Ativan (lorazepam) is a brand-name prescription medication. You might hear it called a sedative-hypnotic or anxiolytic medication. Ativan belongs to a class of medications called benzodiazepines.

Ativan is used to treat anxiety symptoms, insomnia (trouble sleeping), and status epilepticus (a type of severe seizure). It’s also given before surgery to make you sleep.

Ativan comes in two forms:

Ativan contains the active drug lorazepam. Both the tablet and solution form of Ativan are available as generic medications.

Generic drugs are often less expensive than the brand-name version. In some cases, the brand-name drug and the generic version may be available in different forms and strengths.

To learn more about generic lorazepam oral tablets, see this article.

Ativan can cause mild or serious side effects. The following list contains some of the key side effects that may occur while taking Ativan. This list doesn’t include all possible side effects.

For more information on the possible side effects of Ativan, or tips on how to deal with a troubling side effect, talk with your doctor or pharmacist.

Note: The Food and Drug Administration (FDA) tracks and reviews side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Ativan, you can do so through MedWatch.

More common side effects

The more common side effects of Ativan include:

Some people may also experience less frequent side effects such as:

In people who receive the Ativan injection, redness or deepening of skin color and pain at the injection site can commonly occur.

Some of these side effects may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Ativan aren’t common, but they can occur. Call your doctor right away if you have any serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include the following:

  • Breathing effects. Symptoms can include:
  • Low blood pressure, which may be severe enough to cause fainting or falls.
  • Convulsions or seizures. Symptoms can include:
    • uncontrollable, sudden movements in your arms or legs
    • loss of consciousness or awareness
    • stiff muscles
    • staring spells
  • Paradoxical reactions (reactions that cause effects opposite of those expected with the drug), such as aggression, hostility, agitation, or rage.
  • Dependence, misuse, and addiction, which are more likely in people who take higher doses of Ativan or use it long term, or those who misuse alcohol or drugs.*† Symptoms of physical dependence can include:
  • Serious allergic reactions. Symptoms can include:
    • severe rash or hives
    • trouble breathing or swallowing
    • swelling of your lips, tongue, or face
    • rapid heartbeat
  • Suicidal thoughts. (Because of this, Ativan should be avoided by people with depression that’s not treated.)
  • Life threatening side effects if taken with opioid medications.* (See the “Ativan interactions” section for details.)

* Ativan tablets and solution have a boxed warning regarding this risk. A boxed warning is the strongest warning required by the Food and Drug Administration (FDA). Boxed warnings alert doctors and patients about drug effects that may be dangerous.
† With dependence, your body needs a drug in order to function like usual. With misuse, a drug is taken in a way other than how it’s prescribed. And with addiction, it’s difficult to stop taking a drug, even though it’s causing harmful outcomes.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours per day at 800-273-8255. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 800-273-8255.

Click here for more links and local resources.

Side effects in children

Ativan tablets aren’t approved by the Food and Drug Administration (FDA) for use in children younger than 12 years. They’re sometimes used off-label in children under 12 years, but this use hasn’t been confirmed to be safe.

Children may be more likely than adults to experience certain side effects from Ativan.

Side effects in older people

In older adults, Ativan should be used cautiously or avoided altogether. Many older people are more likely to experience side effects such as drowsiness or dizziness. This can increase their risk of falls, which can lead to bone fractures. Lower dosages are often needed for older people.

Long-term side effects

Studies of Ativan tablets for treating anxiety didn’t evaluate whether it’s safe to take the drug for longer than 4 months.

Long-term use of Ativan should be avoided when possible because it can cause serious side effects. These include:

  • Dependence, misuse, and addiction.* Ativan is a habit-forming drug. This means that long-term use can cause physical and psychological dependence. (With dependence, your body needs a drug in order to function like usual.) It can also cause serious withdrawal symptoms when the medication is stopped. Taking Ativan may also lead to misuse and addiction. (With misuse, a drug is taken in a way other than how it’s prescribed. And with addiction, it’s difficult to stop taking a drug, even though it’s causing harmful outcomes.)
  • Rebound effects. In addition, long-term use of Ativan for sleep or anxiety can cause “rebound insomnia” or “rebound anxiety.” This means that Ativan can make symptoms of these conditions worse over time, which makes it even harder to stop taking the drug.

If you’ve been taking Ativan regularly for a long time, talk with your doctor about other medication options, and how you might be able to stop taking Ativan.

* Ativan tablets and solution have a boxed warning regarding this risk. A boxed warning is the strongest warning required by the Food and Drug Administration (FDA). Boxed warnings alert doctors and patients about drug effects that may be dangerous.

Driving warning

Ativan can impair your ability to drive. If you feel lightheaded or sleepy after taking it, don’t drive. Also, don’t use dangerous equipment.

Nausea

It’s not common, but some people who take Ativan can feel nauseated. This side effect may go away with continued use of the drug. If nausea doesn’t go away or is bothersome, talk with your doctor.

Headache

Some people who take Ativan report having headaches afterward. This side effect may go away with continued use of the drug. If headaches don’t get better or are bothersome, talk with your doctor.

Slowed breathing

Ativan can cause your breathing to slow down. In rare cases, this can lead to respiratory failure.

Slowed breathing is more likely to occur in people who are:

Weight gain or weight loss

Weight gain or loss aren’t typical side effects of Ativan, and studies have not confirmed these as side effects of this drug. However, weight changes may still occur.

Some people who take Ativan say they have more of an appetite than usual. This might cause them to eat more and gain weight. Other people who take it have a reduced appetite. This might cause them to eat less and lose weight.

Memory loss

Some people who take Ativan can have temporary memory loss. If this happens, you may have trouble remembering things that occurred while you were taking the medication.

Memory loss should stop after you stop taking Ativan.

Constipation

It’s not common, but some people who take Ativan report constipation. This side effect may go away with continued use of the drug. If it doesn’t get better or is bothersome, talk with your doctor.

Vertigo

It’s not common, but some people who take Ativan can experience vertigo. Vertigo is a feeling that things around you are moving when they’re not. People with vertigo often feel dizzy.

It’s not clear if Ativan is the actual cause of symptoms of vertigo. Also, Ativan is sometimes used off-label to treat people who have symptoms of vertigo caused by other conditions such as Meniere’s disease.

Hallucinations

It’s rare, but some people who take Ativan have hallucinations. If you have this side effect, talk with your doctor about alternatives to Ativan.

The Ativan dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of the condition you’re using Ativan to treat
  • your age
  • the form of Ativan you take
  • other medical conditions you may have

Typically, your doctor will start you on a low dosage and adjust it over time to reach the dosage that’s right for you. They’ll ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

Drug forms and strengths

Ativan comes as oral tablets and a solution that’s given by intramuscular (IM) injection or intravenous (IV) injection. The available strengths of each form are described below.

Ativan tablet strengths: 0.5 mg, 1 mg, and 2 mg

Ativan tablets come in the following strengths:

  • 0.5 milligrams (mg)
  • 1 mg
  • 2 mg

Ativan solution strengths: 2 mg/mL and 4 mg/mL

Ativan solution comes in the following strengths:

  • 2 mg of drug per milliliter (mL) of solution
  • 4 mg/mL

General dosage information for Ativan tablets

The usual oral dosage for Ativan tablets is 2 to 6 mg daily. This dosage amount is usually divided and taken two or three times daily.

Dosage of Ativan tablets for anxiety

Typical dosage: 2 to 3 mg taken two or three times daily.

Dosage of Ativan tablets for insomnia due to anxiety or stress

Typical dosage: 2 to 4 mg at bedtime.

Dosage of Ativan solution for IM or IV injection

Ativan solution will be given as an IV or IM injection by your healthcare professional. Your doctor will determine the best dosage for your condition.

Special dosage considerations

Older adults and people with certain physical conditions may need to start with a lower dosage. This might be 1 to 2 mg, taken two or three times daily for anxiety or once at bedtime for insomnia.

What if I miss a dose?

If you miss a dose, take it as soon as you can. However, if it’s just a few hours until your next dose, skip the missed dose and take the next one on schedule.

Never try to catch up by taking two doses at a time. This can cause dangerous side effects.

The Food and Drug Administration (FDA) approves drugs to treat certain conditions. Ativan is approved to treat several conditions. In addition, it’s sometimes used off-label for purposes that aren’t approved by the FDA.

Approved uses for Ativan

Ativan is FDA-approved for treating several different conditions. These conditions are described below.

Ativan for anxiety

Ativan is FDA-approved for managing anxiety disorders, including the short-term treatment of anxiety symptoms.

It’s also commonly used off-label for treating panic attacks. (With off-label use, a drug is prescribed for a condition other than those it’s approved to treat.)

Ativan for sleep or insomnia

Ativan is FDA-approved for short-term treatment of insomnia (trouble sleeping) that’s caused by anxiety or stress.

Ativan is also used off-label for other types of insomnia. However, according to the American Academy of Sleep Medicine, it’s not a first-choice medication for this use.

Ativan for seizures

The liquid form of Ativan is FDA-approved for treating a severe type of seizure called status epilepticus. With this condition, seizures don’t stop, or one seizure comes after another without allowing the person time to recover.

Ativan for sedation during surgery

The liquid form of Ativan is FDA-approved to cause sleep before surgery.

Non-FDA-approved uses

Ativan is also sometimes prescribed off-label. Off-label use is when a drug is approved for one use but is prescribed for a different use.

Ativan for nausea from vertigo

Ativan is sometimes used off-label for the short-term treatment of symptoms of vertigo. These symptoms include nausea and vomiting. In some cases, Ativan may be used along with other medications for this purpose.

Ativan for depression

Ativan and other similar medications aren’t prescribed to treat depression itself. However, some people with depression also have symptoms of anxiety or insomnia. In these cases, your doctor may prescribe Ativan to reduce those symptoms.

If you have depression only, your doctor will likely prescribe a different medication.

Ativan for pain

Ativan isn’t typically used to treat pain itself. However, people who have severe, long-lasting pain are often prescribed Ativan or similar medications. This may be because they have anxiety or trouble sleeping due to their pain.

People with severe pain are often treated with opioid pain medications. Ativan and other benzodiazepine medications shouldn’t be used with opioids. This is due to the risk of life threatening side effects such as serious sedation, decreased breathing, coma, and death.

If you’re taking an opioid pain medication with Ativan, talk with your doctor about safer options.

Ativan for migraine

Ativan is not approved to treat symptoms of migraine, such as headache. But it may be prescribed off-label for migraine headaches in some cases. (With off-label use, a drug is prescribed for a condition other than those it’s approved to treat.)

Also, keep in mind that headache is a possible side effect of this drug.

Other off-label uses for Ativan

Ativan may also be used off-label to treat other conditions such as:

You may wonder how Ativan and Xanax compare, and whether Ativan is stronger than Xanax. These medications both belong to the class of drugs called benzodiazepines. They work in the same way and are very similar medications.

The generic name of Xanax is alprazolam, while the generic name of Ativan is lorazepam.

Uses

Ativan and Xanax are used for similar and different purposes.

Approved uses for both Ativan and XanaxOther approved uses for AtivanOther approved uses for XanaxOff-label uses for AtivanOff-label uses for both
• treating anxiety symptoms• treating insomnia due to anxiety or stress

• treating status epilepticus

• providing sedation before surgery
• treating generalized anxiety disorder

• treating panic disorder
• treating generalized anxiety disorder

• treating panic disorder
• treating other types of insomnia

Drug forms

Ativan is available as an oral tablet and as a solution that’s given by intramuscular injection or intravenous injection. The oral tablet is usually taken one to three times per day. The solution is given by a healthcare professional.

Xanax is available as an oral tablet, which is usually taken three times daily. It’s also available as an extended-release tablet, which is taken just once daily.

Side effects and risks

Ativan and Xanax have some similar side effects, and some that differ. Below are examples of these side effects.

More common side effects

More common side effects that Ativan and Xanax share include:

In addition to these, other side effects that Xanax can cause include:

  • weight gain or loss
  • irregular menstruation

Serious side effects

Possible serious side effects that Ativan and Xanax share include:

* Ativan tablets, Ativan solution, and Xanax have a boxed warning regarding this risk. A boxed warning is the strongest warning required by the Food and Drug Administration (FDA). Boxed warnings alert doctors and patients about drug effects that may be dangerous.
† With dependence, your body needs a drug in order to function like usual. With misuse, a drug is taken in a way other than how it’s prescribed. And with addiction, it’s difficult to stop taking a drug, even though it’s causing harmful outcomes.

Effectiveness

Ativan and Xanax are both used to treat anxiety symptoms. Xanax is also FDA-approved to treat generalized anxiety disorder and panic attacks. Ativan is used off-label to treat those conditions, too. They work about equally well to treat all three conditions.

It’s important to note, however, that these drugs are usually considered second-choice options for these conditions and should only be used for short-term treatment. This is due to the risk of side effects and dependence.

Both Ativan and Xanax work quickly, but Ativan may last slightly longer than Xanax.

  • When they start working. Both drugs start to work 15 to 30 minutes after you take them.
  • How long they last. Ativan tablets have a peak effect about 2 to 3 hours after taking a dose, while Xanax peaks within 1 to 2 hours after a dose. However, Ativan may last slightly longer than Xanax.

Costs

Ativan and Xanax are both brand-name medications. They’re also both available in generic form. The generic version of a drug usually costs less than the brand-name version. The generic name of Xanax is called alprazolam.

Brand-name Ativan usually costs much more than brand-name Xanax. The generic versions of Ativan and Xanax cost about the same. Whichever drug or version you use, the amount you pay will depend on your insurance.

You may wonder how Ativan compares to other medications that are prescribed for similar uses. Below are comparisons between Ativan and several medications.

Ativan vs. Klonopin

Ativan and Klonopin work in the same way and are very similar medications. They both belong to the class of drugs called benzodiazepines.

The generic name of Klonopin is clonazepam, while the generic name of Ativan is lorazepam..

Uses

Although Ativan and Klonopin are similar medications, they’re FDA-approved for different uses.

Ativan is approved for:

Klonopin is approved for treating:

  • different types of seizures such as Lennox-Gastaut syndrome and myoclonic seizure
  • panic attacks

Klonopin is used off-label for treating anxiety symptoms, insomnia, and status epilepticus.

Drug forms

Ativan is available as an oral tablet and as a solution that’s given by intramuscular injection or intravenous injection. The oral tablet is usually taken one to three times a day. The solution is given by a healthcare professional.

Klonopin is available as an oral tablet that’s usually taken one to three times a day.

Side effects and risks

Ativan and Klonopin have similar side effects. Both drugs can cause these more common side effects:

Both can also cause these serious side effects:

* Ativan tablets, Ativan solution, and Klonopin have a boxed warning regarding this risk. A boxed warning is the strongest warning required by the Food and Drug Administration (FDA). Boxed warnings alert doctors and patients about drug effects that may be dangerous.
† With dependence, your body needs a drug in order to function like usual. With misuse, a drug is taken in a way other than how it’s prescribed. And with addiction, it’s difficult to stop taking a drug, even though it’s causing harmful outcomes.

Effectiveness

While Ativan and Klonopin have different FDA-approved uses, they’re both used to treat the following conditions:

  • For anxiety and panic attacks. Ativan and Klonopin usually work about equally well for treating anxiety and panic attacks. However, they’re typically considered second-choice options for these conditions and should only be used for short-term treatment. This is due to the risk of side effects and dependence.
  • Insomnia. There have been no studies comparing the two drugs, but both can be effective for trouble sleeping. However, they’re usually considered second-choice options and should only be used for short-term treatment. This is due to the risk of side effects and dependence.
  • Status epilepticus. Both drugs are effective for treating status epilepticus, but only Ativan is considered a first-choice treatment. This condition is treated in the hospital, so the drug used would be chosen by the hospital doctor.

Both Ativan and Klonopin work quickly, but Klonopin may last longer than Ativan:

  • When they start working. Both Ativan and Klonopin start to work within 15 to 30 minutes of when you take them.
  • How long they last. Ativan tablets have a peak effect within about 2 to 3 hours of when you take them. Klonopin has a peak effect within 1 to 4 hours of when you take it.

Costs

Ativan and Klonopin are both brand-name medications. They’re also both available in generic form. The generic version of a drug usually costs less than the brand-name version. The generic name of Klonopin is called clonazepam.

Brand-name Ativan usually costs much more than brand-name Klonopin. The generic versions of Ativan and Klonopin cost about the same. Whichever drug or version you use, the amount you pay will depend on your insurance.

Ativan vs. Valium

Ativan and Valium both belong to the class of drugs called benzodiazepines. They work in the same way and are very similar medications.

The generic name of Valium is diazepam, while the generic name of Ativan is lorazepam.

Uses

Ativan and Valium are used for similar and different purposes.

Approved uses for both Ativan and ValiumOther approved uses for AtivanOther approved uses for ValiumOff-label uses for Valium
• short-term treatment of anxiety symptoms

• providing sedation before surgery
• treating insomnia due to anxiety or stress

• treating status epilepticus
• treating symptoms of alcohol withdrawal

• treating muscle spasms and muscle spasticity caused by other conditions (such as cerebral palsy or tetanus)

• treating certain types of seizures when used along with other medications
• treating insomnia due to anxiety or stress

• treating status epilepticus

Drug forms

Ativan is available as an oral tablet and as a solution that’s given by intramuscular injection or intravenous injection. The oral tablet is usually taken one to three times per day. The solution is given by a healthcare professional.

Valium is also available as an oral tablet, which is typically taken one to four times daily.

Side effects and risks

Ativan and Valium have some similar side effects, and some that differ. Below are examples of these side effects.

More common side effects

More common side effects that Ativan and Valium share include:

In addition to these, other side effects that Valium can cause include:

  • weight gain or loss
  • urinary problems such as incontinence

Serious side effects

Possible serious side effects that Ativan and Valium share include:

* Ativan tablets, Ativan solution, and Valium have a boxed warning regarding this risk. A boxed warning is the strongest warning required by the Food and Drug Administration (FDA). Boxed warnings alert doctors and patients about drug effects that may be dangerous.
† With dependence, your body needs a drug in order to function like usual. With misuse, a drug is taken in a way other than how it’s prescribed. And with addiction, it’s difficult to stop taking a drug, even though it’s causing harmful outcomes.

Effectiveness

Ativan and Valium have different FDA-approved uses, but they are both used to treat the following conditions:

  • Anxiety. These drugs usually work about equally well for treating anxiety. However, they’re typically considered second-choice options and should only be used for short-term treatment. This is due to the risk of side effects and dependence.
  • Insomnia. No studies have directly compared these two drugs for treating insomnia. However, both drugs can be effective for this condition. It’s important to note that they’re both typically considered second-choice options for treating this condition and should only be used for short-term treatment. This is due to the risk of side effects and dependence.
  • Status epilepticus. Ativan is considered a first-choice treatment for status epilepticus. Valium works as well as Ativan and is also a first-choice treatment, but may cause more side effects, such as sleepiness. Valium is also effective for treating other kinds of seizures. However, it may not be a first-choice medication for those conditions, or may only be used in combination with other medications.

Both Ativan and Valium work quickly. Valium may work longer than Ativan for some uses, but not as long for other uses:

  • When they start working. Ativan starts working within 15 to 30 minutes. Valium starts working within about 15 minutes.
  • How long they last. Ativan tablets have a peak effect within about 2 to 3 hours. They last in the body for about 10 to 20 hours. However, their effect wears off more quickly than that of Valium. Ativan’s effect usually wears off within a few hours. Valium has a peak effect a little more than 1 hour after a dose is taken. It remains in the body for about 32 to 48 hours, but its effects don’t usually last that long. Some effects may wear off within a few hours.

Costs

Ativan and Valium are both brand-name medications. Both are also available in generic form. The generic version of a drug usually costs less than the brand-name version. The generic name of Valium is diazepam.

Brand-name Ativan usually costs much more than brand-name Valium. The generic versions of Ativan and Valium cost about the same. Whichever drug or version you use, the amount you pay will depend on your insurance.

Ativan vs. Ambien

Ativan and Ambien have some similar effects in the body. Both are considered to work as sedative-hypnotic drugs. This means they both cause sleepiness and sedation (relaxation).

However, these medications belong to different drug classes. Ativan is a benzodiazepine, while Ambien belongs to a class of drugs called non-benzodiazepine hypnotics.

The generic name of Ambien is zolpidem, while the generic name of Ativan is lorazepam.

Uses

Ativan is FDA-approved for many uses, including:

Ambien is only FDA-approved for short-term treatment of insomnia.

Drug forms

Ativan is available as an oral tablet and as a solution that’s given by intramuscular injection or intravenous injection. The oral tablet is usually taken one to three times per day. The solution is given by a healthcare professional.

Ambien is available as an oral tablet and as an extended-release tablet called Ambien CR. Both forms are taken once daily just before bedtime.

Side effects and risks

Ativan and Ambien have some similar side effects, and some that differ. Below are examples of these side effects.

Ativan and AmbienAtivanAmbien
More common side effects• daytime drowsiness

• dizziness

headache

depression

• memory problems

• lack of coordination

• confusion
• weakness

fatigue
dry mouth

• back pain

• abnormal dreams

• rash

• diarrhea
Serious side effectsphysical dependence, misuse, and addiction (more common in Ativan)*†

• worsening of depression or suicidal thoughts and actions in people with depression
• life threatening side effects when used with opioid medications* • unusual behaviors during sleep that aren’t remembered after waking‡

* Ativan tablets and solution have a boxed warning regarding this risk. A boxed warning is the strongest warning required by the Food and Drug Administration (FDA). Boxed warnings alert doctors and patients about drug effects that may be dangerous.
† With dependence, your body needs a drug in order to function like usual. With misuse, a drug is taken in a way other than how it’s prescribed. And with addiction, it’s difficult to stop taking a drug, even though it’s causing harmful outcomes.
Ambien has a boxed warning for this side effect. These behaviors can include sleepwalking, and eating, driving, making phone calls, or having sex while asleep.

Effectiveness

The only condition that both Ativan and Ambien are approved to treat is insomnia. Both are effective for treating this condition, although they haven’t been compared in clinical studies for this purpose.

It’s important to note that Ambien is typically a first-choice option for treating insomnia because it usually causes fewer side effects than other drugs.

Ativan is usually considered a second-choice option for treating insomnia. It’s typically used in people for whom first-choice options such as Ambien don’t work well.

Costs

Ativan and Ambien are both brand-name medications. Both are also available in generic form. The generic version of a drug usually costs less than the brand-name version. The generic name of Ambien is zolpidem.

Brand-name Ativan usually costs more than brand-name Ambien. The generic versions of Ativan and Ambien cost about the same. Whichever drug or version you use, the amount you pay will depend on your insurance.

Yes, Ativan is a controlled substance. It’s classified as a Schedule four (IV) prescription drug. This means that it has an accepted medical use but may also cause physical or psychological dependence and may be misused.*

With dependence, your body needs a drug in order to function like usual. With misuse, a drug is taken in a way other than how it’s prescribed.

The government has created special rules for how Schedule IV drugs can be prescribed by a doctor and dispensed by a pharmacist. Your doctor or pharmacist can tell you more.

* Ativan tablets and solution have a boxed warning regarding this risk. A boxed warning is the strongest warning required by the Food and Drug Administration (FDA). Boxed warnings alert doctors and patients about drug effects that may be dangerous.

Some people can have bothersome withdrawal symptoms after stopping Ativan. These can occur after taking Ativan for as little as 1 week. If Ativan is taken longer, withdrawal symptoms are more likely to occur. They’re also likely to be more severe.

Withdrawal symptoms can include:

Talk with your doctor before stopping Ativan. Your doctor can help slowly reduce your dosage before you stop taking the drug completely.

Here are answers to some frequently asked questions about Ativan.

How long does Ativan last?

Most of the effects of Ativan tablets last about 6 to 8 hours. However, this can vary from person to person.

How fast does Ativan work?

Ativan begins to work within minutes after it’s taken. But for tablets, the maximum effect usually happens about 2 to 3 hours after you take them.

When stopping Ativan, should you taper your dosage?

If you’ve been taking Ativan regularly, yes, you’ll likely need to slowly taper your dosage of the medication. If you don’t taper your dosage, you may experience withdrawal symptoms.

In some cases, the taper may last several weeks or even a few months. How slowly you taper the medication will depend on how much you’ve been taking and how long you’ve been using Ativan. Talk with your doctor before stopping Ativan to find out the best way to taper the medication.

What are the withdrawal effects of stopping Ativan?

Ativan can cause withdrawal effects in some people when they stop taking the medication. These effects are more likely to happen if you’ve taken higher doses or taken Ativan for a long period of time.

Symptoms of withdrawal can include:

For people with severe Ativan dependence who abruptly stop taking it, more severe withdrawal symptoms can occur. These can include:

Is Ativan addictive?

Ativan may lead to physical and psychological dependence and addiction.*

With dependence, your body needs a drug in order to function like usual. With addiction, a drug is taken, even if it’s causing harmful outcomes.

Be sure to talk with your doctor about your risk of these side effects with Ativan. Your doctor can recommend if this medication is right for you.

* Ativan tablets and solution have a boxed warning regarding this risk. A boxed warning is the strongest warning required by the Food and Drug Administration (FDA). Boxed warnings alert doctors and patients about drug effects that may be dangerous.

What are the effects of long-term use of Ativan?

Long-term use of Ativan can increase your risk of certain side effects, especially physical and psychological dependence.* This can lead to withdrawal symptoms (see above) when the medication is stopped.

Ativan is typically prescribed for short-term use of 2 to 4 weeks. If you’re concerned that you might need to use this medication for longer periods, talk with your doctor.

* Ativan tablets and solution have a boxed warning regarding this risk. A boxed warning is the strongest warning required by the Food and Drug Administration (FDA). Boxed warnings alert doctors and patients about drug effects that may be dangerous.

If you’re taking Ativan, you shouldn’t drink alcohol. Consuming alcohol with Ativan can increase the risk of serious side effects such as:

It’s also important to note that Ativan can lower your tolerance to alcohol. This means you’ll feel more intoxicated than usual after drinking smaller amounts of alcohol. It also means you’re at higher risk for the side effects mentioned above if you consume alcohol while taking Ativan.

Ativan can interact with several other medications. It can also interact with certain supplements and foods.

Different interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.

Ativan and other medications

Below is a list of medications that can interact with Ativan. This list doesn’t contain all drugs that may interact with Ativan.

Before taking Ativan, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Ativan and opioids

Taking opioids with Ativan can cause dangerous side effects.* These include excessive drowsiness, breathing problems, respiratory failure, and coma.

Examples of these drugs include:

Opioids should only be used with Ativan when there are no other treatment alternatives.

* Ativan tablets and solution have a boxed warning regarding this risk. A boxed warning is the strongest warning required by the Food and Drug Administration (FDA). Boxed warnings alert doctors and patients about drug effects that may be dangerous.

Ativan and sedative drugs

Taking sedative drugs with Ativan can cause excessive drowsiness and breathing problems. Examples of sedative drugs include:

Ativan and probenecid

Taking Ativan with probenecid (Probalan), a drug that can be used to treat gout, can increase the levels of Ativan in your body. This can increase your risk of Ativan side effects. For people who take probenecid and Ativan together, the Ativan dosage needs to be reduced by half.

Ativan and valproic acid or divalproex

Taking Ativan with valproic acid or divalproex (Depakote), a drug used to treat seizures and other conditions, can increase the levels of Ativan in your body. This can increase your risk of Ativan side effects.

For people who take valproic acid or divalproex and Ativan together, the Ativan dosage needs to be reduced by half.

Ativan and Zoloft

Zoloft (sertraline) can make some people feel tired or drowsy. Ativan can also cause drowsiness. Taking these medications together may cause you to feel even more tired or drowsy.

Ativan and Ambien

Ativan and Ambien (zolpidem) shouldn’t be taken together. Both medications are used to help promote sleep. If taken together, they can cause excessive sleepiness and sedation.

Taking this combination of medications can also increase the risk of odd behaviors such as sleep-driving (trying to drive while asleep).

Ativan and Tylenol (not an interaction)

There are no known interactions between Ativan and Tylenol (acetaminophen).

Ativan and herbs and supplements

Taking Ativan with herbs or supplements that have sedative effects can cause excessive drowsiness. Examples of sedative herbs and supplements that can cause these effects include:

Ativan and cannabis

Cannabis should not be used with Ativan. Using cannabis with Ativan can cause excessive drowsiness or sedation.

Ativan is classified as a benzodiazepine. These drugs are typically used to treat anxiety and insomnia, but can also be used to treat other conditions.

Benzodiazepines are often categorized by how fast they work (onset of action) and how long they last in the body (duration). This chart includes examples of these classifications.

DrugOnset of actionDuration
alprazolam (Xanax)rapidshort
clonazepam (Klonopin)rapidintermediate
clorazepate (Tranxene)intermediatelong
diazepam (Valium)rapidlong
flurazepamrapidlong
lorazepam (Ativan)rapidintermediate
midazolam (Nayzilam)rapidshort
oxazepamslowintermediate
temazepam (Restoril)intermediateintermediate
triazolam (Halcion)rapidshort

Taking too much Ativan can increase your risk of harmful or serious side effects. In extreme cases, it can even be fatal.

Overdose symptoms

Symptoms of overdose can include:

What to do in case of overdose

If you think you or your child has taken too much of this drug, call your doctor or seek guidance from the American Association of Poison Control Centers at 800-222-1222 or through their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

Ativan is sometimes prescribed by veterinarians to sedate an animal during surgery or to treat seizures. It’s also used to help reduce stress or fears, especially related to loud noises.

If you think your dog or cat is in distress, see your veterinarian for an evaluation and treatment. Don’t give your pet any Ativan that your doctor has prescribed for you.

If you think your pet has eaten your Ativan, call your veterinarian immediately.

Ativan can harm a fetus when taken by a pregnant person. Avoid using Ativan during pregnancy.

If you’re pregnant or planning to become pregnant, talk with your doctor. If you’re taking Ativan, you may need to stop.

You should not breastfeed while taking Ativan. This medication can pass through breast milk and cause side effects in a child who is breastfed.

Tell your doctor if you’re breastfeeding. You may need to decide whether to stop breastfeeding or stop taking this medication.

There are other medications that are often used to treat the same conditions as Ativan. Some may be better suited for you than others.

The best choice may depend on your age, the type and severity of your condition, and previous treatments you’ve used.

To learn more about other medications that may work well for you, talk with your doctor.

Note: Some of the drugs listed here are used off-label for treating conditions also treated by Ativan.

Medication alternatives

Examples of medications that could be used as alternatives to Ativan include:

Herb and supplement alternatives

Some people use certain herbs and dietary supplements to help manage their anxiety. Examples include:

Be sure to talk with your doctor before using herbs or supplements to treat your anxiety.

Taking Ativan may cause a positive result for benzodiazepines on urine drug screenings. If you’re taking Ativan, consider disclosing this information before completing a drug screening.

The length of time Ativan stays in your system varies from person to person, but it’s usually 3 to 5 days.

Ativan tablets should be taken in the way your doctor prescribed them. Don’t take more or less Ativan than prescribed without first talking with your doctor.

Timing

Ativan tablets are usually taken two or three times daily. These doses are usually spread out at equal intervals. However, when Ativan is used for insomnia, it’s usually taken just once at bedtime.

Taking Ativan with food

You can take Ativan with or without food. If it upsets your stomach, try taking it with food to help decrease this side effect.

Can Ativan be crushed?

Yes, Ativan tablets can be crushed. Some Ativan tablets may also be split. If you’d like to split your tablets, ask your pharmacist if it’s safe to do so.

Ativan belongs to a class of medications called benzodiazepines. These medications work by boosting the activity of gamma-aminobutyric acid (GABA) within your body.

GABA is a neurotransmitter that transmits messages between cells in different parts of your body. Increasing GABA in the body results in a tranquilizing effect that reduces feelings of stress and anxiety.

How long does it take to work?

Benzodiazepines such as Ativan are categorized based on how fast they work. Ativan is classified as having a rapid to intermediate onset (start) of action. It begins to work right away after it’s taken, but its peak effect occurs within 2 to 3 hours.

Before taking Ativan, talk with your doctor about any medical conditions you have. Ativan may not be appropriate for you if you have certain medical conditions.

FDA warnings

This drug has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.

  • Using Ativan in combination with opioid medications can result in life threatening side effects. These effects include serious sedation, decreased breathing, coma, and death. Ativan and opioids should only be combined when there are no other treatment options. The lowest possible dosage should be used for the shortest time needed.
  • Using Ativan, even as prescribed, can lead to physical dependence and withdrawal if you stop taking the drug suddenly. (With dependence, your body needs a drug in order to function like usual.) Withdrawal can be life threatening. Taking this drug can also lead to misuse and addiction. (With misuse, a drug is taken in a way other than how it’s prescribed. With addiction, it’s difficult to stop taking a drug, even though it’s causing harmful outcomes.) Misuse of Ativan increases your risk of overdose and death. Only take this drug as your doctor prescribes. Talk with your healthcare professional if you have any concerns about safely taking this drug.

Other warnings

Before taking Ativan, talk with your doctor about your health history. This drug may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Depression. Ativan and other benzodiazepine medications can worsen symptoms of depression. Ativan should not be used by people with depression who aren’t receiving adequate treatment for this condition.
  • Breathing disorders. Ativan can slow breathing. People with sleep apnea, chronic obstructive pulmonary disease (COPD), or other breathing disorders should use Ativan cautiously or avoid it.
  • Acute narrow-angle glaucoma. Ativan may increase the pressure inside the eye, worsening glaucoma. Due to this risk, doctors typically won’t prescribe Ativan to people with acute narrow-angle glaucoma.
  • Kidney or liver problems. Having kidney or liver problems can affect how your body breaks down Ativan after you take a dose. Your doctor may prescribe a different Ativan dose if you have kidney or liver problems.

Some people who take Ativan can become physically and psychologically dependent on the drug.* (With dependence, your body needs the drug in order to function like usual.)

The risk of dependence increases if Ativan is used in doses that are higher than prescribed, or for long periods of time.

In some cases, Ativan dependence can lead to misuse (also called abuse) of the drug.* The risk is higher with people who have previously misused alcohol or drugs. (With misuse, a drug is taken in a way other than how it’s prescribed.)

Symptoms of Ativan misuse can include:

  • confusion
  • loss of coordination
  • memory problems
  • sleep problems
  • irritability
  • unsteadiness when walking
  • impaired judgment

* Ativan tablets and solution have a boxed warning regarding this risk. A boxed warning is the strongest warning required by the Food and Drug Administration (FDA). Boxed warnings alert doctors and patients about drug effects that may be dangerous.

When Ativan is dispensed from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically one year from the date the medication was dispensed.

The purpose of such expiration dates is to guarantee the effectiveness of the medication during this time.

The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. However, an FDA study showed that many medications may still be good beyond the expiration date listed on the bottle.

How long a medication remains good can depend on many factors, including how and where the medication is stored. Ativan should be stored at room temperature in its original container.

If you have unused medication that has gone past the expiration date, talk with your pharmacist to find out whether you might still be able to use it.

The following information is provided for clinicians and other healthcare professionals.

Mechanism of action

Ativan has a tranquilizing effect in the central nervous system. Ativan binds to benzodiazepine receptors, which increases the effects of gamma-aminobutyric acid. This results in sedation, skeletal muscle relaxation, anticonvulsant effects, and coma.

Pharmacokinetics and metabolism

Ativan has a bioavailability of 90 percent. Peak plasma levels occur about two hours after oral administration.

Ativan is conjugated to glucuronide and excreted in the urine.

The mean half-life of Ativan is about 12 hours; however, it can range from 10 to 20 hours.

Nursing implications

The following should be assessed or monitored in patients receiving Ativan:

  • Monitor blood pressure, heart rate, and respiratory function.
  • Monitor sedation level in critical care patients, older adults, or debilitated patients.
  • Determine history of addiction. Long-term use can lead to dependence and addiction, which is more likely with patients who have a history of addiction.
  • Assess fall risk. To prevent falls, ambulation may need to be supervised in older adults taking Ativan.
  • Assess need for ongoing or long-term treatment.
  • Conduct periodic lab monitoring of liver function, blood count, and renal function with long-term use of Ativan.
  • Evaluate for mood disorders such as depression and for improvement in symptoms of anxiety.

Contraindications

Ativan is contraindicated in people with hypersensitivity to benzodiazepines or any component of Ativan. It’s also contraindicated in people with acute narrow-angle glaucoma.

Misuse and dependence

The use of Ativan can cause psychological and physical dependence. The risk of dependence increases when higher doses are used or when it’s used for long periods of time. The risk of dependence is also higher in people with a history of drug or alcohol misuse.

The risk of dependence and misuse can be reduced by using appropriate doses for the shortest time possible.

Storage

Ativan should be stored in a tight container at room temperature of 77°F (25°C). Temperature excursions to 59°F to 86°F (15°C to 30°C) are permissible.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.