Minor/Significance Unknown. Use Caution/Monitor. lorazepam and desipramine both increase sedation. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. To lower your risk, your doctor should have you take the smallest dose of lorazepam that works, and take it for the shortest possible time. DB - Johns Hopkins Guides Both drugs can cause metabolic acidosis. 0000004027 00000 n Modify Therapy/Monitor Closely. Monitor for drug toxiticities when initiating or discontinuing methylphenidate. Monitor Closely (1)lorazepam increases and yohimbine decreases sedation. diazepam intranasal, lorazepam. Monitor Closely (1)lorazepam and doxylamine both increase sedation. Either increases effects of the other by sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. lorazepam decreases effects of rapacuronium by pharmacodynamic antagonism. Monitor Closely (1)lorazepam and risperidone both increase sedation. lorazepam and baclofen both increase sedation. Enhanced metabolism incr levels of hepatotoxic metabolites. Paradoxical reactions (anxiety, excitation, agitation, hostility, aggression, rage), Use of injectable dosage form in premature infants (contains benzyl alcohol), Concomitant use of benzodiazepines, including lorazepam, and opioids may result in profound sedation, respiratory depression, coma, and death (see BBW), Advise both patients and caregivers about the risks of respiratory depression and sedation when lorazepam is used with opioids; advise patients not to drive or operate heavy machinery until the effects of concomitant use with the opioid have been determined, Use of benzodiazepines, including lorazepam, both used alone and in combination with other CNS depressants, may lead to potentially fatal respiratory depression, Not recommended for use in patients with primary depressive disorder or psychosis, Injection contains benzyl alcohol associated with potentially fatal "gasping syndrome" in neonates and an increased incidence of kernicterus, particularly in small preterm infants; if patient requires more than recommended dosages or other medications containing this preservative, practitioner must consider daily metabolic load of benzyl alcohol from combined sources, Prolonged use may lead to physical and psychological dependence especially in patients with history of alcohol or drug abuse; risk of dependence is decreased with short-term treatment (eg, 2-4 weeks); evaluate need for continued treatment prior to extending therapy duration, Use of drug, particularly in patients at elevated risk, necessitates counseling about risks and proper use of drug along with monitoring for signs and symptoms of abuse, misuse, and addiction; do not exceed recommended dosing frequency, Avoid or minimize concomitant use of CNS depressants and other substances associated with abuse, misuse, and addiction (eg, opioid analgesics, stimulants); advise patients on proper disposal of unused drug; if a substance use disorder is suspected, evaluate patient and institute (or refer them for) early treatment, as appropriate, For patients using treated more frequently than recommended, to reduce risk of withdrawal reactions, use a gradual taper to discontinue therapy (a patient-specific plan should be used to taper the dose), Patients at an increased risk of withdrawal adverse reactions after benzodiazepine discontinuation or rapid dosage reduction include those who take higher dosages, and those who have had longer durations of use, In some cases, benzodiazepine users have developed a protracted withdrawal syndrome with withdrawal symptoms lasting weeks to more than 12 months, Use caution in patients with history of suicide attempt or drug abuse, Do not withdraw abruptly after prolonged use; terminate dosage gradually, Use caution in patients with impaired gag reflex, May cause CNS depression, impairing physical and mental abilities; caution patients to not operate dangerous machinery or motor vehicles, Use caution in patients with respiratory disease, including COPD or sleep apnea, Hyperactive or aggressive behavior and other paradoxical reactions reported with use, Caution patients that tolerance for alcohol and other CNS depressants will be diminished, There is a pregnancy registry that monitors pregnancy outcomes in woman exposed to psychiatric medications; healthcare providers are encouraged to register patients by calling the National Pregnancy Registry for Psychiatric Medications at 1-866-961-2388 or visiting online at https://womensmentalhealth.org/pregnancyregistry/Neonates born to mothers using benzodiazepines late in pregnancy have been reported to experience symptoms of sedation and/or neonatal withdrawal; available data from published observational studies of pregnant women exposed to benzodiazepines do not report a clear association with benzodiazepines and major birth defects, Benzodiazepines cross the placenta and may produce respiratory depression, hypotonia, and sedation in neonates; monitor neonates exposed to this medication during pregnancy or labor for signs of sedation, respiratory depression, hypotonia, and feeding problems, Monitor neonates exposed to therapy during pregnancy for signs of withdrawal; manage these neonates accordingly, Advise pregnant females who are administered this medication late in pregnancy that therapy can result in sedation (respiratory depression, lethargy, hypotonia) and/or withdrawal symptoms (hyperreflexia, irritability, restlessness, tremors, inconsolable crying, and feeding difficulties) in newborns; instruct patients to inform their healthcare provider if they are pregnant, There are insufficient data regarding obstetrical safety of parenteral lorazepam, including use in cesarean section; such use, therefore, is not recommended, This drug is present in breast milk; there are reports of sedation. Use Caution/Monitor. lorazepam and papaveretum both increase sedation. Symptoms of overdose may include confusion, slow reflexes, clumsiness, deep sleep, and loss of consciousness. Minor/Significance Unknown. Effect of interaction is not clear, use caution. hydrocodone, lorazepam. Use Caution/Monitor.Minor (1)dexmethylphenidate increases effects of lorazepam by decreasing metabolism. Monitor Closely (1)lorazepam and amitriptyline both increase sedation. Use Caution/Monitor.lorazepam, clozapine. Use Caution/Monitor. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. Nemeroff CB. lorazepam and loxapine inhaled both increase sedation. Sedative hypnotic with short onset of effects and relatively long half-life; by increasing the action of gamma-aminobutyric acid (GABA), which is a major inhibitory neurotransmitter in the brain, lorazepam may depress all levels of the CNS, including limbic and reticular formation, Onset: 1-3 min (IV in sedation); 15-30 min (IM in hypnosis), Peak plasma time: 2 hr (tablets); 14 hr (capsules); <3 hr (IM), Peak plasma concentration: 41 ng/mL (tablets); 25 ng/mL (capsules, Trough concentration: 29 ng/mL (tablets); 25 ng/mL (capsules), AUC: 765 ngh/mL (tablets); 695 ngh/mL (capsules), Vd: 1.9 L/kg (adolescents); 1.3 L/kg (adults); 0.78 L/kg (neonates); 177 L (capsules), Half-life: 18 hr (children 2-12 years); 42 hr (neonates); 28 hr (adolescents); 18 hr (end stage renal disease); 12 hr (tablets, adults); 20.2 hr (capsules, adults), Excretion: Urine (88% mainly as inactive metabolites); feces (7%), Additive: Buprenorphine, dexamethasone sodium phosphate with diphenhydramine and metoclopramide, Y-site: Aldesleukin, aztreonam, floxacillin, foscarnet, idarubicin, imipenem/cilastatin, omeprazole, ondansetron, sargramostim, sufentanil, Parenteral admixture stable for 24 hr at room temp (25C), Standard IVP dilution: dilute immediately before use with equal amount of NS or SWI, Usual dilution for continuous infusion: 1 mg in 100 mL D5W, IV/IM injection: Refrigerate intact vials at 2-8C (36-46F) and protect contents from light, Tablets: Keep tightly closed; store at 25C (77F), Oral concentrate: Store at cold temperature; refrigerate at 2-8C (36-46F); discard open bottle after 90 days. 0000003779 00000 n Use Caution/Monitor. Desirable interaction enhanced memory improvement (based on preliminary trial). Effect of interaction is not clear, use caution. Design: Use Caution/Monitor. Compare formulary status to other drugs in the same class. Use Caution/Monitor. Monitor Closely (1)amobarbital and lorazepam both increase sedation. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. Monitor Closely (1)loprazolam and lorazepam both increase sedation. 0000008826 00000 n Caffeine component of green tea may decrease sedative effects of benzodiazepines. Continuously monitor vital signs during sedation and recovery period if coadministered. WebNAME Generic (Brand) Approx. lorazepam and haloperidol both increase sedation. Clipboard, Search History, and several other advanced features are temporarily unavailable. butabarbital and lorazepam both increase sedation. Monitor Closely (1)lorazepam increases and fenfluramine decreases sedation. cyclizine and lorazepam both increase sedation. Use Caution/Monitor. Use Caution/Monitor. In many, but not all of these cases, buprenorphine was misused by self-injection. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. Limit dosages and durations to the minimum required. lorazepam and buprenorphine buccal both increase sedation. S;~.>J;UKF.3`:3YAz Monitor Closely (1)lorazepam increases and midodrine decreases sedation. In. WebPharmacist initiated IV to PO conversion program of antimicrobials. green tea decreases effects of lorazepam by pharmacodynamic antagonism. Profound sedation, respiratory depression, coma, and death may result if coadministered. cenobamate, lorazepam. Use Caution/Monitor. Monitor Closely (1)desflurane and lorazepam both increase sedation. Benzodiazepines. Use Caution/Monitor. lorazepam increases and terbutaline decreases sedation. Minor/Significance Unknown. Minor/Significance Unknown. Use Caution/Monitor. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. lorazepam and clomipramine both increase sedation. lorazepam and motherwort both increase sedation. lorazepam and dosulepin both increase sedation. Use Caution/Monitor. lorazepam, calcium/magnesium/potassium/sodium oxybates. endobj Benzodiazepine conversion calculations were applied according to institutional clinical pathway guidance. Monitor Closely (1)difelikefalin and lorazepam both increase sedation. Avoid or Use Alternate Drug. Limit dosages and durations to the minimum required. lorazepam and daridorexant both increase sedation. Effect of interaction is not clear, use caution. lorazepam and trifluoperazine both increase sedation. Use Caution/Monitor. Use Caution/Monitor. lorazepam and lormetazepam both increase sedation. Use Caution/Monitor. Use Caution/Monitor. lorazepam and ziprasidone both increase sedation. Effect of interaction is not clear, use caution. Effect of interaction is not clear, use caution. brexanolone, lorazepam. Use Caution/Monitor. Use Caution/Monitor. Either increases toxicity of the other by pharmacodynamic synergism. lorazepam increases and dopamine decreases sedation. Use Caution/Monitor. Monitor Closely (1)lorazepam and codeine both increase sedation. Use Caution/Monitor. An intramuscular dose (not available in the U.S.) of 50-100 mg can be given every 4 hours if needed for alcohol withdrawal. depression, hypotension. Monitor Closely (1)lorazepam and carisoprodol both increase sedation. STORAGE: Store at room temperature away from light and moisture. Use Caution/Monitor. Minor/Significance Unknown. WebDependence and Withdrawal Reactions. Use Caution/Monitor. WebBackground. Serious - Use Alternative (1)sufentanil SL, lorazepam. Use Caution/Monitor. Minor/Significance Unknown. Patients: <> Use Caution/Monitor. Profound sedation, respiratory depression, coma, and death may result if coadministered. Monitor Closely (2)lorazepam, loxapine. lorazepam increases and benzphetamine decreases sedation. National Library of Medicine Use Caution/Monitor. Monitor Closely (1)lorazepam increases and formoterol decreases sedation. zolpidem, lorazepam. Either increases toxicity of the other by pharmacodynamic synergism. Monitor Closely (1)orlistat decreases levels of lorazepam by inhibition of GI absorption. <> Use Caution/Monitor. Minor/Significance Unknown. Use Caution/Monitor. Either increases effects of the other by sedation. Use Caution/Monitor. Mechanism: unknown. Use Caution/Monitor. Avoid or Use Alternate Drug. lorazepam increases toxicity of buprenorphine subdermal implant by pharmacodynamic synergism. Use Caution/Monitor. Severe adverse events associated with oversedation and/or withdrawal were minimal and confounded by underlying disease states. Call your doctor to find out what to do. Monitor Closely (1)lorazepam and benperidol both increase sedation. Use Caution/Monitor. Search for Similar Articles Either increases effects of the other by sedation. Monitor Closely (1)lorazepam and nalbuphine both increase sedation. Profound sedation, respiratory depression, coma, and death may result if coadministered. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Consider reducing the dose when concomitantly using UGT2B7 substrates. lorazepam increases and methamphetamine decreases sedation. Minor/Significance Unknown. These findings suggest that standardized benzodiazepine conversions successfully achieved consistent Withdrawal Assessment Tool-Version 1 scores compared with preconversion values. WebIV:PO conversion a desirable treat-ment option. If you have any questions, ask your doctor or pharmacist.Take this medication by mouth with or without food as directed by your doctor. Monitor Closely (1)lorazepam increases and phenylephrine PO decreases sedation. Use Caution/Monitor. Use Caution/Monitor. Use Caution/Monitor. lorazepam and methocarbamol both increase sedation. lorazepam increases and isoproterenol decreases sedation. Use Caution/Monitor. Use Caution/Monitor. Monitor Closely (1)triprolidine and lorazepam both increase sedation. Effect of interaction is not clear, use caution. Serious - Use Alternative (1)lorazepam, sodium oxybate. Monitor for drug toxiticities when initiating or discontinuing methylphenidate. Monitor Closely (1)acrivastine and lorazepam both increase sedation. Use Caution/Monitor. lorazepam and thiothixene both increase sedation. %Uc2rxRX8]:1D\l|@VaP$xGAaEd3& NOTES: Lifestyle changes such as starting a stress reduction program may increase the effectiveness of this medication. lorazepam and zotepine both increase sedation. The .gov means its official. Minor (1)lorazepam decreases levels of biotin by unspecified interaction mechanism. Risk of resp. Either increases effects of the other by pharmacodynamic synergism. lorazepam and loxapine inhaled both increase sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. Use Caution/Monitor. difelikefalin and lorazepam both increase sedation. Wolters Kluwer Health Boudinot FD, Homon CA, Jusko WJ, et al. Monitor Closely (1)lorazepam and oxycodone both increase sedation. 81 0 obj <> endobj Step 1- Starting dose of lorazepam PO q6h x8 doses (see above calculation) 2. Johns Hopkins Guide App for iOS, iPhone, iPad, and Android included. Either increases toxicity of the other by sedation. Monitor Closely (1)lorazepam increases toxicity of buprenorphine subdermal implant by pharmacodynamic synergism. Effect of interaction is not clear, use caution. A 55-bed, mixed-medical, noncardiac surgical PICU in a tertiary care childrens hospital. Use Caution/Monitor. Minor (1)lorazepam decreases effects of rocuronium by pharmacodynamic antagonism. Use Caution/Monitor. Use Caution/Monitor. Use Caution/Monitor. ketamine and lorazepam both increase sedation. lorazepam and chlorpromazine both increase sedation. dimenhydrinate and lorazepam both increase sedation. amisulpride and lorazepam both increase sedation. Modify Therapy/Monitor Closely. Monitor Closely (1)clonazepam and lorazepam both increase sedation. metronidazole). Monitor Closely (1)lorazepam increases and caffeine decreases sedation. depression, hypotension. Use Caution/Monitor. Minor/Significance Unknown. Monitor Closely (1)lorazepam and alfentanil both increase sedation. primidone and lorazepam both increase sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. A 55-bed, mixed-medical, noncardiac surgical PICU in a tertiary care children's hospital. Use Caution/Monitor. @`qhGH[ 4XI3`` ) `uo$!%XvJ8K*21``HbdztiFO#11fe8i'":R u Use Caution/Monitor. Minor/Significance Unknown. Benzodiazepines are a group of drugs used for treating anxiety they will also make you feel more relaxed, help you fall asleep faster and on top of that they may combat a few kinds of seizures. flurazepam and lorazepam both increase sedation. Unable to load your collection due to an error, Unable to load your delegates due to an error. lorazepam and meperidine both increase sedation. lorazepam and sage both increase sedation. government site. Monitor Closely (1)stiripentol, lorazepam. Monitor Closely (1)carbinoxamine and lorazepam both increase sedation. Monitor Closely (1)cinnarizine and lorazepam both increase sedation. Avoid or Use Alternate Drug. Limit dosages and durations to the minimum required. STOP-BANG calculator screens for the risk factors & symptoms of obstructive sleep apnea (OSA). Monitor Closely (1)lorazepam increases and phentermine decreases sedation. Use Caution/Monitor. Most As needed benzodiazepine doses were administered in 38% of encounters post conversion, but escalation of a scheduled enteral benzodiazepine regimen was only required in 2.8% of encounters. Monitor Closely (1)lorazepam and doxepin both increase sedation. Use Caution/Monitor. lorazepam and morphine both increase sedation. Use Caution/Monitor. Use Caution/Monitor. BT - Johns Hopkins Psychiatry Guide Benzodiazepines, such as lorazepam and midazolam, are frequently administered to surgical intensive care unit (ICU) patients for postoperative sedation. Monitor Closely (1)lorazepam and trifluoperazine both increase sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. NCI CPTC Antibody Characterization Program. Use Caution/Monitor. Effect of interaction is not clear, use caution. Sharing it is against the law.Lab and/or medical tests (such as blood counts, liver function) should be done while you are taking this medication. WebMeasurements and main results: Withdrawal Assessment Tool-Version 1 scores were compared pre and post benzodiazepine conversion. Modify Therapy/Monitor Closely. lorazepam increases and dexmethylphenidate decreases sedation. lorazepam and clozapine both increase sedation. Use Caution/Monitor. Minor/Significance Unknown. 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