Lorazepam 1mg Tablets — Summary of Product Characteristics

electronic medicines compendium (emc). Version last updated on emc 8 April 2026.

• Section 4.2, dosageFor elderly and debilitated patients reduce the initial dose by approximately 50% and adjust the dosage as needed and tolerated
• Section 4.3, contraindicationsAcute pulmonary insufficiency: respiratory depression; sleep apnoea (risk of further respiratory depression)
• Section 4.4, warningsLorazepam should be used with caution in elderly due to the risk of sedation and/or musculoskeletal weakness that can increase the risk of falls, with serious consequences in this population.
• Section 4.8, undesirable effects (rare)Confusion, depression and unmasking of depression
• Section 4.8, undesirable effects (rare)Apnoea, worsening of sleep apnoea, worsening of obstructive pulmonary disease. Respiratory depression

Benzodiazepine Use in Older Adults: Dangers, Management, and Alternative Therapies

Markota M, Rummans TA, Bostwick JM, Lapid MI. Mayo Clinic Proceedings 2016; 91(11): 1632–1639.

• The American Geriatrics Society (AGS) placed benzodiazepines on a list of medications that should be avoided in patients over 65 years of age.
• The panel strongly recommends that short- and intermediate-acting benzodiazepines be avoided in this population.
• in general, all benzodiazepines increase risk of cognitive impairment, delirium, falls, fractures, and motor vehicle crashes in older adults.
• the risk of fractures is dose dependent and starts at 20% of an average prescribed daily dose (ie, at approximately 0.3 mg/d of lorazepam or 3 mg/d of diazepam).
• Benzodiazepine use is associated with a considerable increase in all-cause mortality, with exposed patients dying at a 1.2- to 3.7-times higher rate per year compared with unexposed individuals. However, as with dementia, it remains unclear whether this connection is causal

The impact of benzodiazepines on occurrence of pneumonia and mortality from pneumonia: a nested case-control and survival analysis in a population-based cohort

Obiora E, Hubbard R, Sanders RD, Myles PR. Thorax 2013; 68(2): 163–170.

• UK primary care records: 4,964 cases of community-acquired pneumonia compared with 29,697 controls.
• Benzodiazepine use was associated with a 54% higher risk of pneumonia (odds ratio 1.54, 95% CI 1.42–1.67).
• Diazepam, lorazepam and temazepam were each individually associated with an increased incidence of pneumonia.
• In patients with pneumonia, benzodiazepines were associated with 22% higher mortality at 30 days (hazard ratio 1.22) and 32% higher long-term mortality (hazard ratio 1.32).

Benzodiazepines or related drugs and risk of pneumonia: a systematic review and meta-analysis

Sun GQ, Zhang L, Zhang LN, Wu Z, Hu DF. International Journal of Geriatric Psychiatry 2019.

• Ten studies, covering more than 120,000 pneumonia cases.
• The odds of developing pneumonia were 25% higher in users than in non-users (odds ratio 1.25, 95% CI 1.09–1.44), and 40% higher in current users (odds ratio 1.4, 95% CI 1.22–1.6).