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Patients should be closely monitored for respiratory depression and hypotensive effects.
With normal sized doses, it is normally 6 to 12 hours, but a larger dose will cause more marked drug effects and longer duration of action. It should not be prescribed for this use on an outpatient basis, since it interacts strongly with alcohol and this particular patient group would be in danger of an interaction between lorazepam and large amounts of alcohol.
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Lorazepam is metabolised in the liver, by conjugation, into lorazepam glucuronide which is excreted in the urine. An oral dose of 2mg lorazepam will result in a total serum lorazepam level of around 20nanograms/ml, half of which is lorazepam and half its inactive metabolite, lorazepam glucuronide.
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Lorazepam belongs to the Food and Drug Administration pregnancy category D which means that it is likely to cause harm to the unborn baby.
It is also available as a parenteral patch. Safety and effectiveness of lorazepam is not well determined in children under 18 years of age, but it is used to treat serial seizures. A single acute dose of lorazepam therefore has longer duration of peak effects than an equivalent single acute dose of diazepam, even though diazepam has both a longer half-life and an active metabolite with even longer half-life. After injections of lorazepam a patient should normally not be released from hospital settings without a care-giving person before 24 hours have elapsed, due to variable residual effects like sleepiness, vertigo, hypotension, etc.
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