Lorazepam contraindications

High-potency benzodiazepines (e.g., clonazepam and lorazepam) are common alternatives to or in combination with antipsychotics for acute mania, agitation, anxiety, panic, and insomnia or in those who cannot take mood stabilizers. Lorazepam IM may be used for acute agitation. A relative contraindication for long-term benzodiazepines is a history of drug or alcohol abuse or dependency. 

Although b-blockers are considered the treatment of choice for akathisia, low doses of clonazepam, diazepam, or lorazepam may also reduce its severity ( 172, 389, 445, 447, 448, 449 and 450). These BZDs may be a useful alternative when a-blockers are contraindicated (e.g., in patients with asthma, insulin-dependent diabetes meilitus, cardiac conduction abnormalities) or as an adjunct when akathisia persists despite stepwise escalation of these agents ( 177). 

Patients receiving intravenous benzodiazepines must be monitored for respiratory depression, which may demand artificial ventilation during intensive treatment. Diazepam may cause more respiratory depression than lorazepam at equieffective dosages (SEDA-20, 59) and is contraindicated in neonates for this reason and because it produces unacceptably prolonged sedation (9). 

Probenecid but not cidofovir alters zidovudine pharmacokinetics such that zidovudine doses should be reduced when probenecid is present, as should the doses of drugs similarly affected by probenecid fe.g., /i-lactam antibiotics, nonsteroidal anti-inflammatory drugs [NSAIDs], acyclovir, lorazepam, furosemide, methotrexate, theophylline, and rifampin). Concurrent nephrotoxic agents are contraindicated, and an interval of 1 week before beginning cidofovir treatment is recommended after prior exposure to aminoglycosides, intravenous pentamidine, amphotericin foscamet, NSAIDs, or contrast dye. Cidofovir and oral ganciclovir in combination are poorly tolerated at full doses. 

---