Lorazepam ("Luh-RA-zi-pam")
Ativan ("A-ti-van")
Benzodiazepine
Tablets: 0.25mg, 0.5mg, 1mg or 2.5mg
Liquid: 1mg in 1ml
Injections: 4mg in 1ml (This would only ever be used in an emergency situation in hospital where it was not possible for someone to take lorazepam as a tablet or a liquid.)
If you are 18 or over, the doctor can prescribe lorazepam for you as a licensed medicine for anxiety or insomnia (sleep problems) for no longer than four weeks. Lorazepam should always be prescribed at the lowest effect dose for the shortest possible time.
If you are under 18 (or if the length of use if more than four weeks) a specialist doctor may still consider this as a treatment option.
Lorazepam belongs to a group of medicines called benzodiazepines. It helps 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 improving the effect of a naturally occurring chemical in the brain called gamma-aminobutyric acid (GABA).
This is because it has the potential to be misused as a street drug.
A prescription for lorazepam must be dispensed by the pharmacy and collected within 28 days of the prescription being written. Other prescriptions for medication that isn’t a controlled drug are valid for up to six months.
If you need to take it to school, check your school policy on how your medicine should be stored safely.
Lorazepam starts to work very quickly in your body. The calming effects from lorazepam usually start after about 30 minutes.
In most people, lorazepam has not been shown to affect weight.
It can affect the appetite but this is rare.
Talk to your doctor or pharmacist if you are concerned about your weight, or changes to your weight, while taking lorazepam.
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.
When you stop taking lorazepam, you may experience ‘rebound insomnia’. This means your sleep might be worse and you might get more vivid dreams immediately after stopping it, but this should improve again. If it doesn’t, discuss this with your doctor.
Alcohol
Drinking alcohol if you are taking lorazepam is not recommended as this is likely to make you very sleepy. Lorazepam may lower your tolerance to alcohol and you may experience more side effects.
This will be most noticeable during the early part of your treatment, so it is recommended that you don’t drink alcohol until you know how the medicine affects you. After this you may be able to drink a small amount of alcohol but be very careful.
Taking large amounts of alcohol and lorazepam together could be very dangerous. It may 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 impair your ability to do this safely and be dangerous to yourself and others.
Drinking alcohol every day, or in large amounts, can make your symptoms worse and may mean you won’t get the maximum benefit from your medication.
Street drugs
It is very easy, and serious, to overdose with any combination of lorazepam and drugs. Any combination could be very dangerous.
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.
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.
There are many other street drugs, but we don’t know what effect taking them with lorazepam will have, so it’s best to be cautious. There is no regulation of street drugs or ‘legal highs’, so even if there are no known issues with the medication you take, the supply you receive might be mixed with other substances that could be dangerous.
Lorazepam does not mix well with some other medicines, including herbal remedies. It may affect the way in which they work or could cause more side effects.
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.
You should be very careful if you take lorazepam with other medicines that can cause sedation, especially medicines for pain relief that contain opioids (for example dihydrocodeine or morphine). When combined, these medicines may make you extremely sedated or could affect your breathing. Your doctor will monitor this carefully if you are prescribed these medicines together.
Always tell the pharmacist that you are taking lorazepam if you buy any medicines from a pharmacy.
Look at the leaflet inside your medicine box for more information about other medicines that can interact with lorazepam. With some medicines your doctor may need to adjust the dose of your medicines if you take them together. Ask a doctor or pharmacist for more information if you have any questions.
Caffeine interferes with the way lorazepam works on your body, as it has the opposite effect on your body 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 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.
Always let your pharmacist know if you have any food allergies or intolerances, and always check with them if you’re concerned about any of the ingredients in your medication.
The lorazepam liquid contains a small amount of alcohol but not enough to affect your blood alcohol level (less than the amount in 1ml of beer).
If you need to avoid animal products, please note that non-active ingredients used in the production of medicines may sometimes be of animal origin. Ask your pharmacist if you have any questions about the ingredients.
Further information about practical considerations for medicines if you need to avoid animal products can be found on the Vegan Society website.
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.
For these reasons, you should not ride a bike or drive a car until you know how you will be affected.
It is illegal to drive with medication in your body if it impairs your driving. It is important to stick to the dose on the prescription, and to check that you can drive safely while taking it. Ask your doctor if you’re not sure if your condition or your medicine will affect your driving.
You may also have to prove that you have been prescribed lorazepam by your doctor, so you should keep your repeat prescription slip with you in case you asked. The Department of Transport website has more details.
Pregnancy
If you become pregnant while on lorazepam, you should carry on taking it and make an appointment to see your doctor as soon as possible. They can discuss the benefits and risks of continuing lorazepam and help you to make a decision that is best for you and your baby.
They may refer you to a specialist perinatal mental health team to support you with your decision,
You can find out more information about taking amitriptyline during pregnancy at Bumps (Best Use of Medicines in Pregnancy).
Untreated anxiety can also be harmful to you and your developing baby, so decision about stopping or avoiding medication when you are pregnant need to be discussed carefully with your doctor. If you and your doctor agree that it is best for you to continue taking lorazepam while pregnant, you should tell your midwife. If you are planning to get pregnant, it is recommended that you take folic acid while you are trying for a baby and during pregnancy. It is safe to take this together with lorazepam.
Post-natal
Some new born babies whose mothers take lorazepam during pregnancy can get withdrawal symptoms at birth and soon after, like breathing problems or restlessness.
Tell your midwife if you are taking lorazepam, so that they can help if the baby has any symptoms after birth.
Breastfeeding
Lorazepam is passed to the baby in breastmilk in small amounts.
If your baby was born early, then breastfeeding while you are taking lorazepam may not be recommended. Talk to your midwife and doctor about feeding options.
If you breastfeed while taking lorazepam, seek urgent medical advice if your baby becomes restless, very sleepy or develops feeding problems.
Sex
Lorazepam can have side effects that affect your sex life. These are rare but might include:
Untreated anxiety can have a negative effect on your sex life, so if lorazepam helps you to recover, positive effects can include improving your desire, experience and enjoyment of sex as your mood lifts and you become more interested in life and relationships again.
Fertility
There is no evidence that lorazepam affects fertility. Talk to your doctor about your lorazepam if you are trying to get pregnant or planning a family.
Lorazepam is not a banned substance in sport.
Some of the side effects of taking lorazepam might make it more difficult to play sports, such as feeling sleepy, blurred eyesight and difficulty concentrating. If you have any concerns, discuss this with your doctor.
Lorazepam may affect your concentration, give you blurred eyesight and make you feel tired.
Ideally it is best not to take lorazepam for the first time just before your exams.
It is not possible to predict how the medication will make you feel, and if you do get any side effects, there are more likely to occur when you first start taking lorazepam.
You should talk to your doctor about 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 month away, however, you might find that it is better to start lorazepam to improve your sleep and your motivation and ability to study.
Most people take exams as normal while taking lorazepam, but if you have any concerns, discuss this with your doctor.
Your doctor will consider any other medical conditions or symptoms you have before recommending a medicine for you.
Your medicine will come with a ‘patient information leaflet’. It’s important that you read this information. Speak to your pharmacist if:
The information leaflet also includes a list of warnings and precautions to consider before you take the medicine. If you think that any of these apply to you and are concerned that your doctor is not already aware of them, check with your doctor or pharmacist before you start to take your medication (or as soon as possible if you are already taking it).
You and your doctor should talk about how long you need to take lorazepam before you start taking the medication.
It is not recommended to take lorazepam for more than four weeks at a time. You should take the lowest effective dose for the shortest possible time.
If you take it longer than this, your body can become dependent on it. It might be hard to stop taking it and you might need a bigger dose to get the same benefit. You may also get withdrawal symptoms when you stop taking it.
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, and find other things to improve your sleep.
You will get the best effect from lorazepam if you take it at the dose prescribed by your doctor.
Some people may need to take it regularly every day, but for some, just taking it when you need it will be enough to help. Your doctor will be able to discuss this with you to decide what will be best for you to try.
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 lorazepam before or after food.
Swallow the tablet with a drink of water – if you chew it, it tastes bitter.
The liquid comes with a syringe so you can measure the dose accurately. The dose can be swallowed straight form the syringe. The liquid medication needs to be stored in the fridge.
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. Do not try and catch up by taking a double dose.
If you take it for sleeping, you must allow yourself between seven and eight hours of sleep after taking it.
If you forget to take your tablets for a few days, you may start getting your old symptoms back. If you have missed doses, this may mean your anxiety has improved, so this could be a good thing.
Depending on how long you have been taking lorazepam, you may experience withdrawal symptoms.
If you have taken lorazepam regularly or just when needed for less than four weeks, you should be able to stop it straight away, although your doctor may recommend you reduce the dose gradually over a few days or a week.
If you have taken lorazepam regularly for longer than four weeks, it is likely you will experience withdrawal symptoms if you stop it suddenly.
Some of the symptoms you get may be the same or similar to symptoms you had when you were unwell, so understandably, you might feel anxious or upset that your illness could be returning.
You can stop taking lorazepam safely with your doctor’s help. Planning a gradual withdrawal together can help to minimise or prevent the withdrawal symptoms you experience. Your doctor may recommend you switch to a different type so that the dose can be reduced more gradually.
If you stop lorazepam suddenly or reduce the dose too quickly you can get withdrawal symptoms. These include:
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 (sometimes months) at the end of your treatment. Even when you do this, you may get some symptoms, including:
If you suffer from any of these symptoms, go back to your doctor for advice.
If you have taken more than the dose prescribed by your doctor, contact NHS 111 immediately to ask for advice, or ask a family member or friend to do this for you. This is important even if you don’t feel any different.
NHS 111 can give you advice and direct you to the best place to get more help if you need it.
If you have taken too much medication on purpose, or if after taking this you quickly feel unwell, call 999 or get someone to take you to A&E straight away. This includes any of the following signs:
If you need to go to A&E, do not travel alone or drive yourself there. Get your parent, family member or friend to go with you to support you and keep you safe on the way. If someone is not able to drive you there, call for an ambulance. Take your medication with you and tell doctors how much you have taken.
While uncommon, lorazepam can sometimes cause you to have thoughts about hurting yourself or taking your own life. If you have any thoughts like this, it is important you get urgent help. Contact your doctor immediately for advice and support. This could be your GP or specialist mental health team. If you are able, share how you are feeling with family member or friend as well so they can support you to get help.
If you discussed with your doctor what to do if you get these thoughts and created a safety plan, read this to remind you who to contact for support and what you can do to help you cope.
Lorazepam can cause serious side effects, including allergic reactions.
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.
Stop taking lorazepam and go to a hospital straight away if you get any of the following symptoms:
Contact your doctor immediately but don't stop taking lorazepam, if you get any of the following symptoms:
If you are unable to contact your doctor, call NHS 111 for urgent advice.
Side effects are more common when you first start taking a new medicine. Many go away as you continue your medicine. If they don’t get better, or if you are worried by them and they are causing you distress, speak to your doctor, specialist team or pharmacist about them.
Very common side effects of lorazepam (affecting more than one in ten people) include:
Common side effects of lorazepam (affecting up to one in ten people) include:
There are other side effects that you can get when taking this medicine. We have only included the most common ones here.
This list of side effects can look scary. You may not experience any of them, but it’s important to be aware of them so you know what to do if they do happen.
Unless your side effects are very severe or distressing, try to continue taking your medication until you can talk to your doctor. Your doctor can make changes to your medication to help if needed.
There is no additional monitoring routinely recommended with lorazepam.
Your doctor may recommend additional checks depending on any other medical conditions you have or if you get any side effects. These may require a blood test.
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