Can you take lorazepam with methadone

Patient Info Service - information for patients

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1. What is Tavor 2.5 mg and what is it used for?

Tavor 2.5 mg is a soothing and anxiety-relieving drug (tranquilizer) from the benzodiazepine group of active ingredients.

application areas

  • Symptomatic short-term treatment of anxiety, tension and excitement as well as sleep disorders caused by them

  • Calming before diagnostic as well as before and after surgical interventions

Note

Not all anxiety, tension, excitement or sleep disorders require medication. They are often an expression of physical or mental illness and can be remedied by other measures or treatment of the underlying illness. Anxiety and tension resulting from everyday stress should normally not be treated with a medicine such as Tavor 2.5 mg. The use of Tavor 2.5 mg as a sleep aid appears justified only if benzodiazepine effects during the day are desired at the same time.

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2. What should you know before you take Tavor 2.5 mg?

Tavor 2.5 mg must not be taken

  • if you are allergic to lorazepam, other benzodiazepines or any of the other ingredients of this medicine (listed in section 6).

  • if you have an existing or past addiction to drugs, alcohol or drugs.

When should you take Tavor 2.5 mg only after consulting your doctor?

The following describes when you should only use Tavor 2.5 mg under certain conditions and only with special caution. Please ask your doctor about this. This also applies if this information applied to you in the past.

Tavor 2.5 mg may only be used with particular caution in the case of pathological muscle weakness (myasthenia gravis), disorders of the coordination of movements (spinal and cerebellar ataxias), in the case of acute poisoning with alcohol or central depressant drugs (e.g. sleeping pills or painkillers, drugs for Treatment of mental and emotional disorders such as neuroleptics, antidepressants and lithium) as well as respiratory dysfunction, e.g. B. temporary, temporary respiratory arrest during sleep (sleep apnea syndrome) or chronic obstructive pulmonary disease.

Children and adolescents

Children and adolescents under 18 years of age should not be treated with Tavor 2.5 mg, unless there is an urgent need to calm down (sedation) before and after surgery and before diagnostic procedures. Tavor 2.5 mg is not recommended for children under 6 years of age. See the next section for more information.

Warnings and Precautions

Talk to your doctor or pharmacist before taking Tavor 2.5 mg.

In depressed patients, the possibility of an emergence or an intensification of the depressive illness symptoms must be expected. Treatment with benzodiazepines can increase the risk of suicide in these patients; it should not be done without adequate antidepressant therapy.

At the beginning of treatment, the attending physician should check the patient's response to the drug in order to identify possible overdoses as quickly as possible. This is especially true for children and for elderly or debilitated patients. These patients may be more sensitive to the effects of Tavor 2.5 mg and should therefore be monitored more frequently during therapy.

Caution should be exercised in patients with kidney or liver dysfunction as well as existing cardiac insufficiency (heart failure) and / or low blood pressure (hypotension) due to the often observed higher sensitivity to the effects of these drugs; also in elderly patients who are at increased risk of falling.

When used as a sleeping aid, it should be ensured that sufficient sleep time (around 7 to 8 hours) is available. If you adhere to this recommendation, after-effects in the following morning (e.g. tiredness, impaired reactions) can usually be avoided. Please ask your doctor to give you more precise instructions on how to behave in everyday life, taking into account your particular life situation (e.g. occupation)!

Occasional "paradoxical" reactions have been reported with the use of benzodiazepines (see section 4). Such reactions must be expected, especially in children and the elderly. If paradoxical reactions occur, treatment with lorazepam should be discontinued.

As with all benzodiazepines, the use of lorazepam may worsen hepatic encephalopathy (disease of the brain due to liver damage). Therefore, lorazepam should be used with caution in patients with severely impaired liver function and / or hepatic encephalopathy.

Warning notices

The use of benzodiazepines, including lorazepam, can cause respiratory depression, which can be fatal.

Lorazepam has an addictive property (primary addiction potential). Even if Tavor 2.5 mg is taken daily for a few weeks, there is a risk of developing psychological and physical dependence. This applies not only to the misuse of particularly high doses, but also to the therapeutic dose range. The risk increases with the duration and dose and is higher in patients with a history of alcohol or drug abuse and in patients with severe personality disorders. In principle, benzodiazepines should only be prescribed for short periods of time (e.g. 2 to 4 weeks). Continued use should only be carried out if it is absolutely necessary, after carefully weighing the benefit of the treatment against the risk of habituation and dependence. Long-term use of Tavor 2.5 mg is not recommended.

Serious allergic reactions have been reported with the use of benzodiazepines. Cases of angioedema (swelling of the skin and / or mucous membranes) involving the tongue, larynx or the voice-forming area of ​​the larynx (glottis) have been reported after taking the first dose or subsequent doses of benzodiazepines. Some patients have had other symptoms such as shortness of breath (dyspnoea), throat swelling, or nausea and vomiting while taking benzodiazepines. Some patients had to be treated as a medical emergency. If angioedema occurs with involvement of the tongue, larynx or the voice-forming area of ​​the larynx (glottis), the airways can become blocked and be fatal.

Other medicines and Tavor 2.5 mg

Tell your doctor or pharmacist if you are taking, have recently taken, or may take any other medicines.

If Tavor 2.5 mg is used at the same time as other central depressant drugs, the central depressant effects may be mutually amplified, e.g. B .:

  • Means for the treatment of mental illnesses (psychotropic drugs)

  • Sleeping pills, tranquilizers, anesthetics

  • antihypertensive agents (beta blockers)

  • certain painkillers, substitution medicines and cough medicines (opioids)

  • Medicines for allergies (antihistamines)

  • Medicines used to treat seizure disorders (anti-epileptic drugs)

Concomitant use of Tavor 2.5 mg and opioids (strong pain relievers, substitution drugs and some cough suppressants) increases the risk of drowsiness, difficulty breathing (respiratory depression), coma and can be life-threatening. For this reason, concomitant use should only be considered if there are no other treatment options.

However, if your doctor prescribes Tavor 2.5 mg with opioids, the dose and duration of concomitant treatment should be limited by your doctor.

Please tell your doctor about all opioid-containing medicines you are taking and carefully follow your doctor’s dosage recommendation. It might be helpful to let friends or family know to look out for you for the signs and symptoms listed above. Contact your doctor if you experience these symptoms.

Muscle tension relievers (muscle relaxants) and pain relievers may be more effective.

Simultaneous use of lorazepam and clozapine can lead to pronounced attenuation, excessive salivation and impaired movement coordination.

Simultaneous administration of Tavor 2.5 mg and valproic acid can lead to increased levels of lorazepam in the blood. If valproic acid is used concomitantly, the dose of Tavor 2.5 mg should be reduced by about half.

Simultaneous administration of Tavor 2.5 mg and probenecid can lead to a faster onset or a prolonged effect of lorazepam. If used at the same time as probenecid, the dose of Tavor 2.5 mg should be halved.

The use of theophylline or aminophylline may reduce the sedative effect of Tavor 2.5 mg.

Tavor 2.5 mg taken with alcohol

Simultaneous consumption of alcoholic beverages should be avoided, as alcohol can change and intensify the effects of Tavor 2.5 mg in unforeseeable ways.

pregnancy and breast feeding period

Ask your doctor or pharmacist for advice before taking this medicine if you are pregnant or breast-feeding, if you suspect you may be pregnant, or are planning to become pregnant.

pregnancy

Tavor 2.5 mg should not be used during pregnancy.

If you become pregnant during treatment with Tavor 2.5 mg, you should immediately inform your doctor so that he or she can decide whether to discontinue the treatment.

Long-term use of Tavor 2.5 mg by pregnant women can lead to withdrawal symptoms in the newborn. If Tavor 2.5 mg is administered towards the end of pregnancy or during childbirth, the infant may experience decreased activity, decreased muscle tension, decrease in body temperature (hypothermia) and / or blood pressure (hypotension), depressed breathing, apnea and poor drinking (so-called " floppy infant syndrome ").

Breastfeeding

Since the active substance in Tavor 2.5 mg is excreted in breast milk, it should not be used during breast-feeding unless the anticipated benefit outweighs the potential risk to the infant. If Tavor 2.5 mg is taken while breastfeeding, the infant may feel calm (sedation) and suckling weakness. Medical supervision of the infant is recommended.

Driving and using machines

Even if Tavor 2.5 mg is used as intended, you should expect restrictions in your ability to react, especially during the first few days of treatment. You will then no longer be able to react quickly enough to unexpected and sudden events. Do not drive a car or other vehicles! Do not use any dangerous electrical tools or machines! Do not work without a safe grip! Be particularly aware that alcohol will make your reactions even worse.

The decision about the extent to which active participation in road traffic or other dangerous activities is possible is made by the attending physician, taking into account your individual reaction and the dosage.

Tavor 2.5 mg contains lactose

Therefore, please only take Tavor 2.5 mg after consulting your doctor if you know that you are intolerant to certain sugars.

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3. How to take Tavor 2.5 mg

The dosage and duration of use must be adapted to the respective response to treatment, the area of ​​application and the severity of the disease. The principle here is to keep the dose as small and the duration of the treatment as short as possible.

dosage

Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.

Please adhere to the instructions for use, otherwise Tavor 2.5 mg cannot work properly!

The following information applies unless your doctor has prescribed Tavor 2.5 mg otherwise:

Treatment of anxiety, tension and excitement as well as sleep disorders caused by them

The daily dose for adults is usually 0.5 to 2.5 mg lorazepam divided into 2 to 3 single doses or as a single dose in the evening. In individual cases, especially in hospitals, the doctor can increase the daily dose to a maximum of 7.5 mg lorazepam, taking all precautionary instructions into account. For doses in the lower dose range, preparations with a lower single dose are available.

If sleep disorders requiring treatment are in the foreground, the daily dose (0.5 to 2.5 mg lorazepam) can be taken as a single dose about half an hour before going to bed; For this, too, preparations with a lower individual dose are optionally available.

Calming before diagnostic as well as before and after surgical interventions

In adults 1 to 2.5 mg lorazepam) the evening before and / or 2 to 4 mg lorazepam about 1 to 2 hours before the procedure. After the procedure 1 to 2.5 mg lorazepam at appropriate intervals. Here, too, preparations with a lower individual dose are optionally available.

Use in children and adolescents

In children, the dose should be reduced accordingly; single doses should not exceed 0.5 to 1 mg lorazepam or 0.05 mg per kg body weight. A preparation with a lower dosage should be selected for this.

Use in elderly or debilitated patients

In elderly or debilitated patients as well as in patients with organic brain changes, the initial total daily dose should be reduced by approx. 50%. These patients and children should preferably receive preparations with a lower active ingredient content. The dose is to be set by the doctor in each individual case according to the required effect and tolerability.

type of application

Please swallow the tablets whole with some liquid (e.g. with half a glass to a glass of water). The score line is only used to break the tablet if you have difficulty swallowing it whole. The tablets can be taken with or without food.

When used as a sleeping aid, it should be taken about half an hour before going to bed and not on a full stomach, as otherwise the onset of action will be delayed and - depending on the length of sleep - increased after-effects the next morning must be expected.

Duration of application

The duration of treatment will be determined by your doctor. In acute illness, the use of Tavor 2.5 mg should be limited to single doses or a few days. In the case of chronic diseases, the duration of use depends on the course. If the dose is gradually reduced after 2 weeks of daily dosing, your doctor should clarify whether treatment with Tavor 2.5 mg is still indicated.

It should be noted that after a longer period of use (longer than 1 week) and sudden discontinuation of the drug, sleep disorders, states of anxiety and tension, inner restlessness and excitement may temporarily increase again. Treatment should therefore not be stopped suddenly, but rather by gradually reducing the dose.

If you take more Tavor 2.5 mg than you should

If poisoning is suspected after taking large amounts of medicine, a doctor should be notified immediately. Telephone first aid instructions must be observed. Do not induce vomiting without express instruction!

Signs of an overdose are: drowsiness, confusion, drowsiness, decreased breathing, movement disorders (movement coordination), listlessness and, in severe cases, unconsciousness.

If you forget to take Tavor 2.5 mg

If you forget a tablet, take Tavor 2.5 mg as usual the next time. Do not take a double dose to make up for a forgotten dose.

If you stop taking Tavor 2.5 mg

You should never interrupt or stop treatment on your own unless you suspect a serious side effect. In this case you should immediately consult your doctor.

If you suddenly stop treatment after taking it for a long time, the withdrawal symptoms mentioned in section 4 may occur.To avoid these symptoms, treatment is stopped by gradually reducing the dose (see section 3).

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

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4. What side effects are possible?

Like all medicines, this medicine can have side effects, although not everybody gets them.

Side effects are to be expected especially at the beginning of treatment, if the dose is too high and in the patient groups mentioned under “Warnings and precautions” (see section 2).

The frequency of side effects is based on the following categories:

Very common: may affect more than 1 in 10 people

Common: may affect up to 1 in 10 people

Uncommon: may affect up to 1 in 100 people

Rare: may affect up to 1 in 1,000 people

Very rare: may affect up to 1 in 10,000 people

Not known: frequency cannot be estimated from the available data

Blood and lymphatic system disorders

Not known: changes in the blood count (thrombopenia, agranulocytosis, pancytopenia)

Nervous system disorders

Benzodiazepines cause a dose-dependent central nervous depression.

Very common: reassurance (sedation), tiredness, drowsiness

Common: Unsteady movement and gait (ataxia), confusion, depression, emergence of depression, dizziness

Uncommon: changes in sexual desire, impotence, decreased orgasm

Not known: prolonged reaction times, movement disorders (extrapyramidal symptoms), tremors, dizziness, visual disturbances (double vision, blurred vision), articulation disorders / slurred speech, headache, seizures / convulsions, memory gaps (amnesia), disinhibition, euphoria, coma, thoughts of suicide / - attempt, restricted attention / concentration, balance disorders; paradoxical reactions such as B. Fear, states of excitement, agitation, aggressive behavior (hostility, aggression, anger), sleep disorders / insomnia, sexual arousal, illusions. If such reactions occur, treatment with Tavor should be stopped.

Heart disease

Not known: low blood pressure (hypotension), slight drop in blood pressure

Respiratory, thoracic and mediastinal disorders

Not known: Depressed breathing (extent depends on the dose), shortness of breath (apnea), worsening of sleep apnea (temporary respiratory arrest during sleep), worsening of obstructive pulmonary disease (narrowing of the airways)

Digestive system (gastrointestinal) disorders

Uncommon: nausea

Not known: constipation, increased bilirubin, jaundice, increased liver enzymes (transaminases, alkaline phosphatase)

Skin and subcutaneous tissue disorders

Not known: allergic skin reactions, hair loss

General disorders and administration site conditions

Common: muscle weakness, fatigue

Not known: Hypersensitivity reactions, anaphylactic / -oid reactions, swelling of the skin and / or mucous membranes (angioedema), inappropriate release of the antidiuretic hormone (SIADH), low sodium blood levels (hyponatremia), drop in body temperature (hypothermia)

Addiction / abuse

After just a few days of treatment with Tavor 2.5 mg daily, withdrawal symptoms (e.g. sleep disorders, increased dreaming) can occur after discontinuation of therapy, especially if this occurs suddenly. Fear, states of tension as well as excitement and inner restlessness can increase again. Other symptoms that have been reported after stopping benzodiazepines include headache, depression, confusion, irritability, sweating, depressed mood (dysphoria), dizziness, loss of reality, abnormal behavior, excessive sound, numbness and tingling in the limbs, hypersensitivity to light, noise, and Touch, impaired perception, involuntary movements, nausea, vomiting, diarrhea, loss of appetite, hallucinations / delirium, seizures / cramps, tremors, abdominal cramps, muscle pain, states of excitement, palpitations, increased pulse, panic attacks, dizziness, exaggerated reflexes, loss of short-term memory and fever. If Tavor 2.5 mg is used chronically in people with epilepsy or if other drugs that lower the seizure threshold (e.g. antidepressants) are taken, stopping it suddenly may trigger more seizures. The risk of withdrawal symptoms increases with the previous intake duration and dose. These symptoms can usually be avoided by gradually reducing the dose.

There are indications of a development of tolerance (dose increase due to habituation) to the calming (sedative) effect of benzodiazepines.

Lorazepam has potential for abuse. Patients with a history of drug and / or alcohol abuse are particularly at risk.

What action to take in the event of side effects

Many of the side effects mentioned disappear as the treatment continues or when the dose is reduced. If side effects persist, please inform your doctor, who should decide whether to stop treatment. Tell your doctor immediately if you develop unexplained rashes, skin discoloration, or swelling.

Reporting of side effects

If you get any side effects, talk to your doctor, pharmacist or nurse. This also applies to side effects not listed in this leaflet. You can also report side effects directly to the Federal Institute for Drugs and Medical Devices, Dept. Pharmacovigilance, Kurt-Georg-Kiesinger-Allee 3, D-53175 Bonn, website: www.bfarm.de. By reporting side effects you can help provide more information on the safety of this medicine.

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5. How to store Tavor 2.5 mg

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date which is stated on the carton and container after "EXP". The expiry date refers to the last day of the month indicated.

Do not store above 25 ° C.

Do not dispose drugs in the wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. You help to protect our environment.

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6. Contents of the pack and other information

What Tavor 2.5 mg contains:

The active ingredient is: lorazepam. 1 tablet contains 2.5 mg lorazepam.

The other ingredients are: microcrystalline cellulose, lactose monohydrate, polacrilin potassium, magnesium stearate, quinoline yellow aluminum salt (E 104), iron (II, III) oxide (E 172).

What Tavor 2.5 mg looks like and contents of the pack

Tavor 2.5 mg is a yellow, round tablet debossed with “2.5” and a score line.

Packs of 10, 20 or 50 tablets are available.

Not all pack sizes may be marketed.

Pharmaceutic entrepreneur

PFIZER PHARMA PFE GmbH

Linkstrasse 10

10785 Berlin

Tel .: 0800 8535555

Fax: 0800 8545555

Manufacturer

Haupt Pharma Münster GmbH

Schleebrüggenkamp 15

48159 Munster

This leaflet was last revised in October 2018.

For the patient's attention!

This medicinal product contains an active ingredient from the group of benzodiazepines!

Benzodiazepines are medicines used to treat conditions associated with restlessness and anxiety, internal tension, or insomnia. Benzodiazepines are also used to treat epilepsy and certain types of muscle tension.

Not all anxiety or sleep disorders require drug treatment. They are often the expression of physical or mental illnesses or other conflicts and can be influenced by other measures or treatment of the underlying illness.

Benzodiazepines do not eliminate the cause of the disorder. They reduce the stress of suffering and can also be an important help to e.g. B. to facilitate access to further treatment and the corresponding problem processing.

The use of benzodiazepines can lead to the development of physical and psychological dependence. In order to keep this risk as low as possible, you are advised to carefully observe the following information:

1. Benzodiazepines are only suitable for the treatment of pathological conditions and may only be taken on medical advice.

2. If you are currently or have been dependent on alcohol, drugs or drugs, you must not take benzodiazepines; Except for rare situations that can only be assessed by a doctor. Make your doctor aware of this fact.

3. Uncontrolled long-term use must be avoided as it can lead to drug dependence. At the start of therapy, a follow-up appointment must be made with the attending physician so that he can decide on further treatment. If taken without medical advice, there is less chance of being able to help you with these medicines by prescription.

4. Under no circumstances should you increase the dose prescribed by your doctor and under no circumstances should you reduce the time intervals between individual doses, even if the effect wears off. This can be the first sign of an emerging dependency. Unauthorized changes to the dose prescribed by the doctor make targeted treatment more difficult.

5. Benzodiazepines must never be stopped suddenly, but only as part of a gradual dose reduction (tapering off). When discontinuing after prolonged use, restlessness, anxiety, insomnia, seizures and hallucinations can occur - often with a delay of a few days. These withdrawal symptoms disappear after a few days to weeks. If necessary, discuss this with your doctor.

6. Never take benzodiazepines from others or take them because they “have helped others so well”. Never give these medicines to anyone else.

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