Ativan (lorazepam)

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Ativan is used to relieve anxiety. However, anxiety or tension associated with the normal stress of everyday life usually does not require treatment with medicines.

It is also used before surgery to help relax you.

In general, benzodiazepines such as Ativan should be taken for short periods only (for example 2-4 weeks). Continuous long-term use is not recommended unless advised by your doctor. The use of benzodiazepines may lead to dependence on the medicine.

Ask your doctor if you have any questions about why Ativan has been prescribed for you. Your doctor may have prescribed it for another purpose.

This medicine is available only with a doctor’s prescription.

Ativan contains lorazepam as the active ingredient which belongs to a group of medicines called benzodiazepines. They are thought to work by their action on brain chemicals.

The exact mechanism of action of benzodiazepines has not yet been elucidated; however, benzodiazepines appear to work through several mechanisms. Benzodiazepines presumably exert their effects by binding to specific receptors at several sites within the central nervous system either by potentiating the effects of synaptic or pre-synaptic inhibition mediated by gamma-aminobutyric acid or by directly affecting the action potential generating mechanisms.

Each Ativan 1 mg tablet contains 1 mg lorazepam.

Each Ativan 2.5 mg tablet contains 2.5 mg lorazepam.

It also contains the inactive ingredients magnesium stearate, cellulose-microcrystalline, polyacrylic potassium, lactose, iron oxide yellow (2.5 mg only), and quinoline yellow (2.5 mg only).

Ativan does not contain gluten, sucrose, tartrazine, or any other azo dyes.

Before you take it
When you must not take it
Do not take Ativan if:

You are allergic to:
Lorazepam or any of the ingredients listed here;
Any other medicine from the benzodiazepine group of medicines.
Lorazepam can increase thoughts of death or suicide.
Do not take Ativan if the packaging is torn or shows signs of tampering.

Do not take Ativan after the expiry date (EXP) printed on the pack. If you take it after the expiry date has passed, it may not work as well or have no effect at all.

Do not give this medicine to children unless advised by the child’s doctor. The safety and effectiveness of Ativan in children under 16 years have not been established.

Before you take it
You must tell your doctor if:

You have any allergies to:
Any other medicines;
Any other substances, such as foods, preservatives or dyes;
You are pregnant or planning to become pregnant.
Do not take Ativan if you are pregnant or planning to become pregnant unless you and your doctor have discussed the risks and benefits involved;
You are breastfeeding or plan to breastfeed.
Do not take Ativan if you are breastfeeding or planning to breastfeed unless you and your doctor have discussed the risks and benefits involved;
You have or have had any other medical conditions including:
Liver, kidney or lung disease;
Blood disorders;
Fits or convulsions;
Severe muscle weakness known as myasthenia gravis;
Low blood pressure;
Glaucoma (high pressure in the eye);
Depression, psychosis or schizophrenia.
You drink alcohol regularly.
Alcohol may increase the effects of Ativan.
If you have not told your doctor about any of the above, tell them before you take any Ativan.

Taking other medicines
Tell your doctor if you are taking any other medicines, including medicines that you buy without a prescription from a pharmacy, supermarket or health food shop.

Some medicines may interfere with Ativan. These include:

Other sleeping tablets, sedatives or tranquillisers;
Medicines for depression;
Medicines for allergies for example antihistamines or cold tablets;
Pain relievers;
Muscle relaxants;
Medicines to control fits.
These medicines may increase the effects of Ativan. You may need to take different amounts of your medicine or you may need to take different medicines. Your doctor will advise you.

Your doctor or pharmacist may have more information on medicines to be careful with or avoid while taking Ativan.

How to take it
How much to take
The dose of Ativan may be different for each person. Your doctor will decide the right dose for you.

For anxiety, the usual daily dose is 2 to 3 mg administered in divided doses. However, the daily dose can range from 1 to 10 mg.

For sleeping problems (insomnia) due to anxiety, a dose of 1 to 2 mg taken at bedtime is usually prescribed.

If you are taking Ativan before surgery the usual dose is 2 to 4 mg the night before surgery. Another dose of 2 to 4 mg may also be given 1 to 2 hours before surgery.

Elderly people may need a lower dose.

How to take it
Swallow Ativan with a glass of water.

It may be taken with or without food.

When to take it
Your doctor will tell you how many times during the day you need to take Ativan.

How long to take it
Do not take Ativan for longer than your doctor says.

Ativan is usually used for short periods only (for example 2-4 weeks). Continuous long-term use is not recommended unless advised by your doctor. The use of benzodiazepines may lead to dependence on the medicine.

Continue taking Ativan as long as your doctor recommends it.

If you take too much (overdose)
Immediately telephone your doctor or Poisons Information Centre (in Australia telephone 13 11 26, in New Zealand telephone 0800 764 766) for advice, or go to casualty at your nearest hospital, if you think that you or anyone else may have taken too much Ativan. Do this even if there are no signs of discomfort or poisoning. Also, report any other medicine or alcohol which has been taken. You may need urgent medical attention.

If you take too much Ativan you may feel drowsy, confused, tired, dizzy, have difficulty breathing, feel weak or become unconscious.

While you are taking it
Things you must do
Take Ativan exactly as your doctor has prescribed.

Tell all doctors, dentists, and pharmacists who are treating you that you are taking Ativan.

If you become pregnant while you are taking Ativan, tell your doctor immediately.

Tell your doctor if you feel Ativan is not helping your condition.

If you are being treated for anxiety, be sure to discuss with your doctor any problems you may have and how you feel, especially if your anxiety attacks are getting worse or more frequent. This will help your doctor to determine the best treatment for you.

Visit your doctor regularly. Your doctor needs to check your progress and see whether you need to keep taking Ativan.

Always discuss with your doctor any problems or difficulties you have during or after taking Ativan.

Tell your doctor if, for any reason, you have not taken your medicine exactly as prescribed. Otherwise, your doctor may think that it was not effective and change your treatment unnecessarily.

Keep enough Ativan to last weekends and holidays.

Things you must not do
Do not drive or operate machinery until you know how Ativan affects you. This medicine may cause drowsiness or dizziness in some people and therefore may affect alertness. Make sure you know how you react to Ativan before you drive a car, operate machinery, or do anything else that could be dangerous if you are drowsy, dizzy or not alert. Even if you take Ativan at night, you may still be drowsy or dizzy the next day.

Do not take Ativan for a longer time than your doctor has prescribed. Ativan should be taken for short periods only (for example 2 to 4 weeks), unless advised otherwise by your doctor.

Do not change your dose without first checking with your doctor.

Do not stop taking Ativan or lower the dose, without first checking with your doctor. Stopping this medicine suddenly may cause some unwanted effects. Your doctor will slowly reduce your dose before you can stop taking it completely.

Do not suddenly stop taking Ativan if you suffer from epilepsy. Stopping this medicine suddenly may make your epilepsy worse.

Do not use this medicine to treat any other complaints unless your doctor says to.

Do not give Ativan to anyone else, even if their symptoms seem similar to yours.

Things to be careful of
Be careful when drinking alcohol while taking Ativan. Combining Ativan and alcohol can make you more sleepy, dizzy or lightheaded. Your doctor may suggest that you avoid alcohol or reduce the amount of alcohol you drink while you are taking Ativan.

Be careful if you are elderly, unwell or taking other medicines. Some people may experience side effects such as drowsiness, confusion, dizziness, and unsteadiness, which may increase the risk of a fall.

After taking it
Storage
Keep Ativan in a cool dry place where the temperature stays below 25°C.

Keep your tablets in their blister pack until it is time to take them. If you take the tablets out of the box or the blister pack they may not keep well.

Do not store it or any other medicines, in a bathroom or near a sink. Do not leave it in the car or on window sills. Heat and dampness can destroy some medicines.

Keep it where children cannot reach it. A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.

Disposal
If your doctor tells you to stop taking Ativan or the tablets have passed their expiry date, ask your pharmacist what to do with any tablets left over.

Tell your doctor or pharmacist as soon as possible if you do not feel well while you are using Ativan. Ativan helps most people with anxiety but it may have unwanted side effects in some people. All medicines may have side effects. Sometimes they are serious, most of the time they are not. You may need medical treatment if you get some of the side effects.

Ask your doctor or pharmacist to answer any questions you may have.

If side effects do happen, they are more likely to happen when you first start taking Ativan. These side effects may go away during treatment as your body adjusts to the dose.

However, tell your doctor if you notice any of the following and they worry you:

Drowsiness;
Dizziness;
Sleepiness;
Clumsiness or unsteadiness;
Weakness;
Loss of memory.
These are the more common side effects of Ativan.

Other less common or rare side effects include:

Skin rashes;
Feeling sick or vomiting;
Outbursts of anger and increased excitement;
Confusion or depression;
Headache;
Sleep disturbances;
Blurred vision;
Low blood pressure;
Dry mouth;
Excessive salivation;
Changes in appetite;
Nausea.