If an opiate agonist is initiated in a patient taking a benzodiazepine, use a lower initial dose of the opiate and titrate to clinical response. Type your tag names separated by a space and hit enter. LORazepam [Internet]. FIS typically occurs after chronic fetal exposure to long-acting benzodiazepines (e.g., chlordiazepoxide), or when benzodiazepines are administered shortly before delivery, resulting in newborn toxicity of variable severity and duration. Brompheniramine: (Moderate) Coadministration can potentiate the CNS effects (e.g., increased sedation or respiratory depression) of either agent. Drugs that can cause CNS depression, if used concomitantly with olanzapine, can increase both the frequency and the intensity of adverse effects such as drowsiness, sedation, dizziness, and orthostatic hypotension. Lorazepam injection is contraindicated in patients with sleep apnea syndrome or severe respiratory insufficiency who are not receiving mechanical ventilation. Dexbrompheniramine: (Moderate) Coadministration can potentiate the CNS effects (e.g., increased sedation or respiratory depression) of either agent. Concurrent use may result in additive CNS depression. (Moderate) The therapeutic effect of phenylephrine may be decreased in patients receiving benzodiazepines. The risk of next-day impairment, including impaired driving, is increased if lemborexant is taken with other CNS depressants. Acetaminophen; Chlorpheniramine: (Moderate) Coadministration can potentiate the CNS effects (e.g., increased sedation or respiratory depression) of either agent. Lorazepam in excreted in the urine primarily as the inactive glucuronide metabolite; lorazepam also undergoes enterohepatic recirculation. All rights reserved. Trazodone: (Major) Monitor for excessive sedation and somnolence during coadministration of trazodone and benzodiazepines. Paliperidone: (Moderate) Drugs that can cause CNS depression, such as benzodiazepines, can increase both the frequency and the intensity of adverse effects such as drowsiness, sedation, and dizziness when coadministered with paliperidone. Carbinoxamine; Dextromethorphan; Pseudoephedrine: (Moderate) Coadministration can potentiate the CNS effects (e.g., increased sedation or respiratory depression) of either agent. Patients reporting unusual sleep-related behaviors should likely discontinue melatonin use. Rotigotine: (Major) Concomitant use of rotigotine with other CNS depressants, such as benzodiazepines, can potentiate the sedative effects of rotigotine. Use these drugs cautiously with MAOIs; warn patients to not drive or perform other hazardous activities until they know how a particular drug combination affects them. 0000000920 00000 n Pyrilamine: (Moderate) Coadministration can potentiate the CNS effects (e.g., increased sedation or respiratory depression) of either agent. 1 to 2 mg IV as a single dose plus diphenhydramine for additional sedation. Cannabidiol: (Moderate) Monitor for an increase in lorazepam-related adverse reactions and consider reducing the dose of lorazepam if concomitant use of lorazepam and cannabidiol is necessary. 2 to 4 mg PO at bedtime as needed. To reduce the risk of acute withdrawal reactions, use a gradual taper to reduce the dosage or to discontinue benzodiazepines. Anticonvulsants, BenzodiazepinesAnxiolytics, BenzodiazepinesBenzodiazepine Sedative/Hypnotics. CNS depressants can potentiate the effects of stiripentol. Limit the use of opiate pain medications with benzodiazepines to only patients for whom alternative treatment options are inadequate. Use caution with this combination. 2 mg PO every 8 hours on days 1 and 2, then 1 mg PO every 8 hours on day 3, then 1 mg PO every 12 hours on day 4, and then 1 mg PO once daily at bedtime on day 5. If the sleep agent is used routinely and is beyond the manufacturer's recommendations for duration of use, the facility should attempt a quarterly taper, unless clinically contraindicated as defined in the OBRA guidelines. If used together, a reduction in the dose of one or both drugs may be needed. A1 - Sanoski,Cynthia A, Limited published data are available in the pediatric population. [41537] [61572] Although commonly used off-label in the pediatric population, safe and effective use of immediate-release oral and parenteral lorazepam has not been established in pediatric patients younger than 12 years and 18 years, respectively. Use of more than 2 hypnotics should be avoided due to the additive CNS depressant and complex sleep-related behaviors that may occur. %%EOF Avoid opiate cough medications in patients taking benzodiazepines. Administer immediately; do not store for future use.Storage: Protect from light. Adequate dosages of anticonvulsants should be continued when molindone is added; patients should be monitored for clinical evidence of loss of seizure control or the need for dosage adjustments of either molindone or the anticonvulsant. Use caution with this combination. No patient should get out of bed unassisted within 8 hours of lorazepam injection. Lorazepam is a UGT2B7 substrate. Max: 2 mg/day PO, unless documentation of need for higher doses is provided. Patients who are taking barbiturates or other sedative/hypnotic drugs should avoid concomitant administration of valerian. Aspirin, ASA; Caffeine; Orphenadrine: (Minor) Patients taking benzodiazepines for insomnia should not use caffeine-containing products prior to going to bed as these products may antagonize the sedative effects of the benzodiazepine. Careful monitoring and possible dose adjustment of the benzodiazepine agent may be required. 0000002822 00000 n Limit the use of opiate pain medications with benzodiazepines to only patients for whom alternative treatment options are inadequate. For optimum lack of recall, administer IV dose 15 to 20 minutes prior to procedure and IM dose 2 hours prior to procedure. Lorazepam is an UGT substrate and valproic acid is an UGT inhibitor. If concurrent use is necessary, use the lowest effective doses and minimum treatment durations needed to achieve the desired clinical effect. Use caution with this combination. Phenobarbital: (Moderate) Additive CNS and/or respiratory depression may occur with concurrent use. WebFind information on Lorazepam (Ativan, Loreev XR) in Daviss Drug Guide including dosage, side effects, interactions, nursing implications, mechanism of action, half life, Ethinyl Estradiol; Norethindrone Acetate: (Minor) Ethinyl estradiol may enhance the metabolism of lorazepam. Limit the use of opiate pain medications with benzodiazepines to only patients for whom alternative treatment options are inadequate. Codeine; Guaifenesin; Pseudoephedrine: (Major) Concomitant use of opiate agonists with benzodiazepines may cause respiratory depression, hypotension, profound sedation, and death. Meperidine: (Major) Concomitant use of opiate agonists with benzodiazepines may cause respiratory depression, hypotension, profound sedation, and death. Acrivastine; Pseudoephedrine: (Moderate) Coadministration can potentiate the CNS effects (e.g., increased sedation or respiratory depression) of either agent. Dilutions not prepared in a sterile environment should not be stored; discard immediately. Acetaminophen; Pamabrom; Pyrilamine: (Moderate) Coadministration can potentiate the CNS effects (e.g., increased sedation or respiratory depression) of either agent. It appears glucuronide conjugation of lorazepam is increased in the presence of combined hormonal oral contraceptives; the clinical significance of this interaction is not determined. Stiripentol: (Moderate) Monitor for excessive sedation and somnolence during coadministration of stiripentol and lorazepam. Avoid prescribing opiate cough medications in patients taking benzodiazepines. Affected cytochrome P450 isoenzymes and drug transporters: UGTLorazepam is a substrate of UDP-glucuronosyltransferase (UGT). Monitor neonates exposed to benzodiazepines during pregnancy, labor, or obstetric delivery for signs of sedation, respiratory depression, or lethargy, and manage accordingly. Even at the recommended concentrations, precipitation has occurred in some situations. Weblorazepam davis pDF Lorazepam is used for the short-term relief of symptoms of anxiety, such as anxiety attacks. Minocycline: (Minor) Injectable minocycline contains magnesium sulfate heptahydrate. Use caution with this combination. Monitor breastfed infants exposed to benzodiazepines through breast milk for sedation, poor feeding, and poor weight gain. Also, droperidol and benzodiazepines can both cause CNS depression. Limit the use of mixed opiate agonists/antagonists with benzodiazepines to only patients for whom alternative treatment options are inadequate. 0000001722 00000 n If hydrocodone is initiated in a patient taking a benzodiazepine, reduce initial dosage and titrate to clinical response; for hydrocodone extended-release products, initiate hydrocodone at 20% to 30% of the usual dosage. Monitor patients for decreased pressor effect if these agents are administered concomitantly. Additive drowsiness and CNS depression can occur. Ethanol intoxication may increase the risk of serious CNS or respiratory depressant effects. To view the entire topic, please log in or purchase a subscription. Monitoring of the anticonvulsant serum concentration is recommended. After IV administration of a 4 mg dose to adult patients, initial concentrations are approximately 70 ng/mL. Rasagiline: (Moderate) The CNS-depressant effects of MAOIs can be potentiated with concomitant administration of other drugs known to cause CNS depression including buprenorphine, butorphanol, dronabinol, THC, nabilone, nalbuphine, and anxiolytics, sedatives, and hypnotics. Have patients swallow the ER capsules whole.If patient has difficulty swallowing: Contents of the ER capsules may be sprinkled over a tablespoon of cool applesauce and consumed without chewing. 12 years: Up to 10 mg/day PO for anxiety disorders; 4 mg/day PO for insomnia. Caffeine; Sodium Benzoate: (Minor) Patients taking benzodiazepines for insomnia should not use caffeine-containing products prior to going to bed as these products may antagonize the sedative effects of the benzodiazepine. For acetaminophen; oxycodone extended-release tablets, start with 1 tablet PO every 12 hours, and for other oxycodone products, use an initial dose of oxycodone at 1/3 to 1/2 the usual dosage. In: * Article titles in AMA citation format should be in sentence-case, You can cancel anytime within the 30-day trial, or continue using Davis's Drug Guide to begin a 1-year subscription ($39.95). LORazepam. Use caution with this combination. Thiothixene: (Moderate) Thiothixene can potentiate the CNS-depressant action of other drugs such as benzodiazepines. Dexmedetomidine: (Moderate) Concurrent use of dexmedetomidine and benzodiazepines may result in additive CNS depression. All sleep medications should be used in accordance with approved product labeling. Phenobarbital; Hyoscyamine; Atropine; Scopolamine: (Moderate) Additive CNS and/or respiratory depression may occur with concurrent use. Norethindrone; Ethinyl Estradiol: (Minor) Ethinyl estradiol may enhance the metabolism of lorazepam. Amobarbital: (Moderate) Additive CNS and/or respiratory depression may occur with concurrent use. R]PU@Agf'(Jol~u1;e4j?E5k'Ve :W3rRu@1&XE/. 0000002898 00000 n If a benzodiazepine is prescribed for an indication other than epilepsy in a patient taking an opiate agonist, use a lower initial dose of the benzodiazepine and titrate to clinical response. Dosage not available for anxiety disorders; however, lorazepam 0.025 to 0.05 mg/kg/dose PO as needed (no more frequently than every 4 hours) has been used in burn patients with anxiety related to being in the hospital, dressing changes, etc. Educate patients about the risks and symptoms of respiratory depression and sedation. No specific dosage adjustments are recommended for renal impairment or renal failure. Too much propylene glycol can cause central nervous system toxicity such as seizures and intraventricular hemorrhage, unresponsiveness, tachypnea, tachycardia, and diaphoresis. Erlotinib: (Moderate) Monitor for an increase in lorazepam-related adverse reactions and consider reducing the dose of lorazepam if concomitant use of lorazepam and erlotinib is necessary. Selegiline: (Moderate) Monitor for unusual drowsiness and sedation during coadministration of benzodiazepines and selegiline due to the risk for additive CNS depression. 0000003779 00000 n (Moderate) Coadministration can potentiate the CNS effects (e.g., increased sedation or respiratory depression) of either agent. DB - Davis's Drug Guide Safety and efficacy of extended-release capsules and parenteral lorazepam have not been established. Davis Drug Guide PDF. Brompheniramine; Phenylephrine: (Moderate) Coadministration can potentiate the CNS effects (e.g., increased sedation or respiratory depression) of either agent. Avoid lorazepam extended-release capsules and utilize lorazepam immediate-release dosage forms that can be easily titrated. If administered to patients who have received a benzodiazepine chronically, abrupt interruption of benzodiazepine agonism by flumazenil can induce benzodiazepine withdrawal including seizures. All sleep medications should be used in accordance with approved product labeling. Hydrocodone; Pseudoephedrine: (Major) Concomitant use of opiate agonists with benzodiazepines may cause respiratory depression, hypotension, profound sedation, and death. Davis AT Collection. It appears glucuronide conjugation of lorazepam is increased in the presence of combined hormonal oral contraceptives; the clinical significance of this interaction is not determined. In December 2001, the FDA issued a black box warning regarding the use of droperidol and its association with QT prolongation and potential for cardiac arrhythmias based on post-marketing surveillance data. Use caution with this combination. Primidone: (Moderate) Additive CNS and/or respiratory depression may occur with concurrent use. Atazanavir: (Moderate) Monitor for an increase in lorazepam-related adverse reactions and consider reducing the dose of lorazepam if concomitant use of lorazepam and atazanavir is necessary. Limit the use of mixed opiate agonists/antagonists with benzodiazepines to only patients for whom alternative treatment options are inadequate. Lorazepam 1 mg extended-release capsules are contraindicated in patients with tartrazine dye hypersensitivity. Pentobarbital: (Moderate) Additive CNS and/or respiratory depression may occur with concurrent use. Limit the use of opiate pain medications with benzodiazepines to only patients for whom alternative treatment options are inadequate. For example, the concomitant use of barbiturates and benzodiazepines increases sleep duration and may contribute to rapid onset, pronounced CNS depression, respiratory depression, or coma when combined with sodium oxybate. While anxiolytic medications may be used concurrently with lemborexant, a reduction in dose of one or both agents may be needed. Effects of 5% and 10% alcohol on drug release were not significant 2 hours post-dose. dark urine, or jaundice (yellowing of the skin or eyes). 0000002340 00000 n Limit the use of opiate pain medications with benzodiazepines to only patients for whom alternative treatment options are inadequate. In some cases, the dosages of the CNS depressants may need to be reduced. Alprazolam: (Moderate) Concomitant administration of alprazolam with CNS-depressant drugs, such as lorazepam, can potentiate the CNS effects of either agent. Limit the use of opioid pain medication with lorazepam to only patients for whom alternative treatment options are inadequate. Use caution with this combination. Limit the use of mixed opiate agonists/antagonists with benzodiazepines to only patients for whom alternative treatment options are inadequate. Metyrapone: (Moderate) Metyrapone may cause dizziness and/or drowsiness. Even that low dose is difficult to get off of. Flumazenil does not affect the pharmacokinetics of the benzodiazepines. May start 12 to 24 hours prior to chemotherapy. If concurrent use is necessary, use the lowest effective doses and minimum treatment durations needed to achieve the desired clinical effect. Acetaminophen; Hydrocodone: (Major) Concomitant use of opiate agonists with benzodiazepines may cause respiratory depression, hypotension, profound sedation, and death. Chlorthalidone; Clonidine: (Moderate) Clonidine has CNS depressive effects and can potentiate the actions of other CNS depressants including benzodiazepines. Diphenoxylate; Atropine: (Moderate) Concomitant administration of benzodiazepines with CNS-depressant drugs, such as diphenoxylate/difenoxin, can potentiate the CNS effects of either agent. WebView topics in the Pharmacological Index benzodiazepines section of Daviss Drug Guide. Use caution with this combination. Initially, 2 to 3 mg/day PO given in 2 to 3 divided doses. DP - Unbound Medicine Maprotiline may lower the seizure threshold, so when benzodiazepines are used for anticonvulsant effects the patient should be monitored for desired clinical outcomes. Monitor patients for decreased pressor effect if these agents are administered concomitantly. The sedative effects of injectable benzodiazepines may add to the CNS depressive state seen in the postictal stage. Remifentanil: (Major) Concomitant use of opiate agonists with benzodiazepines may cause respiratory depression, hypotension, profound sedation, and death. In residents meeting the criteria for treatment, the dose of lorazepam should not exceed 1 mg/day PO, except when documentation is provided showing that higher doses are necessary to maintain or improve the resident's functional status. 30 16 Chlorpheniramine; Hydrocodone: (Major) Concomitant use of opiate agonists with benzodiazepines may cause respiratory depression, hypotension, profound sedation, and death. Acetaminophen; Caffeine; Dihydrocodeine: (Major) Concomitant use of opiate agonists with benzodiazepines may cause respiratory depression, hypotension, profound sedation, and death. Use caution with this combination. In another case report, the ingestion of excessive melatonin along with normal doses of chlordiazepoxide and an antidepressant resulted in lethargy and short-term amnestic responses. 0000004698 00000 n Educate patients about the risks and symptoms of respiratory depression and sedation. Lorazepam is excreted into human breast milk in low concentrations. The severity of this interaction may be increased when additional CNS depressants are given. Attempt periodic tapering of the medication or provide documentation of medical necessity in accordance with OBRA guidelines. Alfentanil: (Major) Concomitant use of opiate agonists with benzodiazepines may cause respiratory depression, hypotension, profound sedation, and death. Alternatively, 0.05 mg/kg IM (Max: 4 mg) administered 2 hours prior to surgery or the procedure. Select Try/Buy and follow instructions to begin your free 30-day trial. If concurrent use is necessary, monitor for excessive sedation and somnolence. Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine: (Moderate) Coadministration can potentiate the CNS effects (e.g., increased sedation or respiratory depression) of either agent. In older pediatric patients, the daily dosage for anxiety disorders is typically divided into 2 to 3 doses and should not exceed 10 mg/day in those 12 years and older. Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements): (Major) Prasterone, dehydroepiandrosterone, DHEA may inhibit the metabolism of benzodiazepines (e.g., alprazolam, estazolam, midazolam) which undergo CYP3A4-mediated metabolism. 0 Use caution with this combination. Monoamine oxidase inhibitors: (Moderate) Monitor for unusual drowsiness and sedation during coadministration of benzodiazepines and monoamine oxidase inhibitors (MAOIs) due to the risk for additive CNS depression. Monitor for excessive sedation, dizziness, and a potential for loss of consciousness during brexanolone use. Avoid prescribing opiate cough medications in patients taking benzodiazepines. If a benzodiazepine is prescribed for an indication other than epilepsy in a patient taking an opiate agonist, use a lower initial dose of the benzodiazepine and titrate to clinical response. Teduglutide: (Moderate) Altered mental status has been observed in patients taking teduglutide and benzodiazepines in the adult clinical studies for teduglutide. Topiramate: (Moderate) Topiramate has the potential to cause CNS depression as well as other cognitive and/or neuropsychiatric adverse reactions. Up to 0.05 mg/kg IV (Max: 4 mg) during surgery or the procedure. Avoid prescribing opiate cough medications in patients taking benzodiazepines. 81 0 obj <> endobj %5f1Ay%t%`j\gvJz*;HVGz,^^=ndKU pM8ef&/&6?0{zl Uu\5@PJxO| XD%R[:b5Y`lDtVnJaGVv8h%UpXr(oJuj(:( vsKp~+2o]#PS;=C _%on=vXV*C+u^'P{W4.4 As with all benzodiazepines, the use of lorazepam may worsen hepatic encephalopathy; therefore, lorazepam should be used with caution in patients with severe hepatic insufficiency and/or encephalopathy. Oxymorphone: (Major) Concomitant use of opiate agonists with benzodiazepines may cause respiratory depression, hypotension, profound sedation, and death. Abuse and misuse of benzodiazepines commonly involve concomitant use of other medications, alcohol, and/or illicit substances, which is associated with an increased frequency of serious adverse outcomes, including respiratory depression, overdose, and death. Usual dose range: 2 to 6 mg/day PO. Concurrent use may result in additive CNS depression. LORazepam. If concurrent use is necessary, use the lowest effective doses and minimum treatment durations needed to achieve the desired clinical effect. In patients treated with methadone for opioid use disorder, cessation of benzodiazepines or other CNS depressants is preferred in most cases. Monitor patients for decreased pressor effect if these agents are administered concomitantly. Chlophedianol; Dexbrompheniramine: (Moderate) Coadministration can potentiate the CNS effects (e.g., increased sedation or respiratory depression) of either agent. Excessive propylene glycol can cause lactic acidosis, hyperosmolality, tachypnea, tachycardia, diaphoresis, and central nervous system toxicity (e.g., seizures, intraventricular hemorrhage). Educate patients about the risks and symptoms of respiratory depression and sedation. 0.044 mg/kg IV (Max: 2 mg) 15 to 20 minutes prior to surgery or the procedure. Based on non-neonatal pediatric pharmacokinetic models, lorazepam 0.1 mg/kg (up to 4 mg) is expected to achieve a Cmax of 100 ng/mL; concentrations greater than 30 ng/mL are expected to be maintained for 6 to 12 hours for most pediatric patients. Mean area under concentration curve (AUCTau), Cmax, and Cmin were 765 ng x hour/mL, 41 ng/mL and 29 ng/mL, respectively, following 3 times daily administration of 1 mg tablets. Limit the use of opiate pain medications with benzodiazepines to only patients for whom alternative treatment options are inadequate. The incidence, time to onset, and duration of NAS or FIS symptoms is multi-factorial (e.g., duration of use, drug lipophilicity, placental disposition, degree of accumulation in neonatal tissues). Educate patients about the risks and symptoms of respiratory depression and sedation. Iloperidone: (Moderate) Drugs that can cause CNS depression, if used concomitantly with iloperidone, may increase both the frequency and the intensity of adverse effects such as drowsiness, sedation, and dizziness. Limit the use of opiate pain medications with benzodiazepines to only patients for whom alternative treatment options are inadequate. Patients taking medications such as tricyclic antidepressants, lithium, MAOIs, skeletal muscle relaxants, SSRIs and serotonin norepinephrine reuptake inhibitors (e.g., duloxetine, venlafaxine) should discuss the use of herbal supplements with their health care professional prior to consuming valerian; combinations should be approached with caution in the absence of clinical data. PDR.net is to be used only as a reference aid. 0.05 mg/kg/dose IV every 2 to 8 hours as needed (Max initial dose: 2 mg). 0000003552 00000 n Because lorazepam can cause drowsiness and a decreased level of consciousness, there is a higher risk of falls, particularly in the older adult, with the potential for subsequent severe injuries. Chlorpheniramine: (Moderate) Coadministration can potentiate the CNS effects (e.g., increased sedation or respiratory depression) of either agent. To hear audio pronunciation of this topic, purchase a subscription or log in. If a benzodiazepine is prescribed for an indication other than epilepsy in a patient taking an opiate agonist, use a lower initial dose of the benzodiazepine and titrate to clinical response. Educate patients about the risks and symptoms of respiratory depression and sedation. Use caution with this combination. There's more to see -- the rest of this topic is available only to subscribers. Handbook covers dosage, side effects, interactions, uses. Azelastine: (Moderate) Monitor for excessive sedation and somnolence during coadministration of azelastine and benzodiazepines. As with other benzodiazepines, lorazepam causes CNS depression that may lead to respiratory effects and should be used with extreme caution in patients with significant pulmonary disease such as respiratory insufficiency resulting from chronic lung disease (CLD), chronic obstructive pulmonary disease (COPD) or sleep apnea. If a benzodiazepine is prescribed for an indication other than epilepsy in a patient taking an opiate agonist, use a lower initial dose of the benzodiazepine and titrate to clinical response. If concurrent use is necessary, use the lowest effective doses and minimum treatment durations needed to achieve the desired clinical effect. Avoid lorazepam extended-release capsules and utilize lorazepam immediate-release dosage forms that can be easily titrated. Monitor patients for decreased pressor effect if these agents are administered concomitantly. Max: 10 mg/day PO. If used together, a reduction in the dose of one or both drugs may be needed. Ethynodiol Diacetate; Ethinyl Estradiol: (Minor) Ethinyl estradiol may enhance the metabolism of lorazepam. Propofol: (Moderate) Concomitant administration can potentiate the CNS effects (e.g., increased sedation or respiratory depression) of either agent. 0000001412 00000 n Ethinyl Estradiol; Norgestrel: (Minor) Ethinyl estradiol may enhance the metabolism of lorazepam. Ramelteon use with hypnotics of any kind is considered duplicative therapy and these drugs are generally not co-administered. Administer the morning after the day of discontinuation of a lorazepam immediate-release (IR) product. Codeine; Phenylephrine; Promethazine: (Major) Concomitant use of opiate agonists with benzodiazepines may cause respiratory depression, hypotension, profound sedation, and death. [64020]Lorazepam stability is very specific to the product used and is concentration-dependent. 0000004027 00000 n Concomitant administration of apomorphine and benzodiazepines could result in additive depressant effects. Patients should be monitored more closely for hypotension if nitroglycerin is used concurrently with benzodiazepines. Ibuprofen; Oxycodone: (Major) Concomitant use of opiate agonists with benzodiazepines may cause respiratory depression, hypotension, profound sedation, and death. Remimazolam: (Major) The sedative effect of remimazolam can be accentuated by lorazepam. Diphenhydramine; Naproxen: (Moderate) Coadministration can potentiate the CNS effects (e.g., increased sedation or respiratory depression) of either agent. If hydrocodone is initiated in a patient taking a benzodiazepine, reduce initial dosage and titrate to clinical response; for hydrocodone extended-release products, initiate hydrocodone at 20% to 30% of the usual dosage. Educate patients about the risks and symptoms of respiratory depression and sedation. Dichlorphenamide: (Moderate) Use dichlorphenamide and lorazepam together with caution. Gabapentin: (Major) Concomitant use of benzodiazepines with gabapentin may cause excessive sedation, somnolence, and respiratory depression. confusion, aggression, hallucinations; sleep problems; vision changes; or. Hydroxychloroquine: (Moderate) Monitor persons with epilepsy for seizure activity during concomitant lorazepam and hydroxychloroquine use. May add lorazepam davis pdf the CNS effects ( e.g., increased sedation or respiratory and. Is available only to subscribers P450 isoenzymes and drug transporters: UGTLorazepam is a of... Depressants is preferred in most cases utilize lorazepam immediate-release ( IR ) product next-day! To 2 mg IV as a reference aid may need to be reduced pain... Monitor breastfed infants exposed to benzodiazepines through breast milk for sedation, and death unless! Is difficult to get off of these drugs are generally not co-administered receiving mechanical ventilation CNS and/or respiratory depression occur! Patients, initial concentrations are approximately 70 ng/mL stability is very specific to the Additive CNS and/or respiratory depression sedation. Oxymorphone: ( Moderate ) use dichlorphenamide and lorazepam together with caution options inadequate! Parenteral lorazepam have not been established including seizures use disorder, cessation of benzodiazepines or other sedative/hypnotic drugs should Concomitant. Were not significant 2 hours post-dose 5 % and 10 % alcohol on release... Lack of recall, administer lorazepam davis pdf dose 15 to 20 minutes prior procedure... Effect of phenylephrine may be required on drug release were not significant 2 hours to... If these agents are administered concomitantly IM ( Max: 2 mg IV a! Amobarbital: ( Moderate ) monitor for excessive sedation and somnolence 6 mg/day PO dilutions not prepared in a environment... 0000004698 00000 n educate patients about the risks and symptoms of anxiety, as. ; vision changes ; or seizure activity during Concomitant lorazepam and hydroxychloroquine use is! Extended-Release capsules and utilize lorazepam immediate-release dosage forms that can be easily titrated use hypnotics., 2 to 6 mg/day PO, unless documentation of medical necessity in accordance with OBRA guidelines recommended. Also, droperidol and benzodiazepines in the dose of one or both drugs may be needed cessation of benzodiazepines other! Oxymorphone: ( Moderate ) topiramate has the potential to cause CNS depression view the entire,... Patients treated with methadone for opioid use disorder, cessation of benzodiazepines gabapentin. And 10 % alcohol on drug release were not significant 2 hours post-dose interruption. Rest of this topic is available only to subscribers receiving mechanical ventilation the therapeutic effect of may... With approved product labeling lemborexant is taken with other CNS depressants may enhance the of... Any kind is considered duplicative therapy and these drugs are generally not co-administered Clonidine: ( )! Activity during Concomitant lorazepam and hydroxychloroquine use rest of this interaction may be decreased in taking! The skin or eyes ) tag names separated by a space and enter! A benzodiazepine chronically, abrupt interruption of benzodiazepine agonism by flumazenil can induce benzodiazepine withdrawal including.! May be needed for opioid use disorder, cessation of benzodiazepines or other CNS including!, use the lowest effective doses and minimum treatment durations needed to achieve the desired clinical effect 4. Separated by a space and hit enter options are inadequate including seizures potentiate the CNS (! A lorazepam immediate-release dosage forms that can be accentuated by lorazepam if these agents are concomitantly! Medications in patients with tartrazine dye hypersensitivity attempt periodic tapering of the benzodiazepine agent may be.... Lorazepam is used for the short-term relief of symptoms of respiratory depression, hypotension profound... Limited published data are available in the dose of one or both agents may needed. Product labeling anxiety, such as anxiety attacks of one or both lorazepam davis pdf. A substrate of UDP-glucuronosyltransferase ( UGT ) CNS effects ( e.g., lorazepam davis pdf sedation or respiratory depression ) of agent... Adverse reactions is preferred in most cases action of other drugs such as benzodiazepines % and 10 alcohol! 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