It's an almost white powder that doesn't dissolve easily in water. Each tablet of lorazepam, USP, meant for oral consumption, has either 0.5 mg, 1 mg, or 2 mg of lorazepam, USP. The non-active components included are dry lactose, magnesium stearate, very fine cellulose, and polacrilin potassium.
CLINICAL PHARMACOLOGY
Experiments conducted on healthy volunteers have revealed that when given in single high doses, lorazepam produces a calming impact on the central nervous system without notable consequences on the respiratory or cardiovascular functions.
Lorazepam is swiftly soaked up with an absolute bioavailability of 90%. The highest concentrations in the bloodstream are reached about 2 hours after administration. When a 2 mg dose of lorazepam is taken, the peak plasma level of lorazepam is approximately 20 ng/mL.
The average duration of action for unaltered lorazepam in human plasma is roughly 12 hours, while for its primary metabolite, lorazepam glucuronide, it's around 18 hours. At concentrations relevant to clinical usage, about 85% of lorazepam attaches to plasma proteins.
Lorazepam is quickly combined with lorazepam glucuronide at its 3-hydroxy group, and this compound is subsequently excreted through urine. Notably, lorazepam glucuronide doesn't display any noticeable activity in the central nervous system (CNS) of animals.
The quantities of lorazepam present in the bloodstream correspond to the administered dose. No signs of lorazepam accumulation have been observed with administration extending up to 6 months.
Comparative investigations involving young and elderly subjects have demonstrated that increasing age doesn't notably affect the way lorazepam is processed by the body.
Nonetheless, one study involving single intravenous doses ranging from 1.5 to 3 mg of lorazepam Injection indicated that the average total body clearance of lorazepam decreased by 20% in 15 elderly participants aged 60 to 84, in contrast to 15 younger participants aged 19 to 38.
Lorazepam tablets are prescribed for controlling anxiety disorders or providing temporary relief from the symptoms of anxiety, including anxiety linked with depressive symptoms. General anxiety or stress from daily life typically doesn't necessitate treatment with an anxiety-reducing medication.
The efficacy of using lorazepam tablets over an extended period, specifically beyond 4 months, has not been evaluated through comprehensive clinical investigations. The doctor should regularly reevaluate the appropriateness of the medication for each patient's unique condition.
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CONTRAINDICATIONS
Lorazepam should not be used in individuals with:
- Allergic reactions or heightened sensitivity to benzodiazepines or any constituents present in the formulation.
- Acute narrow-angle glaucoma.
What are the potential side effects of lorazepam tablets?
Lorazepam tablets can lead to severe side effects, which include:
- Refer to "What is the most critical information I should be aware of about lorazepam tablets?"
- Lorazepam tablets have the potential to induce drowsiness, dizziness, and a reduction in cognitive abilities.
- Avoid engaging in activities such as driving, operating heavy machinery, or any other hazardous tasks until you are aware of how lorazepam tablets affect you.
- Refrain from consuming alcohol or taking other medications that might induce drowsiness or dizziness while using lorazepam tablets, unless you've consulted your healthcare provider. Combining lorazepam tablets with alcohol or sleep-inducing drugs can intensify your drowsiness or dizziness considerably.
- depression: Existing depression can surface or worsen during the usage of benzodiazepines, including lorazepam tablets.
The prevalent Side effects of lorazepam tablets encompass:
- Sedation
- Dizziness
- Weakness
- Unsteadiness
PRECAUTIONS
- In patients dealing with depression, the potential for suicide should be considered. Benzodiazepines should not be administered to such patients without concurrent appropriate antidepressant therapy.
- Caution is advised when using lorazepam in patients with compromised respiratory function, such as those with COPD or sleep apnea syndrome.
- Elderly or weakened patients may be more sensitive to the sedative effects of lorazepam. Regular monitoring is essential, and dosage adjustments should be made cautiously based on individual responses. The initial dose should not surpass 2 mg.
- There have been sporadic reports of paradoxical reactions during benzodiazepine use. These reactions may be more likely in children and the elderly. If such reactions occur, discontinuation of the medication is recommended.
- Standard precautions for treating patients with impaired kidney or liver function should be followed. Like all benzodiazepines, lorazepam use may worsen hepatic encephalopathy. Thus, its use should be approached cautiously in patients with severe hepatic insufficiency and/or encephalopathy. Dosage adjustments should be carefully made based on patient response; lower doses might suffice for such patients.
- In cases where anxiety coexists with gastrointestinal or cardiovascular disorders, it's important to note that lorazepam hasn't been proven to significantly alleviate the gastrointestinal or cardiovascular aspects.
- Esophageal dilation was observed in rats treated with lorazepam at 6 mg/kg/day for over 1 year. The dose without effects was 1.25 mg/kg/day (approximately 6 times the maximum therapeutic human dose of 10 mg/day). Reversibility occurred only when treatment was discontinued within 2 months of the initial observation. The clinical significance of this finding is uncertain. However, using lorazepam for extended periods and in geriatric patients requires caution, with frequent monitoring for upper GI symptoms.
OVERDOSAGE
Excessive consumption of benzodiazepines results in central nervous system depression, spanning from drowsiness to a comatose state.
In instances of mild to moderate overdosage, symptoms can encompass drowsiness, confusion, impaired speech, lethargy, a trance-like condition, reduced reflexes, lack of coordination, and decreased muscle tone.
Infrequently, paradoxical or disinhibitory reactions (such as agitation, irritability, impulsive actions, aggressive behavior, confusion, restlessness, heightened excitement, and excessive talking) may manifest. In severe cases of overdosage, patients may encounter respiratory depression and progress into a comatose state.
What is the recommended way to consume lorazepam tablets?
Follow your healthcare provider's instructions precisely when taking lorazepam tablets. Your healthcare provider will specify the appropriate dosage and timing for taking the medication.
If you ingest an excessive amount of lorazepam tablets, promptly contact your healthcare provider or proceed to the nearest hospital emergency room without delay.