Name of the medicine:

Lorazepam 1 mg tablets (Genus, PVL, Teva Brand)

 The information given in this leaflet should be read along with any patient information leaflet provided by the manufacturer with your medicine. Click Search Results - (emc) (medicines.org.uk)

What is it for?

Lorazepam is a safe and effective medicine which is used to relieve anxiety or distress, which may feel worse if you are short of breath.

Most medicines available in the UK have a licence. The licence describes the conditions the medicine can be used to treat, and how the medicine can be given. The manufacturer of the medicine has to show that the medicine is safe and made to a high standard before the medicine is licenced.

Use of lorazepam under the tongue in the way you have been told to take it is outside its licence. Medicines used in palliative care are quite often used this way. There is experience and research to support the use of lorazepam in this way. The person who prescribed your medicine will have carefully considered the benefits for you.

The information in this leaflet is not included in the information leaflet supplied with the medicine.

We are giving you this extra leaflet to tell you about the reason(s) why you are taking this medicine and to highlight other information. You should read both leaflets. 

What form(s) of this medicine are there and how is it usually taken?

This medicine is available as a tablet, although an oral solution (liquid to take by mouth) is also available.  If you think the oral solution might be easier for you to take, please contact your nurse or doctor.

Often the starting dose prescribed may be 0.5 mg or 500 micrograms.

Check the strength of the tablet CAREFULLY. It is available in 250 microgram, 500 microgram and 1 mg tablets.

·       If the dose you have been prescribed is 0.5 mg or 500 micrograms the number of tablets you should take will vary according to the strength:

·       If you have 250 microgram tablets, take 2 to achieve the 500 microgram dose.

·       If you have 500 microgram tablets, take 1 to achieve the 500 microgram dose.

·       If you have 1mg tablets you must half a tablet to achieve the 500 microgram dose. There should be a score line down the middle of the tablet that will make it easier for you to half. You can get a pill cutter at your local pharmacy to help you do this. 

When this medicine is first started, it will usually be taken only when you need it (as required).  The effects of lorazepam usually last for about eight hours. The maximum number of doses that you can take is 4 doses in 24 hours.

Follow the information on what dose to take and how often to take it. This will be on the medicine label.

The tablet you have been prescribed is usually placed under your tongue (sublingual).  The medicine can get into your body easily through the soft tissue in your mouth.  Before placing it under your tongue, you may need to take a sip of wate, to make sure that your mouth is moist. This will make it easier for the tablet to dissolve.  The tablet should be kept under your tongue until it has fully dissolved.  You will usually feel the effects of the lorazepam after 10 to 20 minutes.                       

What are the most common side effects I might experience?

Drowsiness

Lorazepam may make you feel drowsy (sleepy) shortly after you take it.  Because of this, you should rest for a while in a comfortable chair or bed after you take it.  You may be more likely to feel drowsy if you are also taking other medicines that can also cause sleepiness. Drinking alcohol may also make these side effects feel worse.

Dizziness

You may feel slightly lightheaded or dizzy after you take lorazepam, if you do experience this it should pass on its own.  If it does not tell your doctor, nurse or pharmacist.

Dry mouth

This may often be helped by:

·       Frequent sips of cool drinks

·       Sucking pieces of crushed ice or ice lollies (sugar free)

·       Sucking sugar-free fruit pastilles

·       Chewing sugar-free chewing gum

·       Applying a water-soluble moisturiser to lips to prevent drying and cracking.

What other information should I know about this medicine?

Please remember to order your repeat prescription with a few days spare, to allow it to be processed.

It is important not to order more medication than you need. Even if you return them to the pharmacy in future, they cannot be reused after they have been labelled for your use and must be disposed of.

Your medication needs to be kept in a safe place out of the reach of children.

It is important to store your medication in the original container.

Return ALL unused medication to a pharmacy.

If for any reason a you or your carer are UNABLE to go to the pharmacy, medication can be disposed of at home. However, it is important NOT to flush it down the toilet as this pollutes the water. Medication can be disposed of in a general waste bin, ensuring that cannot be accessed by children or animals, although disposal at a pharmacy is preferable.

Frequently asked questions

What should I do if I can’t half my tablet?

If your tablet does not have a score (line down the middle of the tablet) or if you or your carer/relative are struggling to half your tablet discuss this with your local pharmacy who will be able to help.

What if I swallow the tablet instead of placing it under my tongue?

The tablets can be swallowed instead of placing them under your tongue, but it will take a little longer for the lorazepam to get into your body to have the same effect.

What should I do if I still get breathless while taking lorazepam?

Anxiety and distress can make feelings of breathlessness worse. Lorazepam is good at relieving these symptoms.  You may have been given another medicine to also help with shortness of breath.  You may find breathing and relaxation techniques helpful https://www.nhsinform.scot/care-support-and-rights/palliative-care/symptom-manage/coping-with-breathlessness

Can I drive?

You should not drive after starting lorazepam until you have discussed driving with your healthcare professional.  There is a risk of feeling drowsy when you start taking this medicine and if your dose is increased, it may affect your ability to drive safely. If this happens, do not drive.  You should also not use any machinery if you feel drowsy.  For further information, please refer to the information leaflet provided via the link

https://www.nhsinform.scot/care-support-and-rights/palliative-care/practical-help-and-advice/driving-when-taking-strong-painkillers

Can I drink alcohol?

It is best to avoid taking more than one small glass of wine, beer, sherry or whisky as you may become too drowsy.