Adverse Side Effects

Drowsiness is the most frequently reported adverse effect. Other reported adverse effects are dizziness, weakness, fatigue and lethargy, disorientation, ataxia, anterograde amnesia, nausea, change in appetite, change in weight, depression, blurred vision and diplopia, psychomotor agitation, sleep disturbance, vomiting, sexual disturbance, headache, skin rashes, gastrointestinal, ear, nose and throat, musculoskeletal and respiratory disturbances. Release of hostility and other paradoxical effects, such as irritability and excitability have occurred with benzodiazepines. In addition, hypotension, mental confusion, slurred speech, oversedation and abnormal liver and kidney function tests and hematocrit values have been reported with these drugs.

The most frequent adverse effects seen with injectable lorazepam are an extension of the CNS depressant effects of the drug. Excessive sleepiness and drowsiness are the main side effects: the incidences reported depended on the dosage, route of administration, concomitant use of other CNS depressants and the investigators' expectations concerning the degree and duration of sedation. When injectable lorazepam was given i.v., patients over 50 years of age had a higher incidence of excessive sedation than patients under 50 years of age. Restlessness, confusion, depression, crying, sobbing, delerium, hallucinations, dizziness, diplopia have been reported. Hypertension and hypotension have occasionally been observed after injectable lorazepam.

Respiratory depression and partial airway obstruction have been observed after injectable lorazepam. Skin rash, nausea and vomiting have been noted occasionally in patients who have received injectable lorazepam combined with other drugs during anesthesia and surgery.

Overdose

With benzodiazepines, including lorazepam, symptoms of mild overdosage include drowsiness, mental confusion and lethargy. In more serious overdosage, symptoms may include ataxia, hypotonia, hypotension, hypnosis, stages I to III coma and, very rarely, death. In the case of an oral overdose, if vomiting has not occurred spontaneously and the patient is fully awake, it may be induced with 20 to 30 mL of ipecac syrup USP. Institute gastric lavage as soon as possible, and introduce 50 to 100 g of activated charcoal to the stomach and allow it to remain there. Institute general supportive therapy as indicated.