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Lorazepam

By Rania Gollakner, BS, DVM, MPH

Medications

What is lorazepam?

Lorazepam (brand names: Ativan®, Lorazepam Intensol®) is a benzodiazepine medication used to treat behavior problems such as anxiety, fears, and phobias. It can also be used to treat seizures or to stimulate appetite in cats.

Its use in cats and dogs to treat seizures or behavior problems is ‘off label’ or ‘extra label’. Many drugs are commonly prescribed for off label use in veterinary medicine. In these instances, follow your veterinarian’s directions and cautions very carefully as their directions may be significantly different from those on the label.

How is lorazepam given?

Lorazepam is given by mouth in the form of a tablet or liquid. It can also be given as an injection in the hospital setting. It may be given with or without food, however, if vomiting occurs when dosed on an empty stomach, give future doses with food. Tablets will dissolve quickly in the mouth, so if pilling is difficult, place the pill in the check followed by a treat a minute later to facilitate swallowing. Measure liquid forms carefully.

When using for behavioral triggers, give this medication about an hour prior to the triggering event. Do not leave your pet unattended the first time this medication is used and monitor your pet for side effects. If using long-term, do not stop this medication abruptly or rebound effects may occur.

This medication should take effect within 1 to 2 days, and improvements in clinical signs should follow.

What if I miss giving my pet the medication?

Give the missed dose as soon as you remember, and then wait the recommended amount of time between doses. Never give your pet two doses at once or give extra doses.

Are there any potential side effects?

Side effects include sleepiness, muscle weakness, incoordination, increased appetite (cats), drooling, aggressive or unusual behavior, increased activity or anxiety, and vocalization. Serious side effects include yellowing of the skin, gums, or eyes. In cats, serious side effects include lack of appetite or depression.

This short-acting medication should stop working within 24 hours, although effects can be longer in pets with liver or kidney disease. Do not stop this medication abruptly or rebound effects may occur.

Are there any risk factors for this medication?

Lorazepam should not be used in pets that are allergic to it or other benzodiazepines. Do not use in pets with severe breathing problems or liver disease. Do not stop this medication abruptly or rebound effects may occur. It should be used cautiously in pets that are pregnant or lactating. Use lorazepam cautiously in pets with kidney disease, glaucoma, debilitated or geriatric pets, or in working dogs.

Are there any drug interactions I should be aware of?

The following medications should be used with caution when given with lorazepam: amiodarone, antacids, antihypertensive agents, carbonic anhydrase inhibitors, central nervous system depressant agents, digoxin, fluoxetine, fluvoxamine, hepatic enzyme inducers or inhibitors, ifosfamide, lithium, non-depolarizing neuromuscular blockers, phenytoin, rifampin, theophylline/aminophylline, tricyclic antidepressants, valproic acid/divalproex, or yohimbine.

Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking.

Is there any monitoring that needs to be done with this medication?

There is no specific monitoring that needs to be done while your pet is taking this medication. Your veterinarian may monitor your pet to be sure that the medication is working. Monitor your pet for serious side effects.

How do I store lorazepam?

Store tablets at room temperature between 68°F and 77°F (20°C and 25°C ) in a tight container and protect from direct sunlight. Store the liquid in the refrigerator between 36°F and 46°F (2°C and 8°C ) and protect from light.

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility.

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