The following provides information on contraindications to the use of Lorazepam in general, pregnancy & amp; Breastfeeding and children. Please note that the contraindications may vary depending on the dosage form of a drug (eg tablet, syringe, ointment).
When should Lorazepam not be used?
The active substance should not be used in the case of hypersensitivity to lorazepam or other benzodiazepines, in patients with eye disease (narrow-angle glaucoma), or in drug, drug or alcohol dependence.
In addition, as an injection solution, the drug must not be given in shock and collapse conditions and in combination with scopolamine in obstetrics.
Very careful medical supervision is required in patients with severe liver damage, hepatic impairment or renal dysfunction, severe respiratory dysfunction (hypercapnia), seizure susceptibility (epilepsy or Lennox-Gastaut syndrome), disorders of balance regulation, and coordination of movement (spinal and cerebral Ataxia), special sleep disorders such as sleep apnea syndrome or myasthenia gravis muscle weakness.
In patients with depression, concomitant treatment with antidepressants is required.
In elderly patients, excretion of lorazepam may be prolonged, increasing the effect. In addition, they may be more sensitive to the application, especially in heart disease with severe respiratory distress. Therefore, the doctor should carefully control the individual response to the drug in elderly patients and patients in poor general condition or with organ-brain changes, circulatory dysfunction and pathological respiratory distress.
What should you watch out for during pregnancy and lactation?
Lorazepam and one of its major metabolites reach the unborn baby’s cake. They can accumulate there, which can lead to overdoses in the child with the consequence of malformations and mental limitations. In particular, with a long-term treatment in the last trimester of pregnancy can also occur after delivery withdrawal symptoms such as difficulty breathing, slack muscles, lowered body temperature and drinking weakness in the newborn. Therefore Lorazepam should only be used during pregnancy if the doctor considers it necessary.
If a pregnancy occurs during a Lorazepam treatment, a doctor should be informed immediately, who then has to decide on continuation or discontinuation of therapy.
Lorazepam and its metabolites pass into breast milk. Since the active ingredient in newborns is degraded much slower than by children or adults, it comes to breathing difficulties and dehydration. So it should be weaned before treatment with Lorazepam.
What should be considered in children?
Children and adolescents should not be treated with lorazepam, except after careful medical benefit-risk assessment prior to diagnostic and surgical procedures or seizures (status epilepticus). The dosage by the doctor depends on age, weight and general condition.
Warnings and Precautions
- After treatment with the drug in a clinic or surgery, an attendant is required for the patient.
- Care must be taken to keep the airway open in high-risk patients (such as those with severe sedation, elderly patients or epileptic seizures). If necessary, the doctor needs artificial respiration.
- For prolonged use, the blood count and liver enzymes should be monitored regularly.
- At the beginning of treatment, individual reactions should be monitored by the physician after taking the drug.
- When drinking alcohol, the dampening effects may increase each other.
- Taking the drug in the evening may reduce the ability to react, concentrate and remain exhausted the next morning.
- Because of the muscle-relaxing effect of the drug, there is an increased risk of falling, especially in elderly patients. Patients should therefore be careful when getting up at night.
- The use of the active substance (even in therapeutic doses) can lead to the development of a physical and psychological dependence. The risk of dependence increases with the dose and the duration of treatment. Especially in patients with a history of alcohol or drug dependence this risk is increased.
- At the end of therapy, withdrawal and rebound phenomena may occur.
- The active substance may cause so-called anterograde amnesia. This means that after ingestion may be performed actions that the patient can not remember later.
- Since the risk of withdrawal or withdrawal symptoms is greater after sudden discontinuation of therapy, it is recommended that treatment be stopped by gradually reducing the dose.
- A loss of efficacy (tolerance) may occur after taking the active substance for several weeks. Long-term use should therefore be avoided.
- The duration of treatment should be as short as possible, as the drug quickly becomes dependent. Therefore, treatment, including the gradual withdrawal phase, should not exceed four weeks.
- Older patients and liver patients usually need lower dosages.
- Even when used as intended, the active substance may affect responsiveness to the extent that it limits the ability to drive machinery and ride on the roads.
- During the first few days after administration of the active substance, avoid hazardous activities, such as operating machinery or driving, until the body has become accustomed to the drug.
Sometimes medications release allergic reactions.
If you notice any signs of allergic reaction, tell your doctor or pharmacist immediately.