Lorez

Lorez Tablet

Lorez is a short-acting tranquilizer of the benzodiazepine group. It is an agonist at benzodiazepine receptors in the CNS. It exerts a depressant action on the CNS, which may be mediated by potentiating the inhibitory actions of GABA (gamma amino butyric acid) in the CNS. This will result in diminution of the ascending activating systems, particularly the serotonergic and noradrenergic pathway from brain stem or the mid-brain to the cerebral cortex.

Uses

Lorez is used for the treatment of anxiety states; including anxiety associated with phobic & obsessional states, psychosomatic, organic or psychotic illness, insomnia associated with anxiety, nervousness, restlessness, nausea and vomiting related to chemotherapy and anticonvulsants, and as a premedicant before dental or general surgery or prior to investigative procedures where there may be discomfort. Lorez is not recommended in anxiety states in children but may be used as premedicant before surgery at a dose of 0.05 mg/Kg in children aged 5 to 13 years. The dosage of Lorez tablet should be increased gradually when needed to avoid adverse effects. When higher dosage is used, the evening dose should be increased before the daytime.

Lorez is also used to associated treatment for these conditions: Agitation, Alcohol Withdrawal Delirium, Alcohol Withdrawal Syndrome, Anxiety, Anxiety Disorders, Catatonia, Chemotherapy-Induced Nausea and Vomiting (CINV), Delirium, Insomnia, Muscle Spasms, Panic Disorder, Refractory seizure disorders, Preanesthetic medication therapy

Lorez

Trade Name Lorez
Generic Lorazepam
Lorazepam Other Names Loracepam, Lorazepam, o-Chlorooxazepam, o-Chloroxazepam
Type Tablet
Formula C15H10Cl2N2O2
Weight Average: 321.158
Monoisotopic: 320.011932988
Protein binding

Reports indicate that 85% of lorazepam administered dose is protein bound.

Therapeutic Class Benzodiazepine hypnotics, Benzodiazepine sedatives
Manufacturer Reliance Lifecare Pvt Ltd
Available Country India
Last Updated: June 23, 2021 at 9:00 am

Structure

Lorez
Lorazepam Structure

Dosage

Lorez dosage

Oral-

Frequency of administration and duration of therapy should be individualized according to patient's response. The usual range is 2 to 6 mg/day given in divided doses, the largest dose being taken before bedtime, but the largest dosage may vary from 1 to 10 mg/day. For anxiety, most patients require an initial dose of 2 to 3 mg/day given b.i.d. or t.i.d. For elderly or debilitated patients, an initial dosage of 1 to 2 mg/day in divided doses is recommended, to be adjusted as needed and tolerated. For insomnia 1 to 2 mg before bedtime and as premedicant 1 to 2 mg the night before surgery and 1 to 2 hour before surgery.

Injection-

Acute anxiety:

  • Adult: IV/IM: 25-30 mcg/kg repeated 6 hrly if necessary. Give IV inj at a rate of not more than 2 mg/min into a large vein.
  • Child: <12 yr Not recommended.
  • Elderly: Half the usual adult dose or less.

Premedication in surgery:

  • Adult: 50 mcg/kg given pre-op over 30-45 min (IV) or 60-90 min (IM).
  • Child: <12 yr Not recommended.
  • Elderly: Half the usual adult dose or less.

Status epilepticus:

  • Adult: 4 mg as a single dose, into a large vein at a rate not more than 2 mg/min. May be repeated once after 10-15 min if seizures recur.
  • Child: 2 mg as single dose.
  • Elderly: Half the usual adult dose or less.

Injection: Dilute with an equal volume of compatible diluent (e.g. sterile water for inj, NaCl 0.9% inj, dextrose 5% inj). 

Oral concentrate solution: Dose should be added to 30 mL or more of diluent (e.g. water, juice, carbonated or soda-like beverage) or to semi-solid food (e.g. applesauce, pudding).

Side Effects

Adverse reactions are usually observed at the beginning of therapy and generally disappeared on continued medication or upon decreasing the dose. The most frequent adverse reactions of Lorez are sedation followed by dizziness, weakness and unsteadiness. Less frequent adverse reactions are disorientation, depression, nausea, change in appetite, headache, sleep disturbance, agitation, dermatological symptoms, eye-function disturbance, together with various gastrointestinal symptoms and autonomic manifestations.

Precaution

In patients with depression accompanying anxiety, a possibility for suicide should be borne in mind. For elderly or debilitated patients, the initial daily dosage should not exceed 2 mg in order to avoid over sedation. The usual precautions for treating patients with impaired renal or hepatic function and with acute and chronic pulmonary insufficiency should be observed. Use of Lorez for prolonged period and gastric patients requires caution and there should be frequent monitoring for symptoms of upper gastrointestinal disease. Machineries should be avoided during taking Lorez.

Interaction

Lorez may potentiate the central depressant effect when combined with other drugs with central depressant action. Such drugs include alcohol, general anesthetics, tricyclic antidepressants and monoamine oxidase inhibitors.

Food Interaction

  • Avoid alcohol.
  • Limit caffeine intake.
  • Take with food.

Volume of Distribution

The reported volume of distribution of lorazepam is 1.3 L/kg. It is important to mention that due to the lipophilicity of lorazepam, it does not redistribute as fast in the brain.

Half Life

When administered parentally, the registered half-life of lorazepam is of 14 hours.

Clearance

In vivo studies with lorazepam have shown a clearance rate of 5.8 ml.min/kg.

Pregnancy & Breastfeeding use

Safety of Lorez in pregnancy has not been established. Because the use of this drug is rarely a matter of urgency, the use of Lorez during this period should almost always be avoided.

It is not known whether oral Lorez is excreted in human milk like other benzodiazepine tranquilizers. As a general rule, nursing should not be undertaken while a patient is on a drug since many drugs are excreted in human milk.

Contraindication

Lorez should not be given to patients with a previous sensitivity to benzodiazepines or with acute narrow-angle glaucoma and myasthenia gravis.

Special Warning

Debilitated patient: Half the usual adult dose or less.

Renal Impairment: May require reduced doses.

Mild to Moderate Hepatic Impairment: May require reduced doses.

Severe Hepatic Impairment: Contraindicated.

Acute Overdose

Overdosage of Lorez is usually manifested by varying degrees of central nervous system depression ranging from drowsiness to coma. In mild cases, symptoms include drowsiness, mental confusion and lethargy. In more serious cases and especially when other drugs or alcohol were ingested, symptoms may include ataxia, hypotonia, hypotension, hypnotic states (stages I to III), coma.

Storage Condition

Tablet: Store between 20-25°C. 

Injection or oral concentrate solution: Store between 2-8°C. Do not freeze. Protect from light.

Innovators Monograph

Lorez contains Lorazepam see full prescribing information from innovator Monograph

FAQ

What is Lorez used for?

It is used to treat anxiety disorders, trouble sleeping, severe agitation, active seizures including status epilepticus, alcohol withdrawal, and chemotherapy-induced nausea and vomiting. It can be taken to help you relax before an operation or other medical or dental treatment.

How safe is Lorez?

Lorez is a safe and effective medication when used as directed.

How does Lorez work?

Lorez works by increasing the levels of a calming chemical, gamma-amino-butyric-acid (GABA), in your brain.

What are the common side effects of Lorez?

Common side effects of Lorez are include:

  • drowsiness
  • dizziness
  • tiredness
  • weakness
  • dry mouth
  • diarrhea
  • nausea
  • changes in appetite
  • restlessness or excitement
  • constipation
  • difficulty urinating
  • frequent urination
  • blurred vision
  • changes in sex drive or ability

Is Lorez safe during pregnancy?

Lorez should be avoided during pregnancy.

Is Lorez safe during breastfeeding?

Evidence from nursing mothers indicates that Lorez does not cause any adverse effects in breastfed infants with usual maternal dosages.

Can I drink alcohol with Lorez?

Alcohol can increase the nervous system side effects of Lorez such as dizziness, drowsiness, and difficulty concentrating.

When should be taken of Lorez?

Lorez may be taken with or without food. Take with food if you experience an upset stomach. Lorez  may be taken every day at regular times or on an as needed.

How often can I take Lorez?

Adults, one capsule once a day in the morning. Dose is based on the total daily dose of Lorez tablets, which you take three times a day in equally divided doses.

How long does Lorez take to work?

Lorez tablets and liquid start to work in around 20 to 30 minutes. The full sedating effect lasts for around 6 to 8 hours.

How long does Lorez stay in my system?

Lorez  may be detectable in urine samples for up to six days, and some of the metabolites may be detectable for even longer (nine days). If regularly abused, urinalysis may reveal the presence of Lorez after a week or longer.

How long can I stay on Lorez?

It's not recommended to use Lorez for longer than 4 weeks. The most common side effect is feeling sleepy (drowsy) during the daytime.

Who should not take Lorez?

If you have or have ever had seizures; or lung, heart, or liver disease you should not take Lorez. Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding.

What happen If I missed Lorez?

If you miss a dose of Lorez, take the missed dose as soon as you remember it. If it is almost time for your next dose, skip the missed dose and continue with your dosing schedule. Do not double up your dose of Lorez to make up for the missed dose.

What happens if I overdose of Lorez?

Overdose symptoms may include extreme drowsiness, confusion, slurred speech, feeling restless, muscle weakness, loss of balance or coordination, feeling light-headed, slow heartbeats, weak or shallow breathing, or coma. If you think you or someone else may have overdosed on: Lorez (Ativan), call your doctor or the Poison Control center.

Can Lorez affects my heart ?

With an Lorez addiction comes a variety of health issues, such as heart problems. Lorez affects the heart by slowing your heart rate and lowering your blood pressure.

Can Lorez affect my kidneys?

Lorez can also damage liver and kidney function.

Can Lorez affect my liver?

Clinically apparent liver injury from Lorez is extremely rare.

Does Lorez cause memory loss?

Lorez  slows down the functions of the brain and body.

Can I cut Lorez in half?

 Swallow the tablet whole. Do not crush, break, or chew it.