tablets are actually Lorazepam tablets.
The tablets contain 1 mg of Lorazepam
(generic for Ativan). Mylan 457 tablets are gray and round, with MYLAN
letters and the number 457 divided by a score written on one side.
A company with a reputation for quality, Mylan has pioneered the
development and production of sophisticated dosage forms such as
extended-release tablets and capsules as well as transdermal patches
that deliver medication through the skin.
Mylan 457 Lorazepam is an anti-anxiety medication which has long been a
drug of choice for status epilepticus.
Lorazepam is an intermediate acting benzodiazepine and its uniqueness,
advantages and disadvantages are largely explained by its
pharmacokinetic properties (poor water and lipid solubility, high
protein binding and non-oxidative metabolism to a pharmacologically
inactive glucuronide form) and by its high relative potency (Lorazepam
1 mg is equal in effect to 457 Mylan pill).
CHILDREN AND THE ELDERLY. The safety and effectiveness of Mylan 457
pills is not well determined in children under 16 years of age, but it
is used to treat serial seizures. Dose requirements have to be
individualized, especially in the elderly and debilitated patients in
whom the risk of oversedation is greater. Long-term therapy may lead
to cognitive deficits, especially in the elderly, but this is
reversible after a period of discontinuation. Benzodiazepines,
including Lorazepam, have been found to increase the risk of falls
and fractures in the elderly.
LIVER OR KIDNEY FAILURE. Lorazepam may be safer than most
benzodiazepines in patients with impaired liver function. Like oxazepam
it does not require hepatic oxidation, but only hepatic glucuronidation
into lorazepam-glucuronide. Therefore, impaired liver function is
unlikely to result in the drug's to an extent causing adverse
reactions. Lorazepam-glucuronide and a small amount of unchanged
Lorazepam are excreted by the kidneys, so in renal failure small
increases in Lorazepam levels may occur.
WITHDRAWAL SYMPTOMS. On abrupt, or overly rapid discontinuation of
Lorazepam, anxiety and signs of physical withdrawal have been observed,
similar to those seen on withdrawal from alcohol and barbiturates.
Mylan Lorazepam as with other benzodiazepine drugs can cause physical
dependence, addiction and what is known as the benzodiazepine
withdrawal syndrome. The higher the dose and the longer the drug is
taken for the greater the risk of experiencing unpleasant withdrawal
symptoms. Withdrawal symptoms can however occur from standard dosages
and also after short term use. Benzodiazepine treatment should be
discontinued as soon as possible via a slow and gradual dose reduction
Prescribers of Mylan 457 tablets must be alert to the possibility of
abuse or diversion for illegitimate use when prescribing for
unsupervised outpatients. This applies particularly to patients with
past or present substance abuse disorders, as persons with addictive
personalities are likelier to abuse medications such as Lorazepam. In
addition to recreational use, benzodiazepines may be diverted and used
to facilitate crime: criminals may take them to deliberately seek
disinhibition before committing crimes (which increases their potential
for violence) or they may give them to unwitting victims as date rape
drugs, notably with alcohol.
DRUG INTERACTIONS: Mylan 457 Lorazepam pills, as all benzodiazepines,
interact with other medications and drugs that slow the brain's
processes such as alcohol, barbiturates, and narcotics. There have
been cases of marked sedation when Mylan 457's were given to patients
taking the tranquilizer loxapine (Loxitane); it is unclear if there
is a drug interaction at all, but concern is warranted.
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