Lorazepam (Ativan ®)
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Standard Dilutions [Amount of drug] [Infusion volume] [Infusion rate]
| Dilute 2 mg/ml (10 ml vials) or 4 mg/ml (10 ml) vials 1:1 with D5W or NS. May add to viaflex bag.
Alternatively: Glass bottle: 40 mg/250 ml (250ml D5W). Infusion Rate: As directed. (See comments).
Stability / Miscellaneous
Concentrations recommended by the manufacturer: 0.1 , 0.16, or 0.2 mg/ml.
Note: high dose infusions (>8-10 mg/hr) that are infused for extended periods (>24 hours) have been associated with nephrotoxcity (reversible acute tubular necrosis) and/or osmolar gap metabolic acidosis due to the presence of the polyethylene glycol and propylene glycol solvents in solution. The recommended IV infusion dose (continuous) for critically ill adults: 0.01 to 0.1 mg/kg/hr IV. Patients should be monitored closely for possible acidosis.
Dosing: Status epilepticus: 4 mg IV push (range: 2 to 8 mg).
DOSAGE AND ADMINISTRATION
EQUIPMENT NECESSARY TO MAINTAIN A PATENT AIRWAY SHOULD BE IMMEDIATELY AVAILABLE PRIOR TO INTRAVENOUS ADMINISTRATION OF LORAZEPAM (see package insert for WARNINGS).
There are insufficient data to support efficacy or make dosage recommendations for intramuscular lorazepam in patients less than 18 years of age; therefore, such use is not recommended.
There are insufficient data to support efficacy or make dosage recommendations for intravenous lorazepam in patients less than 18 years of age; therefore, such use is not recommended.
Dose Administration in Special Populations
Patients With Renal Disease
Injectable ATIVAN can be used with atropine sulfate, narcotic analgesics, other parenterally used analgesics, commonly used anesthetics, and muscle relaxants.
Immediately prior to intravenous use, ATIVAN Injection must be diluted with an equal volume of compatible solution. Contents should be mixed thoroughly by gently inverting the container repeatedly until a homogenous solution results. Do not shake vigorously, as this will result in air entrapment. When properly diluted, the drug may be injected directly into a vein or into the tubing of an existing intravenous infusion. The rate of injection should not exceed 2.0 mg per minute.
Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. Do not use if solution is discolored or contains a precipitate.
ATIVAN Injection is compatible for dilution purposes with the following solutions: Sterile Water for Injection, USP; Sodium Chloride Injection, USP; 5% Dextrose Injection, USP.
2 mg per mL,NDC 60977-112-01, 25 x 1 mL vial
4 mg per mL,NDC 60977-113-01, 25 x 1 mL vial
For IM or IV injection.
ATIVAN is a trademark of Biovail Laboratories, Ltd.
Source: [package insert]