Lorazepam

May be taken with or without food.

Myasthenia gravis, acute narrow-angle glaucoma; sleep apnoea, acute pulmonary insufficiency, respiratory depression; obsessional states. Severe hepatic impairment. Pregnancy.

Patient with chronic respiratory insufficiency, COPD, history of alcoholism or drug abuse; significant personality disorders, fall risk. Debilitated patients. Not indicated for primary treatment of psychotic illness or depressive disorders. Not recommended for long-term use. Avoid abrupt withdrawal. Renal and mild to moderate hepatic impairment. Neonates, children, and elderly. Lactation. Patient Counselling This drug may cause dizziness, sedation, blurred vision, amnesia, impaired concentration and impaired muscular function; if affected, do not drive or operate machinery. Monitoring Parameters Confirm pregnancy status before initiation of treatment. Monitor respiratory and cardiovascular status; heart rate, blood pressure. Obtain CBC, LFTs, LDH for long-term treatment. Assess mental alertness and symptoms of anxiety; signs and symptoms of withdrawal, aggressive or hyperactive behaviour; physical and/or psychological dependence.

Significant: Transient anterograde amnesia, memory impairment, paradoxical reactions, physical and psychological dependence, blood dyscrasia, elevated liver enzymes. Rarely, hypotension. General disorders and administration site conditions: Asthenia, fatigue; inj site pain (IM or IV). Musculoskeletal and connective tissue disorders: Muscle weakness. Nervous system disorders: Daytime drowsiness, dizziness, sedation, ataxia. Psychiatric disorders: Confusion, depression, unmasking of depression, hallucinations.
Potentially Fatal: Respiratory depression, anaphylactic reactions (e.g. angioedema of the tongue, glottis or larynx); acute withdrawal reactions (abrupt discontinuation or rapid dosage reduction after continued use); abuse, misuse and addiction.

Enhanced central depressive effects with other centrally acting drugs such as sedative antihistamines, anaesthetics, neuroleptics, antidepressants, antipsychotics, barbiturates (e.g. phenobarbital), sedatives and hypnotics. Increases effects of Na oxybate. Increased serum concentration with valproate. Prolonged effect with probenecid. Increases the clearance of zidovudine. Increased risk of prolonged sedation with HIV protease inhibitors. Concomitant use with clozapine may result in marked sedation, excessive salivation, hypotension, ataxia, delirium and respiratory arrest. Increased overall muscle-relaxing effect with muscle relaxants. Decreased sedative effect with aminophylline or theophylline. Decreased anxiolytic and sedative effects with caffeine. Decreased clearance with CYP450 inhibitors (e.g. cimetidine, isoniazid, erythromycin, omeprazole, ketoconazole). Increased clearance with CYP450 inducers (e.g. rifampicin). Increased hypotensive effect with antihypertensives (e.g. ACE inhibitors, α-blockers, ARBs, β-blockers, Ca channel blockers), vasodilators (e.g. hydralazine, nitrates) and diuretics. Antacids may delay the absorption of lorazepam. May antagonise the effect of levodopa.

Anticonvulsants / Anxiolytics

N05BA06 - lorazepam ; Belongs to the class of benzodiazepine derivatives anxiolytics. Used in the management of anxiety, agitation or tension.