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
Excreted in breast milk. Drowsiness, lethargy, or weight loss in nursing infants have been observed in case reports following maternal use of some benzodiazepines
Start low, 10 mg tid, titrate cautiously
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.
There are no dosage adjustments provided in the manufacturer's labeling
No dosage adjustments recommended in manufacturer's labeling, however, pharmacokinetic studies have been shown that hepatic dysfunction is not expected to significantly decrease clearance.
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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.