Ativan® (lorazepam)
Brand name: Ativan®
-
Tablets:
0.5 mg, 1 mg, 2 mg
-
Liquid:
2 mg/ml solution
-
Injection:
2 mg/ml, 4 mg/ml
Generic
name: lorazepam (lor
A ze pam)
Medication
class: benzodiazepine, anxiolytic (anti-anxiety)
What
is Ativan® and what does it treat?
Lorazepam
is a benzodiazepine. It is approved for the treatment of anxiety,
status epilepticus (continuous seizures), and as a medication given
right before anesthesia. However, benzodiazepines are also commonly
used to treat difficulty sleeping and alcohol withdrawal.
Generalized
Anxiety Disorder (GAD) occurs
when a person experiences excessive anxiety or worry for at least six
months. Other symptoms include
-
Restlessness
-
Fatigue
(low energy, feeling tired all the time)
-
Difficulty
concentrating
-
Irritability
-
Muscle
tension
-
Sleep
disturbance (difficulty falling asleep or waking up in the middle of
the night)
What
is the most important information I should know about Ativan®?
Do
not drive a car or operate machinery until you know how this
medication affects you because you may notice that you feel tired or
dizzy.
When
starting lorazepam, anxiety or insomnia may improve rapidly or over a
period of days.
Benzodiazepines,
such as lorazepam, are often used for short periods of time only.
They may produce emotional and/or physical dependence (addiction)
even when used as recommended. Only your healthcare provider can
determine the length of treatment that is right for you.
Do
not stop taking lorazepam without talking to your healthcare provider
first. Stopping lorazepam abruptly may result in one or more of the
following withdrawal symptoms: irritability, nausea, tremor,
dizziness, blood pressure changes, rapid heart rate, and seizures.
Are
there specific concerns about Ativan® and
pregnancy?
If
you are planning on becoming pregnant, notify your healthcare
provider to best manage your medications. People living with anxiety
disorders who wish to become pregnant face important decisions. It
is important to discuss this with your doctor and caregivers.
Regarding
breastfeeding, caution is advised since lorazepam does pass into
breast milk.
What
should I discuss with my healthcare provider before taking Ativan®?
-
Symptoms
of your condition that bother you the most
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If
you have thoughts of suicide or harming yourself
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Medications
you have taken in the past for your condition, whether they were
effective or caused any adverse effects
-
If
you experience side effects from your medications, discuss them with
your healthcare provider. Some side effects may pass with time, but
others may require changes in the medication.
-
Any
other psychiatric or medical problems you have including obstructive
sleep apnea
-
All
other medications you are currently taking (including over the
counter products and herbal and nutritional supplements) and any
medication allergies you have
-
Other
non-medication treatment you are receiving such as talk therapy or
substance abuse treatment. Your provider can explain how these
different treatments work with the medication.
-
If
you are pregnant, plan to become pregnant, or are breast-feeding
-
If
you drink alcohol or use drugs
How
should I take Ativan®?
Lorazepam may
be taken with or without food.
Lorazepam
may be taken everyday at regular times or on an as needed (“PRN”)
basis. Typically, your healthcare provider will limit the number of
doses you should take in one day.
Your
healthcare provider will determine the dose and method of taking the
medication that is right for you based upon your response.
Lorazepam
liquid: Measure with a dosing spoon or oral syringe which you can get
from your pharmacy.
If
you take the medication everyday (instead of ‘as needed’), use a
calendar, pillbox, alarm clock, or cell phone alert to help you
remember to take it. You may also ask a family member or friend to
remind you or check in with you to be sure you are taking your
medication.
What
happens if I miss a dose of Ativan®?
If
you miss a dose of lorazepam, take it as soon as you remember, unless
it is closer to the time of your next dose. Discuss this with your
healthcare provider. Do not double your next dose or take more than
what is prescribed.
What
should I avoid while taking Ativan®?
Avoid
drinking alcohol and using illegal drugs while you are taking
lorazepam. They may decrease the benefits (e.g., worsen your
condition) and increase the adverse effects (e.g., sedation) of the
medication. Alcohol increases the risk of accidental overdose with
medications like lorazepam.
What
happens if I overdose with Ativan®?
If
an overdose occurs call your doctor or 911. You may need urgent
medical care. You may also contact the poison control center at
1-800-222-1222.
Symptoms
of overdose include confusion, impaired coordination, slow reflexes,
coma, and death.
A
specific treatment to reverse the effects of lorazepam does exist.
This medicine, called flumazenil, can reverse the effects of
lorazepam but must be given through an IV at a hospital. Only a
doctor can decide if you need this medication.
What
are the possible side effects of Ativan®?
Common
Side Effects
-
Feeling
dizzy, drowsy, fatigued, or lightheaded
-
Impaired
coordination, decreased ability to concentrate
If
you experience these side effects after starting lorazepam they will
often improve over the first week or two as you continue to take the
medication.
Rare
Side Effects
Increased
heart rate, headache, memory impairment, irritability, restlessness
Serious
Side Effects
Some
people taking benzodiazepines develop a severe allergic reaction and
swelling of the face. This can occur as early as with the first
dose.
Some
people taking benzodiazepines for sleep have experienced various
behaviors while they were asleep/not fully awake, such as sleep
driving, making phone calls, and preparing or eating food. The
individuals have no memory of the events when they awaken.
Are
there any risks for taking Ativan® for long periods of time?
Lorazepam
is a safe and effective medication when used as directed.
Benzodiazepines may produce emotional and/or physical dependence
(addiction) even when used as recommended. Physical dependence may
develop after 2 or more weeks of daily use.
What
other medications may interact with Ativan®?
Lorazepam
should not be taken with other benzodiazepine medications.
Lorazepam
causes drowsiness, so caution should be used when combining it with
other medications that cause drowsiness. These could include:
-
Antihistamines
such as diphenhydramine (Benadryl®)
-
Narcotic
pain medication such as morphine, oxycodone (OxyContin®),
and hydrocodone (Vicodin® and Lortab®),
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Sleeping
medications such as zolpidem (Ambien®)
-
Other
anti-anxiety medications, antipsychotic medications, certain
anticonvulsant medications, and tricyclic antidepressant medications
(such as amitriptyline).
How
long does it take for Ativan® to
work?
When
starting lorazepam, anxiety or insomnia may improve rapidly or over a
period of days or within hours of the first dose of medication.
Provided
by the College of Psychiatric and Neurologic Pharmacists
(January
2013)
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