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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Brand Name
Loreev Xr
Generic Name
Lorazepam
Active Ingredient
LorazepamCategory
Benzodiazepine [EPC]
Variants
5
References used for this content
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for Loreev Xr, you must consult a qualified healthcare professional.
| 1 mg/1 | CAPSULE, EXTENDED RELEASE | ORAL | 52427-658 |
| 1.5 mg/1 | CAPSULE, EXTENDED RELEASE | ORAL | 50090-7592 |
Detailed information about Loreev Xr
Lorazepam is a high-potency, intermediate-acting benzodiazepine primarily used for the management of anxiety disorders, insomnia, and status epilepticus. It functions by enhancing the inhibitory effects of GABA within the central nervous system.
The dosage of lorazepam must be individualized based on the patient's age, the severity of the condition, and the clinical response. Healthcare providers generally aim for the lowest effective dose for the shortest possible duration.
Lorazepam's safety and effectiveness in children under the age of 12 have not been established for the treatment of anxiety.
In patients with renal failure, the elimination of the inactive glucuronide metabolite may be delayed. While the parent drug (lorazepam) levels may not rise significantly, caution is advised during chronic dosing to prevent metabolite accumulation. Dose adjustments are typically not required for short-term use, but monitoring is essential.
Because lorazepam is metabolized via glucuronidation rather than the CYP450 system, it is less affected by liver disease than drugs like diazepam or chlordiazepoxide. However, in cases of severe hepatic insufficiency, the dose should be carefully titrated to avoid excessive sedation or hepatic encephalopathy.
Older adults are more sensitive to the effects of benzodiazepines. To reduce the risk of ataxia (lack of muscle coordination), falls, and cognitive impairment, the initial dose for elderly or debilitated patients should not exceed 1 mg to 2 mg per day in divided doses.
Patients should follow their healthcare provider's instructions exactly. Lorazepam can be taken with or without food. If gastrointestinal upset occurs, taking it with food may help. Tablets should be swallowed whole with water. If using the oral concentrate solution, it should be mixed with a liquid or semi-solid food (like water, juice, soda, applesauce, or pudding) immediately before consumption.
Storage should be in a cool, dry place at room temperature (20°C to 25°C or 68°F to 77°F), away from moisture and light. The injectable form and some oral solutions may require refrigeration; check the specific product packaging for instructions.
If a dose is missed, it should be taken as soon as the patient remembers. However, if it is almost time for the next scheduled dose, the missed dose should be skipped. Patients should never double the dose to catch up, as this increases the risk of excessive sedation and respiratory depression.
An overdose of lorazepam can be life-threatening, especially if combined with alcohol or other CNS depressants. Symptoms of overdose include extreme drowsiness, confusion, dysarthria (slurred speech), lethargy, ataxia, hypotonia (low muscle tone), hypotension (low blood pressure), and respiratory depression. In severe cases, coma and death can occur.
Emergency measures include supportive care, monitoring of vital signs, and, in specific hospital settings, the use of flumazenil (a benzodiazepine antagonist). However, flumazenil carries a risk of inducing seizures, particularly in long-term benzodiazepine users.
> Important: Follow your healthcare provider's dosing instructions. Do not adjust your dose without medical guidance. Abruptly stopping the medication can lead to severe withdrawal symptoms.
Side effects of lorazepam are most common at the beginning of therapy and usually diminish with continued use or dose reduction. The most frequently reported adverse reactions include:
Lorazepam is a Schedule IV controlled substance because it has a potential for abuse and may lead to physical or psychological dependence. It should only be used by the person for whom it was prescribed. Sharing this medication is illegal and dangerous. Patients with a history of substance use disorder require extremely close monitoring if this medication is used.
According to the FDA-approved labeling (2024), Lorazepam carries three critical Boxed Warnings:
Lorazepam must NEVER be used in the following circumstances:
Lorazepam is classified by the FDA as Pregnancy Category D. This means there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience.
Lorazepam is excreted in human breast milk in small amounts. Because neonates metabolize benzodiazepines more slowly than adults, the drug can accumulate in the infant's system. This may cause sedation, poor feeding, and weight loss in the nursing child. Generally, breastfeeding is not recommended while taking regular doses of lorazepam, or the infant must be closely monitored for excessive sleepiness.
Lorazepam is an anxiolytic agent that exerts its effects by enhancing the activity of gamma-aminobutyric acid (GABA), the major inhibitory neurotransmitter in the central nervous system. It binds to the benzodiazepine receptor site located on the GABA-A receptor complex. This binding increases the affinity of the receptor for GABA, which in turn increases the frequency of chloride channel opening. The resulting hyperpolarization of the neuronal membrane leads to a decrease in neuronal firing, producing sedative, anxiolytic, muscle relaxant, and anticonvulsant effects.
Lorazepam has a rapid onset of action, particularly when given intravenously (1-5 minutes) or intramuscularly (15-30 minutes). Orally, effects are usually felt within 30 to 60 minutes. The duration of the clinical effect is intermediate, typically lasting 6 to 12 hours for anxiety, though the sedative effects may persist longer. Tolerance to the sedative effects often develops within days, while tolerance to the anxiolytic effects may take longer to develop.
| Parameter | Value |
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Common questions about Loreev Xr
Lorazepam is primarily prescribed for the short-term management of severe anxiety disorders and the relief of anxiety symptoms associated with depression. It is also a critical medication used in emergency settings to stop prolonged seizures, a condition known as status epilepticus. Additionally, healthcare providers use it as a pre-anesthetic medication to help patients relax and to induce temporary memory loss before surgery. Some doctors may also use it off-label to treat alcohol withdrawal or nausea caused by chemotherapy. It is intended for short-term use, typically not exceeding two to four weeks.
The most frequent side effects reported by patients taking lorazepam include significant drowsiness, dizziness, and a feeling of physical weakness or lack of energy. Many people also experience ataxia, which is a lack of muscle coordination that can make walking or fine motor tasks difficult. Some users report feeling lightheaded or having blurred vision shortly after taking a dose. These effects are usually most intense during the first few days of treatment and may decrease as the body adjusts. If these symptoms persist or become severe, it is important to contact a healthcare provider for a dose adjustment.
No, you must strictly avoid alcohol while taking lorazepam. Both substances are central nervous system depressants, and when taken together, they significantly increase the risk of dangerous side effects. This combination can lead to extreme sedation, severely slowed breathing (respiratory depression), and even a fatal overdose. Alcohol also increases the risk of accidental injuries and falls while on this medication. Even small amounts of alcohol can interact unpredictably with lorazepam, so it is safest to abstain entirely during treatment.
Lorazepam is generally not recommended during pregnancy unless the benefits clearly outweigh the risks, as it is classified as a Pregnancy Category D medication. Exposure during the first trimester has been linked in some studies to an increased risk of birth defects like cleft palate. If taken during the later stages of pregnancy, the baby may be born with 'floppy infant syndrome,' exhibiting muscle weakness and breathing problems. Furthermore, the newborn may experience withdrawal symptoms after birth if the mother used the drug chronically. Expectant mothers should have a detailed discussion with their doctor about the risks and alternative treatments.
The onset of lorazepam depends heavily on how it is administered. When taken as an oral tablet, most patients begin to feel the anti-anxiety or sedative effects within 30 to 60 minutes, with the peak effect occurring around 2 hours. If administered intravenously by a medical professional, the onset is much faster, usually within 1 to 5 minutes, which is why it is used for emergency seizure control. Intramuscular injections typically take 15 to 30 minutes to begin working. The duration of the effect usually lasts between 6 and 12 hours for most individuals.
You should never stop taking lorazepam suddenly if you have been using it regularly for more than a few days. Abrupt discontinuation can trigger a severe withdrawal syndrome that includes symptoms like tremors, sweating, insomnia, muscle cramps, and anxiety. In the most serious cases, stopping 'cold turkey' can cause life-threatening seizures or delirium. To safely stop the medication, your doctor will provide a tapering schedule to gradually reduce the dose over several weeks. Always follow your healthcare provider's specific instructions for ending treatment to minimize these risks.
If you miss a dose of lorazepam, you should take it as soon as you remember, provided it is not almost time for your next scheduled dose. If it is close to the time for your next dose, simply skip the missed one and continue with your regular schedule. You should never take two doses at once to make up for a missed one, as this significantly increases the risk of excessive sedation and respiratory issues. If you frequently miss doses, consider using a pill organizer or setting an alarm to stay on track. Consult your pharmacist if you are unsure about the timing of a dose.
Weight gain is not considered a common or direct side effect of lorazepam according to clinical trial data. However, because the medication causes sedation and can decrease overall physical activity, some patients might experience slight weight changes over time. In some cases, a reduction in anxiety may lead to an increased appetite in individuals who previously lost weight due to stress. Conversely, some patients report a decrease in appetite or nausea. If you notice significant or rapid changes in your weight while taking this medication, you should discuss these concerns with your healthcare provider.
Lorazepam has several significant drug interactions that must be managed by a doctor. It should not be taken with opioids, other sedatives, or sleep medications unless specifically directed, due to the risk of fatal respiratory depression. Certain drugs like valproate (for seizures) or probenecid (for gout) can increase the levels of lorazepam in your blood, requiring a dose reduction. Even over-the-counter herbal supplements like kava or valerian root can increase sleepiness. Always provide your doctor and pharmacist with a complete list of all medications and supplements you are currently using.
Yes, lorazepam is widely available as a generic medication in various forms, including oral tablets and injectable solutions. The generic version is typically much less expensive than the brand-name version, Ativan, while containing the same active ingredient and meeting the same FDA standards for quality and effectiveness. Most insurance plans cover the generic form of lorazepam. When picking up your prescription, the tablets may look different depending on the manufacturer, but the clinical effect remains the same. Check with your pharmacist if you have questions about the specific generic brand you receive.
Other drugs with the same active ingredient (Lorazepam)
> Warning: Stop taking Lorazepam and call your doctor immediately if you experience any of these serious symptoms:
Prolonged use of lorazepam (typically more than 2-4 weeks) can lead to several chronic issues:
The FDA has issued several Boxed Warnings for lorazepam, the highest level of safety alert:
Report any unusual symptoms to your healthcare provider immediately. Monitoring for behavioral changes is essential during treatment.
For patients on long-term lorazepam therapy, healthcare providers typically perform the following:
Lorazepam significantly impairs the mental and physical abilities required for driving a vehicle or operating heavy machinery. Patients should not engage in these activities until they are certain the medication does not make them drowsy or dizzy. This impairment can persist even the day after a dose is taken.
Alcohol must be strictly avoided while taking lorazepam. Alcohol synergistically increases the central nervous system depressant effects of the drug, which can lead to fatal respiratory failure or accidental injury.
Lorazepam must never be stopped abruptly after regular use. A gradual tapering schedule, often over several weeks or months, is required to prevent withdrawal symptoms. These symptoms can include tremors, muscle cramps, vomiting, sweating, and life-threatening seizures. Many clinicians follow the Ashton Manual protocols for slow benzodiazepine reduction.
> Important: Discuss all your medical conditions with your healthcare provider before starting Lorazepam, especially if you have a history of depression, lung disease, or addiction.
Lorazepam generally does not interfere with common clinical laboratory tests. However, it may show up on urine drug screens for benzodiazepines. It is important to inform laboratory personnel of its use to ensure accurate interpretation of toxicology results.
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking. A complete list is essential to prevent dangerous drug-drug interactions.
These conditions require a careful risk-benefit analysis by a healthcare provider:
Patients who are allergic to one benzodiazepine are highly likely to be allergic to others. This is known as cross-sensitivity. If you have experienced hives, swelling, or difficulty breathing after taking Xanax (alprazolam), Valium (diazepam), or Klonopin (clonazepam), you must inform your doctor before taking lorazepam.
> Important: Your healthcare provider will evaluate your complete medical history before prescribing Lorazepam. Be honest about your history of respiratory issues and substance use.
Lorazepam is not FDA-approved for the treatment of anxiety in children under 12 years of age. Its use in pediatrics is primarily limited to the acute management of seizures (status epilepticus) in emergency settings. Long-term use in children is discouraged due to potential effects on cognitive development and the high risk of paradoxical reactions (e.g., increased agitation).
According to the American Geriatrics Society's Beers Criteria, benzodiazepines like lorazepam should generally be avoided in older adults.
In patients with kidney disease, the inactive metabolite (lorazepam glucuronide) can accumulate. While the metabolite is not active, high levels may theoretically interfere with the protein binding of the parent drug. Caution and lower doses are advised for long-term therapy in patients with a GFR below 30 mL/min.
Lorazepam is often the benzodiazepine of choice (along with oxazepam and temazepam) for patients with mild-to-moderate liver disease because it does not require oxidative metabolism by the liver. However, in end-stage liver disease or cirrhosis, the risk of over-sedation is high, and dosing should be extremely conservative.
> Important: Special populations require individualized medical assessment. Never share your medication with others, especially those in these high-risk groups.
| Bioavailability | ~90% (Oral) |
| Protein Binding | 85% - 91% |
| Half-life | 10 - 20 hours |
| Tmax | ~2 hours (Oral) |
| Metabolism | Hepatic Glucuronidation (UGT2B7/2B15) |
| Excretion | Renal 88%, Fecal 7% |
Lorazepam belongs to the benzodiazepine class. It is specifically a 1,4-benzodiazepine. Within this class, it is grouped with other intermediate-acting agents like oxazepam and temazepam, which are also metabolized via conjugation. It is distinct from long-acting agents like diazepam and short-acting agents like midazolam.