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Lorazepam EG

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Product name: Lorazepam EG

Active substance: lorazepam

Brand names: Ativan, Lorazepam Intensol

Therapeutic Classifications: Antianxiety

Pharmacologic Classifications: Benzodiazepine, Short or Intermediate Acting

Quantity: 100 Tablets

Strength: 2.5 mg

Description

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PRODUCT DESCRIPTION

Lorazepam is a prescription medical treatment used to manage anxiety. Lorazepam belongs to a class of drugs known as benzodiazepines which act on the brain and nerves (central nervous system) to produce a calming effect that relieve symptoms of anxiety. This drug works by enhancing the effects of a certain natural chemical in the body (GABA). This medication may also be used as a treatment for short-term insomnia. Insomnia is a medical condition that involves poor sleep quality and/or quantity of sleep during a period of time.

Lorazepam is not a narcotic, but may produce narcotic effects. It may have adverse reactions when taken while using antihistamine medications.

This medication is available as an oral drug or by injection.

Your doctor or healthcare provider should advise you that while taking this drug or other benzodiazepines, you should not consume alcohol.

Side effects and symptoms that are most commonly associated with this medicine are drowsiness and lightheadedness.

Read the drug information leaflet that accompanies the prescription as well as every time the prescription is refilled. There may be new health information.

Clients taking this drug should alert their doctors about any problems from the use of this medication and any troublesome side effects.

PROPER USE

Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor if you have any questions.

Swallow the tablet whole. Do not crush, break, or chew it.

Measure the oral liquid using the marked medicine dropper that comes with the package. Dilute each dose with water, juice, soda, applesauce and puddings.

DOSAGE METHOD

Anxiety Disorders

Initial: 2-3 mg oral tablet once every 8-12 hours as needed; not to exceed 10 mg/day

Maintenance: 2-6 mg/day taken orally divided once every 8-12 hours

Geriatric: Lower initial dose recommended; 1-2 mg orally divided once every 8-12 hours

Short-Term Treatment of Insomnia

2-4 mg taken orally at bedtime

Geriatric: Lower initial dose recommended; 0.5-1 mg orally at bedtime, increase as needed. To avoid over-sedation, initial daily dose should not exceed 2 mg

Preoperative Sedation, Anxiety Relief, & Anterograde Amnesia

0.05 mg/kg intramuscularly (IM) for 1 dose; 2 hours before surgery; not to exceed 4 mg (2 mg in elderly), OR

0.044 mg/kg intravenously (IV) for 1 dose; 15-20 minutes before surgery; not to exceed 4 mg (2 mg in elderly)

Status Epilepticus – Adult

Usual 4 mg/dose slow IV at 2 mg/min

If seizure persists after 5-10 min, administer 4 mg IV again

Status Epilepticus (Off-label) – Pediatric

Infants and children: 0.05-0.1 mg/kg IV over 2-5 minutes; not to exceed 4 mg/dose; may repeat every 10-15 minutes as needed

Alternatively, 0.1 mg/kg at slow IV rate not to exceed rate of 2 mg/minute; not to exceed dose of 4 mg

Adolescents: 4 mg slow IV; if seizure persists after 10-15 minutes, administer 4 mg IV again

Anxiolytic/Sedation in ICU (Off-label)

Intubated and mechanically ventilated patients

0.02-0.04 mg/kg IV

0.02-0.06 mg/kg intermittent IV once every 2-6 hours as needed, OR

0.01-0.1 mg/kg/hour continuous IV; not to exceed 10 mg/hour

Children: 0.05 mg/kg orally once every 4-8 hours; not to exceed 2 mg

Chemotherapy-Induced Nausea/Vomiting (Off-label)

0.5-2 mg orally or intravenously (IV) once every 6 hours; as needed thereafter

Children 2 years and older: 0.025-0.05 mg/kg intravenously (IV) once every 6 hours as needed; not to exceed 2 mg

Chronic Insomnia (Off-label)

2-4 mg orally bedtime

Dosing Considerations

Intravenously (IV): Monitor respirations every 5-15 minutes and before each repeated IV dose

Geriatric: When higher dose indicated, increase evening dose before daytime doses

Dosing Modifications

Renal impairment

Orally: Adjustment not necessary

IV/IM: Use with caution in mild-to-moderate impairment; not recommended in severe impairment or renal failure

IV/IM (prolonged periods or high doses): Monitor; risk of propylene glycol toxicity

Hepatic impairment

Orally: No dose adjustment recommended in mild-to-moderate impairment; use with caution (may require lower dose) in severe impairment

IV/IM: Use with caution in mild-to-moderate impairment; not recommended in severe impairment of hepatic failure

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Use & Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Before Using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of lorazepam in children younger than 12 years of age. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of lorazepam in the elderly. However, elderly patients are more likely to have unwanted effects (eg, severe drowsiness or unsteadiness) and age-related kidney or liver problems, which may require caution and an adjustment in the dose.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Flumazenil

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. Alfentanil, Amobarbital, Benzhydrocodone, Bromazepam, Bromopride, Buprenorphine, Butabarbital, Butalbital, Butorphanol, Calcifediol, Carbinoxamine, Carisoprodol, Chloral Hydrate, Chlorzoxazone, Codeine, Dantrolene, Dezocine, Diacetylmorphine, Difenoxin, Dihydrocodeine, Diphenoxylate, Doxylamine, Ethchlorvynol, Ethylmorphine, Fentanyl, Flibanserin, Fospropofol, Hydrocodone, Hydromorphone, Ketobemidone, Levorphanol, Lofexidine, Loxapine, Meclizine, Meperidine, Mephenesin, Mephobarbital, Meprobamate, Meptazinol, Metaxalone, Methadone, Methocarbamol, Methohexital, Metoclopramide, Mirtazapine, Morphine, Morphine Sulfate Liposome, Nalbuphine, Nicomorphine, Opium, Opium Alkaloids, Orlistat, Oxycodone, Oxymorphone, Papaveretum, Paregoric, Pentazocine, Pentobarbital, Periciazine, Phenobarbital, Piritramide, Primidone, Propofol, Secobarbital, Sodium Oxybate, Sufentanil, Tapentadol, Thiopental, Tilidine, Tramadol, Zolpidem

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Posaconazole, Probenecid, Pyrimethamine, St John’s Wort, Theophylline, Valproic Acid

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

Alcohol abuse or Drug abuse or dependence or

Lung or breathing problems (eg, COPD, sleep apnea) or

Seizures, or history of—Use with caution. May make these conditions worse.

Depression or

Psychosis—Use is not recommended in patients with these conditions.

Glaucoma, acute narrow-angle—Should not be used in patients with this condition.

Kidney disease or

Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

If OVERDOSE is suspected:

If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Symptoms of Overdose

  1. Changes in patterns and rhythms of speech

  2. increased sweating

  3. loss of strength or energy

  4. nightmares

  5. shakiness and unsteady walk

  6. slurred speech

  7. trouble speaking

  8. unsteadiness, trembling, or other problems with muscle control or coordination

  9. unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness

  10. unusual excitement, nervousness, restlessness, or irritability

  11. unusual paleness

unusual weak feeling

NEGATIVE EFECTS

Get emergency medical help if you have any of these signs of an allergic reaction: 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:

  1. confusion, depressed mood, thoughts of suicide or hurting yourself;

  2. hyperactivity, agitation, hostility;

  3. hallucinations; or

feeling light-headed, fainting.

Less serious side effects may include:

  1. drowsiness, dizziness, tiredness;

  2. blurred vision;

  3. sleep problems ;

  4. muscle weakness, lack of balance or coordination;

  5. amnesia or forgetfulness, trouble concentrating;

  6. nausea, vomiting, constipation;

  7. appetite changes; or

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

Disclaimer

Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient.

musclegearspharma.com does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.

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