General Toxicity Notes
May cause excessive sedation and encephalopathy in ESRD.
Excreted Unchanged %
Hepatic
Half-Life (Normalesrd) Hours
5-10/32-70
Plasma Protein Binding %
87
Volume Of Distribution L/Kg
0.9-1.3
Dose For Normal Renal Function
1-2 mg q8-12h
Adjustment For Renal Failure Method
D
Adjustment For Renal Failure Gfr, Ml/Min >50 [Recommended Level]
100% [A]
Adjustment For Renal Failure Gfr, Ml/Min 10-50 [Recommended Level]
100% [A]
Adjustment For Renal Failure Gfr, Ml/Min <10 [Recommended Level]
100% [A]
Supplement For Dialysis [Recommendation Level]: Ihd
IHD: None, [B]
Supplement For Dialysis [Recommendation Level]: Pd
PD: None, [D]
Supplement For Dialysis [Recommendation Level]: Crrt
CRRT: Dose for GFR 10-50, titrate, [B]
References
Gaudreault P, Guay J, Thivierge RL, Verdy I. Benzodiazepine poisoning. Clinical and pharmacological considerations and treatment. Drug Saf. 1991; 6: 247-65. [PMID: 1888441] / Greenblatt DJ. Benzodiazepine hypnotics: sorting the pharmacokinetic facts. J Clin Psychiatry. 1991; 52 Suppl: 4-10. [PMID: 1680125] / Greenblatt DJ. Pharmacokinetics and pharmacodynamics. Hosp Pract (Off Ed). 1990; 25 Suppl 2: 9-15; discussion 16-8. [PMID: 2114417] / Greenblatt DJ, Ehrenberg BL, Gunderman J, Scavone JM, Tai NT, Harmatz JS, et al. Kinetic and dynamic study of intravenous lorazepam: comparison with intravenous diazepam. J Pharmacol Exp Ther. 1989; 250: 134-40. [PMID: 2746493] / Greenblatt DJ, Harmatz JS, Dorsey C, Shader RI. Comparative single-dose kinetics and dynamics of lorazepam, alprazolam, prazepam, and placebo. Clin Pharmacol Ther. 1988; 44: 326-34. [PMID: 3138056] / Swart EL, de Jongh J, Zuideveld KP, Danhof M, Thijs LG, Strack van Schijndel RJ. Population pharmacokinetics of lorazepam and midazolam and their metabolites in intensive care patients on continuous venovenous hemofiltration. Am J Kidney Dis. 2005; 45: 360-71. [PMID: 15685515] / Treiman DM. Pharmacokinetics and clinical use of benzodiazepines in the management of status epilepticus. Epilepsia. 1989; 30 Suppl 2: S4-10. [PMID: 2670537]