Lorazepam

( Ativan )

Medically Reviewed by HaVy Ngo, Pharm.D.

Last Reviewed: Jun 09, 2022

Warnings


What are the risks of taking lorazepam?


Lorazepam can cause serious health problems in certain groups of people. You should talk to your healthcare provider if you have any concerns or other treatment options.

Dependence and withdrawal

Risk factors:
  • Taking lorazepam with alcohol or other drugs

  • Family or personal history of drug or alcohol addiction

  • Taking lorazepam for longer than 4 weeks

  • Sudden discontinuation of lorazepam 

Lorazepam is a schedule IV controlled substance, meaning it risks abuse and physical dependence. Even though the risk is lower than schedule III and II controlled substances, you should only take lorazepam exactly as prescribed to lower your risk of dependence and overdose. You should not stop taking lorazepam without discussing it with your doctor. Sudden discontinuation of this medication can cause unpleasant withdrawal symptoms that can even be life-threatening after long-term use.

Sedation and difficulty breathing
Risk factors:

  • Taking lorazepam with alcohol or other drugs

  • Taking lorazepam for a longer time or at higher doses than prescribed

Taking lorazepam with opioid drugs or alcohol can increase the risk of severe respiratory depression, leading to tiredness, drowsiness, lethargy, difficulty breathing, and even death. It is common for people with certain medical conditions such as cancer or chronic pain to be prescribed an opiate for their pain and a benzodiazepine medicine for anxiety. Caregivers and family members should be educated on the signs of respiratory depression. Seek medical help immediately if the patient starts having difficulty breathing, waking up, or staying awake. Talk to your healthcare provider to ensure this combination is within the safest dosage range or if there are other safer options.

Impaired coordination
Risk factors:

  • Taking lorazepam with alcohol or other drugs

  • Taking other medications that cause drowsiness

Lorazepam can make you drowsy and sleepy, thus impairing your ability to think or perform activities that require mental alertness. You should not drive or operate hazardous machinery until you know how your body reacts to this medication. Avoid drinking alcohol and illicit drug use with lorazepam as the combination can enhance the adverse effects. 

Suicidal thoughts and behaviors
Risk factor:

  • Severe depression

Lorazepam can cause unusual changes in mood or behavior. You should monitor for new or worsening signs of depression, suicidal thoughts, and suicidal behaviors. Contact your healthcare provider and seek medical help right away if you notice any of these signs.

Severe side effects
Risk factors:

  • Age 65 and older
  • Being weak and frail
People 65 or older are more likely to experience more severe side effects from lorazepam as it takes longer for the drug to get out of their systems. People who are weak and frail tend to have the same risk of severe side effects. To avoid these side effects, healthcare providers typically start patients 65 and older on a low dose of lorazepam.

Harm to the fetus:
Risk factor:

  • Taking lorazepam while pregnant

Lorazepam may cause harm to your unborn baby. Let your doctor know immediately if you plan to conceive or get pregnant while taking lorazepam.

What should I tell my doctor before starting lorazepam?

You should not use lorazepam if you are allergic to lorazepam or to any benzodiazepine such as alprazolam (Xanax), diazepam (Valium), clonazepam (Klonopin), and others.

If you have narrow-angle glaucoma, you should not take lorazepam. 

Tell your doctor if you have:

  • Allergy to aspirin or yellow food dye
  • Any breathing disorders such as asthma, chronic obstructive pulmonary disease (COPD), and sleep apnea.
  • History of drug or alcohol addiction
  • Any mood disorder such as depression, suicidal thoughts, or behavior
  • Kidney or liver disease
  • Seizures

Tell your doctor if you are pregnant or plan to be pregnant. Using lorazepam during pregnancy can cause your baby to be born with life-threatening withdrawal symptoms that may warrant medical treatments for several weeks. 

Do not breastfeed while taking lorazepam as it can be passed into breast milk, causing sedation and other adverse effects.

What proper medical care should I take while on lorazepam?

Lorazepam will make you drowsy. You should not drive or perform any activities that require mental alertness until you know how your body reacts to the medication. 

When taking lorazepam, you should educate your caregiver or family members on the signs and symptoms of respiratory depression. The signs include slow and shallow breathing, shortness of breath, tiredness, bluish-colored lips/fingers/toes, and confusion.  

It would be best if you did not stop taking lorazepam suddenly. Before discontinuing this medication, talk to your doctor to avoid withdrawal symptoms, especially after prolonged use.

What drugs can interact with lorazepam?

Taking lorazepam with other medications that make you drowsy can worsen this effect. Examples of these medications are opioid pain relievers, sleep medicines, muscle relaxers, and medicine for seizures. However, this is not a complete list. Other drugs, including prescriptions, over-the-counter products, herbal supplements, and vitamins, may interact with lorazepam. Not all potential drug interactions are listed in this guide. It is highly recommended to keep a list of all the drug products you are using (prescriptions, over-the-counter products, herbal supplements, natural products, and vitamins) and share it with your doctor and pharmacist.