Effect of interaction is not clear, use caution. Monitor Closely (1)lemborexant, lorazepam. Monitor Closely (1)cyproheptadine and lorazepam both increase sedation. Profound sedation, respiratory depression, coma, and death may result if coadministered. Avoid or Use Alternate Drug. Modify Therapy/Monitor Closely. Avoid or Use Alternate Drug. rifabutin decreases levels of lorazepam by increasing metabolism. Effect of interaction is not clear, use caution. diazepam , lorazepam , midazolam , pediatric intensive care units , quality improvement , therapeutic equivalency. Use Caution/Monitor. lorazepam and ramelteon both increase sedation. Limit dosages and durations to the minimum required. 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. To evaluate if institutionally established calculations for transitioning continuous IV midazolam to enteral benzodiazepines maintain Withdrawal Assessment ToolVersion 1 scores equal to or less than preconversion values. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Monitor Closely (1)hyaluronidase, lorazepam. Monitor Closely (1)lorazepam increases and dextroamphetamine decreases sedation. Use Caution/Monitor. Benzodiazepine selection in the management of status epilepticus: a review. Effect of interaction is not clear, use caution. UR - https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Psychiatry_Guide/787140/all/Benzodiazepines amobarbital and lorazepam both increase sedation. Effect of interaction is not clear, use caution. lorazepam and metaxalone both increase sedation. lorazepam and perphenazine both increase sedation. Minor/Significance Unknown. Minor/Significance Unknown. Elderly patients often require lower benzodiazepine doses due to slower metabolism of the drugs. Minor/Significance Unknown. Minor (1)lorazepam, pyrimethamine. Monitor Closely (1)promethazine and lorazepam both increase sedation. Monitor Closely (1)lorazepam and orphenadrine both increase sedation. Patient demographics, benzodiazepine dose escalations, as needed benzodiazepine requirements, and severe adverse events within 48 hours of conversion were assessed. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Effect of interaction is not clear, use caution. lorazepam and cyclobenzaprine both increase sedation. Use Caution/Monitor. Patient demographics, benzodiazepine dose escalations, as needed benzodiazepine requirements, and severe adverse events within 48 hours of conversion were assessed. Monitor Closely (1)lorazepam and paliperidone both increase sedation. Therapeutic implications. Use Caution/Monitor. In others, gradually tapering a patient off of a prescribed benzodiazepine or other CNS depressant or decreasing to the lowest effective dose may be appropriate. :T. Use Caution/Monitor. Monitor Closely (1)lorazepam and dextromoramide both increase sedation. Minor/Significance Unknown. Use Caution/Monitor. Use Caution/Monitor. Monitor Closely (1)lorazepam and dosulepin both increase sedation. Use Caution/Monitor. Patients treated with selinexor may experience neurological toxicities. Modify Therapy/Monitor Closely. Use Caution/Monitor. 81 28 Crit Care Med. Continuously monitor vital signs during sedation and recovery period if coadministered. Use Caution/Monitor. gabapentin, lorazepam. Either increases toxicity of the other by pharmacodynamic synergism. lorazepam and marijuana both increase sedation. Please try after some time. Use Caution/Monitor. Use Caution/Monitor. You may search for similar articles that contain these same keywords or you may 0000008826 00000 n Use Caution/Monitor. Monitor Closely (1)lorazepam and motherwort both increase sedation. Clonazepam (Klonopin): The initial dose is 0.25 mg daily to twice a day; the dose can be increased by 0.125-0.25 mg daily or two times a day every 2-3 days; the usual therapeutic dose is 1-4 mg total/day in divided doses. Serious - Use Alternative (1)lorazepam, sodium oxybate. Monitor Closely (1)lorazepam and ziprasidone both increase sedation. Minor/Significance Unknown. For information regarding this article, E-mail: [emailprotected]. The sleep calculator can help you determine when you should go to bed to wake up happy and refreshed. Post conversion, one patient (1.4%) had increased seizure activity, and four patients (5.6%) required fluid boluses secondary to tachycardia or dehydration, but not hypotension. Either increases toxicity of the other by Other (see comment). Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Use Caution/Monitor. 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. Use Caution/Monitor. Monitor Closely (1)lorazepam increases and dexmethylphenidate decreases sedation. Either increases effects of the other by sedation. Effect of interaction is not clear, use caution. Avoid or Use Alternate Drug. Other (see comment). lorazepam and loxapine inhaled both increase sedation. Use Caution/Monitor. All patients age 6 months to 18 years who received continuous midazolam for 5 days or longer while mechanically ventilated for 521 days and were then converted to either enteral diazepam or lorazepam following extubation (or return to baseline ventilator settings in tracheostomy-dependent patients) between January 1, 2015, and June 30, 2016. commonly, these are "non-preferred" brand drugs or specialty Monitor Closely (1)lasmiditan, lorazepam. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient. lorazepam and mirtazapine both increase sedation. Minor (1)lorazepam decreases levels of cyanocobalamin by inhibition of GI absorption. Either increases toxicity of the other by pharmacodynamic synergism. Monitor Closely (1)lorazepam, clobazam. Use Caution/Monitor. Consult your doctor before breast-feeding. Monitor Closely (1)lorazepam and trazodone both increase sedation. The maximum dose is 4 mg/day. Effect of interaction is not clear, use caution. <>/Metadata 485 0 R/ViewerPreferences 486 0 R>> Minor/Significance Unknown. Monitor Closely (1)lorazepam increases and midodrine decreases sedation. Use Caution/Monitor. Clinical pharmacokinetics of alprazolam. diazepam intranasal, lorazepam. Monitor Closely (1)lorazepam and buprenorphine both increase sedation. Use Caution/Monitor. Monitor Closely (1)lorazepam increases and epinephrine decreases sedation. Minor/Significance Unknown. lorazepam increases and modafinil decreases sedation. Use Caution/Monitor. Most Use Caution/Monitor. Use Caution/Monitor. Use Caution/Monitor. Monitor Closely (1)lorazepam and doxepin both increase sedation. lorazepam and clomipramine both increase sedation. lorazepam increases and caffeine decreases sedation. Modify Therapy/Monitor Closely. Use Caution/Monitor. Monitor Closely (1)lorazepam and ramelteon both increase sedation. Limit dosages and durations to the minimum required. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. Effect of interaction is not clear, use caution. Effect of interaction is not clear, use caution. Conversion of IV Midazolam Unlike nearly all other benzodiazepine conversions, the conversion between intravenous midazolam and lorazepam has been Monitor Closely (1)lorazepam and quetiapine both increase sedation. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9yZWZlcmVuY2UubWVkc2NhcGUuY29tL2RydWcvYXRpdmFuLWxvcmVldi14ci1sb3JhemVwYW0tMzQyOTA2, View explanations for tiers and 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. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. Serious - Use Alternative (1)valerian and lorazepam both increase sedation. Monitor Closely (1)difelikefalin and lorazepam both increase sedation. lorazepam increases and yohimbine decreases sedation. Monitor Closely (1)clemastine and lorazepam both increase sedation. Use Caution/Monitor. Oxazepam (Serax): the initial dose is 10-15 mg daily; the dose can be increased by 10 mg daily in divided doses (three times a day); the usual therapeutic dose is 90 mg total/day, with three times a day dosing. stiripentol, lorazepam. Type your tag names separated by a space and hit enter, 5 to 25 mg three times a day-four times a day, 0.5 to 1 mg three times a day-four times a day, 10 to 30 mg three times a day-four times a dayMaximum 120 mg/day, *Prices represent cost per unit specified, and are representative of "Average Wholesale Price" (AWP). 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