Monitor closely for signs of respiratory depression and sedation. Physicians Behaving Badly: Is It Arrogance, Insecurity, or Stress? Effect of interaction is not clear, use caution. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. lorazepam and eucalyptus both increase sedation. Modify Therapy/Monitor Closely. vhaw%"(JDY]&3JlHlHl) V" 3Jl%6l)FDf 3Jl%Zm%6l$6l$6gISH`F 0$`:Y0[4(f =K&/hDX, UVW;ww$ZHTZHZ_IIb j o4+n%sRH5H5jKIWR5:R'R^IO^G_GUcy;tr.Rx`]5,u8VR@#fD'l To date, the pharmacology of lorazepam in critically ill patients has not been described. Data is temporarily unavailable. Effect of interaction is not clear, use caution. Consider decreasing the dose of these drugs when given coadministered with methylphenidate. The significant figures calculator performs operations on sig figs and shows you a step-by-step solution! one may ask; Keywords modify the keyword list to augment your search. Modify Therapy/Monitor Closely. Dose related QTc prolongation and risk of cardiac arrhythmias. Although beneficial for the acute relief of anxiety, long-term use of benzodiazepines is not recommended due to the risk of dependence. Minor/Significance Unknown. Effect of interaction is not clear, use caution. Monitor Closely (1)pentobarbital and lorazepam both increase sedation. Either increases effects of the other by pharmacodynamic synergism. Benzodiazepine conversion calculations were applied according to institutional clinical pathway guidance. This information does not assure that this product is safe, effective, or appropriate for you. Use Caution/Monitor. lorazepam and orphenadrine both increase sedation. Additive hepatotoxicity. Minor/Significance Unknown. lorazepam and loxapine inhaled both increase sedation. Use Caution/Monitor. Monitor Closely (1)suvorexant and lorazepam both increase sedation. Effect of interaction is not clear, use caution. Intravenous to Oral Conversion for Antimicrobials 1-20-6-1-010 Author(s): Antimicrobial Stewardship Program Coordinator Page 6 of 6 Issuing Authority: Vice President Medicine and Clinical Programs; Regional Director, Pharmacy Services Use Caution/Monitor. Minor/Significance Unknown. Before Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Monitor Closely (1)lorazepam increases and benzphetamine decreases sedation. gemifloxacin increases levels of lorazepam by decreasing metabolism. lorazepam and scullcap both increase sedation. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Either increases effects of the other by sedation. A 55-bed, mixed-medical, noncardiac surgical PICU in a tertiary care childrens hospital. Monitor Closely (1)lorazepam increases and midodrine decreases sedation. Use Caution/Monitor. secobarbital and lorazepam both increase sedation. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. Use Caution/Monitor. Additive CNS depression. Theoretical interaction; some species of sage may cause convulsions. Either increases effects of the other by pharmacodynamic synergism. 2015 Apr-Jun;37(2):83-94; quiz E2. Take this medication exactly as prescribed to lower the risk of addiction. Use Caution/Monitor. e-N;CM_[9,jPUO'@O%W]I,7wO;~ -O{GOiZb]]qJy=q4/I3>1&p#!EoA2hF"H kn.u,yQg Either increases effects of the other by sedation. Use Caution/Monitor. For children older than 6 years of age, use 5 mg two to four times a day. Well, the benzodiazepine conversion calculator has got your back! Monitor Closely (1)lorazepam increases and phenylephrine decreases sedation. Use Caution/Monitor. clonidine, lorazepam. Effect of interaction is not clear, use caution. <>/Metadata 485 0 R/ViewerPreferences 486 0 R>> Use Caution/Monitor. lorazepam and metaxalone both increase sedation. 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. <>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Please try again soon. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely. Mechanism: unknown. EPS risk. 0000007240 00000 n rifabutin decreases levels of lorazepam by increasing metabolism. Bethesda, MD 20894, Web Policies <>>> Risk of convulsions. Use Caution/Monitor. lorazepam increases and fenfluramine decreases sedation. lorazepam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Then type a starting value in the top FROM input box. Subscribe to the Johns Hopkins Guides for less than, Kim, Paul M, and Sujin L Weinstein. Use lowest dose possible and monitor for respiratory depression and sedation. Effect of interaction is not clear, use caution. Effect of interaction is not clear, use caution. lorazepam decreases effects of onabotulinumtoxinA by pharmacodynamic antagonism. Use Caution/Monitor. Benzodiazepines are often used to bridge patients who are starting an "antidepressant" for anxiety, since the therapeutic effects may be delayed, and patients may experience stimulating side effects initially. Monitor Closely (1)sevelamer decreases levels of lorazepam by increasing elimination. lorazepam increases and epinephrine racemic decreases sedation. Monitor Closely (1)dichlorphenamide, lorazepam. chlorpheniramine and lorazepam both increase sedation. The dosage is based on your medical condition, age, and response to treatment.If directed by your doctor, use this medication regularly in order to get the most benefit from it. 0000004769 00000 n <> Cannabidiol may potentially inhibit UGT2B7 activity. Use Caution/Monitor. Monitor Closely (1)lorazepam and triazolam both increase sedation. Effect of interaction is not clear, use caution. Minor/Significance Unknown. For more information, please refer to our Privacy Policy. You should not become pregnant while using lorazepam. Either increases toxicity of the other by pharmacodynamic synergism. 3 0 obj Monitor closely for signs of respiratory depression and sedation. USES: This medication is used to treat anxiety. Effect of interaction is not clear, use caution. lorazepam increases and caffeine decreases sedation. Use Caution/Monitor. Severe adverse events associated with oversedation and/or withdrawal were minimal and confounded by underlying disease states. Either increases effects of the other by sedation. dexmethylphenidate increases effects of lorazepam by decreasing metabolism. Use Caution/Monitor. Minor (1)lorazepam increases effects of vinpocetine by unspecified interaction mechanism. Use Caution/Monitor. Modify Therapy/Monitor Closely. HOW TO USE: See also Warning section.Read the Medication Guide provided by your pharmacist before you start taking lorazepam and each time you get a refill. Use Caution/Monitor. Use Caution/Monitor. Use Caution/Monitor. Minor/Significance Unknown. lorazepam and shepherd's purse both increase sedation. Minor/Significance Unknown. lorazepam and tapentadol both increase sedation. 0000010283 00000 n Use Caution/Monitor. The benzodiazepine conversion calculator is an ultimate solution to any dosage problems you might encounter while switching from one drug of this type to another. Monitor Closely (1)amisulpride and lorazepam both increase sedation. <>/Font<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Use Caution/Monitor. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects. H\TKoAqs;O In general, benzodiazepines may have a longer half-life in babies (who have not developed the mechanisms for metabolism). 0000005197 00000 n Profound sedation, respiratory depression, coma, and death may result if coadministered. Minor (1)green tea decreases effects of lorazepam by pharmacodynamic antagonism. Weblorazepam increases toxicity of buprenorphine, long-acting injection by pharmacodynamic synergism. Most lorazepam increases and albuterol decreases sedation. Diazepam (Valium): The initial dose is 2 mg two to four times a day; the dose can be increased by 1-2 mg daily; the usual therapeutic dose is 15-30 mg total/day, with twice daily or three times a day dosing. Monitor Closely (1)lorazepam increases and caffeine decreases sedation. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. lorazepam and diphenoxylate hcl both increase sedation. Use Caution/Monitor. Monitor Closely (1)diazepam intranasal, lorazepam. Effect of interaction is not clear, use caution. Benzodiazepines may be more effective than, However, benzodiazepines may worsen symptoms in patients with comorbid depression or. Monitor Closely (1)lorazepam increases and formoterol decreases sedation. Serious - Use Alternative (1)sufentanil SL, lorazepam. Minor/Significance Unknown. 0000000856 00000 n WebNSAID, and steroid drug conversion factors Opioid Drugs Equivalent Dose IV morphine 1 mg IV fentanyl 0.01 mg IV hydromorphone 0.15 mg Oral oxycodone 3 mg IV nalbuphine 1 mg Oral codeine 20 mg Benzodiazepines Equivalent Dose IV midazolam 1 mg IV lorazepam 0.5 mg Neuromuscular Blockers Equivalent Dose IV vecuronium 1 mg IV Effect of interaction is not clear, use caution. Monitor Closely (1)lorazepam and trifluoperazine both increase sedation. Use Caution/Monitor. Use Caution/Monitor. T1 - Benzodiazepines Studies have shown that the combination of benzodiazepines and buprenorphine altered the usual ceiling effect on buprenorphine-induced respiratory depression, making the respiratory effects of buprenorphine appear similar to those of full opioid agonists. diazepam intranasal, lorazepam. 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