Patient/caregiver was educated on contraindications for using Lorazepam as follows:
- Avoid taking Lorazepam with grapefruit juice, as it can also inhibit the enzymes needed for the metabolism of Lorazepam. Concurrent administration of grapefruit juice with lorazepam can inhibit the metabolism of lorazepam. Thus, lorazepam stays in the body for prolonged duration of time in comparison to normal and stand the risk of causing toxicity.
- Some medications, such as, phenytoin and carbamazepine, induce the enzymes needed for the metabolism of Lorazepam. Concurrent administration of these medications with Lorazepam can quicken the metabolism of lorazepam and clear the medication out of the body quicker. Thus, lorazepam stays in the body for shorter duration of time in comparison to normal and results in compromised therapeutic benefit. If you are being newly started on Lorazepam, discuss with your physician regarding all other medications you are currently taking and their safety with Lorazepam. Also, if you have been taking Lorazepam for long, discuss with your physician regarding your history of Lorazepam intake, when you are being started on any new medication.
- Lorazepam is extensively metabolized in the liver and the metabolites are excreted in the urine. If liver function is deficient, the metabolism of Lorazepam can be compromised. In individuals with history of compromised renal function, the excretion of lorazepam metabolites can be compromised. In either case, lorazepam and metabolites stay in the body for prolonged duration of time in comparison to normal leading to increased blood levels of the medication and metabolites for longer periods of time. This can lead to increased risk for side-effects and consequent toxicity. So, Lorazepam could be cautiously administered or avoided for an alternative medication, in individuals with hepatic and/or renal dysfunction. Periodical labs for liver and/or renal function could be ordered and individuals monitored for development of any toxic symptoms. Discuss with your physician regarding history of compromised liver or kidney function, if any.
