Category D—↑ risk of oral cleft by 0.01%, use just before delivery associated with floppy infant syndrome, 3rd trimester use can cause withdrawal in newborns
Low incidence of infant toxicity and AEs associated with benzodiazepine use during breastfeeding. Benzodiazepines with shorter half-lives (i.e., lorazepam, alprazolam, and oxazepam) have been found to be very low in breast milk
T½ ↑ ≈ 45%; initiate at 0.25 mg bid-tid
2019 BEE℞S Recommendation: Avoid. Older adults have increased sensitivity to benzodiazepines and decreased metabolism of long- acting agents; in general, all benzodiazepines increase risk of cognitive impairment, delirium, falls, fractures, and motor vehicle crashes in older adults. May be appropriate for seizure disorders, RBD, benzodiazepine withdrawal, EtOH withdrawal, severe GAD, and periprocedural anesthesia.
Renal insufficiency has a quantitatively small influence on pharmacokinetics; no dosage adjustments provided in the manufacturer's labeling
T½ ↑ ≈ 73% in patients with alcohol liver disease
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Last updated March 25 2019 15:25:58. Disclaimer: This website does not provide medical advice, nor is it a substitute for clinical judgment.