Medications and Drugs
Pharmacy Author: Omudhome Ogbru, PharmD
Medical and Pharmacy Editor: Jay W. Marks, MD
GENERIC NAME: lorazepam
BRAND NAME: Ativan
DRUG CLASS AND MECHANISM: Lorazepam is a drug used for treating anxiety. It
is in the benzodiazepine family, the same family that includes diazepam
(Valium), alprazolam (Xanax), clonazepam (Klonopin), flurazepam (Dalmane), and
others. It is thought that excessive activity of nerves in the brain may cause
anxiety and other psychological disorders. Gamma-aminobutyric acid (GABA) is a
neurotransmitter, a chemical that nerves in the brain use to send messages to
one another. GABA reduces the activity of nerves in the brain. Lorazepam and
other benzodiazepines may act by enhancing the effects of GABA in the brain.
Because lorazepam is removed from the blood more rapidly than many other
benzodiazepines, there is less chance that lorazepam concentrations in blood
will reach high levels and become toxic. Lorazepam also has fewer interactions
with other medications than most of the other benzodiazepines. The FDA approved
lorazepam in March 1999.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 0.5, 1, and 2 mg. Oral solution: 2 mg/ml. Injection: 2
mg/ml and 4 mg/ml
STORAGE: Tablets should be kept at room temperature 15-30°C (59-86°F). Oral
solutions should be refrigerated at 2-8°C (36-46°F). Injectable solutions should
be refrigerated.
PRESCRIBED FOR: Lorazepam is used for the management of anxiety disorders,
the short-term relief of symptoms of anxiety or anxiety associated with
depression. The effectiveness of lorazepam and other benzodiazepines has not
been adequately studied for treatment beyond 4 months. Lorazepam is effective
for insomnia, panic attacks, and is used in combination with other medications
to prevent nausea and vomiting resulting from chemotherapy. Lorazepam also is
administered before anesthesia and used for prevention and treatment of
alcohol
withdrawal.
DOSING: The dose of lorazepam is tailored to the patient's needs. The usual
dose for treating anxiety is 2-3 mg/day given in two or three divided doses.
Insomnia is treated with 2-4 mg given at bedtime.
DRUG INTERACTIONS: Lorazepam and all benzodiazepines interact with other
medications and drugs that slow the brain's processes such as alcohol,
barbiturates, narcotics, and tranquilizers. There have been cases of marked
sedation when lorazepam was given to patients taking the tranquilizer
loxapine
(Loxitane); it is unclear if there is a drug interaction, but caution should be
used if lorazepam and loxapine are used together.
PREGNANCY: Lorazepam and other benzodiazepines have been associated with
fetal damage, including congenital malformations, when taken by
pregnant women
in their first trimester. Lorazepam is best avoided if at all possible in the
first trimester and probably throughout pregnancy.
NURSING MOTHERS: It is not known if lorazepam is secreted in
breast milk.
SIDE EFFECTS: The most common side effects associated with lorazepam are
sedation (15.9% of patients), dizziness (6.9% of patients), weakness, and
unsteadiness. Other side effects include a feeling of depression, loss of
orientation, headache, and sleep disturbance.
Like all benzodiazepines, lorazepam can cause physical dependence. Suddenly
stopping therapy after a few months of daily therapy may be associated with a
feeling of loss of self-worth, agitation, and insomnia. If lorazepam is taken
continuously for longer than a few months, stopping therapy suddenly may produce
seizures,
tremors,
muscle cramping, vomiting, and sweating.
Reference: FDA Prescribing Information
Last Editorial Review: 10/17/2007
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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