Where is lorazepam manufacturer




















The risk of dependence increases with higher doses and longer term use and is further increased in patients with a history of alcoholism or drug abuse or in patients with significant personality disorders.

The dependence potential is reduced when lorazepam is used at the appropriate dose for short-term treatment. Addiction-prone individuals such as drug addicts or alcoholics should be under careful surveillance when receiving lorazepam or other psychotropic agents.

In general, benzodiazepines should be prescribed for short periods only e. Extension of the treatment period should not take place without reevaluation of the need for continued therapy. Continuous long-term use of the product is not recommended. Withdrawal symptoms e. Abrupt discontinuation of product should be avoided and a gradual dosage-tapering schedule followed after extended therapy.

Abrupt termination of treatment may be accompanied by withdrawal symptoms. In patients with depression, a possibility for suicide should be borne in mind; benzodiazepines should not be used in such patients without adequate anti-depressant therapy. Lorazepam should be used with caution in patients with compromised respiratory function e.

COPD, sleep apnea syndrome. Elderly or debilitated patients may be more susceptible to the sedative effects of lorazepam. Therefore, these patients should be monitored frequently and have their dosage adjusted carefully according to patient response; the initial dosage should not exceed 2 mg. Paradoxical reactions have been occasionally reported during benzodiazepine use. Such reactions may be more likely to occur in children and the elderly.

Should these occur, use of the drug should be discontinued. The usual precautions for treating patients with impaired renal or hepatic function should be observed. Dosage for patients with severe hepatic insufficiency should be adjusted carefully according to patient response; lower doses may be sufficient in such patients. In patients where gastrointestinal or cardiovascular disorders coexist with anxiety, it should be noted that lorazepam has not been shown to be of significant benefit in treating the gastrointestinal or cardiovascular component.

The no-effect dose was 1. The effect was reversible only when the treatment was withdrawn within 2 months of first observation of the phenomenon. The clinical significance of this is unknown. However, use of lorazepam for prolonged periods and in geriatric patients requires caution, and there should be frequent monitoring for symptoms of upper G. Safety and effectiveness of lorazepam in children of less than 12 years have not been established.

To assure the safe and effective use of lorazepam, patients should be informed that, since benzodiazepines may produce psychological and physical dependence, it is advisable that they consult with their physician before either increasing the dose or abruptly discontinuing this drug. Some patients on lorazepam have developed leukopenia, and some have had elevations of LDH.

As with other benzodiazepines, periodic blood counts and liver function tests are recommended for patients on long-term therapy. The concomitant use of benzodiazepines and opioids increases the risk of respiratory depression because of actions at different receptor sites in the CNS that control respiration. When benzodiazepines and opioids are combined, the potential for benzodiazepines to significantly worsen opioid-related respiratory depression exists.

Limit dosage and duration of concomitant use of benzodiazepines and opioids, and monitor patients closely for respiratory depression and sedation.

Concomitant use of clozapine and lorazepam may produce marked sedation, excessive salivation, hypotension, ataxia, delirium and respiratory arrest. Concurrent administration of lorazepam with valproate may result in increased plasma concentrations and reduced clearance of lorazepam. Concurrent administration of lorazepam with probenecid may result in a more rapid onset or prolonged effect of lorazepam due to increased half-life and decreased total clearance.

The effects of probenecid and valproate on lorazepam may be due to inhibition of glucuronidation. Administration of theophylline or aminophylline may reduce the sedative effects of benzodiazepines, including lorazepam. No evidence of carcinogenic potential emerged in rats during an month study with lorazepam.

No studies regarding mutagenesis have been performed. Reproductive studies in animals were performed in mice, rats, and two strains of rabbits. Occasional anomalies reduction of tarsals, tibia, metatarsals, malrotated limbs, gastroschisis, malformed skull, and microphthalmia were seen in drug-treated rabbits without relationship to dosage. Although all of these anomalies were not present in the concurrent control group, they have been reported to occur randomly in historical controls.

The clinical significance of the above findings is not known. However, an increased risk of congenital malformations associated with the use of minor tranquilizers chlordiazepoxide, diazepam, and meprobamate during the first trimester of pregnancy has been suggested in several studies.

Because the use of these drugs is rarely a matter of urgency, the use of lorazepam during this period should be avoided. The possibility that a woman of childbearing potential may be pregnant at the time of institution of therapy should be considered. Patients should be advised that if they become pregnant, they should communicate with their physician about the desirability of discontinuing the drug.

In humans, blood levels obtained from umbilical cord blood indicate placental transfer or lorazepam and lorazepam glucuronide. Infants of mothers who ingested benzodiazepines for several weeks or more preceding delivery have been reported to have withdrawal symptoms during the postnatal period. Symptoms such as hypoactivity, hypotonia, hypothermia, respiratory depression, apnea, feeding problems, and impaired metabolic response to cold stress have been reported in neonates born of mothers who have received benzodiazepines during the late phase of pregnancy or at delivery.

Lorazepam has been detected in human breast milk; therefore, it should not be administered to breast-feeding women, unless the expected benefit to the woman outweighs the potential risk to the infant.

Sedation and inability to suckle have occurred in neonates of lactating mothers taking benzodiazepines. Infants of lactating mothers should be observed for pharmacological effects including sedation and irritability. Clinical circumstances, some of which may be more common in the elderly, such as hepatic or renal impairment, should be considered.

Greater sensitivity e. Most adverse reactions to benzodiazepines, including CNS effects and respiratory depression, are dose dependent, with more severe effects occurring with high doses. In a sample of about patients treated for anxiety, the most frequent adverse reaction to lorazepam was sedation The incidence of sedation and unsteadiness increased with age. Small decreases in blood pressure and hypotension may occur but are usually not clinically significant, probably being related to the relief of anxiety produced by lorazepam.

Therefore, in the management of overdosage, it should be borne in mind that multiple agents may have been taken. Overdosage of benzodiazepines is usually manifested by varying degrees of CNS depression ranging from drowsiness to coma. In mild cases, symptoms include drowsiness, mental confusion, paradoxical reactions, dysarthria and lethargy.

In more serious cases, and especially when other drugs or alcohol were ingested, symptoms may include ataxia, hypotonia, hypotension, cardiovascular depression, respiratory depression, hypnotic state, coma, and death. General supportive and symptomatic measures are recommended; vital signs must be monitored and the patient closely observed. When there is a risk of aspiration, induction of emesis is not recommended.

Gastric lavage may be indicated if performed soon after ingestion or in symptomatic patients. Drug Name : Lorazepam Lorazepam Ativan generic is a benzodiazepine, prescribed for anxiety.

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Anxiety Disorder Anxiety disorder involves excessive worry about actual circumstances, events or conflicts. Munchausen Syndrome Hospital Addiction Syndrome, commonly known as Munchausen syndrome is a factitious mental condition in which the affected individual fakes an illness or self-inflicts injury in order to gain attention.

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What's New on Medindia. Search Drugs. Pharma Links. Medindia Newsletters. Subscribe to our Free Newsletters! Follow Us On :. View in Hindi. Biolar - 2. View Price. Lorivan 2 mg. Almazine 1mg. Almazine 2 mg. Almazine 2. Anxilor 2 mg. Anxilor 2 ml. Anxipose 1 mg. Anxipose 2 mg. Atipam 1 mg. Atipam 2 mg. Ativan 1mg. Ativan 2 mg. Ativan 2mg. Benj 2 mg. There are eleven drug master file entries for lorazepam.

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