chlorpheniramine and lorazepam both increase sedation. Modify Therapy/Monitor Closely. Withdrawal symptoms may sometimes last weeks to months. %Uc2rxRX8]:1D\l|@VaP$xGAaEd3& Possible risk of cardiorespiratory collapse. Minor/Significance Unknown. Clinical assessment is required prior to any changes in Modify Therapy/Monitor Closely. Either increases toxicity of the other by sedation. This information is not individual medical advice and does not substitute for the advice of your health care professional. Monitor Closely (1)cenobamate, lorazepam. These findings suggest that standardized benzodiazepine conversions successfully achieved consistent Withdrawal Assessment ToolVersion 1 scores compared with preconversion values. lorazepam and tramadol both increase sedation. cyproheptadine and lorazepam both increase sedation. HOW TO USE: See also Warning section.Read the Medication Guide provided by your pharmacist before you start taking lorazepam and each time you get a refill. Use Caution/Monitor. Use Caution/Monitor. Use Caution/Monitor. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Y1 - 2016/12/19/ Effect of interaction is not clear, use caution. If you take it once daily at bedtime and miss a dose, do not take it the following morning. Use Caution/Monitor. Let's practice it all with a small example: Take a closer look our equivalent benzodiazepine calculator gives you both generic (pharmaceutical) and brand names of all the drugs! Use Caution/Monitor. Manage and view all your plans together even plans in different states. Use lowest dose possible and monitor for respiratory depression and sedation. MEDICAL ALERT: Your condition can cause complications in a medical emergency. Both drugs can cause metabolic acidosis. In many, but not all of these cases, buprenorphine was misused by self-injection. Use Caution/Monitor. lorazepam and oxazepam both increase sedation. Official website of the Johns Hopkins Antibiotic (ABX), HIV, Diabetes, and Psychiatry Guides, powered by Unbound Medicine. Use Caution/Monitor. Use Caution/Monitor. Monitor Closely (1)lorazepam and clomipramine both increase sedation. WebMeasurements and Main Results: Withdrawal Assessment ToolVersion 1 scores were compared pre and post benzodiazepine conversion. Please enable scripts and reload this page. Modify Therapy/Monitor Closely. Risk of resp. lorazepam decreases levels of acetaminophen IV by increasing metabolism. Careers. Use Caution/Monitor. Monitor Closely (1)suvorexant and lorazepam both increase sedation. Chouinard G. Issues in the clinical use of benzodiazepines: potency, withdrawal, and rebound. Minor (1)lorazepam decreases levels of cyanocobalamin by inhibition of GI absorption. Minor/Significance Unknown. Minor/Significance Unknown. A Johns Hopkins Guides subscription is required to, Benzodiazepines act through the gamma-aminobutyric acid (GABA) A receptor, which regulates chloride entry into neurons, resulting in neuronal hyperpolarization. Use Caution/Monitor. Use Caution/Monitor. Monitor closely for signs of respiratory depression and sedation. :Bn,^&8~z~-_B Minor/Significance Unknown. Monitor Closely (1)lorazepam increases and epinephrine racemic decreases sedation. lorazepam and chlorpromazine both increase sedation. Use lowest dose possible and monitor for respiratory depression and sedation. lorazepam and oxymorphone both increase sedation. Effect of interaction is not clear, use caution. lorazepam and papaveretum both increase sedation. Monitor Closely (1)lorazepam and nabilone both increase sedation. Use Caution/Monitor. Monitor Closely (1)lorazepam and lormetazepam both increase sedation. Intravenous to Oral Conversion for Antimicrobials 1-20-6-1-010 Author(s): Antimicrobial Stewardship Program Coordinator Page 6 of 6 Issuing Authority: Vice President Medicine and Clinical Programs; Regional Director, Pharmacy Services PRECAUTIONS: Before taking lorazepam, tell your doctor or pharmacist if you are allergic to it; or to other benzodiazepines (such as alprazolam, clonazepam, diazepam); or if you have any other allergies. Monitor Closely (1)lorazepam and nortriptyline both increase sedation. Use Caution/Monitor. 1. Use Caution/Monitor. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects. E#]'h>B^L7a$$KAySOPs ,zKMH3 government site. Monitor Closely (1)lorazepam and papaverine both increase sedation. lorazepam and meperidine both increase sedation. Use Caution/Monitor. Modify Therapy/Monitor Closely. Monitor Closely (1)lorazepam and amitriptyline both increase sedation. Use Caution/Monitor. . Monitor Closely (1)lorazepam and levorphanol both increase sedation. Either increases effects of the other by sedation. Minor/Significance Unknown. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. lorazepam and iloperidone both increase sedation. lorazepam and trazodone both increase sedation. 2 0 obj This drug is available at a higher level co-pay. Your list will be saved and can be edited at any time. Monitor Closely (1)pentobarbital and lorazepam both increase sedation. levofloxacin increases levels of lorazepam by decreasing metabolism. 0000001350 00000 n Minor/Significance Unknown. Effect of interaction is not clear, use caution. There have been postmarketing reports of coma and death with coadministration of buprenorphine and benzodiazepines. Profound sedation, respiratory depression, coma, and death may result if coadministered. Monitor Closely (1)lorazepam and chlorpromazine both increase sedation. Johns Hopkins Guide App for iOS, iPhone, iPad, and Android included. DRUG INTERACTIONS: See also Warning section.Drug interactions may change how your medications work or increase your risk for serious side effects. Minor/Significance Unknown. lorazepam, calcium/magnesium/potassium/sodium oxybates. Use Caution/Monitor. %PDF-1.6 % Monitor Closely (1)lorazepam and fluphenazine both increase sedation. <>>> Step 1- Starting dose of lorazepam PO q6h x8 doses (see above calculation) 2. Monitor Closely (1)lorazepam increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Monitor Closely (1)lorazepam and pimozide both increase sedation. See also Drug Interactions section. DB - Johns Hopkins Guides Use Caution/Monitor. Use Caution/Monitor. diazepam , lorazepam , midazolam , pediatric intensive care units , quality improvement , therapeutic equivalency. NCI CPTC Antibody Characterization Program. Modify Therapy/Monitor Closely. Effect of interaction is not clear, use caution. Use Caution/Monitor. Most lorazepam increases and pirbuterol decreases sedation. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Consult your doctor before breast-feeding. Avoid or Use Alternate Drug. Monitor Closely (1)lorazepam and lofepramine both increase sedation. Monitor Closely (1)lorazepam and risperidone both increase sedation. Monitor Closely (1)lorazepam and oxycodone both increase sedation. Use Caution/Monitor. Monitor closely for signs of respiratory depression and sedation. Effect of interaction is not clear, use caution. Monitor Closely (1)lorazepam increases and albuterol decreases sedation. Use Caution/Monitor. Effect of interaction is not clear, use caution. Limit dosages and durations to the minimum required. je 8&K`Y/ o *C'lvpeKBg6CK pIE-azD-`[\s2q&o|in(J|6iT1t>aRkDXs(z%7;PS d\c1"4S#8jk*TR78IgnR(kv Patient demographics, lorazepam decreases levels of biotin by unspecified interaction mechanism. alprazolam and lorazepam both increase sedation. propofol and lorazepam both increase sedation. midazolam intranasal, lorazepam. Monitor for drug toxiticities when initiating or discontinuing methylphenidate. Monitor Closely (1)lorazepam and desipramine both increase sedation. Excreted primary by kidneys and some via feces, Oxazepam: Metabolized by the liver and excreted primary by kidneys. H\TKoAqs;O Use Caution/Monitor. h>1rFv!J ` ,J P^ v V "stX^4(PFpT@D (h.=_)h29N= Avoid or Use Alternate Drug. lorazepam and opium tincture both increase sedation. Setting: Use Caution/Monitor. WebBenzodiazepine Dose and Route Equivalence Diazepam 10mg PO/PR 2.5mg subcut midazolam Clonazepam 1mg PO/SC Lorazepam 1mg PO/IV Oxazepam 15 to 30mg PO Temazepam 10mg PO Midazolam Nasal Spray 5 sprays (=2.5mg) Example: A patient has been taking 1 mg lorazepam PO (equivalent to 2.5 mg subcut midazolam) + used Use Caution/Monitor. Use Caution/Monitor. Use Caution/Monitor. Monitor Closely (1)dichlorphenamide, lorazepam. 0000000856 00000 n Monitor Closely (1)lorazepam increases and modafinil decreases sedation. WebLorazepam (PO/IV): 0.025 - 0.1 mg/kg/dose (Max: 2 mg) Q4-6 Midazolam (PO) 0.25 - 0.5 mg/kg/dose (Max: 20 mg) PRN Voriconazole (IV/PO) 2 - 12 yo: 9 mg/kg/dose x 2 doses then 8 -9 mg/kg/dose Q12 12 yo: 6 mg/kg/dose x 2 doses then 3 - Risk for sedation increased if flibanserin is coadministration with other CNS depressants. Use Caution/Monitor. 0000005452 00000 n Effect of interaction is not clear, use caution. Profound sedation, respiratory depression, coma, and death may result if coadministered. Monitor Closely (1)dexchlorpheniramine and lorazepam both increase sedation. Use Caution/Monitor. Avoid or Use Alternate Drug. lorazepam and midazolam both increase sedation. and transmitted securely. hyaluronidase, lorazepam. 4 0 obj Monitor Closely (1)lorazepam increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Other (see comment). Use Caution/Monitor. C. The pharmacist must enter Epic order comments stating IV to PO Conversion per P&T policy for all interchanged orders. Minor/Significance Unknown. metronidazole). Serious - Use Alternative (1)lorazepam and olopatadine intranasal both increase sedation. Enhanced metabolism incr levels of hepatotoxic metabolites. Monitor Closely (1)lorazepam and amoxapine both increase sedation. An official website of the United States government. Use Caution/Monitor. Monitor Closely (1)lorazepam and morphine both increase sedation. Monitor Closely (1)lorazepam and scullcap both increase sedation. lorazepam and clozapine both increase sedation. Use Caution/Monitor. WebIV to PO Pharmacy Conversion Protocol Inclusion Criteria for IV to PO Conversion: Infections that Require IV Antibiotics Must satisfy below criteria: Tolerate oral diet or Measurements and main results: acrivastine and lorazepam both increase sedation. If WAT-1 score still 3* and assessment consistent with withdrawal, give lorazepam 0.05-0.1 mg/kg (max 4 mg) IV x1. Use Caution/Monitor. Use Caution/Monitor. Use Caution/Monitor. lorazepam increases and levalbuterol decreases sedation. <> Although beneficial for the acute relief of anxiety, long-term use of benzodiazepines is not recommended due to the risk of dependence. Monitor Closely (1)lorazepam and thioridazine both increase sedation. Drug Usual IV Dose* Approximate PO Dose* PO to IV Considerations/Comments Reference digoxin 0.1 -0.4 mg IV Q 24 H 0.125 -0.5 mg PO Q 24 H Oral bioavailability about 80% for tablets and liquid 1,2 dimenhyDRINATE 25-50 mg IV 25-50 mg PO Conversion of IV to PO is 1:1 Monitor Closely (2)lorazepam, loxapine inhaled. unspecified interaction mechanism. lorazepam and buprenorphine buccal both increase sedation. Benzodiazepine exposure in pregnancy and risk of major malformations: a critical overview. Minor (1)lorazepam decreases effects of onabotulinumtoxinA by pharmacodynamic antagonism. Monitor Closely (1)flurazepam and lorazepam both increase sedation. Monitor Closely (1)lorazepam and maprotiline both increase sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. gabapentin, lorazepam. lorazepam and triazolam both increase sedation. Modify Therapy/Monitor Closely. Use Caution/Monitor. @`qhGH[ 4XI3`` ) `uo$!%XvJ8K*21``HbdztiFO#11fe8i'":R u Patient demographics, Taking this medication with alcohol or other drugs that can cause drowsiness or breathing problems (especially opioid medications such as codeine, hydrocodone) may cause very serious side effects, including death. ", Kim, P. M., & Weinstein, S. L. (2016). If used, choose an agent with a shorter half-life. Monitor Closely (1)lorazepam increases and xylometazoline decreases sedation. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics. dosing with pediatric epilepsy staff IV formulation under FDA review, expected 2021 Phenytoin (IV) is non-formulary Administer same total daily dose divided Monitor Closely (1)lorazepam increases and armodafinil decreases sedation. Monitor Closely (1)lorazepam and chloral hydrate both increase sedation. Monitor Closely (1)lorazepam and prochlorperazine both increase sedation. Clinical pharmacokinetics of alprazolam. ewJ;1pRO&+ You can read the full text of this article if you: For resources related to this guideline, please visit the Use Caution/Monitor. Modify Therapy/Monitor Closely. 0000001594 00000 n Use Caution/Monitor. In: * Article titles in AMA citation format should be in sentence-case, You can cancel anytime within the 30-day trial, or continue using Johns Hopkins Guides to begin a 1-year subscription ($39.95). An IM dose of 10 mg can be administered every 4 hours if needed for alcohol withdrawal. Cessation of benzodiazepines or other CNS depressants is preferred in most cases. STORAGE: Store at room temperature away from light and moisture. WebTo make simple unit conversions, select the starting units with the pull-down selector on the right. Use Caution/Monitor. Use Caution/Monitor. WebLorazepam (Ativan ): Dosing (Adults): Anxiety/sedation: 1-10 mg orally in 2-3 divided doses. diazepam and lorazepam both increase sedation. RN2NpN )lbV 3: (KF Use Caution/Monitor. Comment: Drug combination has been found to be incompatible. Either increases toxicity of the other by pharmacodynamic synergism. Benzodiazepines may be beneficial for long-term use in refractory cases. Monitor Closely (1)sevelamer decreases levels of lorazepam by increasing elimination. Minor (1)omeprazole increases levels of lorazepam by decreasing metabolism. Minor/Significance Unknown. This drug works by enhancing the effects of a certain natural chemical in the body (GABA). Use Caution/Monitor. Use Caution/Monitor. Coadministration may potentiate the CNS-depressant effects of each drug. Use Caution/Monitor. Monitor Closely (1)lorazepam increases and isoproterenol decreases sedation. Use Caution/Monitor. Use Caution/Monitor. lorazepam and aripiprazole both increase sedation. Use Caution/Monitor. You may report side effects to Health Canada at 1-866-234-2345. Oxazepam (Serax): the initial dose is 10-15 mg daily; the dose can be increased by 10 mg daily in divided doses (three times a day); the usual therapeutic dose is 90 mg total/day, with three times a day dosing. Minor (1)brimonidine increases effects of lorazepam by pharmacodynamic synergism. lorazepam decreases levels of cyanocobalamin by inhibition of GI absorption. lorazepam increases and dexfenfluramine decreases sedation. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. The dosage is based on your medical condition, age, and response to treatment.If directed by your doctor, use this medication regularly in order to get the most benefit from it. Use Caution/Monitor.lorazepam, loxapine. Use Caution/Monitor. Use Caution/Monitor. Monitor Closely (1)lorazepam increases and phentermine decreases sedation. Use Caution/Monitor. Alprazolam: No dose adjustment is needed; increase as needed/tolerated, Chlordiazepoxide: Decrease the usual dose by 50%, Clonazepam: No dose adjustment is needed; increase as needed/tolerated, Diazepam: Use 2 mg daily initially, and increase as needed/tolerated, Lorazepam: Use an initial dose of 1 mg/day in divided doses, and increase as needed/tolerated, Oxazepam: The maximum dose is 45-60 mg total/day, in divided doses, Chlordiazepoxide: Patients with renal impairment (CrCl less than 10 mL/min) should have their doses decreased by 50%, Diazepam: No dose adjustment is needed; increase as needed/tolerated, Lorazepam: No dose adjustment is needed for mild-to-moderate renal impairment; not recommended for patients with renal failure, Oxazepam: No dose adjustment is needed; increase as needed/tolerated, Chlordiazepoxide: The maximum dose is 20 mg total/day, Lorazepam: No dose adjustment is needed for mild-to-moderate liver impairment; not recommended for patients with hepatic failure, Benzodiazepines are category D drugs, primarily due to concerns with cleft lip/palate and urogenital and neurological malformations; however, recent literature does not show an increased risk of these, When possible, avoid use during the first trimester, Minimize use; i.e., reserve for PRN use if possible, Weigh the benefit vs. the risk of continued therapy; if necessary, consider an agent with a short half-life, and use sparingly and intermittently, Consider initiating and/or maintaining patients on an antidepressant agent. Biotin supplementation may be necessary. Indicated for management of anxiety disorders or for the short-term relief of symptoms of anxiety or anxiety associated with depressive symptoms, Anxiety or tension associated with stress of everyday life usually does not require treatment with an anxiolytic, Efficacy in long-term use (ie, >4 months), has not been assessed by systematic clinical studies, 0.05 mg/kg IM for 1 dose; 2 hours before surgery; not to exceed 4 mg (2 mg/dose in elderly), OR, 0.044 mg/kg IV for 1 dose; 15-20 minutes before surgery; not to exceed 4 mg (2 mg/dose in elderly), If seizure persists after 5-10 min, administer 4 mg IV again, Periodically reassess the usefulness for individual patients, IV: Monitor respirations q5-15min and before each repeated IV dose, Infants and children: 0.05-0.1 mg/kg IV over 2-5 minutes; not to exceed 4 mg/dose; may repeat q10-15min PRN, Alternatively, 0.1 mg/kg at slow IV rate not to exceed rate of 2 mg/min; not to exceed dose of 4 mg, Adolescents: 4 mg slow IV; if seizure persists after 10-15 minutes, administer 4 mg IV again, Children: 0.05 mg/kg/dose PO q4-8hr; not to exceed 2 mg/dose, Children >2 years: 0.025-0.05 mg/kg/dose IV q6hr PRN; not to exceed 2 mg/dose, Preferred agent in elderly because short-acting and has inactive metabolite, Lower initial dose recommended; 1-2 mg PO divided q8-12hr, Lower initial dose recommended; 0.5-1 mg PO qHS, increase PRN, To avoid oversedation, initial daily dose should not exceed 2 mg, When higher dose indicated, increase evening dose before daytime doses. depression, hypotension. Use Caution/Monitor. Use Caution/Monitor. 2001 Aug;95(2):286-98. doi: 10.1097/00000542-200108000-00007. lasmiditan, lorazepam. A1 - Kim,Paul,M.D., Ph.D. Tell your doctor or pharmacist if you are taking other products such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), other drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. lorazepam and clomipramine both increase sedation. Use Caution/Monitor. Serious - Use Alternative (1)lorazepam, metoclopramide intranasal. 0000003285 00000 n Use Caution/Monitor. Use Caution/Monitor. xref Adding plans allows you to compare formulary status to other drugs in the same class. Monitor Closely (1)lorazepam increases and dexmethylphenidate decreases sedation. esomeprazole increases levels of lorazepam by decreasing metabolism. lorazepam decreases levels of acetaminophen rectal by increasing metabolism. This product may contain inactive ingredients, which can cause allergic reactions or other problems. We'll also compare some of the most popular anxiolytic medicines (drugs reducing anxiety), their side effects, and their applications. Either increases effects of the other by sedation. lorazepam and scullcap both increase sedation. Minor (1)gemifloxacin increases levels of lorazepam by decreasing metabolism. lorazepam and nalbuphine both increase sedation. Use Caution/Monitor. The above information is provided for general Benzodiazepines. Use Caution/Monitor. Monitor Closely (1)lorazepam increases toxicity of buprenorphine subdermal implant by pharmacodynamic synergism. Monitor Closely (1)lorazepam increases toxicity of buprenorphine, long-acting injection by pharmacodynamic synergism. Either increases effects of the other by pharmacodynamic synergism. Monitor Closely (1)lorazepam and oxymorphone both increase sedation. lorazepam increases and dextroamphetamine decreases sedation. Use Caution/Monitor. Either increases effects of the other by pharmacodynamic synergism. Profound sedation, respiratory depression, coma, and death may result if coadministered. Monitor Closely (1)lorazepam and iloperidone both increase sedation. triprolidine and lorazepam both increase sedation. to maintaining your privacy and will not share your personal information without Use Caution/Monitor. dexchlorpheniramine and lorazepam both increase sedation. WebPO 7.5 mg Levorphanol 6-8 h 12-16 h IM/IV/SC 2 mg PO 4 mg Meperidine : 2-4 h 3-4 h IM/IV/SC 75 mg PO 300 mg Methadone 4-6 h 15-30 h IM/IV/SC 1-10 mg Medline Short term: 5-10mg Chronic use: 1-4 mg (2 mg) PO 2 - 20 mg Medline Short term use: 20 mg Chronic dosing: 2-4 mg (3mg) Morphine 3-6 h 1.5-3 h IM/IV/SC 10 mg PO Either increases effects of the other by pharmacodynamic synergism. Benzodiazepine and alcohol can have a synergistic interaction, leading to CNS depression and death. Profound sedation, respiratory depression, coma, and death may result if coadministered. Use Caution/Monitor. Monitor Closely (1)lorazepam increases and phenylephrine PO decreases sedation. has gotten 1 dose of IV azithro, (because of its HUGE Vd and Long T), switch to oral therapy at same dose is OK. Chlorothiazide Doxycycline BZ&Ap^b?UC@60ak Minor/Significance Unknown. lorazepam and diamorphine both increase sedation. Minor/Significance Unknown. 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Obj this drug works by enhancing the effects of a certain natural chemical in the body ( GABA ) order... Be necessary if lemborexant is coadministered with other CNS depressants can result in serious, life-threatening, and their.. Life-Threatening, and death with coadministration of lasmiditan and other CNS depressants result! Of a certain natural chemical in the clinical use of benzodiazepines is not clear use. 2001 Aug ; 95 ( 2 ):286-98. doi: 10.1097/00000542-200108000-00007 Android included we 'll also compare some the! Individual medical advice and does not substitute for the advice of your health care professional interaction, to... To compare formulary status to other drugs in the same class dexmethylphenidate decreases sedation together even in! 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