Ativan (lorazepam) is a prescription tranquilizing medication. You might also 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 tablets
  • Ativan solution for intravenous (IV) injection

Ativan is available in a generic form called lorazepam.

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.

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.

More common side effects

The more common side effects of Ativan include:

  • drowsiness
  • dizziness
  • weakness

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

  • confusion
  • lack of coordination
  • depression
  • fatigue
  • headache
  • restlessness

In people who receive the Ativan injection, redness 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 to 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:
  • Psychological and physical dependence (more likely with people who take higher doses of Ativan or use it long term, or who misuse or abuse alcohol or drugs). Symptoms of physical dependence can include:
    • anxiety
    • depression
    • muscle weakness
    • nightmares
    • body aches
    • sweating
    • nausea
    • vomiting
  • 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. (Ativan should be avoided by people with depression that’s not treated.)

Suicide prevention

  • If you think someone is at immediate risk of self-harm or hurting another person:
  • •  Call 911 or your local emergency number.
  • •  Stay with the person until help arrives.
  • •  Remove any guns, knives, medications, or other things that may cause harm.
  • •  Listen, but don’t judge, argue, threaten, or yell.
  • If you or someone you know is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.

Side effects in children

Ativan tablets aren’t approved by the Food and Drug Administration (FDA) for use in children under 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 side effects from Ativan.

Side effects in seniors

In older adults, Ativan should be used cautiously or avoided altogether. Many seniors 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 seniors.

Long-term side effects

Ativan is FDA-approved for short-term use, up to four months. Long-term use of Ativan should be avoided because it can cause serious side effects. These include:

  • Dependence. Ativan is a habit-forming drug. This means that long-term use can cause physical and psychological dependence. It can also cause serious withdrawal symptoms when the medication is stopped.
  • 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.

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:

  • seniors
  • receiving high doses of Ativan
  • taking other medications that affect breathing, such as opioids
  • severely ill or have a breathing disorder such as sleep apnea or chronic obstructive pulmonary disorder (COPD)

Weight gain/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 a bigger appetite. This might cause them to eat more and gain weight. And 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

  • Tablet: 0.5 mg, 1 mg, 2 mg
  • Solution for injection (IV): 2 mg per mL, 4 mg per mL

General dosage information

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 for anxiety

  • Typical dosage: 1 to 3 mg taken two or three times daily.
  • Typical dosage: 2 to 4 mg at bedtime.
  • Intravenous (IV) Ativan will be given by your doctor or nurse. Your doctor will determine the best dosage for your condition.

Dosage for insomnia due to anxiety or stress

Dosage for IV Ativan

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.

Ativan for anxiety

Ativan is FDA-approved for the short-term treatment of anxiety symptoms. It’s also commonly used off-label for treating generalized anxiety disorder and panic attacks.

Ativan for sleep/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 IV 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 IV 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 to your doctor about safer options.

Other off-label uses for Ativan

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

  • agitation
  • alcohol withdrawal
  • nausea and vomiting related to chemotherapy
  • anxiety when flying

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

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.

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:

  • morphine (Astramorph PF, Kadian, MS Contin, and others)
  • oxycodone (Percocet, Roxicet, Oxycontin, and others)
  • hydrocodone (Zohydro ER, Hysingla ER)
  • methadone (Dolophine, Methadose)
  • fentanyl (Abstral, Duragesic, and others)

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

Sedative drugs

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

  • anticonvulsant medications such as carbamazepine (Carbatrol, Epitol, Equetro, Tegretol), phenytoin (Dilantin, Phenytek), and topiramate (Qudexy XR, Topamax, Trokendi XR)
  • antihistamines such as diphenhydramine (Benadryl), cetirizine (Zyrtec), chlorpheniramine (Chlor-Trimeton and others), and doxylamine (Unisom and others) — also found in over-the-counter and combination products
  • antipsychotic drugs such as clozapine (Clozaril, Fazaclo ODT), haloperidol (Haldol), quetiapine (Seroquel), and risperidone (Risperdal)
  • anxiety drugs such as buspirone (Buspar)
  • barbiturates such as phenobarbital
  • other benzodiazepines such as alprazolam (Xanax), clonazepam (Klonopin), diazepam (Valium), and midazolam

Probenecid

Taking Ativan with probenecid, 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.

Valproic acid

Taking Ativan with valproic acid (Depakene, 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 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

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 and breathing problems. Examples of sedative herbs and supplements that can cause these effects include:

Ativan and marijuana

Marijuana shouldn’t be used with Ativan. Using marijuana with Ativan can cause excessive drowsiness or sedation.

Some people can have bothersome withdrawal symptoms after stopping Ativan. These can occur after taking Ativan for as little as one 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:

  • headache
  • anxiety
  • trouble sleeping
  • irritability
  • tremor
  • panic attacks
  • depression

Talk with your doctor before stopping Ativan. Your doctor may recommend that you slowly reduce your dosage before stopping the drug completely.

Taking too much Ativan can increase your risk of harmful or serious side effects.

Overdose symptoms

Symptoms of overdose can include:

  • drowsiness
  • confusion
  • lethargy
  • low blood pressure
  • trouble breathing
  • coma

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.

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 to 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:

  • Antidepressants such as:
  • Buspirone, an anxiolytic drug
  • Benzodiazepines such as:

    Herb and supplement alternatives

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

    • kava
    • lavender
    • lemon balm
    • passion flower
    • rhodiola
    • St. John’s wort
    • valerian

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

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. Xanax

Ativan and Xanax 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.

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 an intravenous (IV) solution. The oral tablet is usually taken one to three times a day. The IV solution is given by your healthcare provider.

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:

  • drowsiness
  • dizziness
  • weakness
  • lack of coordination
  • confusion
  • depression
  • fatigue
  • headache
  • increase or decrease in libido (sex drive)
  • memory problems
  • constipation

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:

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 it starts working: Both drugs start to work 15 to 30 minutes after you take them.
  • How long it lasts: Both drugs have a peak effect within 1.5 hours of when you take them. 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.

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.

Uses

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

Ativan is approved for:

  • short-term treatment of symptoms of anxiety
  • treating insomnia (trouble sleeping) due to anxiety or stress
  • treating a severe type of seizure called status epilepticus
  • providing sedation before surgery

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 an intravenous (IV) solution. The oral tablet is usually taken one to three times a day. The IV solution is given by your healthcare provider.

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:

  • drowsiness
  • dizziness
  • weakness
  • lack of coordination
  • confusion
  • depression
  • fatigue
  • headache

Both can also cause these serious side effects:

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 it starts working: Both Ativan and Klonopin start to work within 15 to 30 minutes of when you take them.
  • How long it lasts: Ativan has a peak effect within 1.5 hours of when you take it. Klonopin has a peak effect within 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.

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 an intravenous (IV) solution. The oral tablet is usually taken one to three times a day. The IV solution is given by your healthcare provider.

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:

  • drowsiness
  • dizziness
  • weakness
  • lack of coordination
  • confusion
  • depression
  • fatigue
  • headache
  • increase or decrease in libido (sex drive)
  • memory problems

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

  • weight gain or loss
  • urinary problems such as incontinence
  • irregular menstruation

Serious side effects

Possible serious side effects that Ativan and Valium share include:

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 it starts working: Ativan starts working within 15 to 30 minutes. Valium starts working within about 15 minutes.
  • How long it lasts: Ativan has a peak effect within about 1.5 hours. It lasts in the body for about 10 to 20 hours. However, its effects wear off more quickly — usually within a few hours. Valium has a peak effect within an hour. 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.

Uses

Ativan is FDA-approved for many uses, including:

  • short-term treatment of symptoms of anxiety
  • treating insomnia (trouble sleeping) due to anxiety or stress
  • treating a severe type of seizure called status epilepticus
  • providing sedation before surgery

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

Drug forms

Ativan is available as an oral tablet and as an intravenous (IV) solution. The oral tablet is usually taken one to three times a day. The IV solution is given by your healthcare provider.

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
• weakness
• lack of coordination
• confusion
• fatigue
• dry mouth
• back pain
• abnormal dreams
• rash
• diarrhea
Serious side effectspsychological and physical dependence (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 (boxed warning)• unusual behaviors during sleep that aren’t remembered after waking*

* These 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.

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 is 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 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 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
midazolamrapidshort
oxazepamslowintermediate
temazepam (Restoril)intermediateintermediate
triazolam (Halcion)rapidshort

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 1 to 1.5 hours.

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 woman. Avoid using Ativan during pregnancy.

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

You shouldn’t 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.

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.

  • For people with depression. Ativan and other benzodiazepine medications can worsen symptoms of depression. Ativan shouldn’t be used by people with depression who aren’t receiving adequate treatment for this condition.
  • For people with 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.
  • For people with acute narrow-angle glaucoma. Ativan may increase the pressure inside the eye, worsening glaucoma.

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 be may be abused.

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.

Some people who take Ativan can become physically and psychologically dependent on the drug. 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 or abuse of the drug. The risk is higher with people who have previously abused alcohol or drugs.

Symptoms of Ativan abuse can include:

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

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 three to five days.

Here are answers to some frequently asked questions about Ativan.

How long does Ativan last?

Most of the effects of Ativan last about six to eight hours. However, this can vary from person to person.

How fast does Ativan work?

Ativan begins to work within minutes, but its maximum effect usually happens about 1 to 1.5 hours after you take it.

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. 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:

  • headache
  • anxiety
  • trouble sleeping
  • irritability
  • sweating
  • dizziness

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

  • hallucinations
  • seizures
  • tremor
  • panic attacks

Is Ativan addicting?

Ativan is habit-forming and can lead to physical and psychological dependence and addiction.

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 two to four weeks. If you’re concerned that you might need to use this medication for longer periods, talk with your doctor.

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 to 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.

Abuse 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 abuse.

The risk of dependence and abuse 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: Healthline 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 other 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.