Lorazepam (Lorazepam) - Summary

LORAZEPAM SUMMARY

LORAZEPAM INJECTION USP

Lorazepam, a benzodiazepine with antianxiety, sedative, and anticonvulsant effects, is intended for the intramuscular or intravenous routes of administration. It has the chemical formula: 7-chloro-5(2-chlorophenyl)-1,3-dihydro-3-hydroxy-2 H -1, 4-benzodiazepin-2-one.

Status Epilepticus

Lorazepam Injection is indicated for the treatment of status epilepticus.

Preanesthetic

Lorazepam Injection is indicated in adult patients for preanesthetic medication, producing sedation (sleepiness or drowsiness), relief of anxiety, and a decreased ability to recall events related to the day of surgery. It is most useful in those patients who are anxious about their surgical procedure and who would prefer to have diminished recall of the events of the day of surgery (see PRECAUTIONS, Information for Patients).

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NEWS HIGHLIGHTS

Published Studies Related to Lorazepam

The pharmacokinetic and pharmacodynamic effects of SL65.1498, a GABA-A alpha2,3 selective agonist, in comparison with lorazepam in healthy volunteers. [2009.08]
Benzodiazepines are effective short-term treatments for anxiety disorders, but their use is limited by undesirable side effects related to Central Nervous System impairment and tolerance development. SL65.1498 is a new compound that acts in vitro as a full agonist at the gamma-aminobutyric acid(A) 2 and 3 receptor and as a partial agonist at the 1 and 5 receptor subtypes...

A randomized, double-blind comparison of lorazepam and chlordiazepoxide in patients with uncomplicated alcohol withdrawal. [2009.05]
CONCLUSIONS: With the treatment schedule used in this study, lorazepam is as effective as the more traditional drug chlordiazepoxide in attenuating uncomplicated alcohol withdrawal. Lorazepam, therefore, could be used with confidence when liver disease or the inability to determine liver function status renders chlordiazepoxide therapy problematic. The absence of clinically significant withdrawal complications with lorazepam in this large study contrasts with findings from previously published studies and suggests that higher doses of lorazepam than those formerly used may be necessary during alcohol withdrawal.

Lorazepam versus diazepam-phenytoin combination in the treatment of convulsive status epilepticus in children: A randomized controlled trial. [2009.03.16]
BACKGROUND: Convulsive status epilepticus demands urgent and appropriate management with anticonvulsants. Intravenous diazepam is an established drug in the management of convulsive status epilepticus in adults as well as in children. The efficacy of intravenous lorazepam has not been well established in children. OBJECTIVE: To determine whether intravenous lorazepam is as efficacious as diazepam-phenytoin combination in the treatment of convulsive status epilepticus in children. STUDY DESIGN: Randomized controlled trial... CONCLUSION: Lorazepam is as efficacious and safe as diazepam-phenytoin combination. We recommend use of lorazepam as a single drug to replace the two drug combination of diazepam-phenytoin combination to control the initial seizure in pediatric convulsive status epilepticus.

The apolipoprotein E epsilon4 allele and memory performance in HIV-1 seropositive subjects: differences at baseline but not after acute oral lorazepam challenge. [2008.11]
RATIONALE: The APOE epsilon4 allele, an established genetic risk factor for late-onset Alzheimer's disease, has been linked to an increased risk for dementia especially in older individuals with HIV-1 infection. This allele has also been associated with increased memory impairment following oral lorazepam challenge in healthy elderly. Lorazepam and other benzodiazepines are widely prescribed in individuals with HIV-1 infection who are at increased risk for cognitive impairment. OBJECTIVE: The aim of this study was to examine if the epsilon4 allele influences lorazepam-induced memory deficits in this population... CONCLUSION: Future studies should clarify the role of epsilon4 in the modulation of drug-induced cognitive toxicity and baseline performance and their relationship to progressive decline, especially in older individuals with HIV-1 infection, a group at increased risk for dementia.

Economic evaluation of propofol and lorazepam for critically ill patients undergoing mechanical ventilation. [2008.03]
OBJECTIVE: The economic implications of sedative choice in the management of patients receiving mechanical ventilation are unclear because of differences in costs and clinical outcomes associated with specific sedatives. Therefore, we aimed to determine the cost-effectiveness of the most commonly used sedatives prescribed for mechanically ventilated critically ill patients... CONCLUSION: Propofol has superior value compared with lorazepam when used for sedation among the critically ill who require mechanical ventilation when used in the setting of daily sedative interruption.

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Clinical Trials Related to Lorazepam

Lorazepam Sedation for Critically Ill Children [Suspended]
This clinical trial is being performed under the Best Pharmaceuticals for Children Act, signed into law in 2002 in order to improve pediatric labeling for off-patent drugs. The purpose of this study is to make sure that lorazepam, when given to children who are very sick in the Intensive Care Unit and who are on a breathing machine, is safe and works as well as a drug called midazolam. Midazolam is already approved by the FDA for this use, but lorazepam is not, even though both drugs are commonly used for sedation.

A Comparison of Lorazepam and Diazepam in the Treatment of Alcohol Withdrawal [Completed]
The purpose of this study is to compare the efficacy of two commonly used medications in the treatment of alcohol withdrawal, diazepam and lorazepam.

Fasting Study of Lorazepam Tablets 2 mg and Ativan Tablets 2 mg [Completed]
The objective of this study was to investigate the bioequivalence of Mylan's lorazepam 2 mg tablets to Wyeth's Ativan 2 mg tablets following a single, oral 2 mg (1 x 2 mg) dose administered under fasting conditions.

The Impact of Lorazepam on Cognition in APOE e4 Carriers [Completed]
We expect the results of this pilot study to justify a larger study that follows people to determine if certain tests of memory and attention, performed while sleepiness is induced by a single dose of lorazepam (a widely used anti-anxiety medication) could predict an individual's risk of developing AD. We plan to compare cognitively normal people who possess a common gene that increases risk for AD— the apolipoprotein E (APOE) e4 allele—to individuals without this gene. We hypothesize that a single 2 mg dose of lorazepam will cause more cognitive impairment in carriers of the APOE e4 allele than in noncarriers, and that the carriers will recover more slowly from these impairments than noncarriers.

Lorazepam for the Treatment of Status Epilepticus in Children [Completed]
The purpose of this study is to gather the data to: 1) determine the best dose, and 2) evaluate its effectiveness and safety in stopping seizures. Part 1 is a pharmacokinetic study (study of how much drug is found in the body after it is given through a vein and how fast the body gets rid of the drug).

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PATIENT REVIEWS / RATINGS / COMMENTS

Lorazepam review by 51 year old male patient
		Rating
Overall rating:
Effectiveness:		Ineffective
Side effects:		No Side Effects
		Treatment Info
Condition / reason:		ANXIETY
Dosage & duration:		0.5 MG taken once a day for the period of 1 WEEK
Other conditions:		HIGH BLOOD PRESSURE
Other drugs taken:		HYZARR AND LIPIDOR
		Reported Results
Benefits:		THE BENEFITS WERE NONE. HOWEVER, IT DID NOT CAUSE ME ANY DIFFICULTIES OR SIDE EFFECTS. I APPROVED OF THE IDEA OF TAKING THE MEDICATION TO REDUCE MY GENERAL LOW LEVEL ANXIETY AS AN ADDITIONAL TREATMENT TO LOWERING MY HIGH BLOOD PRESSURE. BUT I EXPERIENCED NO IMPROVEMENTS AT THIS DOSE.
Side effects:		THE IDEA WAS TO HELP WITH ANXIETY AS AN AID TO LOWER MY BLOOD PRESSURE. HOWEVER, NEITHER MY BLOOD PRESSURE, WITH ANOTHER MEDICATION, OR THE LEVEL OF ANXIETY WAS REDUCED. THE LORAZEPAM WAS STOPPED AFTER A WEEK WHEN I COMPLAINED OF INEFFECTIVENESS. I DID NOT EXPERIENCE ANY SIDE EFFECTS WITH THIS MEDICATION.
Comments:		I WAS TO TAKE THIS MEDICATION ONCE A DAY IN THE MORNING. WHEN I FELT NO BENEFIT I DISCUSSED IT WITH THE DOCTOR WHO SUGGESTED AN INCREASE OF THE DOSAGE. I DECLINED. THE TREATMENT THEORY WAS THAT THE LORAZEPAM WOULD HELP ME WITH ANXIETY AND STRESS WHICH IN TURN WOULD BE AN AID IN ADDITION WITH THE BLOOD PRESSURE MEDICATION TO LOWER MY BLOOD PRESSURE.

Lorazepam review by 45 year old male patient
		Rating
Overall rating:
Effectiveness:		Considerably Effective
Side effects:		No Side Effects
		Treatment Info
Condition / reason:		Mild sedative
Dosage & duration:		1 mg taken 2 perscriptions for the period of taken when needed
Other conditions:		none
Other drugs taken:		none
		Reported Results
Benefits:		The prescription was given for anxiety and to help with sleep during long flights and when under high anxiety situations. Lorazepam helped to calm and induced drowziness. I would not recomend this if you have to stay alert as it can make functioning dificult.
Side effects:		none
Comments:		To be taken when needed to relieve stress and assist in sleeping.

Lorazepam review by 35 year old female patient
		Rating
Overall rating:
Effectiveness:		Highly Effective
Side effects:		Moderate Side Effects
		Treatment Info
Condition / reason:		anxiety
Dosage & duration:		10mg taken once every 10 days for the period of 3 years
Other conditions:		very tired
Other drugs taken:		vitamans
		Reported Results
Benefits:		Even split pill severly reduced anxiety, made me feel more relaxed, took away physical feelings associated with anxiety like sweating and racing thoughts. Made it easier to sleep. Continued to work for 12 to 15 hours after taking. Took away mental stress and cleared my mind of all worries.
Side effects:		made me very tierd even after 12 hours. It was very hard to wake up even after having drak 12 ounces of coffee. Throughout the day my mind had an empty feeling that made it hard to jump start my responsiblties. I find it hard to get into physical activity such as going to the gym becuase I am tiered througout the day.
Comments:		can be taken: one to two every 12 hours