LORazepam

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:
  1. Draw up 0.5 mL of a 4 mg/mL solution
  2. 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