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Your guide to medication Lorazepam

Lorazepam is a benzodiazepine commonly used to treat anxiety or insomnia.

Medication name: Lorazepam ("Luh-RA-zi-pam")
Brand name: Ativan ("A-ti-van")
Medication type: Benzodiazepine

Ways to take lorazepam
Tablets*: 0.5mg (white), 1mg (blue) or 2.5mg (yellow).
Liquid: 1mg in 1ml
Injections: 4mg in 1ml

*Do not rely on colour of tablets to confirm strength as some unbranded products may be of a different colour.

 

What can it be used for?
If you are 18 or over, the doctor can prescribe lorazepam for you as a licensed medicine for anxiety or insomnia (sleep problems).

There is less research about its use and effectiveness in young people under 18. Even so, specialists might prescribe it ‘off-label’ if they believe it is the best medicine for you.

N.B. Lorazepam is a 'controlled drug', meaning there are special rules and laws regarding how it is supplied when prescribed.

Read our guide to anxiety

About lorazepam

Please note

  • This page will give you general information about lorazepam. It is not medical advice.

    Always talk to your doctor about your situation and whether this medication is for you.

  • Lorazepam is a 'controlled drug'

    This is because it has the potential to be misused as a street drug. This means that:

    • a prescription for lorazepam must be dispensed within 28 days (you can keep most other prescriptions for six months)
    • if you must take it to school, it might have to be locked in a safe place
    • you should allow plenty of time to get the prescription from the doctor and the pharmacy – controlled drug prescriptions may take more time to check

How lorazepam works

Lorazepam is a benzodiazepine medicine. Benzodiazepines help to calm people if they are anxious or finding it difficult to sleep. It can also be called an anxiolytic medicine. Anxiolytic is a word used to refer to any medicine that treats anxiety.

Lorazepam works by binding to a receptor in the brain for a chemical messenger called Gamma-aminobutyric acid (GABA) which has a calming effect. GABA usually binds to a receptor called GABA-A, found on nerve cells in the brain. When this happens, it inhibits the nerve cell from sending messages to other nerve cells. Lorazepam, like other benzodiazepines, also binds to the GABA-A receptor, but in a different position to GABA itself. When lorazepam binds to the GABA-A receptor, this makes it easier for GABA to do its job, increasing calming effects and helping to relieve anxiety.

Lorazepam is a controlled drug as it has the potential to be misused as a street drug. This means that:

  • a prescription for lorazepam must be dispensed within 28 days (you can keep most other prescriptions for six months)
  • if you must take it to school, it might have to be locked in a safe place
  • you should allow plenty of time to get the prescription from the doctor and the pharmacy – controlled drug prescriptions may take more time to check
Find out more about anxiety

Lorazepam and everyday life

Frequently asked questions

Lorazepam starts to work very quickly in your body. You should get the calming effects from lorazepam in a few hours.

Lorazepam has not been shown to affect weight in most people.

It can affect the appetite, but this is rare (happens in up to one in 10,000 people).

Talk to your doctor about this if it worries you.

You may want to let your family and friends know you are taking lorazepam so they can support you and help you look out for side effects.

For guidance on this, check out our page on getting support with your medication.

Lorazepam is used to help people who cannot sleep, so you would expect it to make you feel sleepy.

Lorazepam can, however, make people feel sleepy during the day which can become a problem.

If lorazepam makes it more difficult for you to get to sleep, or gives you strange nightmares, you should go back to your doctor as soon as possible.

Alcohol

You can drink a small amount of alcohol while taking lorazepam, but having the two together is likely to make you very sleepy. This will be most noticeable during the early part of your treatment

Taking large amounts of alcohol and lorazepam together could affect your breathing especially if you have an existing lung problem.

If you need to drive a car, ride a bike, or use machines at work, taking alcohol and lorazepam together could be dangerous to yourself and other people.

Street drugs

It is very easy, and serious, to overdose with any combination of lorazepam and drugs.

Using cannabis with lorazepam will make sedative effects worse. You could go into a very deep sleep where you do not breathe properly and have difficulty waking up.

Cannabis and other drugs may have their own side effects on your mental health, like anxiety or psychosis. For more information, have a look at our drugs and alcohol page.

Using heroin or methadone with lorazepam will increase their combined sedative effects. You could go into a very deep sleep where you do not breathe properly and have difficulty waking up.

Using cocaine or other stimulants (like ecstasy, amfetamines, MDA, 6-APB) with lorazepam can lead to uncertain and dangerous effects.

Lorazepam does not mix well with some other medicines and drugs and may affect the way in which they work. Tell your doctor if you are taking any other medications including over-the-counter medicines for common illnesses and things you put on your skin.

Caffeine interferes with the way lorazepam works on your body, as it has the opposite effect to the medicine.

Try not to drink caffeine drinks (like coffee, cola or energy drinks) while you are taking lorazepam.

Caffeine can cause anxiety and sleep loss – stopping these drinks might help to improve your symptoms.

The tablets contain lactose and may not be suitable for you if you have problems eating some sugars or dairy (milk-based) products. The yellow 2.5mg tablets may also contain tartrazine (E102), a food additive that can cause allergic reactions. Check with your pharmacist if this is important.

The lorazepam oral solution is likely to contain alcohol but dose volumes will be small, so it should not significantly affect your blood alcohol levels.

The injection contains a very small amount of benzyl alcohol but this type of alcohol will not affect your blood alcohol levels.

Do not drive a car or ride a bike just after you start taking lorazepam.

Taking lorazepam may make you feel dizzy, sleepy or forgetful, and you may find it difficult to concentrate.

It may also cause blurred vision and muscle weakness.

This could affect you if you drive a car, ride a bike, or do anything else that needs a lot of focus.

If you are not sleeping well, this could also make driving dangerous for yourself and other people.

It might be best to stop doing these things for the first few days, until you know how it affects you.

Under new ‘drug driving’ laws introduced in 2015, you could be arrested if driving dangerously while taking lorazepam. However, the limit for the medication is higher than what a doctor would normally prescribe.

It is important to stick to the dose on the prescription, and to check that you can drive safely while taking it.

Pregnancy

Lorazepam can affect the developing baby, and cause symptoms in a newborn baby. For this reason, it is usually recommended to avoid taking lorazepam during pregnancy.

However, the risks to the developing baby from taking lorazepam will need to be weighed up against the risks of not taking lorazepam to your mental health.

Some studies suggest a low risk of possible mouth defects, but other studies didn’t find this.

If you and your doctor decide that you need to take lorazepam during the pregnancy, then this will be at the lowest dose that works for you and for the shortest period that is necessary. This is to minimise the amount of lorazepam that the developing baby is exposed to.

If you are taking lorazepam in the last few weeks of pregnancy, you should tell your midwife and doctor so that they can look out for symptoms in the newborn baby.

Post-natal

Your baby may be less active than other babies, have a low body temperature, be floppy, or have breathing or feeding difficulties for a while.

Your baby’s response to the cold might be affected for a while.

Your baby may develop withdrawal symptoms after birth.

Breastfeeding

Lorazepam is passed to the baby in breast milk in small amounts. It is not usually seen as a problem unless your baby was born early or has other health problems.

Breastfeeding can reduce any withdrawal symptoms the baby may have from lorazepam.

If your baby becomes restless, very sleepy or develops feeding problems, stop breastfeeding and quickly seek medical advice.

It is important that you remain well while you are bonding with your newborn baby. For this reason, you may need to keep taking some medicines on your doctor’s advice.

Sex

Lorazepam can have side effects that affect your sex life. These are rare but might include:

  • losing interest in sex, or sometimes feeling more like having sex
  • feeling ‘numb’ to your normal emotions
  • feeling less inhibited about sex
  • finding it difficult to reach orgasm (come)
  • finding it difficult to get an erection (get hard)

These effects should pass after the first couple of weeks on the medication. If they don’t and this is a problem for you, go back to your doctor.

The good effects of lorazepam may have a positive impact on your sex life as your symptoms settle, you sleep better, and you can concentrate on your relationships.

Fertility

There is no evidence that lorazepam affects fertility.

Lorazepam is not a banned substance in sport.

However, lorazepam has many side effects that might make you less able to take part in sports that need a lot of focus.

These side effects include feeling sleepy, blurred eyesight, being forgetful, muscle weakness and finding it difficult to concentrate.

The good effects of lorazepam may have a positive impact on your sporting performance as your symptoms settle, and you start to feel the benefits of the medication.

Try not to take lorazepam for the first time just before your exams.

You may feel forgetful, very sleepy, and find it difficult to concentrate when you start taking lorazepam.

You should talk to your doctor about any future exams if you are starting lorazepam. You might decide together to delay starting it until you have done them.

If they are more than a few days away, however, you might find that it is better to start lorazepam to improve your sleep and your ability to study.

Try not to drink caffeine drinks to stay awake for exam revision – they stop the lorazepam working.

Lorazepam might make you forgetful and make it difficult to concentrate.

After the first few days you will know how it affects you.

Your doctor should know

  • You need to talk to your doctor or pharmacist before starting treatment with lorazepam if any of the following apply to you:

    • you have severe breathing or chest problems
    • you are allergic to benzodiazepines or any of the other ingredients in lorazepam tablets or liquid
    • you have myasthenia gravis (very weak or tired muscles)
    • you have sleep apnoea (breathing problems when you are asleep)
    • you are breastfeeding, since the drug may pass into breast milk
    • you are planning a pregnancy or are pregnant
    • you have ever misused drugs or alcohol
    • you have a personality disorder (you have a greater chance of becoming dependent on lorazepam)
    • you have any kidney or liver problems
    • you have depression, as lorazepam may increase any thoughts of harming yourself or taking your life
    • you have had depression before (it could come back during treatment with lorazepam)

Uses, warnings, safety and side effects

Taking lorazepam

How long will I need to take lorazepam for?

It is not recommended to take lorazepam for more than four weeks at a time.

You and your doctor should talk about how long you need to take lorazepam before you start taking the medication.

People can become dependent on the effects of lorazepam if they take it for more than a month, and then when they stop, they get withdrawal symptoms.

If you take lorazepam for anxiety or sleeping you will probably take it for two to four weeks, to get you into a new routine, before stopping so that you do not get withdrawal symptoms.

You should only take lorazepam as agreed with your doctor

Make sure that you know your dose. If it is not written on the label, check with your pharmacist or doctor.

You may have to take lorazepam a few times each day.

If you are taking it to help you sleep, you should take it an hour before bedtime.

You can take it before or after food.

Swallow the tablet with a drink of water - if you chew it, it tastes bitter.

What if I miss a dose?

If you remember later during the day, take it as soon as possible.

If you forget to take it by more than three hours after you would normally take it, just start again when the next dose is due.

If you take it for sleeping, you must allow yourself between seven and eight hours’ sleep after taking it. So, for example, do not take it if you have only got five hours left to sleep.

Do not take a double dose.

What will happen if I forget to take my lorazepam?

If you forget to take your tablets for a few days, you may start getting your old symptoms back. This means that you should talk to your doctor about it.

Stopping the use of lorazepam

Do not stop taking lorazepam all at once. This could lead to serious symptoms, including:

  • feeling unreal or detached from life, and an inability to feel emotions
  • numbness or tingling of the arms or legs
  • tinnitus (ringing sounds in the ears)
  • oversensitivity to light, sound and touch
  • uncontrolled or overactive movements
  • twitching, shaking
  • feeling sick, being sick, stomach upsets or stomach pain
  • loss of appetite
  • agitation, panic attacks
  • fast heartbeat
  • dizziness or feeling that you are about to fall
  • memory loss
  • feeling stiff and unable to move easily
  • feeling very warm
  • having seizures (fits) - this is more likely in people who have epilepsy

Depending how long you have been taking lorazepam, your doctor will help you to reduce the medication slowly over the course of several days or even weeks at the end of your treatment. Even when you do this, you may get some symptoms, including:

  • headaches
  • muscle pain
  • anxiety, tension, depression, restlessness, irritability or confusion
  • sweating
  • your original sleeplessness may also return

If you suffer from any of these symptoms, go back to your doctor for advice.

Warnings and safety

Safety headlines

If you have taken more lorazepam than the dosage recommended by the doctor who prescribed it to you, you must get medical help immediately – even if you do not feel any different.

While taking lorazepam, some people may think about hurting themselves or taking their own lives. You must go straight to hospital with your tablets if you have any of these thoughts.

Lorazepam can cause serious side effects: allergic reactions (difficulty breathing, swelling of your face or throat, itching skin lumps), and other serious symptoms that you can find here. Go to a hospital with your medicine if you get any of these symptoms.

Stopping lorazepam suddenly can cause serious side effects. Go to your doctor if you want to stop, or if you are having these effects.

You might feel sleepy or dizzy in the first few days after taking lorazepam. Do not drive a car, ride a bike or operate machines until you see how this affects you.

Use good contraception while you are taking lorazepam. If you take lorazepam while you are pregnant, it may affect the developing baby. It can also cause symptoms in newborn babies if you take it at the end of pregnancy. Talk to your doctor or midwife about this and get their help.

When to go to the hospital

If you have taken more lorazepam than the dosage recommended by the doctor who prescribed it to you, you must get medical help immediately – even if you do not feel any different.

Go to A&E. Take your medicine with you to show to the doctors. Tell them how much you have taken. Get a friend or family member to go with you, if you can, just in case you feel ill on the way.

You might feel tired or confused, get strange movements of your eyes, or have problems with your balance, co-ordination or speech.

Your breathing might get very slow, and you could fall into a coma.

If you have taken lorazepam with other drugs, including alcohol, you could get more serious side effects. You must get help quickly and tell the doctors everything you have taken, so they can help you.

If you have any thoughts of taking your own life, or of other ways of hurting yourself, go straight to a hospital with your tablets. You must tell the doctor that you are taking lorazepam. There are other medications you can take instead.

Get medical help immediately if you get any of the following symptoms:

  • thoughts of harming yourself or taking your own life
  • impaired consciousness (which could lead to coma)
  • breathing difficulties
  • confusion, numbed emotions
  • depression (low mood)
  • restlessness, agitation, irritability, aggressiveness, violent anger, hallucinations, personality changes
  • sleeping difficulties, nightmares
  • sexual arousal, abnormal behaviour, or false beliefs
  • unexplained bleeding and/or bruising
  • increased risk of infections e.g. frequent sore throats, mouth ulcers, weakness and pale skin
  • difficulty in breathing, swelling of the lips, mouth, tongue, throat, hands, feet and/or severe faintness or dizziness as this may be an allergic reaction
  • symptoms of jaundice like yellowing of the skin, eyes, nose, mouth, pale coloured faeces (poo) and dark coloured urine
  • skin problems such as rashes and inflammation

Side effects

Side effects

Please do not be worried by the side effects listed on this page. Many people take lorazepam without any side effects or only a few mild side effects. If you think you might be getting a side effect from lorazepam, then you should discuss this with your doctor, nurse, or pharmacist.

Very common side effects of lorazepam (affecting more than one in ten people) include:

  • daytime drowsiness and tiredness

Common side effects of lorazepam (affecting up to one in ten people) include:

  • dizziness, feeling less alert
  • poor muscle control, muscle weakness

Go and see your doctor but do not stop taking the tablets if you notice any of the following:

  • feeling that you are becoming reliant on lorazepam and finding it difficult to stop
  • a feeling of wellbeing for no reason
  • memory loss or forgetfulness

Taking lorazepam

How long will I need to take lorazepam for?

It is not recommended to take lorazepam for more than four weeks at a time.

You and your doctor should talk about how long you need to take lorazepam before you start taking the medication.

People can become dependent on the effects of lorazepam if they take it for more than a month, and then when they stop, they get withdrawal symptoms.

If you take lorazepam for anxiety or sleeping you will probably take it for two to four weeks, to get you into a new routine, before stopping so that you do not get withdrawal symptoms.

You should only take lorazepam as agreed with your doctor

Make sure that you know your dose. If it is not written on the label, check with your pharmacist or doctor.

You may have to take lorazepam a few times each day.

If you are taking it to help you sleep, you should take it an hour before bedtime.

You can take it before or after food.

Swallow the tablet with a drink of water - if you chew it, it tastes bitter.

What if I miss a dose?

If you remember later during the day, take it as soon as possible.

If you forget to take it by more than three hours after you would normally take it, just start again when the next dose is due.

If you take it for sleeping, you must allow yourself between seven and eight hours’ sleep after taking it. So, for example, do not take it if you have only got five hours left to sleep.

Do not take a double dose.

What will happen if I forget to take my lorazepam?

If you forget to take your tablets for a few days, you may start getting your old symptoms back. This means that you should talk to your doctor about it.

Stopping the use of lorazepam

Do not stop taking lorazepam all at once. This could lead to serious symptoms, including:

  • feeling unreal or detached from life, and an inability to feel emotions
  • numbness or tingling of the arms or legs
  • tinnitus (ringing sounds in the ears)
  • oversensitivity to light, sound and touch
  • uncontrolled or overactive movements
  • twitching, shaking
  • feeling sick, being sick, stomach upsets or stomach pain
  • loss of appetite
  • agitation, panic attacks
  • fast heartbeat
  • dizziness or feeling that you are about to fall
  • memory loss
  • feeling stiff and unable to move easily
  • feeling very warm
  • having seizures (fits) - this is more likely in people who have epilepsy

Depending how long you have been taking lorazepam, your doctor will help you to reduce the medication slowly over the course of several days or even weeks at the end of your treatment. Even when you do this, you may get some symptoms, including:

  • headaches
  • muscle pain
  • anxiety, tension, depression, restlessness, irritability or confusion
  • sweating
  • your original sleeplessness may also return

If you suffer from any of these symptoms, go back to your doctor for advice.

Warnings and safety

Safety headlines

If you have taken more lorazepam than the dosage recommended by the doctor who prescribed it to you, you must get medical help immediately – even if you do not feel any different.

While taking lorazepam, some people may think about hurting themselves or taking their own lives. You must go straight to hospital with your tablets if you have any of these thoughts.

Lorazepam can cause serious side effects: allergic reactions (difficulty breathing, swelling of your face or throat, itching skin lumps), and other serious symptoms that you can find here. Go to a hospital with your medicine if you get any of these symptoms.

Stopping lorazepam suddenly can cause serious side effects. Go to your doctor if you want to stop, or if you are having these effects.

You might feel sleepy or dizzy in the first few days after taking lorazepam. Do not drive a car, ride a bike or operate machines until you see how this affects you.

Use good contraception while you are taking lorazepam. If you take lorazepam while you are pregnant, it may affect the developing baby. It can also cause symptoms in newborn babies if you take it at the end of pregnancy. Talk to your doctor or midwife about this and get their help.

When to go to the hospital

If you have taken more lorazepam than the dosage recommended by the doctor who prescribed it to you, you must get medical help immediately – even if you do not feel any different.

Go to A&E. Take your medicine with you to show to the doctors. Tell them how much you have taken. Get a friend or family member to go with you, if you can, just in case you feel ill on the way.

You might feel tired or confused, get strange movements of your eyes, or have problems with your balance, co-ordination or speech.

Your breathing might get very slow, and you could fall into a coma.

If you have taken lorazepam with other drugs, including alcohol, you could get more serious side effects. You must get help quickly and tell the doctors everything you have taken, so they can help you.

If you have any thoughts of taking your own life, or of other ways of hurting yourself, go straight to a hospital with your tablets. You must tell the doctor that you are taking lorazepam. There are other medications you can take instead.

Get medical help immediately if you get any of the following symptoms:

  • thoughts of harming yourself or taking your own life
  • impaired consciousness (which could lead to coma)
  • breathing difficulties
  • confusion, numbed emotions
  • depression (low mood)
  • restlessness, agitation, irritability, aggressiveness, violent anger, hallucinations, personality changes
  • sleeping difficulties, nightmares
  • sexual arousal, abnormal behaviour, or false beliefs
  • unexplained bleeding and/or bruising
  • increased risk of infections e.g. frequent sore throats, mouth ulcers, weakness and pale skin
  • difficulty in breathing, swelling of the lips, mouth, tongue, throat, hands, feet and/or severe faintness or dizziness as this may be an allergic reaction
  • symptoms of jaundice like yellowing of the skin, eyes, nose, mouth, pale coloured faeces (poo) and dark coloured urine
  • skin problems such as rashes and inflammation

Side effects

Side effects

Please do not be worried by the side effects listed on this page. Many people take lorazepam without any side effects or only a few mild side effects. If you think you might be getting a side effect from lorazepam, then you should discuss this with your doctor, nurse, or pharmacist.

Very common side effects of lorazepam (affecting more than one in ten people) include:

  • daytime drowsiness and tiredness

Common side effects of lorazepam (affecting up to one in ten people) include:

  • dizziness, feeling less alert
  • poor muscle control, muscle weakness

Go and see your doctor but do not stop taking the tablets if you notice any of the following:

  • feeling that you are becoming reliant on lorazepam and finding it difficult to stop
  • a feeling of wellbeing for no reason
  • memory loss or forgetfulness

About this information

The information on this page was reviewed by the College of Mental Health Pharmacy in March 2020.

Visit the CMHP website
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