Adult Dosing
Anxiety
- Start 2-3 mg/day IM/IV divided bid-tid; 1-2 mg/day in elderly
- Range: 2-6 mg/day IM/IV divided bid-tid
- Max: 10 mg/day
Status epilepticus
- 4 mg IV at a rate of 2 mg/min x 1; may repeat x 1 after 10-15 mins
Preoperative sedation
- 0.05 mg/kg IM x 1 given 2 hrs before surgery; Max: 4 mg/dose
- 2 mg IV x 1 or 0.02 mg/lb (0.044 mg/kg) whichever is smaller; in patients with lack of recall for perioperative events 0.05 mg/kg IV x 1 15-20 minutes before surgery; Max 4mg/dose
Chemo related nausea/vomiting [Not FDA approved]
- 1.5 mg/m2 IV x 1; give 45 mins before chemotherapy
- MAX: 3 mg/dose
Neuroleptic malignant syndrome [Non-FDA approved]
- 1 mg IV q5min; dose limited by level of consciousness
Pediatric Dosing
- Safety and effectiveness in pediatric population have not been established
Acute treatment of seizures [Non-FDA Approved]
- 0.05-0.1 mg/kg/dose IV over 2-5 min. May repeat 0.05 mg/kg × 1 in 10-15 min; Max: 2 mg/dose
Status Epilepticus [Non-FDA Approved]
- Infants and children: 0.05–0.1 mg/kg IV over 2–5 minutes; may repeat 1 dose of 0.5 mg/kg in 10–15 min [Max 4 mg/dose]
Vertigo [Non-FDA Approved]
- 0.05 mg/kg/dose q4–8hr IV; max dose: 2 mg/dose
[Outline]
- Dilute lorazepam injection with an equal amount of compatible diluent prior to IV administration. Intravenous injection may be made slowly and with repeated aspiration
- There are insufficient data to support the use of lorazepam Injection for outpatient endoscopic procedures
- Use of benzodiazepines, including lorazepam, both used alone and in combination with other CNS depressants, may lead to potentially fatal respiratory depression
- Use of lorazepam may cause emergence or worsening of pre-existing depression. Monitor patients for emergence of suicidality or unusual changes in behavior
- Avoid use during pregnancy, especially during first trimester because of possible increased risk of congenital malformations. Advise women of childbearing age to use effective contraceptive method
- Use of lorazepam, may lead to physical and psychological dependence. The risk of dependence increases with higher doses, long term use, history of alcoholism or drug abuse or in patients with significant personality disorders. Prescribe for short periods only (e.g. 2-4 weeks)
- Use with caution in patients with suicidal tendencies; do not allow access to large quantities of drug
- Do not with draw abruptly. Taper to discontinue
Cautions: Use cautiously in
Pregnancy Category:D
Breastfeeding: Lorazepam is excreted in breastmilk in low levels. Due to its relatively short half-life compared to other benzodiazepines, it would not be expected to cause any adverse events in breastfed infants with usual maternal doses. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 9 June 2010).
