Lorazepam
Ativan ® |
| Usual
Diluents |
| D5W,
NS |
| Standard
Dilutions [Amount of drug]
[Infusion volume] [Infusion rate] |
Dilute
2 mg/ml (10 ml vials) or 4 mg/ml (10 ml) vials 1:1
with D5W or NS. May add to viaflex bag.
Alternatively: Glass bottle: 40 mg/250 ml (250ml
D5W). Infusion Rate: As directed. (See comments).
Primary:
Dilution for 2 mg/ml - 10 ml vials.
= Final Concentration 1 mg/ml ==
20 mg/20 ml (10 ml diluent + 10ml of drug)
Total volume =20ml.
40 mg/ 40 ml (20 ml diluent + 20ml of drug)
Total volume =40ml.
80 mg/ 80 ml (40 ml diluent + 40ml of drug)
Total volume =80ml. |
|
| Stability
/ Miscellaneous |
EXP: 1
DAY (RT)
Label: Do not Refrigerate /An in-line 0.22u filter
should be used.
Concentrations recommended by the manufacturer:
0.1 , 0.16, or 0.2 mg/ml.
May also dilute 4 mg/ml and 2 mg/ml vials 1:1 with
D5W or NS.
Do not send if solution is yellow or contains a
precipitate.
Maximum infusion rate: 2 mg/min.
Maximum dose/day: 480 mg (20 mg/hr).
Dosing: Status epilepticus: 4 mg IV push (range: 2
to 8 mg).
May repeat q5 to 15 minutes.
Monitor patient for acidosis.
DOSAGE AND ADMINISTRATION
ATIVAN must never be used without
individualization of dosage particularly when used
with other medications capable of producing
central-nervous-system depression.
EQUIPMENT NECESSARY TO MAINTAIN A PATENT AIRWAY
SHOULD BE IMMEDIATELY AVAILABLE PRIOR TO
INTRAVENOUS ADMINISTRATION OF LORAZEPAM (see
package insert for WARNINGS).
Status Epilepticus
Intravenous Injection
For the treatment of status epilepticus, the usual
recommended dose of ATIVAN Injection is 4 mg given
slowly (2 mg/min) for patients 18 years and older.
If seizures cease, no additional ATIVAN Injection
is required. If seizures continue or recur after a
10- to 15-minute observation period, an additional
4 mg intravenous dose may be slowly administered.
Experience with further doses of ATIVAN is very
limited. The usual precautions in treating status
epilepticus should be employed. An intravenous
infusion should be started, vital signs should be
monitored, an unobstructed airway should be
maintained, and artificial ventilation equipment
should be available.
Intramuscular Injection
IM ATIVAN is not preferred in the treatment of
status epilepticus because therapeutic lorazepam
levels may not be reached as quickly as with IV
administration. However, when an intravenous port
is not available, the IM route may prove useful.
Pediatric
The safety of ATIVAN in pediatric patients has not
been established.
Preanesthetic
Intramuscular Injection
For the designated indications as a premedicant,
the usual recommended dose of lorazepam for
intramuscular injection is 0.05 mg/kg up to a
maximum of 4 mg. As with all premedicant drugs,
the dose should be individualized. Doses of other
central-nervous-system-depressant drugs ordinarily
should be reduced. For optimum effect, measured as
lack of recall, intramuscular lorazepam should be
administered at least 2 hours before the
anticipated operative procedure. Narcotic
analgesics should be administered at their usual
preoperative time.
There are insufficient data to support efficacy or
make dosage recommendations for intramuscular
lorazepam in patients less than 18 years of age;
therefore, such use is not recommended.
Intravenous Injection
For the primary purpose of sedation and relief of
anxiety, the usual recommended initial dose of
lorazepam for intravenous injection is 2 mg total,
or 0.02 mg/lb (0.044 mg/kg), whichever is smaller.
This dose will suffice for sedating most adult
patients and ordinarily should not be exceeded in
patients over 50 years of age. In those patients
in whom a greater likelihood of lack of recall for
perioperative events would be beneficial, larger
doses as high as 0.05 mg/kg up to a total of 4 mg
may be administered. Doses of other injectable
central-nervous-system-depressant drugs ordinarily
should be reduced. For optimum effect, measured as
lack of recall, intravenous lorazepam should be
administered 15 to 20 minutes before the
anticipated operative procedure.
There are insufficient data to support efficacy or
make dosage recommendations for intravenous
lorazepam in patients less than 18 years of age;
therefore, such use is not recommended.
Dose Administration in Special Populations
Elderly Patients and Patients With Hepatic
Disease
No dosage adjustments are needed in elderly
patients and in patients with hepatic disease.
Patients With Renal Disease
For acute dose administration, adjustment is not
needed for patients with renal disease. However,
in patients with renal disease, caution should be
exercised if frequent doses are given over
relatively short periods of time.
Administration
When given intramuscularly, ATIVAN Injection,
undiluted, should be injected deep in the muscle
mass.
Injectable ATIVAN can be used with atropine
sulfate, narcotic analgesics, other parenterally
used analgesics, commonly used anesthetics, and
muscle relaxants.
Immediately prior to intravenous use, ATIVAN
Injection must be diluted with an equal volume of
compatible solution. Contents should be mixed
thoroughly by gently inverting the container
repeatedly until a homogenous solution results. Do
not shake vigorously, as this will result in air
entrapment. When properly diluted, the drug may be
injected directly into a vein or into the tubing
of an existing intravenous infusion. The
rate of injection should not exceed 2.0 mg per
minute.
Parenteral drug products should be inspected
visually for particulate matter and discoloration
prior to administration, whenever solution and
container permit. Do not use if solution is
discolored or contains a precipitate.
ATIVAN Injection is compatible for dilution
purposes with the following solutions: Sterile
Water for Injection, USP; Sodium Chloride
Injection, USP; 5% Dextrose Injection, USP.
HOW SUPPLIED
ATIVAN (lorazepam) Injection is available in the
following dosage strengths in single-dose and
multiple-dose vials:
2 mg per mL,NDC 60977-112-01, 25 x 1 mL vial
NDC 60977-112-02, 10 x 10 mL vial
4 mg per mL,NDC 60977-113-01, 25 x 1 mL vial
NDC 60977-113-02, 10 x 10 mL vial
For IM or IV injection.
Store in a refrigerator.
PROTECT FROM LIGHT.
Use carton to protect contents from light.
ATIVAN is a trademark of Biovail Laboratories,
Ltd.
Manufactured by
Baxter Healthcare Corporation
Deerfield, IL 60015 USA
For Product Inquiry 1 800 ANA DRUG
(1-800-262-3784)
MLT-01086/1.0
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