become unbalanced and cause anxiety.
Lorazepam is used to treat anxiety disorders.
Lorazepam may also be used for other purposes not listed in this medication guide.
Important information
Do not use this medication if you are allergic to lorazepam or to other benzodiazepines, such as alprazolam (Xanax), chlordiazepoxide (Librium), clorazepate (Tranxene), diazepam (Valium), or oxazepam (Serax). This medication can cause birth defects in an unborn baby. Do not use lorazepam if you are pregnant.
Before taking lorazepam, tell your doctor if you have any breathing problems, glaucoma, kidney or liver disease, or a history of depression, suicidal thoughts, or addiction to drugs or alcohol.
Do not drink alcohol while taking lorazepam. This medication can increase the effects of alcohol.
Avoid using other medicines that make you sleepy. They can add to sleepiness caused by lorazepam.
Lorazepam may be habit-forming and should be used only by the person it was prescribed for. Lorazepam should never be shared with another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.
Before taking this medicine
It is dangerous to try and purchase lorazepam on the Internet or from vendors outside of the United States. Medications distributed from Internet sales may contain dangerous ingredients, or may not be distributed by a licensed pharmacy. Samples of lorazepam purchased on the Internet have been found to contain haloperidol (Haldol), a potent antipsychotic drug with dangerous side effects. For more information, contact the U.S. Food and Drug Administration (FDA) or visit www.fda.gov/buyonlineguide.
Do not use this medication if you have narrow-angle glaucoma, or if you are allergic to lorazepam or to other benzodiazepines, such as alprazolam (Xanax), chlordiazepoxide (Librium), clorazepate (Tranxene), diazepam (Valium), or oxazepam (Serax).
Before taking lorazepam, tell your doctor if you are allergic to any drugs, or if you have:
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glaucoma;
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asthma, emphysema, bronchitis, chronic obstructive pulmonary disorder (COPD), or other breathing problems;
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kidney or liver disease;
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a history of depression or suicidal thoughts or behavior; or
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a history of drug or alcohol addiction.
If you have any of these conditions, you may need a dose adjustment or special tests to safely take lorazepam.
FDA pregnancy category D. Lorazepam can cause birth defects in an unborn baby. Do not use lorazepam without your doctor"s consent if you are pregnant. Tell your doctor if you become pregnant during treatment. Use an effective form of birth control while you are using this medicine. It is not known whether lorazepam passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
See also: Pregnancy and breastfeeding warnings (in more detail)
The sedative effects of lorazepam may last longer in older adults. Accidental falls are common in elderly patients who take benzodiazepines. Use caution to avoid falling or accidental injury while you are taking lorazepam. Do not give this medication to a child younger than 12 years old.
How should I take lorazepam?
Take lorazepam exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.
Your doctor may occasionally change your dose to make sure you get the best results from this medication.
Measure the liquid form of lorazepam with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.
Lorazepam should be used for only a short time. Do not take this medication for longer than 4 months without your doctor"s advice. Lorazepam may be habit-forming and should be used only by the person it was prescribed for. Lorazepam should never be shared with another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it. Contact your doctor if this medicine seems to stop working as well in treating your symptoms. Do not stop using lorazepam suddenly without first talking to your doctor. You may need to use less and less before you stop the medication completely.
Your symptoms may return when you stop using lorazepam after using it over a long period of time. You may also have seizures or withdrawal symptoms when you stop using lorazepam. Withdrawal symptoms may include tremor, sweating, muscle cramps, stomach pain, vomiting, unusual thoughts or behavior, and seizure (convulsions).
To be sure lorazepam is not causing harmful effects, your doctor may need to check your progress on a regular basis. Do not miss any scheduled visits to your doctor.
Store lorazepam at room temperature away from moisture, heat, and light. Store the liquid form of this medicine in the refrigerator.
Keep track of how many pills have been used from each new bottle of this medicine. Benzodiazepines are drugs of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.
What happens if I miss a dose?
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention if you think you have used too much of this medicine. An overdose of lorazepam can be fatal.
Overdose symptoms may include extreme drowsiness, confusion, muscle weakness, fainting, or coma.
What should I avoid?
Do not drink alcohol while taking lorazepam. This medication can increase the effects of alcohol. Lorazepam can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by lorazepam. Tell your doctor if you regularly use any of these other medicines.
Lorazepam side effects
Get emergency medical help if you have any of these signs of an allergic reaction to lorazepam: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:
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confusion, depressed mood, thoughts of suicide or hurting yourself;
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hyperactivity, agitation, hostility;
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hallucinations; or
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feeling light-headed, fainting.
Less serious lorazepam side effects may include:
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drowsiness, dizziness, tiredness;
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blurred vision;
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sleep problems (insomnia);
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muscle weakness, lack of balance or coordination;
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amnesia or forgetfulness, trouble concentrating;
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nausea, vomiting, constipation;
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appetite changes; or
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skin rash.
This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
Lorazepam dosing information
Usual Adult Lorazepam Dose for ICU Agitation:
IV, intermittent:
Initial dose: 1-4 mg IV every 10-20 minutes to control acute agitation.
Maintenance dose: 1-4 mg IV every 2-6 hours and as needed to maintain desired level of sedation.
IV, continuous infusion:
0.01-0.1 mg/kg/hr IV to maintain desired level of sedation.
High-dose infusions (greater than 18 mg/hour for more than 4 weeks, or greater than 25 mg/hour for several hours or days) have been associated with tubular necrosis, lactic acidosis and hyperosmolality states due to the polyethylene glycol and propylene glycol solvents.
Usual Adult Lorazepam Dose for Anxiety:
Oral:
Initial dose: 1 mg orally 2-3 times a day.
Maintenance dose: 1-2 mg orally 2-3 times a day. The daily dosage may vary from 1-10 mg/day orally.
IV:
Alternatively, an initial intravenous dose of 2 mg or 0.044 mg/kg, whichever is smaller, may be given.
Usual Adult Lorazepam Dose for Insomnia:
2-4 mg orally at bedtime.
Usual Adult Lorazepam Dose for Light Anesthesia:
Premedication for Anesthesia:
IM: 0.05 mg/kg up to a maximum of 4 mg.
IV: 2 mg total, or 0.044 mg/kg, whichever is smaller.
This dose should not ordinarily be exceeded in patients over 50 years of age.
Larger doses as high as 0.05 mg/kg up to a total of 4 mg may be administered.
Usual Adult Lorazepam Dose for Nausea/Vomiting:
Oral or IV: 0.5-2 mg every 4-6 hours as needed.
Usual Lorazepam Adult Dose for Status Epilepticus:
4 mg/dose slow IV over 2-5 minutes (maximum rate: 2 mg/minute); may repeat in 10-15 minutes; usual total maximum dose: 8 mg
Usual Lorazepam Pediatric Dose for Nausea/Vomiting -- Chemotherapy Induced:
2-15 years: 0.04-0.08 mg/kg IV (maximum 4 mg/dose) prior to chemotherapy and every 6 hours as needed.
Usual Lorazepam Pediatric Dose for Anxiety:
1 month-12 years: 0.02-0.1 mg/kg (maximum 2 mg) every 4-6 hours as needed.
Usual Lorazepam Pediatric Dose for Sedation:
Premedication for Anesthesia:
1 month-12 years:
IM, oral: 0.05 mg/kg, maximum 2 mg/dose.
IV: 0.01-0.03 mg/kg, maximum 2 mg/dose, 15-20 minutes before procedure.
13-18 years:
IM, oral: 0.05 mg/kg, maximum 4 mg/dose.
IV: 2 mg total, or 0.044 mg/kg, whichever is smaller, 15-20 minutes before procedure.
Larger doses as high as 0.05 mg/kg up to a total of 4 mg may be administered.
Usual Lorazepam Pediatric Dose for Status Epilepticus:
Up to 4 weeks: 0.05 mg/kg slow IV over 2-5 minutes; may repeat in 10-15 minutes
1 month to 12 years: 0.05-0.1 mg/kg (maximum: 4 mg/dose) slow IV over 2-5 minutes (maximum rate: 2 mg/minute); may repeat every 10-15 minutes if needed
13 to 18 years: 0.07 mg/kg (maximum: 4 mg/dose) slow IV over 2-5 minutes (maximum rate: 2 mg/minute); may repeat in 10-15 minutes if needed; usual total maximum dose: 8 mg
What other drugs will affect lorazepam?
Before taking lorazepam, tell your doctor if you are using any of the following drugs:
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a barbiturate such as amobarbital (Amytal), butabarbital (Butisol), mephobarbital (Mebaral), secobarbital (Seconal), or phenobarbital (Luminal, Solfoton);
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an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate);
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medicines to treat psychiatric disorders, such as chlorpromazine (Thorazine), haloperidol (Haldol), mesoridazine (Serentil), pimozide (Orap), or thioridazine (Mellaril);
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narcotic medications such as butorphanol (Stadol), codeine, hydrocodone (Lortab, Vicodin), levorphanol (Levo-Dromoran), meperidine (Demerol), methadone (Dolophine, Methadose), morphine (Kadian, MS Contin, Oramorph), naloxone (Narcan), oxycodone (OxyContin), propoxyphene (Darvon, Darvocet); or
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antidepressants such as amitriptyline (Elavil, Etrafon), amoxapine (Asendin), citalopram (Celexa), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), imipramine (Janimine, Tofranil), nortriptyline (Pamelor), paroxetine (Paxil), protriptyline (Vivactil), sertraline (Zoloft), or trimipramine (Surmontil).
This list is not complete and there may be other drugs that can interact with lorazepam. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.
