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LORAZEPAM is a brand name for Lorazepam. The medicine, its uses, side effects and dosage are the same regardless of brand.
Used for: FOR SHORT TERM (2-4 weeks only) USE (adults only) • Symptomatic relief of anxiety that is severe, disabling or subjecting the individual to unacceptable distress occurring alone or in association with insomnia or short- term psychometric, organic or psychotic illness. AS PREMEDICATION (adults and children 5 years and…
Verbatim from this product's MHRA label. Tap a section to expand.
4). Treatment should be given for the shortest possible duration. If this medicine is being used for the treatment of epilepsy this medicine should be used for as long as the prescriber considers it necessary. 4). When treatment is started the patient should be informed that • treatment will be of limited duration • the dosage will be progressively decreased • there is a possibility of rebound phenomena Dosage: Adults: Anxiety: 1-4mg daily in divided doses.
Insomnia: 1-2mg before retiring Premedication before operative dentistry or general surgery: 2-3mg the night before operation 2-4mg one to two hours before the procedure Elderly and debilitated patients: For elderly and debilitated patients reduce the initial dose by approximately 50% and adjust the dosage as needed and tolerated (see section
). Therefore, the drug should always be discontinued gradually. It may be useful to inform the patient that treatment will be of limited duration and that it will be discontinued gradually. The patient should also be made aware of the possibility of "rebound" phenomena to minimise anxiety should they occur.
Abuse of benzodiazepines has been reported. Some loss of efficacy to the hypnotic effects of short-acting benzodiazepines may develop after repeated use for a few weeks. Anxiety or insomnia may be a symptom of several other disorders.
The possibility should be considered that the complaint may be related to an underlying physical or psychiatric disorder for which there is more specific treatment. Caution should be used in the treatment of patients with acute narrow-angle glaucoma.
Patients with impaired renal or hepatic function should be monitored frequently and have their dosage adjusted carefully according to patient response. Lower doses may be sufficient in these patients. The same precautions apply to elderly or debilitated patients and patients with chronic respiratory insufficiency.
As with all CNS-depressants, the use of benzodiazepines may precipitate encephalopathy in patients with severe hepatic insufficiency. Therefore, use in these patients is contraindicated. Some patients taking benzodiazepines have developed a blood dyscrasia, and some have had elevations in liver enzymes.
Periodic haematology and liver- function assessments are recommended where repeated courses of treatment are considered clinically necessary. Transient anterograde amnesia or memory impairment has been reported in association with the use of benzodiazepines.
This effect may be advantageous when Lorazepam is used as a premedicant. , 7-8 hours). Paradoxical reactions have been occasionally reported during benzodiazepine use. Such reactions may be more likely to occur in children and the elderly.
). 5mg according to weight, not less than one hour before operation. 4). Use in patients with severe hepatic insufficiency is contraindicated. 6). 4 Special warnings and precautions for use Patients should be advised that since their tolerance for alcohol and other CNS depressants will be diminished in the presence of Lorazepam, these substances should either be avoided or taken in reduced dosage.
Lorazepam is not intended for the primary treatment of psychotic illness or depressive disorders and should not be used alone to treat depressed patients. The use of benzodiazepines may have a disinhibiting effect and may release suicidal tendencies in depressed patients.
Therefore, large quantities of Lorazepam should not be prescribed to these patients. Pre-existing depression may emerge during benzodiazepine use. The use of benzodiazepines may lead to physical and psychological dependence. The risk of dependence on Lorazepam is low when used at the recommended dose and duration but increases with higher doses and longer-term use.
The risk of dependence is further increased in patients with a history of alcoholism or drug abuse, or in patients with significant personality disorders. Therefore, use in individuals with a history of alcoholism or drug abuse should be avoided.
Dependence may lead to withdrawal symptoms, especially if treatment is discontinued abruptly. 8 Undesirable effects). Therefore, the drug should always be discontinued gradually. It may be useful to inform the patient that treatment will be of limited duration and that it will be discontinued gradually.
The patient should also be made aware of the possibility of "rebound" phenomena to minimise anxiety should they occur. Abuse of benzodiazepines has been reported. Some loss of efficacy to the hypnotic effects of short-acting benzodiazepines may develop after repeated use for a few weeks.
6) • Myasthenia gravis; Benzodiazepines should not be used alone in depression or anxiety with depression (may precipitate suicide)
Not medical advice. Always read the patient information leaflet and follow your prescriber or pharmacist.
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Although hypotension has occurred only rarely, benzodiazepines should be administered with caution to patients in whom a drop in blood pressure might lead to cardiovascular or cerebrovascular complications. This is particularly important in elderly patients.
Risk from concomitant use of opioids:
Concomitant use of lorazepam and opioids may result in sedation, respiratory depression, coma, and death. Because of these risks, concomitant prescribing of sedative medicines such as benzodiazepines or related drugs such as lorazepam with opioids should be reserved for patients for whom alternative treatment options are not possible.
2). The patients should be followed closely for signs and symptoms of respiratory depression and sedation. 5). Contains lactose. Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicine.
Elderly patients Lorazepam should be used with caution in elderly due to the risk of sedation and/or musculoskeletal weakness that can increase the risk of falls, with serious consequences in this population. 2 Posology). Drug dependence, tolerance and potential for abuse Drug addiction comprises behavioural, cognitive and physiological phenomena that may include a strong desire to take the drug, difficulties in controlling drug use and possible tolerance or physical dependence.
Physical dependence is a state that develops as a result of physiological adaptation in response to repeated drug use, which manifests as withdrawal signs and symptoms after abrupt discontinuation or a significant dose reduction of a drug.
Addiction and dependence are related but distinct presentations and in discussing these themes, terminology that apportion blame to the individual should be avoided. For all patients, prolonged use of this product may lead to drug dependence and addiction but can occur with short-term use at recommended therapeutic doses.
, major depression). Additional support and monitoring may be necessary when prescribing for patients at risk of drug misuse. A comprehensive patient history should be taken to document concomitant medications, including over-the-counter medicines and medicines obtained on-line, and past and present medical and psychiatric conditions.
Patients may find that treatment is less effective with chronic use and express a need to increase the dose to obtain the same level of symptom control as initially experienced. Patients may also supplement their treatment with additional medications to achieve the same effect.
These could be signs that the patient is developing tolerance. The risks of developing tolerance should be explained to the patient. Overuse or misuse may result in overdose and/or death. It is important that patients only use medicines that are prescribed for them at the dose they have been prescribed and do not give this medicine to anyone else.
Patients should be closely monitored for signs of misuse, abuse, or addiction. The clinical need for treatment with lorazepam should be reviewed regularly, with frequent assessments of patients being undertaken during the course of their treatment.
Drug withdrawal […]
Anxiety or insomnia may be a symptom of several other disorders. The possibility should be considered that the complaint may be related to an underlying physical or psychiatric disorder for which there is more specific treatment. Caution should be used in the treatment of patients with acute narrow-angle glaucoma.
Patients with impaired renal or hepatic function should be monitored frequently and have their dosage adjusted carefully according to patient response. Lower doses may be sufficient in these patients. The same precautions apply to elderly or debilitated patients and patients with chronic respiratory insufficiency.
As with all CNS-depressants, the use of benzodiazepines may precipitate encephalopathy in patients with severe hepatic insufficiency. Therefore, use in these patients is contraindicated. Some patients taking benzodiazepines have developed a blood dyscrasia, and some have had elevations in liver enzymes.
Periodic haematology and liver- function assessments are recommended where repeated courses of treatment are considered clinically necessary. Transient anterograde amnesia or memory impairment has been reported in association with the use of benzodiazepines.
This effect may be advantageous when Lorazepam is used as a premedicant. , 7-8 hours). Paradoxical reactions have been occasionally reported during benzodiazepine use. Such reactions may be more likely to occur in children and the elderly.
Although hypotension has occurred only rarely, benzodiazepines should be administered with caution to patients in whom a drop in blood pressure might lead to cardiovascular or cerebrovascular complications. This is particularly important in elderly patients.
Risk from concomitant use of opioids:
Concomitant use of lorazepam and opioids may result in sedation, respiratory depression, coma, and death. Because of these risks, concomitant prescribing of sedative medicines such as benzodiazepines or related drugs such as lorazepam with opioids should be reserved for patients for whom alternative treatment options are not possible.
2). The patients should be followed closely for signs and symptoms of respiratory depression and sedation. 5). Contains lactose. Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicine.
Elderly patients Lorazepam should be used with caution in elderly due to the risk of sedation and/or musculoskeletal weakness that can increase the risk of falls, with serious consequences in this population. 2 Posology). Drug dependence, […]