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Lorazepam Oral Concentrate and Renal/liver disease

Result of checking the interaction of drug Lorazepam Oral Concentrate and disease Renal/liver disease for safety when used together.

Check result:
Lorazepam Oral Concentrate <> Renal/liver disease
Relevance: 23.07.2019 Reviewer: Shkutko P.M., M.D., in

When checking interaction based on authoritative sources Drugs.com, Rxlist.com, Webmd.com, Medscape.com there are contraindications or side effects that may cause harm or increase the negative effect from drug use in presence of concomitant diseases.

Consumer:

Benzodiazepines are metabolized by the liver, and the metabolites are excreted in the urine. Chlordiazepoxide, clorazepate, diazepam, flurazepam and quazepam undergo oxidative N-dealkylation to active metabolites that are substantially longer-acting than the parent compound. These metabolites then undergo further biotransformation to pharmacologically inactive products before excretion by the kidney. Therapy with benzodiazepines should be administered cautiously at lower initial dosages in patients with impaired renal and/or hepatic function. Agents that are converted to weakly active, short-acting, or inactive metabolites may be preferable in hepatic impairment. Lorazepam, oxazepam and temazepam are conjugated to inactive metabolites, while alprazolam, estazolam and triazolam undergo hydroxylation to weakly active or inactive metabolites.

References:
  • Dehlin O, Kullingsjo H, Liden A, Agrell B, Moser G, Olsen I "Pharmacokinetics of alprazolam in geriatric patients with neurotic depression." Pharmacol Toxicol 68 (1991): 121-4
  • Murray TG, Chiang ST, Koepke HH, Walker BR "Renal disease, age, and oxazepam kinetics." Clin Pharmacol Ther 30 (1981): 805-9
  • de Silva JAF, Strojny N "Determination of flurazepam and its major biotransformation products in blood and urine by spectrophotofluorometry and spectrophotometry." J Pharm Sci 60 (1971): 1303-14
  • "Product Information. Ativan (lorazepam)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  • Ghabrial H, Desmond PV, Watson KJ, et al "The effects of age and chronic liver disease on the elimination of temazepam." Eur J Clin Pharmacol 30 (1986): 93-7
  • "Product Information. Tranxene (clorazepate)." Abbott Pharmaceutical, Abbott Park, IL.
  • "Product Information. Serax (oxazepam)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  • Chung M, Hilbert JM, Gural RP, Radwanski E, Symchowicz S, Zampaglione N "Multiple-dose quazepam kinetics." Clin Pharmacol Ther 35 (1984): 520-4
  • Allen MD, Greenblatt DJ, Arnold JD "Single- and multiple-dose kinetics of estazolam, a triazolo benzodiazepine." Psychopharmacology (Berl) 66 (1979): 267-74
  • Klotz U, Avant GR, Hoyumpa A, Schenker S, Wikinson GR "The effects of age and liver disease on the disposition and elimination of diazepam in adult man." J Clin Invest 55 (1975): 347-59
  • Wilensky AJ, Levy RH, Troupin AS, Moretti-Ojemann L "Clorazepate kinetics in treated epileptics." Clin Pharmacol Ther 24 (1978): 22-30
  • Greenblatt DJ, Divoll MK, Soong MH, Boxenbaum HG, Harmatz JS, Shader RI "Desmethyldiazepam pharmacokinetics: studies following intravenous and oral desmethyldiazepam, oral clorazepate, and intravenous diazepam." J Clin Pharmacol 28 (1988): 853-9
  • Kroboth PD, Smith RB, Silver MR, Rault R, Sorkin MI, Puschett JB, Juhl RP "Effects of end stage renal disease and aluminium hydroxide on triazolam pharmacokinetics." Br J Clin Pharmacol 19 (1985): 839-42
  • Schmith VD, Piraino B, Smith RB, Kroboth PD "Alprazolam in end-stage renal disease: I. Pharmacokinetics." J Clin Pharmacol 31 (1991): 571-9
  • "Product Information. Restoril (temazepam)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  • Kroboth PD, Smith RB, Van Thiel DH, Juhl RP "Nighttime dosing of triazolam in patients with liver disease and normal subjects: kinetics and daytime effects." J Clin Pharmacol 27 (1987): 555-60
  • Hilbert JM, Chung M, Radwanski E, Gural R, Symchowicz S, Zampaglione N "Quazepam kinetics in the elderly." Clin Pharmacol Ther 36 (1984): 566-9
  • "Product Information. Xanax (alprazolam)." Pharmacia and Upjohn, Kalamazoo, MI.
  • Kroboth PD, Smith RB, Rault R, Silver MR, Sorkin MI, Puschett JB, Juhl RP "Effects of end-stage renal disease and aluminum hydroxide on temazepam kinetics." Clin Pharmacol Ther 37 (1985): 453-9
  • "Product Information. Dalmane (flurazepam)." Roche Laboratories, Nutley, NJ.
  • Juhl RP, Van Thiel DH, Dittert LW, Smith RB "Alprazolam pharmacokinetics in alcoholic liver disease." J Clin Pharmacol 24 (1984): 113-9
  • Tedesco FJ, Mills LR "Diazepam (valium) hepatitis." Dig Dis Sci 27 (1982): 470-2
  • Cutler RE, Blair AD "Pharmacokinetics of diazepam in normal and uremic humans." Clin Pharmacol Ther 25 (1979): 219-20
  • Hoyumpa AM "Disposition and elimination of minor tranquilizers in the aged and in patients with liver disease." South Med J 71 (1978): 23-8
  • Johnson J, Padilla BG, Carter J, Holt JH, Ozawa T "Adverse effects of flurazepam in a hemodialysis patient." J Am Assoc Nephrol Nurses Tech 4 (1977): 93-5
  • "Product Information. Doral (quazepam)." Wallace Laboratories, Cranbury, NJ.
  • Ochs HR, Rauh HW, Greenblatt DJ, Kaschell HJ "Clorazepate dipotassium and diazepam in renal insufficiency: serum concentrations and protein binding of diazepam and desmethyldiazepam." Nephron 37 (1984): 100-4
  • "Product Information. ProSom (estazolam)." Abbott Pharmaceutical, Abbott Park, IL.
  • "Product Information. Valium (diazepam)." Roche Laboratories, Nutley, NJ.
  • American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  • Roberts RK, Wilkinson GR, Branch RA, Schenker S "Effect of age and parenchymal liver disease on the disposition and elimination of chlordiazepoxide (librium)." Gastroenterology 75 (1978): 479-85
  • "Product Information. Librium (chlordiazepoxide)." Roche Laboratories, Nutley, NJ.
  • Gustavson LE, Carrigan PJ "The clinical pharmacokinetics of single doses of estazolam." Am J Med 88 (1990): s2-5
  • Verbeeck RK, Tjandramaga TB, de Schepper PJ, Verberckmoes R "Impaired elimination of lorazepam following subchronic administration in two patients with renal failure." Br J Clin Pharmacol 12 (1981): 749-50
  • Morgan DD, Robinson JD, Mendenhall CL "Clinical pharmacokinetics of chlordiazepoxide in patients with alcoholic hepatitis." Eur J Clin Pharmacol 19 (1981): 279-85
  • Greenblatt DJ, Divoll M, Harmatz JJ "Kinetics and clinical effects of flurazepam in young and elderly noninsomniacs." Clin Pharmacol Ther 30 (1981): 475-86
  • "Product Information. Halcion (triazolam)." Pharmacia and Upjohn, Kalamazoo, MI.
  • Kaplan SA, de Silva JAF, Jack ML, et al "Blood level profile in man following chronic oral administration of flurazepam hydrochloride." J Pharm Sci 62 (1973): 1932-5
  • Kraus JW, Desmond PV, Marshall JP, Johnson RF, Schenker S, Wilkinson GR "Effects of age and liver disease on disposition of lorazepam." Clin Pharmacol Ther 24 (1978): 411-9
  • Ochs HR, Greenblatt DJ, Kaschell HJ, Klehr U, Divoll M, Abernathy DR "Diazepam kinetics in patients with renal insufficiency or hyperthyroidism." Br J Clin Pharmacol 12 (1981): 829-32
  • "Product Information. Klonopin (clonazepam)." Roche Laboratories, Nutley, NJ.
  • Sellers EM, Greenblatt DJ, Giles HG, et al "Chlordiazepoxide and oxazepam disposition in cirrhosis." Clin Pharmacol Ther 26 (1979): 240-6
  • Greenblatt DJ "Clinical pharmacokinetics of oxazepam and lorazepam." Clin Pharmacokinet 6 (1981): 89-105
  • Sellers EM, Greenblatt DJ, Giles HG, et al "Chlordiazepoxide and oxazepam disposition in cirrhosis." Clin Pharmacol Ther 26 (1979): 240-6
  • Morrison G, Chiang ST, Koepke HH, Walker BR "Effect of renal impairment and hemodialysis on lorazepam kinetics." Clin Pharmacol Ther 35 (1984): 646-52
  • Hicks R, Dysken MW, Davis JM, et al "The pharmacokinetics of psychotropic medication in the elderly: a review." J Clin Psychiatry 42 (1981): 374-85
  • Busch U, Molzahn M, Bozler G, Koss FW "Pharmacokinetics of oxazepam following multiple administration in volunteers and patients with chronic renal disease." Arzneimittelforschung 31 (1981): 1507-11
Lorazepam Oral Concentrate

Generic Name: lorazepam

Brand Name: Ativan, Lorazepam Intensol

Synonyms: Lorazepam, LORazepam

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