Description and Brand Names

Drug information provided by: IBM Micromedex

US Brand Name

  1. Ativan
  2. Lorazepam Intensol

Descriptions


Lorazepam is used to treat anxiety disorders. It is also used for short-term relief of the symptoms of anxiety or anxiety caused by depression. Lorazepam is a benzodiazepine that works in the brain to relieve symptoms of anxiety. Benzodiazepines are central nervous system (CNS) depressants, which are medicines that slow down the nervous system.

This medicine is available only with your doctor's prescription.

This product is available in the following dosage forms:

  • Tablet
  • Solution

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.

Breastfeeding

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

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
  • Alprazolam
  • Amobarbital
  • Anileridine
  • Benzhydrocodone
  • Bromazepam
  • Bromopride
  • Buprenorphine
  • Butabarbital
  • Butalbital
  • Butorphanol
  • Calcifediol
  • Calcium Oxybate
  • Cannabidiol
  • Carbinoxamine
  • Carisoprodol
  • Cetirizine
  • Chloral Hydrate
  • Chlorzoxazone
  • Clobazam
  • Codeine
  • Dantrolene
  • Dezocine
  • Diacetylmorphine
  • Difenoxin
  • Dihydrocodeine
  • Diphenoxylate
  • Doxylamine
  • Esketamine
  • Ethchlorvynol
  • Ethylmorphine
  • Fentanyl
  • Flibanserin
  • Fospropofol
  • Gabapentin
  • Gabapentin Enacarbil
  • Hydrocodone
  • Hydromorphone
  • Ketamine
  • Ketobemidone
  • Lemborexant
  • Levocetirizine
  • Levorphanol
  • Lofexidine
  • Loxapine
  • Magnesium Oxybate
  • Meclizine
  • Meperidine
  • Mephenesin
  • Mephobarbital
  • Meprobamate
  • Meptazinol
  • Metaxalone
  • Methadone
  • Methocarbamol
  • Methohexital
  • Metoclopramide
  • Midazolam
  • Mirtazapine
  • Morphine
  • Morphine Sulfate Liposome
  • Nalbuphine
  • Nicomorphine
  • Opium
  • Opium Alkaloids
  • Orlistat
  • Oxycodone
  • Oxymorphone
  • Papaveretum
  • Paregoric
  • Pentazocine
  • Pentobarbital
  • Periciazine
  • Phenobarbital
  • Piritramide
  • Potassium Oxybate
  • Pregabalin
  • Primidone
  • Propofol
  • Remifentanil
  • Remimazolam
  • Scopolamine
  • Secobarbital
  • Sodium Oxybate
  • Sufentanil
  • Tapentadol
  • Thiopental
  • Tilidine
  • Tramadol
  • Trazodone
  • 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.

  • Desogestrel
  • Dienogest
  • Drospirenone
  • Estradiol
  • Ethinyl Estradiol
  • Ethynodiol
  • Gestodene
  • Levonorgestrel
  • Mestranol
  • Nomegestrol
  • Norethindrone
  • Norgestimate
  • Norgestrel
  • Posaconazole
  • Probenecid
  • Pyrimethamine
  • Rifapentine
  • 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 or drug abuse or dependence, or history of or
  • Lung or breathing problems (eg, COPD, sleep apnea) or
  • Seizures, or history of—Use with caution. May make these conditions worse.
  • Depression or
  • Mental problems (eg, 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.

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. If too much of this medicine is taken for a long time, it may become habit-forming (causing mental or physical dependence).

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.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (oral solution):
    • For anxiety:
      • Adults and children 12 years of age and older—2 to 6 milligrams (mg) in divided doses per day. Your doctor may adjust your dose as needed.
      • Older adults—At first, 1 to 2 mg in divided doses per day. Your doctor may adjust your dose as needed.
      • Children younger than 12 years of age—Use and dose must be determined by your doctor.
  • For oral dosage form (tablets):
    • For anxiety:
      • Adults and children 12 years of age and older—At first, 2 to 3 milligrams (mg) in divided doses per day. Your doctor may adjust your dose as needed.
      • Older adults—At first, 1 to 2 mg in divided doses per day. Your doctor may adjust your dose as needed and tolerated.
      • Children younger than 12 years of age—Use and dose must be determined by your doctor.
    • For insomnia caused by anxiety or transient situational stress:
      • Adults and children 12 years of age and older—2 to 4 milligrams (mg) taken as a single dose at bedtime. Your doctor may adjust your dose as needed.
      • Children younger than 12 years of age—Use and dose must be determined by your doctor.

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.

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.

Precautions

It is very important that your doctor check your or your child's progress at regular visits to see if this medicine is working and allow for changes in the dose. Blood tests may be needed to check for any unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.

This medicine may be habit-forming. If you feel that the medicine is not working as well, do not use more than your prescribed dose. Call your doctor for instructions.

If you develop any unusual and strange thoughts or behavior while you are taking lorazepam be sure to discuss it with your doctor. Some changes that have occurred in people taking this medicine are like those seen in people who drink alcohol and then act in a manner that is not normal. Other changes may be more unusual and extreme, such as confusion, worsening of depression, hallucinations (seeing, hearing, or feeling things that are not there), thoughts of killing oneself, and unusual excitement, nervousness, or irritability.

This medicine may cause drowsiness, trouble with thinking, trouble with controlling movements, or trouble with seeing clearly. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert or able to think or see well.

Symptoms of an overdose include: blurred vision, change in consciousness, confusion, dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position, hallucinations, increased sweating, loss of consciousness, loss of strength or energy, muscle pain or weakness, nightmares, shakiness and unsteady walk, slow or irregular heartbeat, sweating, trouble in speaking, unsteadiness, trembling, or other problems with muscle control or coordination, trouble sleeping, unusual excitement, nervousness, restlessness, or irritability, or unusual tiredness or weakness. Call your doctor right away if you notice these symptoms.

This medicine may cause respiratory depression (serious breathing problem that can be life-threatening), especially when used with narcotic pain medicines. Tell your doctor if you are using any narcotic medicine.

Do not stop taking it without checking with your doctor first. Your doctor may want you to gradually reduce the amount you are using before stopping it completely. This may help prevent a worsening of your condition and reduce the possibility of withdrawal symptoms, including hallucinations, headache, seizures, stomach or muscle cramps, tremors, trouble sleeping, or unusual behavior.

This medicine will add to the effects of alcohol and other central nervous system (CNS) depressants. CNS depressants are medicines that slow down the nervous system, which may cause drowsiness or make you less alert. Some examples of CNS depressants are antihistamines or medicine for hay fever, allergies, or colds, sedatives, tranquilizers, or sleeping medicine, prescription pain medicine or narcotics, barbiturates or medicine for seizures, muscle relaxants, or anesthetics (numbing medicines), including some dental anesthetics. This effect may last for a few days after you stop taking this medicine. Check with your doctor before taking any of the above while you are using this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

  1. Drowsiness
  2. relaxed and calm
  3. sleepiness

Incidence not known

  1. Aggressive, angry
  2. agitation
  3. attack, assault, or force
  4. black, tarry stools
  5. bleeding gums
  6. blood in the urine or stools
  7. bluish lips or skin
  8. blurred vision
  9. change in consciousness
  10. chills
  11. coma
  12. confusion
  13. confusion about identity, place, and time
  14. cough or hoarseness
  15. dark urine
  16. decreased urine output
  17. difficulty with breathing or swallowing
  18. difficulty with speaking
  19. discouragement
  20. dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  21. drooling
  22. dry mouth
  23. excitation
  24. false or unusual sense of well-being
  25. fast or irregular heartbeat
  26. feeling sad or empty
  27. fever with or without chills
  28. general feeling of tiredness or weakness
  29. headache
  30. hives, itching, or rash
  31. hyperventilation
  32. increased thirst
  33. irregular, fast or slow, or shallow breathing
  34. irritability
  35. loss of appetite
  36. loss of balance control
  37. loss of consciousness
  38. loss of interest or pleasure
  39. loss of memory
  40. lower back or side pain
  41. muscle pain, cramps, trembling, jerking, or stiffness
  42. nausea or vomiting
  43. not breathing
  44. painful or difficult urination
  45. pale or blue lips, fingernails, or skin
  46. pinpoint red spots on the skin
  47. problems with memory
  48. puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  49. reddening of the skin, especially around ears
  50. restlessness
  51. seeing, hearing, or feeling things that are not there
  52. seizures
  53. shaking
  54. shuffling walk
  55. sore throat
  56. sores, ulcers, or white spots on the lips or in the mouth
  57. stiffness of the limbs
  58. stomach pain
  59. sweating
  60. swelling of the eyes or inside of the nose
  61. swelling of the face, ankles, or hands
  62. swollen glands
  63. thoughts or attempts at killing oneself
  64. tightness in the chest
  65. trouble concentrating
  66. trouble sleeping
  67. twisting movements of body
  68. uncontrolled movements, especially of the face, neck, and back
  69. unexplained bleeding or bruising
  70. unpleasant breath odor
  71. unusual bleeding or bruising
  72. unusual tiredness or weakness
  73. vomiting of blood
  74. yellow eyes or skin

Get emergency help immediately if any of the following symptoms of overdose occur:

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
  12. unusual weak feeling

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

  1. Being forgetful
  2. clumsiness
  3. constipation
  4. decreased interest in sexual intercourse
  5. disturbed color perception
  6. dizziness or lightheadedness
  7. double vision
  8. drowsiness
  9. feeling of constant movement of self or surroundings
  10. hair loss or thinning of the hair
  11. halos around lights
  12. inability to have or keep an erection
  13. increased in sexual ability, desire, drive, or performance
  14. increased interest in sexual intercourse
  15. lack or loss of self-control
  16. lethargy
  17. loss in sexual ability, desire, drive, or performance
  18. muscle aches, twitching, or weakness
  19. night blindness
  20. overbright appearance of lights
  21. rapid weight gain
  22. sensation of spinning
  23. shakiness in the legs, arms, hands, or feet
  24. shivering
  25. stupor
  26. trembling or shaking of the hands or feet
  27. tunnel vision
  28. weak or feeble pulse

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.