Lorazepam (Oral)

Lorazepam is used to treat anxiety caused by depression and for the short-term relief of anxiety.

Overview

Lorazepam is taken orally in the treatment of anxiety disorders. It can be used for the short-term relief of anxiety and can be used to relieve the symptoms of anxiety that are suffering from depression.

Lorazepam works on the brain to relieve these symptoms and is a part of the medicine group benzodiazepines. These medicines are central nervous system depressants that work to slow down the reception of the patient's nervous system. Central nervous system suppressants should never be used in conjunction with one another because the effects can be greatly increased.

Lorazepam is available only with a prescription from a doctor and is given as either a solution or a tablet.

Condition treated

Anxiety

Type Of Medicine

Benzodiazepine

Side Effects

In addition to the desired effects of Lorazepam, certain other side effects can also occur that are unwanted. These side effects may not all occur, but in some cases may require the patient to seek medical attention.

If the following side effects are experienced with use of Lorazepam then you must seek immediate attention from your doctor:

Occurring more commonly:

  • Sleepiness
  • Relaxed and calm
  • Drowsiness

Frequency of incidence not known:

  • Yellow eyes or skin
  • White spots on the lips or in the mouth
  • Vomiting of blood
  • Unusual tiredness or weakness
  • Unusual bleeding or bruising
  • Unpleasant breath odor
  • Unexplained bleeding or bruising
  • Uncontrolled movements of the face, neck and back
  • Twisting movements of body
  • Trouble sleeping
  • Trouble concentrating
  • Tightness in the chest
  • Swollen glands
  • Swelling of the face, ankles, or hands
  • Swelling of the eyes or inside of the nose
  • Sweating
  • Suicidal thoughts or attempts at killing oneself
  • Stiffness of the limbs
  • Sores or ulcerations
  • Sore throat
  • Shuffling walk
  • Shaking
  • Seizures
  • Seeing, hearing, or feeling things that are not there
  • Restlessness
  • Reddening of the skin, especially around ears
  • Puffy or swollen around the eyes, face, lips or tongue
  • Problems with memory
  • Pinpoint red spots on the skin
  • Pale or blue lips, fingernails, or skin
  • Painful or difficult urination
  • Not breathing
  • Nausea or vomiting
  • Muscle trembling, jerking, or stiffness
  • Muscle pain or cramps
  • Lower back or side pain
  • Loss of memory
  • Loss of interest or pleasure
  • Loss of consciousness
  • Loss of balance control
  • Loss of appetite
  • Irritability
  • Increased thirst
  • Hyperventilation
  • Hives, itching, or rash
  • Headache
  • General feeling of tiredness
  • Fever with or without chills
  • Feeling sad or empty
  • Feeling of weakness
  • Fast or irregular heartbeat
  • False or unusual sense of well-being
  • Faintness of dizziness experienced when rising suddenly from sitting or lying
  • Excitation
  • Dry mouth
  • Drooling
  • Discouragement
  • Difficulty with speaking
  • Difficulty with breathing or swallowing
  • Decreased urine output
  • Dark urine
  • Cough or hoarseness
  • Convulsions
  • Confusion about identity, place, person and/or time
  • Confusion
  • Coma
  • Chills
  • Changed or unusual breathing
  • Change in consciousness
  • Blurred vision
  • Bluish lips or skin
  • Blood in the urine or stools
  • Bleeding gums
  • Black, tarry stools
  • Attack, assault, or force
  • Agitation
  • Aggressive, angry
  • Abdominal or stomach pain

Other side effects from the use of Lorazepam can also occur that do not normally require that you seek medical attention. These side effects may abate over time and are generally less serious. If these side effects do become bothersome to you or are ongoing, however, then your healthcare professional may be able to help you in alleviating these side effects:

Frequency of incidence not known:

  • Weak or feeble pulse
  • Tunnel vision
  • Trembling or shaking of the hands or feet
  • Stupor
  • Shivering
  • Shakiness in the legs, arms, hands, or feet
  • Sensation of spinning
  • Rapid weight gain
  • Overbright appearance of lights
  • Night blindness
  • Muscle aches, twitching, or weakness
  • Loss in sexual ability, desire, drive, or performance
  • Lethargy
  • Lack or loss of self-control
  • Increased interest in sexual intercourse
  • Increased in sexual ability, desire, drive, or performance
  • Inability to have or keep an erection
  • Halos around lights
  • Hair loss or thinning of the hair
  • Feeling of constant movement of self or surroundings
  • Drowsiness
  • Double vision
  • Dizziness or lightheadedness
  • Disturbed color perception
  • Decreased interest in sexual intercourse
  • Constipation
  • Clumsiness
  • Being forgetful

It is also possible to suffer from an overdose of Lorazepam. This can be very serious and life-threatening. If you believe that you or anyone else may be suffering an overdose from this medication then you should contact the emergency services immediately. The symptoms of an overdose may include the following:

  • Unusual weakness
  • Unusual weak feeling
  • Unusual tiredness
  • Unusual restlessness
  • Unusual paleness
  • Unusual nervousness
  • Unusual excitement
  • Unusual dullness
  • Unusual drowsiness
  • Unsteadiness
  • Trouble speaking
  • Trembling
  • Slurred speech
  • Shakiness and unsteady walk
  • Problems with muscle control or coordination
  • Nightmares
  • Loss of strength or energy
  • Increased sweating
  • Increased irritability
  • Feeling of sluggishness
  • Changed patterns and rhythms of speech

Other side effects from the use of Lorazepam can also occur that have not been listed herein. If you experience any other side effects then you should inform your doctor and seek advice. If you are concerned about your immediate health, however, then you must contact the emergency services for help. If you have any thoughts of suicide or self-harm during use of this treatment then you should inform your doctor immediately.

Dosage

This medication should only ever be used exactly as you have been directed to use it by your doctor. Taking it in higher doses or more frequently than prescribed can expose you to very serious side effects and further complications.

This medicine will always be given with a medication guide that will explain more of the risks and potential dangers of use as well as how to use it properly. You should read this thoroughly and ask your doctor for advice if you have any questions about the medication following this reading.

This tablet form of this medication must be swallowed whole and should not be broken or crushed in any way.

The oral liquid form of this medication should be measured using the provided device only and should be added to water, juice or deserts for ease of use.

You must only ever take this medication as directed and must not ever share any of your medication with others. Follow the instructions given by your doctor directly and do not make any changes to dose unless ordered to by your doctor. The following information is for guidance only and should not be used to make any adjustments to your dose:

When using the oral solution for treatment:

  • Those aged over 12 should use 2-6mg per day.
  • Elderly patients should be treated with 1-2mg per day initially before the dose is increased.
  • The doctor will determine the dose and use for children below the age of 12.

When using the tablets for treatment:

  • Those aged over 12 should use 2-3mg per day. This dose may then be increased by the doctor.
  • Elderly patients may be treated with 1-2mg per day. The dose may be increased as required with the patient's tolerance.
  • The doctor must determine any use in children below the age of 12.

When treating insomnia as a result of anxiety with tablets:

  • Over the age of 12 patients should be treated with 2-4mg taken as a single dose before bed. This may be adjusted as required.
  • The doctor will determine use in patients below the age of 12.

If a dose of this medication is missed then you should take it as soon as you are able to do so. If you are close to your next dose being due, however, then you should skip the dose you have missed and return to your normal schedule of dosing. You should not take a double dose under any circumstances.

Interactions

Certain medications should never be used in conjunction with one another. This is because they can interact with the body with sometimes life-threatening consequences. In less serious cases, medications can also stop one another from working or may increase the side effects experienced. To ensure that no drug interactions occur you must inform your doctor of all medications that you are taking before you begin treatment with Lorazepam. This includes all prescribed medications and any over the counter treatments you may be using. It is especially important that you inform your doctor if you are taking any of the following treatments:

The use of Lorazepam with the following medicines is not recommended and your doctor may decide not to prescribe it:

  • Flumazenil

The use of the following medications in conjunction with Lorazepam is not normally recommended but may be required in some cases. In these scenarios, the doctor may adjust the dose or frequency of use of one or both treatments.

  • 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.

  • Zolpidem
  • Tramadol
  • Tilidine
  • Thiopental
  • Tapentadol
  • Sufentanil
  • Sodium Oxybate
  • Secobarbital
  • Remifentanil
  • Propoxyphene
  • Propofol
  • Primidone
  • Piritramide
  • Phenobarbital
  • Periciazine
  • Pentobarbital
  • Pentazocine
  • Paregoric
  • Papaveretum
  • Oxymorphone
  • Oxycodone
  • Orlistat
  • Opium Alkaloids
  • Opium
  • Nicomorphine
  • Nalbuphine
  • Morphine Sulfate Liposome
  • Morphine
  • Mirtazapine
  • Methohexital
  • Methocarbamol
  • Methadone
  • Metaxalone
  • Meptazinol
  • Meprobamate
  • Mephobarbital
  • Mephenesin
  • Meperidine
  • Meclizine
  • Levorphanol
  • Ketobemidone
  • Hydromorphone
  • Hydrocodone
  • Fospropofol
  • Flibanserin
  • Fentanyl
  • Ethylmorphine
  • Ethchlorvynol
  • Doxylamine
  • Diphenoxylate
  • Dihydrocodeine
  • Difenoxin
  • Diacetylmorphine
  • Dezocine
  • Dantrolene
  • Codeine
  • Chlorzoxazone
  • Chloral Hydrate
  • Carisoprodol
  • Carbinoxamine
  • Calcifediol
  • Butorphanol
  • Butalbital
  • Butabarbital
  • Buprenorphine
  • Bromopride
  • Bromazepam
  • Anileridine
  • Amobarbital
  • Alfentanil

Using Lorazepam with the following medications may increase the risk of suffering certain side effects from use. This may still be the best treatment for you but your doctor may need to make adjustments to the dose you are given or the frequency of use:

  • Valproic Acid
  • Theophylline
  • St John's Wort
  • Pyrimethamine
  • Probenecid
  • Posaconazole

Other interactions may occur with Lorazepam that have not been listed herein. Inform your doctor of all substances you take before you begin treatment.

Other medical problems from which you suffer can also affect your use of Lorazepam. This is because certain conditions can be worsened by the use of medications not intended for their treatment. You must inform your doctor of all other medical conditions from which you suffer. This is especially important in the following cases

These conditions may be worsened by use:

  • Alcohol abuse
  • Drug abuse or dependency
  • Lung problems
  • Breathing problems
  • History of seizures

Use of Lorazepam is not recommended in patients with the following conditions:

  • Depression
  • Psychosis

Do not treat patients with the following condition using Lorazepam:

  • Acute narrow-angle glaucoma

The side effects and effects of treatment may be increased in patients with the following conditions:

  • Kidney disease
  • Liver disease

Other medical conditions that have not been listed herein can also affect the use of Lorazepam. Ensure that your doctor is fully aware of your complete medical history before beginning treatment.

Warnings

Before beginning to take this medication it is important that you understand the risks of doing so in relation to the benefits. You must also be aware of some of the side effects and how you must respond when they occur. You must inform the doctor immediately if you start having suicidal thoughts or if suicidal thoughts worsen, for example. You must make the decision to begin use with your doctor having considered all of the following:

Allergies 'You must inform your doctor if you have had any unusual allergic reactions to any medications in the past. Also, ensure that you have informed your doctor of any other allergies from which you suffer.

Pediatric' The safety and efficiency of use has been established in children over the age of 12. The medication is not recommended for use in any form in children below this age. Ensure that you discuss this with your doctor.

Geriatric 'Elderly patients are more likely to suffer unwanted side effects from the use of Lorazepam. They are also more likely to be suffering from age-related medical problems that may limit the use of this treatment. There are no limitations to use where tolerance is shown, however. The initial dose should be lower and should be increased with tolerance to the medication.

Pregnancy ' The use of this medication while pregnant can be harmful to the unborn baby. You should not take it when pregnant and should use effective forms of birth control to prevent pregnancy from occurring during use. If you believe that you may have become pregnant then inform your doctor right away. If you think you may become pregnant or want to become pregnant then discuss this with your doctor.

Breastfeeding' Studies have shown only a minimal risk to the infant when breastfeeding from a mother who is taking Lorazepam. Discuss this with your doctor to understand the risk fully.

During use of Lorazepam you will need to have regular check-ups with your doctor. The doctor will determine if it is being effective in use and will look for unwanted effects that may be occurring.

This medication is habit forming so you must not increase the amount you are taking for any reason. Discuss all changes with your doctor.

You may become drowsy and have trouble with your vision during use. You must not drive or operate machinery when you are inhibited in this way. Remember that it is your legal responsibility to ensure you are safe to do so.

You should not ever stop the use of this medication without checking with your doctor first. You may need to have your dose gradually reduced to prevent unwanted withdrawal symptoms from occurring.

This medication can increase the effect of other central nervous system suppressants. You should not take any such substances unless directed to by your doctor. Central nervous system suppressants that you may commonly be taking and must avoid include, but are not limited to, the following:

  • Alcohol
  • Muscle relaxants
  • Seizure medications
  • Anesthetics
  • Hay fever medications
  • Sedatives
  • Barbituates

Do not take any medication while you are taking Lorazepam unless it has been approved by your prescribing doctor. Doing so may put you in life-threatening conditions.

Storage

Lorazepam must be kept out of the reach of children at all times, even when the treatment is for their use. Store the medication at room temperature in a safe and high place. Keep out of direct light and away from heat and moisture.

Do not keep outdated medication for any longer than required and dispose of it properly as directed by your healthcare professional.

Summary

Lorazepam is a medication used for the treatment of anxiety. It works on the brain to suppress the central nervous system and prevent feelings of anxiety and the symptoms of anxiety from occurring.

Lorazepam is a habit-forming medication that is available only with a prescription and should only ever be used as directed by your doctor. Taking too great a dose or using it too frequently will put you at significant risk.

Patients taking Lorazepam may also experience an increased occurrence of suicidal thoughts and inclination to self-harm. If any such side effects are experienced it is vital that you inform your doctor immediately.

Before beginning the use of Lorazepam, it is important that you understand the potential risks of using this treatment. The medication will be provided with a medication guide that you must read and fully understand before you begin treatment. Discuss any concerns that you have with your doctor so that you can be completely clear on all of the risks.

Elderly patients will need to be treated with a lower dose initially before it is increased with tolerance. This is because geriatric patients may be more likely to suffer from some of the unwanted side effects including drowsiness and sleepiness.

It is possible to suffer an overdose of this medication. You should be aware of the symptoms of an overdose before use and should contact the emergency services immediately that they occur.