Disclaimer to the Online Edition
This Manual has been designed for use in the NICU at London Health Sciences Centre (LHSC), London, Ontario, Canada, and represents clinical practice at this institution. The information contained within the Manual may not be applicable to other centres. If users of this Manual are not familiar with a drug, it is recommended that the official monograph be consulted before it is prescribed and administered. Any user of this information is advised that the contributors, Editor and LHSC are not responsible for any errors or omissions, and / or any consequences arising from the use of the information in this Manual.
LORazepam
Indication
- Treatment of neonatal seizures as an adjunct to PHENobarbital in certain situations
- Sedation
Dosage Guidelines
- Seizures: 0.05-1 mg/kg/dose IV/rectal; May repeat in 10 to 15 minutes x 1 dose if needed (Maximum 4 mg/dose)
- Sedation: 0.02-0.05 mg/kg/dose IV/IM/rectal/ORAL/SL q4-6 hours
- Palliative Care: 0.1 mg/kg/dose ORAL q4 hours prn for agitation
Administration
- ORAL/SL
- IM: Injection may be administered undiluted
- IV direct over 3 to 5 minutes
- Must be diluted prior to IV administration
- To make 5 mL of a 0.4 mg/mL solution for IV/rectal use:
- Draw up 0.5 mL of a 4 mg/mL solution
- Add 4.5 mL sterile water for injection to make a total volume of 5 mL
Adverse Effects
- Respiratory depression, hypotonia, sedation, hypotension
- Discontinue if paradoxical CNS stimulation occurs
- May increase liver enzymes with long-term use
Comments
- Onset of action: 5 to 10 minutes (IV), 15 to 30 minutes (IM), 60 minutes (ORAL)
- Duration of action: 3 to 24 hours
- PHENobarbital serum concentrations may increase after LORazepam administration
Supplied As
- 4 mg/mL, 1 mL ampoule (refrigerated)
- 1 mg/mL oral suspension
References
LexiComp Sick Kids. Neofax