Lorazepam
Status epilepticus, Acute agitation, Alcohol withdrawal, Anxiolysis
Indications
- Status epilepticus
- Acute agitation
- Alcohol withdrawal
- Anxiolysis
Adult dosing
- seizure: dose: 4; unit: mg; route: IV; interval: may repeat x1 in 5-10min; fixed: true; agitation: dose: 2; unit: mg; route: IV/IM; interval: q30-60min PRN; fixed: true; alcohol withdrawal: dose: 2; unit: mg; route: IV; interval: q15-30min titrate to CIWA; fixed: true
Pediatric dosing
- seizure: dose: 0.1; unit: mg/kg; maxDose: 4; maxDoseAbsolute: true; route: IV; weightBased: true; anxiolysis: dose: 0.05; unit: mg/kg; maxDose: 2; maxDoseAbsolute: true; route: IV; weightBased: true
Contraindications
- Acute narrow-angle glaucoma
- Severe respiratory depression (without ventilatory support)
Clinical pearls
- First-line IV benzodiazepine for status epilepticus — lorazepam 4mg IV
- No active metabolites — preferred benzodiazepine in hepatic impairment
- IM absorption more reliable than diazepam IM
Source and review
- Neurocritical Care Society Status Epilepticus Guidelines 2012. Last reviewed: 2024-10-01