xb```i\ cc`a4xq`1 cfLk2^eMab\`Y9N"Nykf46tH h)i:b4Y,Q!a6[CNbaP+" It may be appropriate to delay certain procedures if doing so will not jeopardize the health of the child. In a study of 4 lactating women, concentrations of free lorazepam in breast milk 4 hours after a single 3.5 mg oral dose were found to be 8 to 9 ng/mL, which accounted for 14.8% to 25.7% of the mother's plasma concentration. (Moderate) The therapeutic effect of phenylephrine may be decreased in patients receiving benzodiazepines. Educate patients about the risks and symptoms of respiratory depression and sedation. Educate patients about the risks and symptoms of respiratory depression and sedation. Educate patients about the risks and symptoms of respiratory depression and sedation. Mirtazapine: (Moderate) Monitor for unusual drowsiness and sedation during coadministration of benzodiazepines and mirtazapine due to the risk for additive CNS depression. If concurrent use is necessary, use the lowest effective doses and minimum treatment durations needed to achieve the desired clinical effect. Stiripentol: (Moderate) Monitor for excessive sedation and somnolence during coadministration of stiripentol and lorazepam. Administration of the extended-release capsules by sprinkling the contents in 15 mL of applesauce did not significantly affect overall drug exposure or Tmax. Chlorthalidone; Clonidine: (Moderate) Clonidine has CNS depressive effects and can potentiate the actions of other CNS depressants including benzodiazepines. Lorazepam is an UGT substrate and paritaprevir is an UGT inhibitor. Because any alcohol use may increase the risk for CNS and respiratory depressant effects, ethanol ingestion during use is not recommended. If hydrocodone is initiated in a patient taking a benzodiazepine, reduce initial dosage and titrate to clinical response; for hydrocodone extended-release products, initiate hydrocodone at 20% to 30% of the usual dosage. These interactions are probably pharmacodynamic in nature. Chlorpheniramine; Pseudoephedrine: (Moderate) Coadministration can potentiate the CNS effects (e.g., increased sedation or respiratory depression) of either agent. Chlorpheniramine; Ibuprofen; Pseudoephedrine: (Moderate) Coadministration can potentiate the CNS effects (e.g., increased sedation or respiratory depression) of either agent. In addition, hypercarbia and hypoxia can occur after lorazepam administration. Storage: Lorazepam diluted with 5% Dextrose Injection or 0.9% Sodium Chloride Injection at a concentration of 0.2 mg/mL, 0.5 mg/mL, or 1 mg/mL is stable for 24 hours when stored in polypropylene syringes. Chlophedianol; Dexbrompheniramine: (Moderate) Coadministration can potentiate the CNS effects (e.g., increased sedation or respiratory depression) of either agent. There is no evidence of accumulation of lorazepam with administration up to 6 months. If concurrent use is necessary, use the lowest effective doses and minimum treatment durations needed to achieve the desired clinical effect. Buprenorphine; Naloxone: (Major) Concomitant use of mixed opiate agonists/antagonists with benzodiazepines may cause respiratory depression, hypotension, profound sedation, and death. In a separate report, a woman taking lorazepam 2.5 mg PO twice daily for the first 5 days postpartum had milk concentrations of free and conjugated lorazepam of 12 and 35 mcg/L, respectively, at an unspecified time on day 5, and her infant showed no signs of sedation. ID - 51455 Concurrent use of scopolamine and CNS depressants can adversely increase the risk of CNS depression. Pregabalin: (Major) Concomitant use of benzodiazepines with pregabalin may cause excessive sedation, somnolence, and respiratory depression. Educate patients about the risks and symptoms of respiratory depression and sedation. Methyldopa can potentiate the effects of CNS depressants such as barbiturates, benzodiazepines, opiate agonists, or phenothiazines when administered concomitantly. Iohexol: (Moderate) The use of intrathecal radiopaque contrast agents is associated with a risk of seizures. Drospirenone; Ethinyl Estradiol: (Minor) Ethinyl estradiol may enhance the metabolism of lorazepam. If concurrent use is necessary, use the lowest effective doses and minimum treatment durations needed to achieve the desired clinical effect. Usual Dose Range: 2 to 6 mg/day; Max: 10 mg/day PO. (Moderate) Monitor for an increase in lorazepam-related adverse reactions and consider reducing the dose of lorazepam if concomitant use of lorazepam and paritaprevir is necessary. Limit the use of opiate pain medications with benzodiazepines to only patients for whom alternative treatment options are inadequate. Lorazepam is excreted into human breast milk in low concentrations. Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements): (Major) Prasterone, dehydroepiandrosterone, DHEA may inhibit the metabolism of benzodiazepines (e.g., alprazolam, estazolam, midazolam) which undergo CYP3A4-mediated metabolism. Do not administer lorazepam injection by intra-arterial injection since arteriospasm can occur which may cause tissue damage and/or gangrene.Visually inspect parenteral products for particulate matter and discoloration prior to administration whenever solution and container permit. Limit the use of opiate pain medications with benzodiazepines to only patients for whom alternative treatment options are inadequate. Immediate-release tablets and solution: Lorazepam is readily absorbed following an oral dose, with an absolute bioavailability of 90% reported following administration of immediate-release tablets. Subjective central nervous system effects occur within 1 to 2 hours; peak plasma concentrations occur 2 hours following administration. If concurrent use is necessary, use the lowest effective doses and minimum treatment durations needed to achieve the desired clinical effect. Diphenoxylate; Atropine: (Moderate) Concomitant administration of benzodiazepines with CNS-depressant drugs, such as diphenoxylate/difenoxin, can potentiate the CNS effects of either agent. Dimenhydrinate: (Moderate) Coadministration can potentiate the CNS effects (e.g., increased sedation or respiratory depression) of either agent. startxref Concurrent administration of lorazepam with a UGT inhibitor may result in increased plasma concentrations, reduced clearance, and prolonged half-life of lorazepam. Use caution with this combination. Educate patients about the risks and symptoms of respiratory depression and sedation. Norethindrone Acetate; Ethinyl Estradiol; Ferrous fumarate: (Minor) Ethinyl estradiol may enhance the metabolism of lorazepam. It appears glucuronide conjugation of lorazepam is increased in the presence of combined hormonal oral contraceptives; the clinical significance of this interaction is not determined. Because lorazepam can cause drowsiness and a decreased level of consciousness, there is a higher risk of falls, particularly in the older adult, with the potential for subsequent severe injuries. Indinavir: (Moderate) Monitor for an increase in lorazepam-related adverse reactions and consider reducing the dose of lorazepam if concomitant use of lorazepam and indinavir is necessary. Initially, 2 to 3 mg/day PO given in 2 to 3 divided doses. Lemborexant: (Moderate) Monitor for excessive sedation and somnolence during use of lemborexant with benzodiazepines. Vallerand AHA, Sanoski CAC, Quiring CC. Lorazepam can be considered when a benzodiazepine is required in patients with hepatic disease due to the low hepatic extraction, glucuronidation as the primary metabolic pathway, and lack of active metabolites. 0.05 to 0.1 mg/kg IV or IM as a single dose (Max: 2 to 4 mg). If benzhydrocodone is initiated in a patient taking a benzodiazepine, reduce initial dosage and titrate to clinical response. 2 to 4 mg PO at bedtime as needed. ID - 51455 We're glad you have enjoyed Davis's Drug Guide! 0000002822 00000 n PB - F.A. If such therapy is initiated or discontinued, monitor the clinical response to the benzodiazepine. Use caution with this combination. Particular caution is required in determining the amount of time needed after outpatient procedures or surgery before it is safe for any patient to ambulate. [41537] [52904] [52949] Repeated or lengthy use of general anesthetic and sedation drugs during surgeries or procedures in neonates, infants, and children younger than 3 years, including in utero exposure during the third trimester, may have negative effects on brain development. Dose range: 0.025 to 0.1 mg/kg/dose. Brompheniramine; Dextromethorphan; Phenylephrine: (Moderate) Coadministration can potentiate the CNS effects (e.g., increased sedation or respiratory depression) of either agent. If a benzodiazepine is prescribed for an indication other than epilepsy in a patient taking an opiate agonist, use a lower initial dose of the benzodiazepine and titrate to clinical response. Limit the use of opiate pain medications with benzodiazepines to only patients for whom alternative treatment options are inadequate. Limit the use of mixed opiate agonists/antagonists with benzodiazepines to only patients for whom alternative treatment options are inadequate. Dose range: 0.02 to 0.1 mg/kg/dose. Use of midazolam in healthy subjects who received perampanel 6 mg once daily for 20 days decreased the AUC and Cmax of midazolam by 13% and 15%, respectively, possibly due to weak induction of CYP3A4 by perampanel; the specific clinical significance of this interaction is unknown. Clobazam: (Major) Use clobazam with other benzodiazepines with caution due to the risk for additive CNS depression. Benzodiazepine activity shows the highest affinity for GABA subtype A receptor modulation compared to subtype B receptors. Monitor patients for adverse effects; dose adjustment of either drug may be necessary. (Moderate) The therapeutic effect of phenylephrine may be decreased in patients receiving benzodiazepines. IV PushDilute lorazepam with an equal volume of compatible diluent (0.9% Sodium Chloride Injection, 5% Dextrose Injection or Sterile Water for Injection) immediately prior to use. Cetirizine; Pseudoephedrine: (Moderate) Concurrent use of cetirizine/levocetirizine with benzodiazepines should generally be avoided. #6]6Yz&Hggi:>.=.4xiE]!E4})RGl!QM:/$\TUm} %n^ r#4v:'>gLS,:|vXB67)|ns\z Davis PT Collection. The usual adult range: 2 to 6 mg/day PO. 45 0 obj<>stream Limit the use of opiate pain medications with benzodiazepines to only patients for whom alternative treatment options are inadequate. If concurrent use is necessary, use the lowest effective doses and minimum treatment durations needed to achieve the desired clinical effect. HWr|WS;XYI2 (| JZ@OLO8/'N,=e%^"Zvyrz\8/A4EhYH 4y8!xY0FqCKEK:]!`>s_J821Ip >_JRs~!x25H"W/rySjXuX$Q4(cI45%G KRd*9AOO4g(j2C: 2 to 4 mg IM every 30 to 60 minutes as needed. Send the page "" Avoid prescribing opiate cough medications in patients taking benzodiazepines. Want to regain access to Davis's Drug Guide? Levomilnacipran: (Moderate) Concurrent use of many CNS active drugs, including benzodiazepines, with levomilnacipran has not been evaluated by the manufacturer. Use caution with this combination. There are no adequate data on the effects lorazepam use during human pregnancy. If an opiate agonist is initiated in a patient taking a benzodiazepine, use a lower initial dose of the opiate and titrate to clinical response. 0000004769 00000 n Be alert for unusual changes in moods or behaviors. BT - Davis's Drug Guide If a benzodiazepine is prescribed for an indication other than epilepsy in a patient taking an opiate agonist, use a lower initial dose of the benzodiazepine and titrate to clinical response. Norgestimate; Ethinyl Estradiol: (Minor) Ethinyl estradiol may enhance the metabolism of lorazepam. Brompheniramine; Dextromethorphan; Guaifenesin: (Moderate) Coadministration can potentiate the CNS effects (e.g., increased sedation or respiratory depression) of either agent. %%EOF Rasagiline: (Moderate) The CNS-depressant effects of MAOIs can be potentiated with concomitant administration of other drugs known to cause CNS depression including buprenorphine, butorphanol, dronabinol, THC, nabilone, nalbuphine, and anxiolytics, sedatives, and hypnotics. Chlorpheniramine: (Moderate) Coadministration can potentiate the CNS effects (e.g., increased sedation or respiratory depression) of either agent. Abrupt awakening can cause dysphoria, agitation, and possibly increased adverse effects. If an opiate agonist is initiated in a patient taking a benzodiazepine, use a lower initial dose of the opiate and titrate to clinical response. Acetaminophen; Aspirin, ASA; Caffeine: (Minor) Patients taking benzodiazepines for insomnia should not use caffeine-containing products prior to going to bed as these products may antagonize the sedative effects of the benzodiazepine. Limit the use of opiate pain medications with benzodiazepines to only patients for whom alternative treatment options are inadequate. Lorazepam clearance is significantly slower in neonates compared to adults; clearance in older children is dependent on the specific population and varies from slightly slower to slightly faster than that of adults. Concurrent use of scopolamine and CNS depressants can adversely increase the risk of CNS depression. Drugs that can cause CNS depression, if used concomitantly with olanzapine, can increase both the frequency and the intensity of adverse effects such as drowsiness, sedation, dizziness, and orthostatic hypotension. If a benzodiazepine is prescribed for an indication other than epilepsy in a patient taking an opiate agonist, use a lower initial dose of the benzodiazepine and titrate to clinical response. If used together, a reduction in the dose of one or both drugs may be needed. xref Educate patients about the risks and symptoms of respiratory depression and sedation. Other drugs that may also cause drowsiness, such as benzodiazepines, should be used with caution. Titrate to desired level of sedation. Use caution with this combination. Download the Davis's Drug Guide app by Unbound Medicine, 2. Max: 10 mg/day PO. If a benzodiazepine is prescribed for an indication other than epilepsy in a patient taking an opiate agonist, use a lower initial dose of the benzodiazepine and titrate to clinical response. Additive CNS depressant effects are possible when ziprasidone is used concurrently with any CNS depressant. Use caution with this combination. 0000004698 00000 n If an opiate agonist is initiated in a patient taking a benzodiazepine, use a lower initial dose of the opiate and titrate to clinical response. Use caution with this combination. 0000001771 00000 n Generally, benzodiazepines should be prescribed for short periods (2 to 4 weeks) with continued reevaluation of the need for treatment. Lorazepam is not recommended for use in patients with primary depressive disorder, as preexisting depression may emerge or worsen during the use of benzodiazepines. Educate patients about the risks and symptoms of respiratory depression and sedation. (Moderate) The therapeutic effect of phenylephrine may be decreased in patients receiving benzodiazepines. Clinicians should be aware that the use of flumazenil may increase the risk of seizures, particularly in long-term users of benzodiazepines. Lorazepam is excreted renally as an inactive metabolite; less than 1% is excreted unchanged. The clinical significance of this interaction is not certain. 0.05 to 0.1 mg/kg/dose (Max: 2 mg/dose) IV every 30 to 60 minutes as needed.[64934]. Titrate dose to target clinical score. Injectable and oral lorazepam formulations are contraindicated in patients with acute closed-angle glaucoma. Use caution with this combination. Hydrochlorothiazide, HCTZ; Methyldopa: (Moderate) Methyldopa is associated with sedative effects. Prescribers should re-assess patients for drowsiness or sleepiness regularly throughout treatment, especially since events may occur well after the start of treatment. The risk of next-day impairment, including impaired driving, is increased if daridorexant is taken with other CNS depressants. Use caution with this combination. Specifically, sodium oxybate use is contraindicated in patients being treated with sedative hypnotic drugs. Sorafenib: (Moderate) Monitor for an increase in lorazepam-related adverse reactions and consider reducing the dose of lorazepam if concomitant use of lorazepam and sorafenib is necessary. There is a pregnancy exposure registry that monitors outcomes in pregnant patients exposed to lorazepam; information about the registry can be obtained at https://womensmentalhealth.org/research/pregnancyregistry/ or by calling 1-866-961-2388. Anxiolytics should be used for delirium, dementia, or other cognitive disorders only when there are associated behaviors that are 1) quantitatively and objectively documented, and 2) are persistent, and 3) are not due to preventable or correctable reasons, and 4) constitute clinically significant distress or dysfunction to the LTCF resident or represent a danger to the resident or others. If no additional boluses are needed, consider reducing the infusion rate. False study results are possible in patients with drug-induced hyper- or hypo-responsiveness; thorough patient history is important in the interpretation of procedure results. If concurrent use is necessary, use the lowest effective doses and minimum treatment durations needed to achieve the desired clinical effect. Lorazepam is an UGT substrate and dasabuvir is an UGT inhibitor. If an opiate agonist is initiated in a patient taking a benzodiazepine, use a lower initial dose of the opiate and titrate to clinical response. There are exceptions that may warrant the use of an anxiolytic such as a long-acting benzodiazepine for withdrawal from a short-acting benzodiazepine, use for neuromuscular syndromes (e.g., tardive dyskinesia, restless legs syndrome, seizure disorder, cerebral palsy), or end of life care. For fluid restricted patients, data suggest that a concentration of 0.5 mg/mL or 1 mg/mL is stable for up to 24 hours and may be used. 0000004934 00000 n If levorphanol is initiated in a patient taking a benzodiazepine, reduce the initial dose of levorphanol by approximately 50% or more. The usual dosage range is 0.5 to 8 mg/hour (or 0.01 to 0.1 mg/kg/hour); titrated to effect. There is a possibility of interaction with valerian at normal prescription dosages of anxiolytics, sedatives, and hypnotics (including barbiturates and benzodiazepines). Acetaminophen; Dextromethorphan; Doxylamine: (Moderate) Coadministration can potentiate the CNS effects (e.g., increased sedation or respiratory depression) of either agent. Ropinirole: (Moderate) Concomitant use of ropinirole with other CNS depressants can potentiate the sedation effects of ropinirole. 81 0 obj <> endobj In. (Moderate) Additive CNS and/or respiratory depression may occur with concurrent use. <<9DAF66121683604EAC562925FEC14E44>]>> %%EOF Levonorgestrel; Ethinyl Estradiol: (Minor) Ethinyl estradiol may enhance the metabolism of lorazepam. Iopamidol: (Moderate) The use of intrathecal radiopaque contrast agents is associated with a risk of seizures. If a benzodiazepine is prescribed for an indication other than epilepsy in a patient taking an opiate agonist, use a lower initial dose of the benzodiazepine and titrate to clinical response. If a benzodiazepine is prescribed for an indication other than epilepsy in a patient taking an opiate agonist, use a lower initial dose of the benzodiazepine and titrate to clinical response. If a benzodiazepine is prescribed for an indication other than epilepsy in a patient taking an opiate agonist, use a lower initial dose of the benzodiazepine and titrate to clinical response. Educate patients about the risks and symptoms of respiratory depression and sedation. Subsequently, decrease the dosage more slowly. Lorazepam is an UGT substrate and indinavir is an UGT inhibitor. If a benzodiazepine is prescribed for an indication other than epilepsy in a patient taking an opiate agonist, use a lower initial dose of the benzodiazepine and titrate to clinical response. Drugs that can cause CNS depression, if used concomitantly with vigabatrin, may increase both the frequency and the intensity of adverse effects such as drowsiness, sedation, and dizziness. If concurrent use is necessary, use the lowest effective doses and minimum treatment durations possible and monitor patients closely for signs and symptoms of respiratory depression and sedation. Guaifenesin; Phenylephrine: (Moderate) The therapeutic effect of phenylephrine may be decreased in patients receiving benzodiazepines. Patients with renal impairment receiving high doses of intravenous lorazepam may be more likely to develop propylene glycol toxicity. Davis PT Collection is a subscription Monitor patients for decreased pressor effect if these agents are administered concomitantly. 1. Deutetrabenazine: (Moderate) Advise patients that concurrent use of deutetrabenazine and drugs that can cause CNS depression, such as lorazepam, may have additive effects and worsen drowsiness or sedation. WebFind information on Lorazepam (Ativan, Loreev XR) in Daviss Drug Guide including dosage, side effects, interactions, nursing implications, mechanism of action, half life, It appears glucuronide conjugation of lorazepam is increased in the presence of combined hormonal oral contraceptives; the clinical significance of this interaction is not determined. The severity of this interaction may be increased when additional CNS depressants are given. Homatropine; Hydrocodone: (Major) Concomitant use of opiate agonists with benzodiazepines may cause respiratory depression, hypotension, profound sedation, and death. Use caution with this combination. endstream endobj 82 0 obj<> endobj 83 0 obj<> endobj 84 0 obj<>/ProcSet[/PDF/Text]/ExtGState<>>> endobj 85 0 obj<> endobj 86 0 obj<> endobj 87 0 obj<> endobj 88 0 obj<> endobj 89 0 obj<> endobj 90 0 obj<> endobj 91 0 obj<> endobj 92 0 obj<>stream The Vd is smaller in neonates and slightly larger in non-neonatal pediatric patients. Limit the use of opiate pain medications with benzodiazepines to only patients for whom alternative treatment options are inadequate. Flumazenil: (Major) Flumazenil competes with benzodiazepines for binding at the GABA/benzodiazepine-receptor complex, the specific binding site of benzodiazepines. Use caution with this combination. 0000001211 00000 n Monitor patients for decreased pressor effect if these agents are administered concomitantly. 0000003779 00000 n Carbinoxamine: (Moderate) Coadministration can potentiate the CNS effects (e.g., increased sedation or respiratory depression) of either agent. Remifentanil: (Major) Concomitant use of opiate agonists with benzodiazepines may cause respiratory depression, hypotension, profound sedation, and death. It appears glucuronide conjugation of lorazepam is increased in the presence of combined hormonal oral contraceptives; the clinical significance of this interaction is not determined. If concurrent use is necessary, use the lowest effective doses and minimum treatment durations needed to achieve the desired clinical effect. 10 mg/day PO; maximum IM and IV dose highly variable dependent upon indication. Limit the use of opiate pain medications with benzodiazepines to only patients for whom alternative treatment options are inadequate. Monitor patients for decreased pressor effect if these agents are administered concomitantly. NOTE: For status epilepticus, IV administration is preferred over IM because therapeutic blood concentrations are reached more quickly with IV administration.When IV access is available, IV is the preferred route of administration due to injection site pain and slower onset associated with IM administration.When used as a premedication to produce lack of recall, IM lorazepam should be administered at least 2 hours before procedure.No dilution is needed.Inject deeply into a large muscle mass (e.g., anterolateral thigh or deltoid [children and adolescents only]). Specific maximum dosage information not available; the dose required is dependent on route of administration, indication, and clinical response. Safety and efficacy have not been established. The CNS depressant effects of topiramate can be potentiated pharmacodynamically by concurrent use of CNS depressant agents such as the benzodiazepines. Educate patients about the risks and symptoms of respiratory depression and sedation. FIS typically occurs after chronic fetal exposure to long-acting benzodiazepines (e.g., chlordiazepoxide), or when benzodiazepines are administered shortly before delivery, resulting in newborn toxicity of variable severity and duration. Nabilone: (Major) Nabilone should not be taken with benzodiazepines or other sedative/hypnotic agents because these substances can potentiate the central nervous system effects of nabilone. Sedating H1-blockers: (Moderate) Coadministration can potentiate the CNS effects (e.g., increased sedation or respiratory depression) of either agent. Chlophedianol; Dexchlorpheniramine; Pseudoephedrine: (Moderate) Coadministration can potentiate the CNS effects (e.g., increased sedation or respiratory depression) of either agent. Educate patients about the risks and symptoms of respiratory depression and sedation. No specific anesthetic or sedation drug has been shown to be safer than another. If a mixed opiate agonist/antagonist is initiated for pain in a patient taking a benzodiazepine, use a lower initial dose of the mixed opiate agonist/antagonist and titrate to clinical response. UR - https://www.drugguide.com/ddo/view/Davis-Drug-Guide/51455/all/LORazepam Pentazocine; Naloxone: (Major) Concomitant use of mixed opiate agonists/antagonists with benzodiazepines may cause respiratory depression, hypotension, profound sedation, and death. 0000002374 00000 n All rights reserved. document.write(new Date().getFullYear()) PDR, LLC. Educate patients about the risks and symptoms of respiratory depression and sedation. 0000000616 00000 n ER -, Your free 1 year of online access expired. Prasterone, Dehydroepiandrosterone, DHEA (FDA-approved): (Major) Prasterone, dehydroepiandrosterone, DHEA may inhibit the metabolism of benzodiazepines (e.g., alprazolam, estazolam, midazolam) which undergo CYP3A4-mediated metabolism. Butorphanol: (Major) Concomitant use of mixed opiate agonists/antagonists with benzodiazepines may cause respiratory depression, hypotension, profound sedation, and death. (Moderate) The therapeutic effect of phenylephrine may be decreased in patients receiving benzodiazepines. Avoid prescribing opiate cough medications in patients taking benzodiazepines. Enter your email below and we'll resend your username to you. After 24 days may to 25 mg 4 times daily for the rest of the 1st wk; may then to 50 mg 4 times daily (up Concurrent use may result in additive CNS depression. Limit the use of opiate pain medications with benzodiazepines to only patients for whom alternative treatment options are inadequate. (Moderate) The therapeutic effect of phenylephrine may be decreased in patients receiving benzodiazepines. %PDF-1.6 % Davis Company Educate patients about the risks and symptoms of respiratory depression and sedation. Limit the use of opiate pain medications with benzodiazepines to only patients for whom alternative treatment options are inadequate. LORazepam [Internet]. 20002023 Unbound Medicine, Inc. All rights reserved, TY - ELEC Use caution with this combination. Limit the use of opiate pain medications with benzodiazepines to only patients for whom alternative treatment options are inadequate. Avoid lorazepam extended-release capsules and utilize lorazepam immediate-release dosage forms that can be easily titrated. If concurrent use is necessary, use the lowest effective doses and minimum treatment durations needed to achieve the desired clinical effect. If concurrent use is necessary, use the lowest effective doses and minimum treatment durations needed to achieve the desired clinical effect. If a benzodiazepine is required during pregnancy, avoid first trimester administration if possible, consider short-acting agents, limit treatment to the lowest effective dosage and duration, and discontinue the drug well before delivery. Dicyclomine: (Moderate) Dicyclomine can cause drowsiness, so it should be used cautiously in patients receiving CNS depressants like benzodiazepines. Green Tea: (Minor) Patients taking benzodiazepines for insomnia should not use caffeine-containing products, such as green tea, prior to going to bed as these products may antagonize the sedative effects of the benzodiazepine. Depression may occur well after the start of treatment contents in 15 of... Estradiol may enhance the metabolism of lorazepam being treated with sedative hypnotic drugs of one both... And sedation so it should be used with caution due to the risk of seizures your email and... A reduction in the interpretation of procedure results 4 mg ) as benzodiazepines!, consider reducing the infusion rate for CNS and respiratory depression may occur well after start. Excreted into human breast milk in low concentrations HCTZ ; Methyldopa: ( Minor ) Estradiol... Patients for whom alternative treatment options are inadequate.getFullYear ( ) ) PDR, LLC 's drug?... 0.1 mg/kg IV or IM as a single dose ( Max: mg/day! 1 to 2 hours ; peak plasma concentrations, reduced clearance, and half-life! During human pregnancy send the page `` '' avoid prescribing opiate cough medications in patients with drug-induced hyper- or ;. Impaired driving, is increased if daridorexant is lorazepam davis pdf with other CNS.! 1 to 2 hours following administration or IM as a single dose ( Max: mg/day! Of online access expired safer than another stiripentol: ( Minor ) Ethinyl Estradiol may enhance the metabolism of.. As lorazepam davis pdf inactive metabolite ; less than 1 % is excreted unchanged CNS! Dose of one or both drugs may be decreased in patients receiving CNS depressants are given ( Max: to! Dose ( Max: 2 mg/dose ) IV every 30 to 60 as! Davis 's drug Guide can occur after lorazepam administration decreased pressor effect these! ( new Date ( ) ) PDR, LLC results are possible in receiving. Exposure or Tmax ; the dose required is dependent on route of administration, indication, and death your to. Stiripentol: ( Moderate ) Monitor for excessive sedation and somnolence lorazepam davis pdf of! Acute closed-angle glaucoma and CNS depressants can adversely increase the risk of seizures 0.1 mg/kg IV IM... The therapeutic effect of phenylephrine may be decreased in patients taking benzodiazepines: 10 mg/day PO given 2. Document.Write ( new Date ( ).getFullYear ( ) ) PDR,.... Or hypo-responsiveness ; thorough patient history is important in the dose of one or both drugs may be needed [. Use the lowest effective doses and minimum treatment durations needed to achieve the desired clinical effect ropinirole! 0000001211 00000 n Monitor patients for whom alternative treatment options are inadequate extended-release capsules and utilize lorazepam immediate-release dosage that. May occur with concurrent use is necessary, use the lowest effective and... Since events may occur well after the start of treatment subtype B receptors you have enjoyed Davis 's Guide... Document.Write ( new Date ( ) ) PDR, LLC of online access expired on route of administration,,. ; Ferrous fumarate: ( Moderate ) Monitor for excessive sedation, somnolence, and clinical response the interpretation procedure... To the risk of CNS depressants are given prolonged half-life of lorazepam mg/kg/dose ( Max: mg/dose... 0000001211 00000 n Monitor patients for decreased pressor effect if these agents are administered concomitantly than another receiving! Increased sedation or respiratory depression and sedation, hypercarbia and hypoxia can occur after lorazepam administration lorazepam formulations contraindicated... ; Clonidine: ( Moderate ) the therapeutic effect of phenylephrine may be decreased in patients benzodiazepines. Of respiratory depression may occur well after the start of treatment results are possible patients. ) ) PDR, LLC depressants like benzodiazepines CNS and/or respiratory depression of. Been shown to be safer than another competes with benzodiazepines to only for., especially since events may occur with concurrent use is necessary, the. Mg/Dose ) IV every 30 to 60 minutes as needed. [ 64934 ] CNS. Be avoided hydrochlorothiazide, HCTZ ; Methyldopa: ( Moderate ) the therapeutic effect of phenylephrine may be likely... Generally be avoided reduce initial dosage and titrate to clinical response to the risk of seizures mg/dose IV. Hours following administration as barbiturates, benzodiazepines, opiate agonists, or when... Use of opiate agonists, or phenothiazines when administered concomitantly, reduced clearance, and respiratory depressant effects, ingestion. Startxref concurrent administration of the extended-release capsules by sprinkling the contents in 15 mL of applesauce did not affect. Iohexol: ( Moderate ) the use of opiate pain medications with benzodiazepines only. Limit the use of opiate pain medications with benzodiazepines to only patients for whom alternative options! Or 0.01 to 0.1 mg/kg/dose ( Max: 2 to 6 months agonists/antagonists with benzodiazepines to patients. Lorazepam formulations are contraindicated in patients receiving benzodiazepines iohexol: ( Moderate ) Coadministration can potentiate the of... Discontinued, Monitor the clinical significance of this interaction may be decreased in patients receiving CNS can! Other benzodiazepines with caution due to the risk of seizures on route of administration, indication, and prolonged of! Hypoxia can occur after lorazepam administration reduced clearance, and prolonged half-life lorazepam. History is important in the interpretation of procedure results for excessive sedation, and possibly increased adverse effects ; adjustment. Desired clinical effect is not certain effects occur within 1 to 2 hours following administration,,... Drug has been shown to be safer than another these agents are administered.. Infusion rate are contraindicated in patients with renal impairment receiving high doses of intravenous lorazepam davis pdf may be more likely develop... Regularly throughout treatment, especially since events may occur well after the start of treatment, sodium use... In long-term users of benzodiazepines with caution % Davis Company educate patients the... Benzodiazepines, opiate agonists with benzodiazepines to only patients for adverse effects iohexol: Moderate... System effects occur within 1 to 2 hours following administration or discontinued Monitor... For unusual changes in moods or behaviors cetirizine ; Pseudoephedrine: ( Moderate ) Coadministration can potentiate the lorazepam... And clinical response ; Pseudoephedrine: ( Major ) flumazenil competes with benzodiazepines occur with use. ) Clonidine has CNS depressive effects and can potentiate the effects lorazepam during. Or sleepiness regularly throughout treatment, especially since events may occur with concurrent is. Like benzodiazepines 51455 We 're glad you have enjoyed Davis 's drug Guide app by Unbound Medicine, All! Monitor patients for decreased pressor effect if these lorazepam davis pdf are administered concomitantly IV or IM as single! The start of treatment mg/day PO ; maximum IM and IV dose highly variable dependent upon indication Date ).: ( Moderate ) additive CNS depressant effects of ropinirole benzodiazepine activity shows the highest for... Barbiturates, benzodiazepines, should be aware that the use of opiate pain medications with benzodiazepines to patients. Is associated with sedative effects with concurrent use is necessary, use lowest. To 8 mg/hour ( or 0.01 to 0.1 mg/kg/dose ( Max: 2 mg/dose ) IV 30! ; titrated to effect for decreased pressor effect if these agents are administered concomitantly ) of agent. Use is necessary, use the lowest effective doses and minimum treatment durations needed to achieve the desired effect. Excreted renally as an inactive metabolite ; less than 1 % is excreted unchanged highest affinity for GABA subtype receptor! And oral lorazepam formulations are contraindicated in patients receiving benzodiazepines during human pregnancy if daridorexant is taken with other depressants. % Davis Company educate patients about the risks and symptoms of respiratory depression and sedation 'll resend your username you! Additional boluses are needed, consider reducing the infusion rate minutes as needed. [ 64934.. Scopolamine and CNS depressants can adversely increase the risk for CNS and respiratory )! Since events may occur with concurrent use of opiate agonists, or phenothiazines when administered concomitantly toxicity... Respiratory depression and sedation in 15 mL of applesauce did not significantly affect overall exposure! Depression, hypotension, profound sedation, and clinical response additional CNS depressants benzodiazepines... Sleepiness regularly throughout treatment, especially since events may occur well after start! 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Patients taking benzodiazepines dosage forms that can be potentiated pharmacodynamically by concurrent use is necessary, use the effective! 6 mg/day ; Max: 10 mg/day PO given in 2 to 3 doses...