Ativan

Generic Name: lorazepam (Oral route)

lor-AZ-e-pam

Commonly used brand name(s)

In the U.S.

• Ativan


• Lorazepam Intensol

Available Dosage Forms:

• Tablet


• Solution

Therapeutic Class: Antianxiety

Pharmacologic Class: Benzodiazepine, Short or Intermediate Acting

Uses For Ativan

Lorazepam is used to treat anxiety. This medicine is a benzodiazepine. Benzodiazepines belong to the group of medicines called central nervous system (CNS) depressants, which are medicines that slow down the nervous system.

This medicine is available only with your doctor's prescription.

Before Using Ativan

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of lorazepam in children under 12 years of age. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of lorazepam in the elderly. However, severe drowsiness or unsteadiness are more likely to occur in the elderly, who are usually more sensitive than younger adults to the effects of lorazepam. Elderly patients may require a lower dose to help reduce unwanted effects.

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	D	Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.

Breast Feeding

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Alfentanil


• Amobarbital


• Anileridine


• Aprobarbital


• Butabarbital


• Butalbital


• Carisoprodol


• Chloral Hydrate


• Chlorzoxazone


• Codeine


• Dantrolene


• Ethchlorvynol


• Fentanyl


• Fospropofol


• Hydrocodone


• Hydromorphone


• Levorphanol


• Meperidine


• Mephenesin


• Mephobarbital


• Meprobamate


• Metaxalone


• Methocarbamol


• Methohexital


• Morphine


• Morphine Sulfate Liposome


• Oxycodone


• Oxymorphone


• Pentobarbital


• Phenobarbital


• Primidone


• Propoxyphene


• Remifentanil


• Secobarbital


• Sodium Oxybate


• Sufentanil


• Tapentadol


• Thiopental


• Zolpidem

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Probenecid


• Pyrimethamine


• St John's Wort


• Theophylline


• Valproic Acid

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Glaucoma, acute narrow-angle—Should not be used in patients with this condition.

• Kidney disease or


• Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

• Lung diseases (e.g., COPD, sleep apnea syndrome) or


• Seizures—Use with caution. May make these conditions worse.

Proper Use of lorazepam

This section provides information on the proper use of a number of products that contain lorazepam. It may not be specific to Ativan. Please read with care.

Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

To use the oral solution:

This medicine is to be taken by mouth. Measure the oral liquid with the provided medicine dropper. Dilute each dose with water, juice, soda, applesauce and puddings.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage forms (tablets or solution):
  
  • For anxiety:
    
    • Adults or teenagers—2 to 6 milligrams (mg) in divided doses per day. Your doctor may adjust your dose as needed.
    
    
    • Older adults—At first, 1 to 2 mg in divided doses per day. Your doctor may adjust your dose as needed.
    
    
    • Children younger than 12 years of age—Use and dose must be determined by your doctor.
    
    
  
  

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using Ativan

It is very important that your doctor check your progress at regular visits to allow for changes in your dose and to check for any unwanted effects. Blood tests may be needed to check for any unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.

This medicine may cause drowsiness, trouble with thinking, trouble with controlling movements, or trouble with seeing clearly. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert or able to think or see well.

Do not stop taking it without checking with your doctor first. Your doctor may want you to gradually reduce the amount you are using before stopping it completely. This may help prevent a worsening of your condition and reduce the possibility of withdrawal symptoms, such as convulsions (seizures), hallucinations, stomach or muscle cramps, tremors, or unusual behavior.

This medicine will add to the effects of alcohol and other central nervous system (CNS) depressants. CNS depressants are medicines that slow down the nervous system, which may cause drowsiness or make you less alert. Some examples of CNS depressants are antihistamines or medicine for hay fever, allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates (used for seizures); muscle relaxants; or anesthetics (numbing medicines), including some dental anesthetics. This effect may last for a few days after you stop taking this medicine. Check with your doctor before taking any of the above while you are using this medicine.

Ativan Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

• Drowsiness


• relaxed and calm


• sleepiness

Incidence not known

• Abdominal or stomach pain


• aggressive, angry


• agitation


• anxiety


• attack, assault, or force


• black, tarry stools


• bleeding gums


• blood in urine or stools


• bluish lips or skin


• blurred vision


• change in consciousness


• chills


• coma


• confusion


• confusion about identity, place, and time


• convulsions


• cough or hoarseness


• dark urine


• decreased urine output


• difficulty in breathing and/or swallowing


• difficulty in speaking


• discouragement


• dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly


• drooling


• dry mouth


• excitation


• false or unusual sense of well-being


• fast or irregular heartbeat


• fear or nervousness


• feeling sad or empty


• fever with or without chills


• general feeling of tiredness or weakness


• headache


• hives


• hyperventilation


• increased thirst


• irregular, fast or slow, or shallow breathing


• irritability


• itching


• loss of appetite


• loss of balance control


• loss of consciousness


• loss of interest or pleasure


• loss of memory


• lower back or side pain


• muscle pain or cramps


• muscle trembling, jerking, or stiffness


• nausea or vomiting


• not breathing


• painful or difficult urination


• pale or blue lips, fingernails, or skin


• pinpoint red spots on skin


• problems with memory


• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue


• rash


• reddening of the skin, especially around ears


• restlessness


• seeing, hearing, or feeling things that are not there


• seizures


• shaking


• shortness of breath


• shuffling walk


• sleeplessness


• sore throat


• sores, ulcers, or white spots on lips or in mouth


• stiffness of limbs


• sweating


• swelling of eyes or inside of nose


• swelling of face, ankles, or hands


• swollen glands


• thoughts or attempts at killing oneself


• tightness in chest


• trouble concentrating


• trouble sleeping


• twisting movements of body


• unable to sleep


• uncontrolled movements, especially of face, neck, and back


• unexplained bleeding or bruising


• unpleasant breath odor


• unusual bleeding or bruising


• unusual tiredness or weakness


• vomiting of blood


• wheezing


• yellow eyes or skin

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

• Changes in patterns and rhythms of speech


• increased sweating


• loss of strength or energy


• low blood pressure


• nightmares


• shakiness and unsteady walk


• slurred speech


• trouble in speaking


• unsteadiness, trembling, or other problems with muscle control or coordination


• unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness


• unusual excitement, nervousness, restlessness, or irritability


• unusual paleness unusual weak feeling

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

• Being forgetful


• clumsiness


• constipation


• decreased interest in sexual intercourse


• disturbed color perception


• dizziness or lightheadedness


• double vision


• drowsiness


• feeling of constant movement of self or surroundings


• hair loss, thinning of hair


• halos around lights


• hostility


• inability to have or keep an erection


• increased in sexual ability, desire, drive, or performance


• increased interest in sexual intercourse


• lack or loss of self-control


• lethargy


• loss in sexual ability, desire, drive, or performance


• low body temperature


• muscle aches


• muscle twitching


• muscle weakness


• night blindness


• overbright appearance of lights


• rapid weight gain


• sensation of spinning


• shakiness in legs, arms, hands, or feet


• shivering


• sleepiness


• stupor


• trembling or shaking of hands or feet


• tunnel vision


• weak or feeble pulse

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Ativan side effects (in more detail)

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More Ativan resources

• Ativan Side Effects (in more detail)
• Ativan Use in Pregnancy & Breastfeeding
• Drug Images
• Ativan Drug Interactions
• Ativan Support Group
• 125 Reviews for Ativan - Add your own review/rating

• Ativan Prescribing Information (FDA)


• Ativan Consumer Overview


• Ativan Monograph (AHFS DI)


• Ativan MedFacts Consumer Leaflet (Wolters Kluwer)


• Lorazepam Prescribing Information (FDA)


• Lorazepam Professional Patient Advice (Wolters Kluwer)

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