Lorazepam

General

• Type: Benzodiazepine
• Dosage Forms: Tablet: 0.5, 1, 2 mg. IV solution: 2mg/ml, 4 mg/ml
• Common Trade Names: Ativan

Adult Dosing

• Active Seizure
  • 2mg IV or IM

Pediatric Dosing

Seizure

• 0.1 mg/kg IV

Special Populations

• Pregnancy Rating:
• Lactation:
  • Lorazepam is present in breast milk
• Renal Dosing
  • Adult
    • PO: no adjustment necessary
    • IV:
      • Mild to moderate impairment
        • No adjustment necessary
      • Severe impairment
        • Use not recommended
  • Pediatric
    • PO: not defined
    • IV:
      • Mild to moderate impairment
        • No adjustment necessary
      • Severe impairment
        • Use not recommended
• Hepatic Dosing
  • Adult
    • PO:
      • Mild to moderate impairment: No adjustment necessary
      • Severe impairment: May need lower doses, use caution
    • IV:
      • Mild to moderate impairment: No adjustment necessary
      • Severe impairment: Use not recommended
  • Pediatric
    • ≥ 12 years old: No adjustment necessary however use caution with severe hepatic disease

Contraindications

• Allergy to class/drug
• Respiratory depression

Adverse Reactions

Serious

• Respiratory depression
• apnea
• hypotension
• paradoxical CNS stimulation

Common

• sedation
• ataxia
• disinhibition
• dysarthria

Pharmacology

• Half-life: 10-20 hours
• Metabolism: liver
• Excretion: renal
• Mechanism of Action: GABA receptor agonist

Indications by Condition

The following table is automatically generated from disease/condition pages across WikEM.

Indication	Dose	Context	Route	Population
Agitated or combative patient	2 mg IV/IM	Benzodiazepine for agitation	IV/IM	Adult
Cannabinoid hyperemesis syndrome	1-2mg IV	Anxiolytic/antiemetic	IV	Adult
Cholinergic crisis	2-4mg IV	Seizure control	IV	Adult
Ethanol withdrawal	1-4 mg IV q15-20min (titrated to effect)	1st line benzodiazepine (medium-acting, preferred in liver disease)	IV	Adult

See Also

• Anticonvulsants