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Lorazepam (lor A ze pam) has been approved by the FDA to treat status epilepticus as a component of the management of seizure emergencies (injectable only).

Lorazepam is a member of a group of drugs known as benzodiazepines. Benzodiazepines are commonly used in epilepsy on an “as needed” basis as a rescue medicine. These treatments are meant to rapidly stop seizures, whether to prevent an emergency or during one while under the care of healthcare providers. These medications do not replace your daily seizure medication and should not be taken daily. Talk to your healthcare provider about how your rescue medication should be used.

Your epilepsy treatment should always be discussed with your healthcare provider before use. Based on their judgment and knowledge, a drug may be prescribed for situations not included in the indications. For more information, please see the prescribing information.

How can you take lorazepam? (Available formulations)

Lorazepam is available as a solution for intravenous or intramuscular injection and is administered by a healthcare provider as a single dose in an emergency setting. It is also available as a tablet or concentrate (liquid) to take by mouth, with or without food.

Who should not take lorazepam?

If you are allergic to lorazepam or any other benzodiazepines (alprazolam, diazepam, clonazepam, clobazam), or if you have a known sensitivity to polyethylene glycol, propylene glycol, or benzyl alcohol, then you should not take it.

Patients with acute narrow-angle glaucoma, sleep apnea syndrome (temporarily stopped breathing during sleep), or severe breathing problems should not take lorazepam. Lorazepam injection should not be used in premature infants because the formulation contains benzyl alcohol.

Other considerations may influence whether you should take lorazepam. If possible, tell your healthcare provider if you:

  • have asthma or other breathing disorders.
  • have kidney or liver disease.
  • use narcotic (opioid) medication(s).
  • are pregnant or plan to become pregnant.
  • are breastfeeding or plan to breastfeed.

What is important to know about taking lorazepam?

As status epilepticus is a potentially life-threatening condition associated with a high risk of permanent neurological impairment, there may be occasions where the use of lorazepam is required despite the risks of serious adverse events. The treatment of seizure emergencies such as status epilepticus requires observation and management of vital functions by healthcare providers within the emergency setting. While it may not be possible in an emergency setting to communicate with your healthcare providers, advanced preparation can overcome this barrier.

Do not stop taking lorazepam suddenly unless directed to do so by your healthcare provider.

As with all antiseizure medications, lorazepam should be withdrawn gradually to minimize the risk of causing or worsening seizures or status epilepticus. You should not stop using lorazepam suddenly unless your healthcare provider tells you to stop the medicine because of a serious side effect.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Taking lorazepam with certain other medicines may cause side effects or affect how well they work. Do not start or stop other medicines without talking to your healthcare provider. Especially tell your healthcare provider if you take: drugs that cause sleepiness or dizziness.

Pre-existing depression may emerge or worsen during the use of benzodiazepines including lorazepam.

Boxed warnings

Lorazepam is approved by the FDA because it is safe and effective for the majority of people who take it. However, there are risks associated with all medicines. Some side effects caused by lorazepam can be very serious, and even life-threatening. It is important to be informed about these serious reactions and to be aware of their symptoms.

Use with opioids or other central nervous system depressants

Lorazepam can slow or stop your breathing, especially if you have recently used an opioid medication, alcohol, or other central nervous system depressants as they also may slow your breathing. If you are administered lorazepam injection, your healthcare providers will watch you for symptoms such as weak or shallow breathing.

Tell your healthcare provider right away if you have:

  • weak or shallow breathing
  • severe drowsiness
  • restlessness or you feel agitated or irritable
  • unusual thoughts, hallucinations
  • a light-headed feeling, like you might pass out

Get emergency help right away if you experience shallow or slowed breathing, breathing stops (which may lead to the heart stopping), or excessive sleepiness (sedation).

Abuse, misuse, and addiction

Lorazepam is a federally controlled substance (Schedule IV) as it has a risk of abuse, misuse, and addiction, which can lead to overdose or death. Using lorazepam more frequently than recommended, even at recommended dosages, may increase these risks, especially when used in combination with other medications (e.g., opioids), alcohol, and/or illicit substances. Talk to your healthcare provider about the signs and symptoms of lorazepam addiction.

Dependence and withdrawal reactions

The use of lorazepam more frequently than recommended may cause physical dependence. This means that stopping lorazepam suddenly can worsen your condition and cause withdrawal symptoms including irritability, sleeplessness, nervousness, and seizures. Physical dependence is not the same as drug addiction. Your healthcare provider can tell you more about the differences between physical dependence and drug addiction.

Women or those who are/plan to become pregnant

Lorazepam may hurt your baby if taken while pregnant.

Use in pregnancy

Ordinarily, lorazepam should not be used during pregnancy except in serious or life-threatening conditions where safer drugs cannot be used or are ineffective. Seizure emergencies such as status epilepticus may represent such a serious and life-threatening condition. During the first trimester of pregnancy, several studies suggest the use of minor tranquilizers (chlordiazepoxide, diazepam, and meprobamate), which are similar to lorazepam, can increase the risk of birth defects. Studies have also shown in humans that lorazepam and some metabolites are transferred to the placenta.

If you become pregnant while taking lorazepam, talk to your healthcare provider about registering with the North American Antiepileptic Drug (NAAED) Pregnancy Registry. The purpose of this registry is to collect information about the safety of antiseizure medicine during pregnancy. You can enroll in this registry by calling 1-888-233-2334.

Use during breastfeeding

Lorazepam has been detected in human breast milk. Therefore, nursing mothers should not take lorazepam because, like other benzodiazepines, the possibility exists that lorazepam may sedate or otherwise adversely affect the infant.

What are the side effects of lorazepam?

Common side effects

The most common side effects associated with lorazepam are sedation, weakness, unsteadiness, and dizziness.

Serious side effects
Excessive sedation

Lorazepam can make you sleepy or dizzy and can slow your thinking and motor skills. Do not drive, operate heavy machinery, or do other dangerous activities until you know how lorazepam affects you. Do not drink alcohol or take other drugs that may make you sleepy or dizzy while taking lorazepam without first talking to your healthcare provider. When taken with alcohol or drugs that cause sleepiness or dizziness, lorazepam may make your sleepiness or dizziness much worse.