Lorazepam: reduction of recommended maximum daily dose
Article date: October 2007
Maximum dose of lorazepam for short term, symptomatic treatment is 4 mg per day for severe, disabling anxiety, and 2 mg per day for severe, disabling insomnia
Lorazepam is a benzodiazepine anxiolytic; its indications include short-term use in anxiety or insomnia.
Prescribers are reminded of previous advice:
- Benzodiazepines are indicated for the short-term relief (2–4 weeks only) of anxiety that is severe, disabling, or subjecting the individual to unacceptable distress, occurring alone or in association with insomnia or short-term psychosomatic, organic, or psychotic illness
- The use of benzodiazepines to treat short-term mild anxiety is inappropriate and unsuitable
- Benzodiazepines should be used to treat insomnia only when it is severe, disabling, or subjecting the individual to extreme distress
Doses of lorazepam above 4 mg per day are not considered appropriate in view of the recommended maximum treatment duration of 4 weeks, which includes a dose-reduction period. Prescribing information, which previously contained posology for up to 10 mg per day for lorazepam (equivalent to 100 mg per day of diazepam), is being updated for relevant products.
Advice for healthcare professionals:
- The maximum dose of lorazepam is 4 mg per day for the short-term treatment of anxiety and phobia, and is 2 mg per day for the treatment of insomnia
See also British National Formulary for information about lorazepam dosing.
Article citation: Drug Safety Update October 2007; Vol 1, Issue 3: 8.