Drug Index


Mechanism :

Lorazepam is a benzodiazepine. Benzodiazepines presumably exert their effects by binding at stereo specific receptors at several sites within the central nervous system. All benzodiazepines cause a dose-related central nervous system depressant activity.

Indication :

  • Anxiety
  • Psychosomatic Disorders
  • Premedication
  • Insomnia due to anxiety
  • Acute panic attacks
  • Status epilepticus

Contraindications :

Lorazepam is contraindicated in patients with hypersensitivity to benzodiazepines or to any components of the formulation, in acute narrow-angle glaucoma, pre-existing CNS depression, coma, acute pulmonary insufficiency or sleep apnea. Encephalopathy may be precipitated in patients with severe hepatic insufficiency.

Dosing :

0.05-0.1 mg/kg/dose orally 4-8 hourly. Max: 2 mg/dose.
Status epilepticus:
0.05-0.1 mg/kg over 2-5 min and if required repeat every 10-15 min as needed. Max dose: 4 mg OR,
0.1 mg/kg at slow IV, max rate of 2 mg/min. Max dose: 4 mg.
4 mg slow IV, if seizure persists may repeat after 10-15 min.

Adverse Effect :

The common side effects seen are drowsiness, ataxia, irritability, light-headedness, dysarthria and disinhibition. Occasionally, confusion, hangover, headache, dizziness, blurred vision, depression and hallucinations have been seen. Withdrawal symptoms on long term usage: Muscle cramps, tremor, irritability, convulsions and perceptual distortions.

Interaction :

CNS depressants - Anaesthetics, Opioids, Antihistamines, Baclofen, Barbiturates, Antipsychotics, Anxiolytics, Antidepressants: Enhanced effectiveness.

Renal Dose :

Dose in Renal Impairment GFR (mL/min)
20-50Dose as in normal renal function
10-20Dose as in normal renal function
<10Dose as in normal renal function

Dose in Patients undergoing Renal Replacement Therapies
CAPDUnlikely dialysability. Dose as in normal renal function
HDNot dialysed. Dose as in normal renal function
HDF/High fluxUnknown dialysability. Dose as in normal renal function
CAV/VVHDNot dialysed. Dose as in normal renal function

Hepatic Dose :

Dose may be reduced as per clinical response. Since the drug is metabolized into its inactive form by liver, hepatic impairment can lead to high levels of drug in the body.
12/19/2023 01:15:42 Lorazepam
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