Lorazepam:

Intravenous, benzodiazepine gamma-aminobutyric acid (GABA) receptor agonist

ECMO Dose Adjustment:

NONE

Renal Impairment Dose Adjustment:

NONE

CRRT Dose Adjustment:

NONE

Hepatic Impairment Dose Adjustment:

NONE

Adult Starting Dose^:

Adult Intermittent: 0.02-0.03 mg/kg IV every 2-6 hrs (0.5-1 mg IV every 2-6 hrs)

Adult Continuous Infusion: 0.01-0.02 mg/kg/hr (0.5-2 mg/hr)

Pediatric Starting Dose^:

Pediatric Intermittent: 0.03-0.05 mg/kg IV every 2-4 hrs

Pediatric Continuous Infusion: 0.02-0.03 mg/kg/hr

Neonatal Starting Dose^:

Neonatal Intermittent: 0.03-0.05 mg/kg IV every 2-4 hrs

Neonatal Continuous Infusion: 0.02-0.03 mg/kg/hr

^Always use the lowest effect dose to an objective endpoint (e.g., sedation scale).

Intravenous sedative physicochemical and pharmacokinetic characteristics

Drug	Lorazepam


Onset (min)	5-20
Log P	2.5-3.0
Protein Binding (%)	91
Metabolism / Elimination	Hepatic
Dose Adjustment on ECMO	-
Dose Range*	Adult: 0.01-0.1 mg/kg/hr (0.5-10 mg/hrs)
	Pediatric: 0.02-0.1 mg/kg/hr
	Neonatal: 0.02-0.1 mg/kg/hr

- Minimal sequestration; no need for Dose Adjustment

++ Moderate sequestration; may require Dose Adjustment

+++ Significant sequestration; need for Dose Adjustment

*Titrate to patient-specific goals, using the lowest effective dose. Dose ranges represent doses typically used in clinical practice; in some situations, patients may require doses above the usual dose range to achieve patient-specific goals.