Jeffrey Panko NP Psychiatry · Patient education
Lorazepam
Ativan / Loreev XR / Generic oral and injectable formulations
A guide for adults taking lorazepam.
Follow the directions on your prescription and your provider's recommendations.
Formulations: Immediate-release tablets, oral concentrate, extended-release capsules, and injections have separate instructions. A long-acting formulation should not be substituted without a plan.
What it is used for
Lorazepam treats anxiety and is used in clinical settings for certain seizures, procedures, or other acute conditions. The schedule and duration depend on the indication.
How it works
It enhances GABA activity, reducing nerve-cell excitability. It can relieve anxiety while impairing alertness, memory, and coordination.
What to expect over time
Effects can begin after the first dose. The timing and duration depend on the formulation and dose. Sleepiness or impaired coordination may last longer than the relief you notice.
Your provider should review whether ongoing treatment is helping and whether the dose or duration should change. Do not increase the dose when the effect seems weaker.
Taking your medication
- Follow your scheduled or specifically prescribed as-needed regimen.
- Measure concentrate with the supplied device. Follow XR capsule instructions if that formulation is prescribed.
- If you miss a dose, take it when you remember unless it is almost time for the next dose. Then skip it. Do not double a dose.
- Do not abruptly stop after regular use.
When to get help
Emergency symptoms. Call 911 for slow or difficult breathing, inability to wake, collapse, or a seizure. Severe confusion or hallucinations after reducing or stopping may be dangerous withdrawal.
Prompt medical advice. Contact your provider promptly for repeated falls, marked memory problems, unusual aggression, or needing more medication to get the same effect.
If you feel unsafe or have thoughts of self-harm, call 911 or go to an emergency department.
Possible side effects
- Sleepiness, slowed reactions, or fatigue
- Dizziness, poor balance, or falls
- Memory problems or difficulty concentrating
Keeping track of treatment
Some side effects resolve with time; others may require a change of medication. Discuss persistent or bothersome side effects with your provider.
Watch for daytime sedation, falls, memory changes, and breathing problems. Older adults and people taking other sedatives may be more sensitive.
Physical dependence can develop with regular use. Sudden stopping or a rapid reduction can cause severe withdrawal, including seizures. Dependence is different from addiction, but misuse and addiction are also possible.
If you take too much
For a suspected overdose, call Poison Control at 1-800-222-1222 immediately, even if you feel well. Call 911 for a seizure, collapse, trouble breathing, or inability to wake.
Before you start
Discuss sleep apnea, lung disease, liver or kidney disease, glaucoma, falls, and any history of substance use problems. Tell your provider about all opioids and other sedatives.
Discuss pregnancy, pregnancy plans, and breastfeeding with your provider. Treatment decisions should consider both the medication and the condition being treated.
Medicines and interactions
Review all your medications with your provider, including over-the-counter medicines and supplements. Have new medications checked before taking them.
Combining a benzodiazepine with an opioid can cause profound sedation, slowed breathing, coma, or death. Use such combinations only under a specifically reviewed treatment plan.
Avoid alcohol. Sleeping pills, sedating antihistamines, muscle relaxants, and other sedatives can increase impairment and breathing risks.
Valproate and probenecid can increase exposure and may require dose adjustment.
Everyday tips
Do not drive until you know how the medication affects you. Avoid driving whenever sleepy or impaired.
Keep medication locked away. Never share it, even with someone who has similar symptoms.
Arrange refills or taper instructions before you run out.
Your questions answered
Can I stop after taking it regularly?
Consult with your provider before reducing or stopping. A gradual, individualized taper helps limit withdrawal. Do not borrow medication or change the schedule to manage withdrawal yourself.
What if I feel unusually agitated?
Some people develop disinhibition, irritability, or agitation. Contact your provider rather than taking an extra dose.
Storage and safety
Keep medication in its labeled container, away from excess heat and moisture and out of reach of children and pets. Do not share it. Ask a pharmacy about disposal of unused medication.
Sources
About this information
Educational handout; does not replace your prescription or provider's recommendations.
Educational inclusion does not mean this medication or its indications are treated at this practice. Review the guide for your exact product with your prescriber or pharmacist.