Lorazepam is a drug that is commonly used to help make patients relax. This may be used to treat mental, emotional or physical conditions in a variety of age groups. There are a few dosing limitations that will need to be considered in order to ensure that the effects of the drug do not become overpowering. This could lead to an increased risk of side effects or dangerous conditions that could impact the overall health and safety of the patient. Working with a doctor to monitor your condition as you start your prescription can help avoid these issues. Most patients should also limit the length of their Lorazepam prescription to ensure that dependent behavior does not develop over time.
Indications and Usage
Lorazepam is typically used to treat anxiety and promote relaxation in patients. It can also be used to treat epilepsy, insomnia, irritable bowel syndrome or extreme nausea and vomiting. Those having issues with alcohol withdrawal may be prescribed a temporary prescription to help deal with the agitation. These conditions will have very different directions for your prescription size and dosing schedule. Go over any instructions with your doctor and read the packaging carefully before you begin to take your medication. You can also go over additional instructions with your pharmacist.
Lorazepam is available in liquid and tablet form. The generic version of the drug is known as Ativan. Typically it is taken two to three times a day, and does not need to be taken with food. The liquid version will come with a dropper that you can use to measure out your dose. This version of the medication will be mixed with a beverage before you take it. Some find it easier to take the Lorazepam concentrate when it is mixed with applesauce or pudding. Do not mix these substances before you are ready to take your medication.
The tablet version of Lorazepam is available in .5 mg, 1 mg and 2 mg tablets. Most patients will take 2-6 mg daily in divided doses. Patients may be given up to 10 mg per day depending on the size of the individual and the severity of the condition being treated.
Those using Lorazepam for anxiety are typically given 2-3 mg per day and those dealing with insomnia are given 2-4 mg right before they go to bed for the night. Those who are using the liquid concentrate will be given a dose in milligrams that they are to measure out using the dropper which is provided. Your pharmacist can help you mark the proper line that you need to fill your dropper to for each dose.
- Elderly patients are restricted to 1 or 2 mg in divided doses. This may be increased once it has been proven that the patient is not at risk for an overdose or increased risk of side effects. This may be increased or otherwise adjusted to meet the patient's condition as they are monitored by their doctor.
- Young patients and children should also be restricted to low doses because they are also at risk for increased instances of side effects. The level of sedation is also significantly higher in children who are still developing so it is very important to monitor their condition while they begin their prescriptions.
- Pregnant women are often advised to avoid Lorazepam, especially during the first trimester. If you are pregnant or may become pregnant you should discuss your risk with your physician so you can determine how to adjust your Lorazepam prescription to reduce the potential risk. Those who are breastfeeding should be aware of the fact that Lorazepam can be transferred to your infant via breast milk. You will need to determine whether or not the benefits outweigh this risk before continuing your prescription.
- Those with liver disease may be at risk of developing additional side effects when taking Lorazepam. If you are suffering from heart or lung disease are also at risk for similar reasons. Those who have had glaucoma or seizures should tell your doctor before you start taking Lorazepam as this medication may make your condition worse.
Lorazepam Side Effects
Common Side Effects
- Those who suffer from depression are known to see an increase in their condition while taking Lorazepam. Those who suffer from psychosis or any type of depressive disorder should talk with their doctor before starting a prescription.
- Those who suffer from dependency to medication are recommended to have a serious discussion with their doctor before beginning a Lorazepam regimen. This drug has a serious risk of causing withdrawal symptoms and dependency. Do not stop taking Lorazepam suddenly, especially without a doctor's supervision. This can lead to withdrawal symptoms including dysphoria, dizziness, numbness, hypersensitivity, and diarrhea, loss of appetite, hallucinations, tremors and panic attacks.
- Other side effects for Lorazepam are quite rare, most of which occur in less than ten percent of users. The most common at nearly 16 percent is sedation, or a calming, sleeping effect. In many cases this prescription is intended to cause this effect, so it should not be a cause for concern. Some age groups are more susceptible to this condition, however, so they should be monitored to ensure that they are still breathing properly and remaining conscious while under the influence of the drug.
- Other common side effects for Lorazepam include dizziness, occurring in about 7 percent of users, weakness which occurs in approximately 4 percent and unsteadiness which occurs in approximately 3 percent of users. None of these side effects are particularly dangerous and appeared to get better as the patient continued with their prescription. Most users continued to take Lorazepam in spite of developing these side effects. If these effects or others are interfering with your life or giving you any cause for concern, then contact your doctor to determine the best solution. Do not stop taking your prescription unless your doctor informs you to.
Uncommon Side Effects
Uncommon side effects of Lorazepam include constipation, sex drive changes, disorientation, memory loss, fatigue, vertigo, vision changes and headaches. Those using the generic version saw an increased likelihood for developing impotence and hair loss. In most cases these side effects were not dangerous, but you should always report any abnormal effects to your doctor. If at any time your side effects appear life threatening do not hesitate to seek emergency medical services. Do not stop taking your prescription unless a medical professional tells you to.
- For pregnant women, no studies on humans have been done to determine the risk of taking Lorazepam while pregnant. Tests on animals showed instances malformations in infants when exposed to the drug. Some high doses also resulted in fetal loss in some animals. Some pregnant women have noted placental transfer of Lorazepam, and traces of the drug were reported in infant blood samples several weeks after birth. Some infants were reported to suffer apnea, feeding problems, cold stress, hypothermia and respiratory depression when exposed to Lorazepam late in the pregnancy. Some mothers who were breastfeeding saw instances of sedation and irritability, so have your condition monitored carefully.
- Seniors and children saw significantly increased risks of sedation and common side effects while taking Lorazepam. Those already suffering from kidney, lung or heart issues are at risk for their condition becoming worse while on Lorazepam. If you are suffering from liver issues your body may have difficulty clearing the drug in a timely manner so you may need to adjust your dosage schedule to accommodate this.
Lorazepam cannot be combined with CNS-based depressants. These will increase the effects of the drug, which could lead to an overdose or excessive symptoms which could be dangerous. CNS-based depressants include alcohol, antipsychotics, sedatives, barbiturates, antidepressants, anticonvulsants, anesthetics and narcotics. On a similar note, using medications that contain clozapine while you are taking Lorazepam can increase the sedation effects and cause salivation, delirium, respiratory arrest or hypotension.
In some cases, Lorazepam has interrupted valproate results which can lead to increased plasma concentrations. Due to the half-life decomposition of the drug being very slow, you many need to wait several hours before taking drugs that would include the theophylline, probenecid or aminophylline, as this can inhibit glucuronidation.