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Lorazepam kinetics in the elderly.

D J Greenblatt, M D Allen, A Locniskar

Clinical Pharmacology and Therapeutics

|July 1, 1979

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Elderly individuals show slightly reduced lorazepam clearance, but absorption remains rapid and complete, similar to younger adults. These minor pharmacokinetic changes suggest lorazepam is generally well-tolerated in older populations.

Area of Science:

Pharmacology
Geriatric Medicine
Clinical Pharmacy

Background:

Lorazepam, a benzodiazepine, is metabolized via glucuronidation and excreted as a metabolite.
Understanding age-related pharmacokinetic differences is crucial for safe medication use in the elderly.

Purpose of the Study:

To assess the pharmacokinetic properties of lorazepam in healthy elderly versus young adults.
To evaluate the absorption characteristics of intramuscular and oral lorazepam in the elderly.

Main Methods:

Intravenous lorazepam (1.5-3.0 mg) administered to 15 elderly (60-84 yrs) and 15 young (19-38 yrs) healthy subjects.
Plasma concentrations analyzed to determine volume of distribution, elimination half-life, and clearance.
Absorption of intramuscular and oral lorazepam assessed in 10 elderly subjects.

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Main Results:

Elderly subjects had a smaller volume of distribution (0.99 L/kg) compared to young subjects (1.11 L/kg).
Lorazepam clearance was 22% lower in the elderly (0.77 ml/min/kg) versus young subjects (0.99 ml/min/kg), partly due to smoking habits.
Absorption half-life for both IM and oral lorazepam in the elderly did not exceed 45 min, with 80-100% completeness.

Conclusions:

Aging is associated with minor alterations in lorazepam pharmacokinetics, specifically reduced clearance.
Intramuscular and oral lorazepam absorption in the elderly is rapid and nearly complete, similar to younger individuals.
These findings support the safe administration of lorazepam in elderly populations with appropriate dosing considerations.