Lorafen is a psychotropic drug containing one of the benzodiazepines - lorazepam. This measure is primarily used to manage anxiety. Although Lorafen is effective in relieving anxiety, it is not a drug that doctors prescribe for anyone suffering from these disorders. This is due to, inter alia, from the fact that there is a risk of addiction to lorazepam. So how long is it safe to use Lorafen and what are the potential side effects of the drug? Can Lorafen be taken by all patients experiencing anxiety?

The active substance of the drugLorafenislorazepam , which is a substance belonging to the group of benzodiazepines. Lorafen is available in the form of dragees containing 1 or 2.5 milligrams of lorazepam. The preparation can only be purchased with a prescription. The main effects of Lorafen are sedative and anxiolytic, in addition, the agent also has anticonvulsant and miorelaxant (muscle-relaxing) effects.

Lorafen - the mechanism of action of the drug

Lorazepam, like other benzodiazepine agents, works by affecting GABA-A receptors in the brain. After lorazepam joins these structures, the affinity of gamma-aminobutyric acid (GABA) increases. When GABA binds with its receptors, chloride ions begin to flow inside nerve cells - this leads to a state of hyperpolarization, i.e. reduced excitability of neurons.

Lorazepam is absorbed orally in the digestive tract when taken orally. The maximum concentration of the drug in the blood occurs about two hours after taking it. It is metabolized in the liver, and then its metabolites are mainly excreted in the urine.

Lorafen - indications for use and dosage of the drug

There are two indications for the use of Lorafen:

  • treatment of anxiety disorders associated with other diseases (e.g. heart diseases),
  • treatment of anxiety-related sleep disorders.

In anxiety disorders, the recommended doses of lorazepam are initially 2-3 mg per day, it is possible to later increase the dose to 2-6 mg per day (maximum you can take up to 10 mg of lorafen in 24 hours). The drug is used in the event of this problemdivided doses, i.e. the total daily dose is broken down into two or three smaller doses throughout the day.

The above-mentioned Lorafen dosing methods apply to adults and children over 12 years of age. There are three specific groups of patients for whom the drug may or may not be used at lower than the standard recommended doses.

Lorafen is not used in three groups of patients:

The first of these groups arechildren under the age of 12- due to the lack of appropriate research, the use of Lorafen in such patients is not recommended. The second group iselderly patients- in such people, due to the increased sensitivity of the nervous system and changes in metabolism occurring in these patients, it may be sufficient to use even half of the standard recommended doses of lorazepam.

The last of the special groups of patients arepregnant and breastfeeding women . In patients in the first trimester of pregnancy, the drug is not used until it is absolutely necessary - because Lorafen may cause harm to the fetus.

The preparation can be used by breastfeeding women, but if they take it, they should stop breastfeeding - the drug, although in a small amount, gets into the breast milk.

Lorafen - contraindications to use

Lorafen is contraindicated primarily in patients who are allergic to lorazepam, any other benzodiazepines or any other ingredient in the preparation. The drug is also not used in patients with:

  • narrow-angle glaucoma,
  • myasthenia gravis (muscle fatigue),
  • respiratory failure,
  • obstructive sleep apnea,
  • severe liver or kidney failure,
  • acute porphyria attack,
  • symptoms of intoxication with alcohol or other nervous system depressants.

Lorafen - precautions

Patients taking Lorafen should not drive machinery during the treatment and for up to three days after its completion. Another important information is that the preparation contains lactose, so it may not be suitable for patients with intolerance to this disaccharide - if you have any doubts, talk to your doctor who prescribes Lorafen.

Lorazepam should not be used as monotherapy in patients with depressive disorders. The necessity to exercise caution here results from the fact that in such patients benzodiazepines may increase suicidal tendencies, and additionallythere is an increased risk that patients will deliberately overdose on Lorafen in order to kill themselves.

Patients should not consume alcohol while taking Lorafen. Abstinence is indicated due to the fact that drinking ethyl alcohol could increase both the sedative effect of lorazepam and increase the risk of paradoxical reactions after benzodiazepines.

Lorafen - interactions with other drugs

Patients who are to be administered Lorafen should inform their doctor about all medications they take. This necessity results from the fact that lorazepam may interact with other pharmaceuticals, some of which even lead to he alth-threatening phenomena.

The most important thing is to inform your doctor about the use of drugs such as:

  • opioid painkillers,
  • neuroleptics,
  • anticonvulsants or antidepressants,
  • sleeping pills and antihistamines (they can increase the depressive effect of lorazepam on the nervous system),
  • rifampicin,
  • karmazepina,
  • phenytoin,
  • oral contraceptives (these drugs reduce the effect of lorazepam),
  • erythromycin,
  • ketoconazole,
  • disulfiram (these preparations inhibit the breakdown of lorazepam, which may lead to an increase in its amount in the body).

Side effects of using Lorafen

The most common side effects of Lorafen include:

  • sleepiness,
  • headaches,
  • dizziness,
  • confusion,
  • visual disturbance,
  • gastrointestinal complaints (e.g. nausea, vomiting, abdominal pain),
  • muscle weakness.

Other side effects, such as drops in blood pressure, liver dysfunction or allergic reactions, can also occur, but they rarely occur with Lorafen.

The phenomena that cannot be ignored, and that can also occur in patients taking lorazepam, are paradoxical reactions and anterograde amnesia.

Paradoxical reactionsare states in which, after taking benzodiazepines, an effect is clearly opposite to that of the state of calmness and relaxation - patients then become significantly aroused, irritable and aggressive.

The risk of paradoxical reactions is greatest in the elderly and in patients with organic lesions of the central nervous system, and in the event of their occurrence, the use of Lorafen must be discontinued immediately.

The second of the aforementioned possible side effectslorazepamu isafteraccuracy . The state of amnesia usually affects a few hours after taking the drug and the risk of its occurrence increases with the higher the dose of benzodiazepines. Fortunately, it is possible to prevent the occurrence of subsequent amnesia after lorazepam - for this purpose, you should take the preparation shortly before going to bed, and then ensure you have a sufficient night's rest (lasting about 7 hours).

Problem

Lorafen - addiction risk

Usually, patients are recommended to use Lorafen for a few to several days. However, in justified cases, treatment may be continued for four or more weeks. Such limitations as to the duration of Lorafen therapy are associated with the risk of addiction to the drug. In addition, during the use of lorazepam, a tolerance phenomenon may occur, in which the body 'gets used to' the preparation and in order to achieve the effects of the drug, the patient needs more and more doses.

The risk of becoming addicted to lorazepam is the greater, the higher the dose of this drug is used by the patient and the longer the therapy with this preparation lasts. In the case of Lorafen, there may be both mental and physical dependence. The manifestation of the latter may be the appearance of a withdrawal syndrome (especially after the sudden discontinuation of Lorafen), in the course of which there may be significant irritability, sleep disturbances, headaches, but also psychomotor agitation or even psychotic symptoms (e.g. hallucinations). To avoid withdrawal discomfort, patients may be advised to gradually reduce the dose of lorazepam, and only stop treatment altogether when their doses of Lorafen are very low.

IMPORTANT!Due to the potential risk of addiction, lorazepam should be prescribed with particular caution. The increased risk of drug addiction occurs, inter alia, in in people who are or have been addicted to some other substance, e.g. alcohol or drugs. In such patients, there is a need to consider whether prescribing them Lorafen will actually be the best therapeutic option, or whether they should be advised to use other drugs with less potential for addiction.

Lorafen - overdose

Taking higher than recommended doses of Lorafen may lead to drug overdose. This state may appear as:

  • severe sleepiness,
  • confusion,
  • speech disorder,
  • loss of consciousness,
  • coma.

First aid for the patient,Lorafen overdose is based on attempts to remove the drug before it is even absorbed from the gastrointestinal tract into the blood. For this purpose, gastric lavage can be performed, patients can also be treated with activated charcoal preparations. A specific benzodiazepine antidote, flumazenil, is also sometimes used.

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