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Lorazepam: Brands, Price & Uses in Bangladesh
Lorazepam is a benzodiazepine indicated for the following uses: Established / FDA-approved uses Anxiety disorders: short-term relief (generally not longer than 4 months) of the symptoms of anxiety and more.
About Lorazepam
Indications of Lorazepam
Lorazepam is a benzodiazepine indicated for the following uses:
Established / FDA-approved uses
- Anxiety disorders: short-term relief (generally not longer than 4 months) of the symptoms of anxiety, or anxiety associated with symptoms of depression.
- Status epilepticus: injectable Lorazepam is indicated for the treatment of status epilepticus, given intravenously by a healthcare professional.
- Preanesthetic sedation: injectable Lorazepam is used for sedation, relief of anxiety, and to produce a decreased ability to recall events related to surgery or unpleasant procedures, when given intramuscularly or intravenously prior to a procedure.
Commonly used off-label (not formally FDA-approved for this use)
- Short-term management of insomnia associated with anxiety.
- Alcohol withdrawal syndrome (adjunct, to control agitation, tremor, and prevent seizures).
- Adjunct antiemetic for chemotherapy-induced nausea and vomiting (used in combination with standard antiemetics).
Lorazepam is not indicated for the treatment of anxiety associated with everyday stress, and long-term use is generally not recommended.
Dosage & Administration of Lorazepam
Adult Dosage
| Indication | Typical Adult Dose |
|---|---|
| Anxiety disorders (oral) | 1–10 mg/day in divided doses; a common starting dose is 2–3 mg/day given 2–3 times daily, titrated to response. Larger doses at bedtime, smaller during the day. |
| Insomnia associated with anxiety (oral, off-label) | 2–4 mg at bedtime. |
| Status epilepticus (IV, hospital setting) | Typically 4 mg given by slow intravenous injection; may be repeated once after 10–15 minutes if seizures persist, per treating physician's judgment. |
| Preanesthetic sedation (IM/IV) | Dose individualized by the anesthesia provider based on age, weight, and clinical status. |
Dosage in the Elderly / Debilitated Patients
A lower starting dose (e.g., 1–2 mg/day in divided doses) is recommended, adjusted according to response and tolerability, due to increased sensitivity to sedative effects.
Hepatic/Renal Impairment
Because Lorazepam is metabolized by glucuronidation rather than oxidative liver metabolism, it is often preferred in patients with hepatic impairment compared with other benzodiazepines; nonetheless, dose reduction and close monitoring are advised in significant hepatic or renal impairment.
Administration
Oral tablets may be taken with or without food. Injectable Lorazepam must be administered only by trained healthcare professionals in a setting equipped to manage sedation and respiratory depression.
Lorazepam should be used at the lowest effective dose for the shortest duration necessary, as prescribed by a physician.
Side Effects of Lorazepam
The most common side effects of Lorazepam are related to central nervous system depression and include:
- Sedation and drowsiness (most common)
- Dizziness
- Weakness and unsteadiness (ataxia)
- Fatigue
- Disorientation or confusion, particularly in elderly patients
Less common effects include headache, blurred vision, nausea, changes in appetite, and skin rash. Rarely, paradoxical reactions such as agitation, irritability, or aggression can occur, especially in children and the elderly. Abrupt discontinuation after prolonged use can cause withdrawal symptoms (see Precautions and Warnings). Patients should report any unusual or severe side effects to their physician promptly.
Contraindications of Lorazepam
Lorazepam is contraindicated in patients with:
- Known hypersensitivity to Lorazepam or to other benzodiazepines.
- Acute narrow-angle glaucoma.
- Severe respiratory insufficiency (for the injectable form, except in patients who are already mechanically ventilated).
- Sleep apnea syndrome (injectable form).
Concomitant use with opioids carries a boxed warning for risk of profound sedation, respiratory depression, coma, and death (see Interactions and Precautions), and should be avoided unless no alternative treatment options are adequate.
Frequently Asked Questions about Lorazepam
What is Lorazepam used for?
Lorazepam is a benzodiazepine primarily used for the short-term relief of anxiety symptoms and anxiety associated with depression. Injectable forms are also used for status epilepticus (a prolonged seizure emergency) and for sedation before procedures, always under medical supervision.
Can I stop taking Lorazepam suddenly?
No. Lorazepam should never be stopped abruptly after regular use, as this can cause withdrawal symptoms such as anxiety rebound, tremor, insomnia, and, rarely, seizures. Your physician will guide you on gradually tapering the dose.
Is Lorazepam safe during pregnancy?
Lorazepam should be used during pregnancy only if clearly needed and if the potential benefit justifies the potential risk to the baby, since use late in pregnancy has been associated with neonatal sedation and withdrawal symptoms. Always consult your physician before using Lorazepam if you are pregnant or planning pregnancy.
Can I drive after taking Lorazepam?
Lorazepam commonly causes drowsiness, dizziness, and impaired coordination. You should avoid driving or operating machinery until you know how Lorazepam affects you, and avoid alcohol, which increases these effects.
What should I do if I take too much Lorazepam?
An overdose of Lorazepam can cause severe drowsiness, confusion, and dangerous respiratory depression, especially if combined with alcohol or opioids. Seek immediate medical attention or contact emergency services/poison control right away; do not wait for symptoms to worsen.
Can Lorazepam be taken with other sedatives or opioid painkillers?
Combining Lorazepam with opioids or other central nervous system depressants (including alcohol) significantly increases the risk of profound sedation, slowed breathing, coma, and death. This combination should only be used if specifically directed by a physician, at the lowest possible doses.
Disclaimer
The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.