Benzodiazepine
Enhances GABAergic transmission by binding benzodiazepine sites on GABA-A receptors, increasing chloride influx and neuronal inhibition.
Anxiety disorders, insomnia due to anxiety, status epilepticus, and pre-anesthesia sedation.
Acute agitation, alcohol withdrawal syndrome, catatonia, procedural sedation.
Oral tablets, injectable solution.
0.5–1 mg orally twice or three times daily, titrated as clinically indicated.
0.5–6 mg/day in divided doses.
Half-life approximately 10–20 hours; metabolized by hepatic conjugation without active metabolites.
Sedation, dizziness, weakness, confusion, and ataxia.
Respiratory depression, paradoxical agitation, dependence and withdrawal symptoms.
Monitor sedation, cognition, fall risk, and signs of misuse or dependence.
Increased risk of respiratory depression and sedation when used concomitantly with opioids.
Lorazepam should be used cautiously in elderly patients and those with dementia due to increased risk of sedation, cognitive impairment, and falls. Its metabolism via conjugation without active metabolites may permit safer use in hepatic impairment, but monitoring remains important. Use the lowest effective dose for the shortest duration due to dependence risk.