Lorazepam

💊 What is Lorazepam used for?

• •The label says lorazepam is used to manage anxiety disorders, or for short-term relief of anxiety or anxiety that happens with symptoms of depression. The label says that anxiety or tension from everyday stress usually does not need treatment with this type of medicine. It also notes that insomnia due to anxiety or short-term stress is mentioned in the dosing section. The label says its effectiveness for use longer than 4 months has not been studied, and the prescriber should check periodically whether it is still useful.

How it works

The label says benzodiazepines act at GABA-A sites in the central nervous system. It does not explain this in more detail.

How it is usually taken

• •The label says lorazepam tablets are taken by mouth. The dose, how often it is taken, and how long treatment lasts are individualized based on how the patient responds. When the total daily dose is split, the label says the largest part is usually taken at bedtime. The dose is increased gradually when needed to help avoid side effects. The label says to take the medicine exactly as the prescriber directs, not to take more than prescribed, and not to take it for longer than prescribed. Stopping or lowering the dose should be done with a gradual taper, as described below. Follow the instructions from your prescriber or pharmacist.

Comes as

• •0.5 mg tablets
• •1 mg tablets
• •2 mg tablets (white to off-white, round tablets sold in bottles of 30)

⚠️ Lorazepam side effects

🛑 Who should not take Lorazepam, and who should be careful

The label says not to take it if

• 🚨You are allergic to lorazepam, other benzodiazepines, or any ingredient in lorazepam tablets.
• 🚨You have acute narrow-angle glaucoma. The label lists this as a contraindication.

Tell your doctor before taking it if

• •Tell your healthcare provider about all of your medical conditions, including depression, mood problems, or suicidal thoughts or behavior.
• •Tell your provider if you have a history of drug or alcohol abuse or addiction.
• •Tell your provider if you have lung disease or breathing problems, such as COPD or sleep apnea syndrome.
• •Tell your provider if you have liver or kidney problems, or a history of seizures.
• •Tell your provider if you are pregnant or plan to become pregnant, or if you are breastfeeding or plan to breastfeed.
• •Tell your provider about all medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
• •The label says not to drive or operate heavy machinery until you know how lorazepam affects you, especially if you also take opioids.
• •The label says safety has not been established for children under 12 years of age, and it is not known whether it is safe for use longer than 4 months.

🔀 Lorazepam with other medicines, food and alcohol

The label says to discuss these with your doctor or pharmacist

• •Opioid medicines: combining with benzodiazepines can cause severe sedation, breathing problems, coma, and death. The label says the risk of slowed breathing increases with this combination.
• •Alcohol and street drugs: the label says these can cause severe drowsiness, breathing problems, coma, and death when taken with lorazepam.
• •Other CNS depressants: barbiturates, antipsychotics, sedative/hypnotics, other anxiety medicines, antidepressants, narcotic pain relievers, sedating antihistamines, anticonvulsants, and anesthetics can increase sedation.
• •Clozapine: the label says this combination may cause marked sedation, excessive salivation, low blood pressure, unsteadiness, delirium, and respiratory arrest.
• •Valproate and probenecid: the label says the lorazepam dose must be reduced when taken with either of these medicines.
• •Theophylline or aminophylline: the label says these may reduce the sedative effects of benzodiazepines.
• •The label says not to start or stop other medicines without talking to your healthcare provider.

Alcohol and food

The label says alcohol should not be combined with lorazepam because the combination can cause severe drowsiness, breathing problems, coma, and death. The label excerpt provided does not include specific guidance about taking lorazepam with food.

🤰 Lorazepam in pregnancy and breastfeeding

Pregnancy

The label says that benzodiazepines cross the placenta. Babies born to mothers who used benzodiazepines late in pregnancy have had sedation and neonatal withdrawal symptoms, such as breathing problems, low muscle tone, jitteriness, and feeding problems. Published observational studies have not shown a clear link between benzodiazepines and major birth defects, but the label says the background risk is unknown. Tell your healthcare provider right away if you become pregnant or think you may be pregnant. The label mentions the National Pregnancy Registry for Psychiatric Medications, which can be reached at 1-866-961-2388 or https://womensmentalhealth.org/pregnancyregistry/.

Breastfeeding

The label says lorazepam passes into breast milk. Infants exposed this way have had sedation, poor feeding, and poor weight gain. The label says to talk with your healthcare provider about the best way to feed your baby while taking lorazepam.

🗓️ Storage, missed doses and taking too much

Storage

The label says to store at 20 to 25 degrees C (68 to 77 degrees F). Keep bottles tightly closed and in a tight, light-resistant container. Keep out of reach of children. Keep the medicine in a safe place to prevent misuse and abuse. The label says to talk with your provider about proper disposal of unused medicine.

If a dose is missed

The label does not say.

If too much is taken

The label says benzodiazepine overdose causes central nervous system depression, ranging from drowsiness to coma. Symptoms can include confusion, slurred speech, lethargy, reduced reflexes, unsteadiness, and low muscle tone. In severe cases, breathing can be depressed and coma can develop. Overdose combined with alcohol or opioids may be fatal. The patient guide says to get emergency help right away for slowed breathing or excessive sleepiness.

🗒️ Questions to ask about Lorazepam

• Is lorazepam right for my type of anxiety, and how long do I need to take it?
• What signs of slowed breathing or excessive sleepiness should I watch for, especially if I also take opioids?
• How will we lower my dose safely with a gradual taper when it is time to stop?
• What withdrawal symptoms should I report to you right away?
• Are any of my other medicines, supplements, or alcohol use a concern with lorazepam?
• Am I at higher risk for abuse, misuse, or addiction, and how can I store and dispose of the medicine safely?
• What should I do if I think I am pregnant or if I am breastfeeding while taking lorazepam?

❓ Lorazepam: frequently asked questions