DRUG CLASS AND MECHANISM:
Lorazepam is a drug used for treating anxiety. It is in the benzodiazepine family of drugs, 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 that reduces the activity of nerves in the brain. It is thought that Lorazepam and other benzodiazepines may act by enhancing the effects of GABA in the brain to reduce activity. 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.
Lorazepam is used for the management of anxiety disorders, the short-term relief of symptoms of anxiety or anxiety associated with depression. Lorazepam is effective for insomnia and panic attacks, and is used in combination with other medications to prevent nausea and vomiting resulting from chemotherapy. Lorazepam also is administered before anesthesia for sedation and used for prevention and treatment of alcohol withdrawal. It is also used for treating seizures (status epilepticus).
The dose of Lorazepam may be different for each person. Your doctor will decide the right dose for you.
For anxiety, the usual daily dose is 2 to 3 mg administered in divided doses. However, the daily dose can range from 1 to 10 mg.
For sleeping problems (insomnia) due to anxiety, a dose of 1 to 2 mg taken at bedtime is usually prescribed.
If you are taking Lorazepam before surgery the usual dose is 2 to 4 mg the night before surgery. Another dose of 2 to 4 mg may also be given 1 to 2 hours before surgery.
Elderly people may need a lower dose.
How to take it ?
Swallow Lorazepam with a glass of water. It may be taken with or without food.
When to take it ?
Your doctor will tell you how many times during the day you need to take Lorazepam.
How long to take it?
Do not take Lorazepam for longer than your doctor says. Lorazepam is usually used for short periods only (for example 2-4 weeks). Continuous long term use is not recommended unless advised by your doctor. The use of benzodiazepines may lead to dependence on the medicine. Continue taking Lorazepam as long as your doctor recommends it.
Everyone's reaction to a medicine is different. It is difficult to predict which side-effects you will have from taking a particular medicine, or whether you will have any side-effects at all. However, tell your doctor if you notice any of the following and they worry you:
-clumsiness or unsteadiness
-loss of memory.
These are the more common side effects of Lorazepam.
Other less common or rare side effects include:
-feeling sick or vomiting
-outbursts of anger and increased excitement
-confusion or depression
-low blood pressure
-changes in appetite -nausea.
Tell your doctor if you notice anything else that is making you feel unwell when you are taking, or soon after you have finished taking, Lorazepam. Other side effects not listed above may occur in some people. Do not be alarmed by this list of possible side effects. You may not experience any of them.
- Hypersensitivity to benzodiazepines or to any of the other ingredients
- Acute pulmonary insufficiency: respiratory depression; sleep apnoea (risk of further respiratory depression)
- Obsessional states (inadequate evidence of safety and efficacy)
- Severe hepatic insufficiency (may precipitate encephalopathy)
- Planning a pregnancy (see section 4.6)
- Pregnancy (unless there are compelling reasons- see section 4.6)
- Myasthenia gravis.
Benzodiazepines should not be used alone in depression or anxiety with depression (may precipitate suicide)
Immediately telephone your doctor for advice, or go to casualty at your nearest hospital, if you think that you or anyone else may have taken too much Lorazepam. Do this even if there are no signs of discomfort or poisoning. Also report any other medicine or alcohol which has been taken. You may need urgent medical attention.
If you take too much Lorazepam you may feel drowsy, confused, tired, dizzy, have difficulty breathing, feel weak or become unconscious.
Keep Lorazepam in a cool dry place where the temperature stays below 25°C. Keep your tablets in their blister pack until it is time to take them. If you take the tablets out of the box or the blister pack they may not keep well. Do not store it or any other medicines, in a bathroom or near a sink. Do not leave it in the car or on window sills. Heat and dampness can destroy some medicines. Keep it where children cannot reach it. A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.