Maximum Daily Dose of Ativan (Lorazepam) for Specific Clinical Scenarios

Dosing Guidelines for Special Populations

For management of anxiety or agitation in adults who can swallow, the American Academy of Family Physicians recommends 0.5-1 mg orally four times a day as required (maximum 4 mg in 24 hours) 1
For elderly or debilitated patients who can swallow, the American Academy of Family Physicians recommends 0.25-0.5 mg orally (maximum 2 mg in 24 hours) 1

For status epilepticus, the American Academy of Pediatrics recommends 0.05-0.1 mg/kg IV (maximum: 4 mg per dose); may repeat every 10-15 minutes if needed 2
For psychosis with agitation, the American Academy of Pediatrics recommends 0.05-0.15 mg/kg IM/IV; may repeat hourly as necessary with a maximum single dose of 5 mg 3
For sedation/anxiolysis, the American Academy of Pediatrics recommends 0.05-0.1 mg/kg IV given over 2-3 minutes (maximum single dose: 5 mg) 2

Regular use of lorazepam can lead to tolerance, addiction, depression, and cognitive impairment, according to the American Academy of Family Physicians 4
The American Academy of Family Physicians reports that paradoxical agitation occurs in approximately 10% of patients treated with benzodiazepines 4
There is an increased incidence of apnea when lorazepam is combined with other sedative agents, as noted by the American Academy of Pediatrics 2
The American Academy of Pediatrics advises to monitor oxygen saturation and be prepared to provide respiratory support when administering lorazepam 2