Lorazepam Dosing in Specific Clinical Contexts

Pediatric Benzodiazepine Weaning Protocol

The American Academy of Pediatrics recommends four times daily (every 6 hours) dosing when converting from continuous IV midazolam to oral lorazepam in pediatric patients, calculating the 24-hour midazolam dose and dividing it by 12 to account for lorazepam's potency and half-life 1, 2
The calculated lorazepam dose should be divided by 4 and administered every 6 hours for the initial conversion period, with subsequent weaning by 10-20% per day 1
The weaning time is proportional to the duration of IV benzodiazepine treatment, and four times daily dosing is a temporary bridging strategy during acute conversion, not a long-term maintenance regimen 1, 2

For conversion from IV benzodiazepines in pediatric patients, every 6-hour dosing (4 times daily) is recommended only during the initial 48-hour conversion, followed by a rapid transition to less frequent dosing intervals 1