Ativan (lorazepam): Side effects, dosage, uses, and more

Ativan (lorazepam) is a brand-name prescription medication. You might hear it called a sedative-hypnotic or anxiolytic medication. Ativan belongs to a class ... HealthConditionsHealthConditionsAlzheimer's&DementiaAnxietyArthritisAsthma&AllergiesBreastCancerCancerCardiovascularHealthCOVID-19Dermatology&SkincareDiabetesEnvironment&SustainabilityExercise&FitnessEyeHealthHeadache&MigraineHealthEquityHIV&AIDSHumanBiologyInflammatoryBowelDiseaseLeukemiaLGBTQIA+Men'sHealthMentalHealthMultipleSclerosis(MS)NutritionParkinson'sDiseasePsoriasisSexualHealthWomen'sHealthDiscoverNewsLatestNewsOriginalSeriesMedicalMythsHonestNutritionThroughMyEyesNewNormalHealthPodcastsTheamazingstoryofhepatitisC,fromdiscoverytocureNewdirectionsindementiaresearchCanpsychedelicsrewireadepressed,anxiousbrain?WhyclimatechangemattersforhumanhealthWhatdoesthelatestresearchsayaboutmultiplesclerosis?LongCOVID'scardiovascularimplicationsToolsGeneralHealthDrugsA-ZHealthHubsHealthToolsBMICalculatorsandChartsBloodPressureChart:RangesandGuideBreastCancer:Self-ExaminationGuideSleepCalculatorHealthProductsAffordableTherapyOptionsBloodPressureMonitorsDiabeticSuppliesFitnessTrackersHomeGymsGreenCleaningProductsHowtoShopforCBDQuizzesRAMythsvsFactsType2Diabetes:ManagingBloodSugarAnkylosingSpondylitisPain:FactorFictionConnectAboutMedicalNewsTodayWhoWeAreOurEditorialProcessContentIntegrityConsciousLanguageNewslettersSignUpFollowUsMedicalNewsTodayHealthConditionsDiscoverToolsConnectSubscribeAtivan(lorazepam)MedicallyreviewedbyAlexBrewer,PharmD,MBA—WrittenbyMNTMedicalNetwork—UpdatedonFebruary11,2022ContentsGenericSideeffectsDosageUsesAtivanvs.XanaxAtivanvs.otherdrugsControlledsubstanceWithdrawalFAQsAtivanandalcoholInteractionsClassificationOverdoseAtivanfordogsPregnancyBreastfeedingAlternativesAtivananddrugtestingHowtotakeHowitworksPrecautionsMisuseExpirationForprofessionalsWhatisAtivan?Ativan(lorazepam)isabrand-nameprescriptionmedication.Youmighthearitcalledasedative-hypnoticoranxiolyticmedication.Ativanbelongstoaclassofmedicationscalledbenzodiazepines.Ativanisusedtotreatanxietysymptoms,insomnia(troublesleeping),andstatusepilepticus(atypeofsevereseizure).It’salsogivenbeforesurgerytomakeyousleep.Ativancomesintwoforms:tabletssolutionforintramuscularinjectionorintravenous(IV)injectionAtivangenericAtivancontainstheactivedruglorazepam.BoththetabletandsolutionformofAtivanareavailableasgenericmedications.Genericdrugsareoftenlessexpensivethanthebrand-nameversion.Insomecases,thebrand-namedrugandthegenericversionmaybeavailableindifferentformsandstrengths.Tolearnmoreaboutgenericlorazepamoraltablets,seethisarticle.AtivansideeffectsAtivancancausemildorserioussideeffects.ThefollowinglistcontainssomeofthekeysideeffectsthatmayoccurwhiletakingAtivan.Thislistdoesn’tincludeallpossiblesideeffects.FormoreinformationonthepossiblesideeffectsofAtivan,ortipsonhowtodealwithatroublingsideeffect,talkwithyourdoctororpharmacist.Note:TheFoodandDrugAdministration(FDA)tracksandreviewssideeffectsofdrugsithasapproved.IfyouwouldliketonotifytheFDAaboutasideeffectyou’vehadwithAtivan,youcandosothroughMedWatch.MorecommonsideeffectsThemorecommonsideeffectsofAtivaninclude:drowsinessorsleepinessdizzinessweaknessSomepeoplemayalsoexperiencelessfrequentsideeffectssuchas:confusionlackofcoordinationdepressionfatigueheadacherestlessnesschangesinlibido(sexdrive)memoryproblemsInpeoplewhoreceivetheAtivaninjection,rednessordeepeningofskincolorandpainattheinjectionsitecancommonlyoccur.Someofthesesideeffectsmaygoawaywithinafewdaysoracoupleofweeks.Ifthey’remoresevereordon’tgoaway,talkwithyourdoctororpharmacist.SerioussideeffectsSerioussideeffectsfromAtivanaren’tcommon,buttheycanoccur.Callyourdoctorrightawayifyouhaveanyserioussideeffects.Call911ifyoursymptomsfeellifethreateningorifyouthinkyou’rehavingamedicalemergency.Serioussideeffectsandtheirsymptomscanincludethefollowing:Breathingeffects.Symptomscaninclude:slowedbreathingrespiratoryfailure,whichisrareLowbloodpressure,whichmaybesevereenoughtocausefaintingorfalls.Convulsionsorseizures.Symptomscaninclude:uncontrollable,suddenmovementsinyourarmsorlegslossofconsciousnessorawarenessstiffmusclesstaringspellsParadoxicalreactions(reactionsthatcauseeffectsoppositeofthoseexpectedwiththedrug),suchasaggression,hostility,agitation,orrage.Dependence,misuse,andaddiction,whicharemorelikelyinpeoplewhotakehigherdosesofAtivanoruseitlongterm,orthosewhomisusealcoholordrugs.*†Symptomsofphysicaldependencecaninclude:anxietydepressionmuscleweaknessnightmaresbodyachessweatingnauseavomitingSeriousallergicreactions.Symptomscaninclude:severerashorhivestroublebreathingorswallowingswellingofyourlips,tongue,orfacerapidheartbeatSuicidalthoughts.(Becauseofthis,Ativanshouldbeavoidedbypeoplewithdepressionthat’snottreated.)Lifethreateningsideeffectsiftakenwithopioidmedications.*(Seethe“Ativaninteractions”sectionfordetails.)*Ativantabletsandsolutionhaveaboxedwarningregardingthisrisk.AboxedwarningisthestrongestwarningrequiredbytheFoodandDrugAdministration(FDA).Boxedwarningsalertdoctorsandpatientsaboutdrugeffectsthatmaybedangerous.†Withdependence,yourbodyneedsadruginordertofunctionlikeusual.Withmisuse,adrugistakeninawayotherthanhowit’sprescribed.Andwithaddiction,it’sdifficulttostoptakingadrug,eventhoughit’scausingharmfuloutcomes.SuicidepreventionIfyouknowsomeoneatimmediateriskofself-harm,suicide,orhurtinganotherperson:Askthetoughquestion:“Areyouconsideringsuicide?”Listentothepersonwithoutjudgment.Call911orthelocalemergencynumber,ortextTALKto741741tocommunicatewithatrainedcrisiscounselor.Staywiththepersonuntilprofessionalhelparrives.Trytoremoveanyweapons,medications,orotherpotentiallyharmfulobjects.Ifyouorsomeoneyouknowishavingthoughtsofsuicide,apreventionhotlinecanhelp.TheNationalSuicidePreventionLifelineisavailable24hoursperdayat800-273-8255.Duringacrisis,peoplewhoarehardofhearingcanusetheirpreferredrelayserviceordial711then800-273-8255.Clickhereformorelinksandlocalresources.SideeffectsinchildrenAtivantabletsaren’tapprovedbytheFoodandDrugAdministration(FDA)foruseinchildrenyoungerthan12years.They’resometimesusedoff-labelinchildrenunder12years,butthisusehasn’tbeenconfirmedtobesafe.ChildrenmaybemorelikelythanadultstoexperiencecertainsideeffectsfromAtivan.SideeffectsinolderpeopleInolderadults,Ativanshouldbeusedcautiouslyoravoidedaltogether.Manyolderpeoplearemorelikelytoexperiencesideeffectssuchasdrowsinessordizziness.Thiscanincreasetheirriskoffalls,whichcanleadtobonefractures.Lowerdosagesareoftenneededforolderpeople.Long-termsideeffectsStudiesofAtivantabletsfortreatinganxietydidn’tevaluatewhetherit’ssafetotakethedrugforlongerthan4months.Long-termuseofAtivanshouldbeavoidedwhenpossiblebecauseitcancauseserioussideeffects.Theseinclude:Dependence,misuse,andaddiction.*Ativanisahabit-formingdrug.Thismeansthatlong-termusecancausephysicalandpsychologicaldependence.(Withdependence,yourbodyneedsadruginordertofunctionlikeusual.)Itcanalsocauseseriouswithdrawalsymptomswhenthemedicationisstopped.TakingAtivanmayalsoleadtomisuseandaddiction.(Withmisuse,adrugistakeninawayotherthanhowit’sprescribed.Andwithaddiction,it’sdifficulttostoptakingadrug,eventhoughit’scausingharmfuloutcomes.)Reboundeffects.Inaddition,long-termuseofAtivanforsleeporanxietycancause“reboundinsomnia”or“reboundanxiety.”ThismeansthatAtivancanmakesymptomsoftheseconditionsworseovertime,whichmakesitevenhardertostoptakingthedrug.Ifyou’vebeentakingAtivanregularlyforalongtime,talkwithyourdoctoraboutothermedicationoptions,andhowyoumightbeabletostoptakingAtivan.*Ativantabletsandsolutionhaveaboxedwarningregardingthisrisk.AboxedwarningisthestrongestwarningrequiredbytheFoodandDrugAdministration(FDA).Boxedwarningsalertdoctorsandpatientsaboutdrugeffectsthatmaybedangerous.DrivingwarningAtivancanimpairyourabilitytodrive.Ifyoufeellightheadedorsleepyaftertakingit,don’tdrive.Also,don’tusedangerousequipment.NauseaIt’snotcommon,butsomepeoplewhotakeAtivancanfeelnauseated.Thissideeffectmaygoawaywithcontinueduseofthedrug.Ifnauseadoesn’tgoawayorisbothersome,talkwithyourdoctor.HeadacheSomepeoplewhotakeAtivanreporthavingheadachesafterward.Thissideeffectmaygoawaywithcontinueduseofthedrug.Ifheadachesdon’tgetbetterorarebothersome,talkwithyourdoctor.SlowedbreathingAtivancancauseyourbreathingtoslowdown.Inrarecases,thiscanleadtorespiratoryfailure.Slowedbreathingismorelikelytooccurinpeoplewhoare:olderinagereceivinghighdosesofAtivantakingothermedicationsthataffectbreathing,suchasopioidsseverelyillorhaveabreathingdisordersuchassleepapneaorchronicobstructivepulmonarydisorder(COPD)WeightgainorweightlossWeightgainorlossaren’ttypicalsideeffectsofAtivan,andstudieshavenotconfirmedtheseassideeffectsofthisdrug.However,weightchangesmaystilloccur.SomepeoplewhotakeAtivansaytheyhavemoreofanappetitethanusual.Thismightcausethemtoeatmoreandgainweight.Otherpeoplewhotakeithaveareducedappetite.Thismightcausethemtoeatlessandloseweight.MemorylossSomepeoplewhotakeAtivancanhavetemporarymemoryloss.Ifthishappens,youmayhavetroublerememberingthingsthatoccurredwhileyouweretakingthemedication.MemorylossshouldstopafteryoustoptakingAtivan.ConstipationIt’snotcommon,butsomepeoplewhotakeAtivanreportconstipation.Thissideeffectmaygoawaywithcontinueduseofthedrug.Ifitdoesn’tgetbetterorisbothersome,talkwithyourdoctor.VertigoIt’snotcommon,butsomepeoplewhotakeAtivancanexperiencevertigo.Vertigoisafeelingthatthingsaroundyouaremovingwhenthey’renot.Peoplewithvertigooftenfeeldizzy.It’snotclearifAtivanistheactualcauseofsymptomsofvertigo.Also,Ativanissometimesusedoff-labeltotreatpeoplewhohavesymptomsofvertigocausedbyotherconditionssuchasMeniere’sdisease.HallucinationsIt’srare,butsomepeoplewhotakeAtivanhavehallucinations.Ifyouhavethissideeffect,talkwithyourdoctoraboutalternativestoAtivan.AtivandosageTheAtivandosageyourdoctorprescribeswilldependonseveralfactors.Theseinclude:thetypeandseverityoftheconditionyou’reusingAtivantotreatyouragetheformofAtivanyoutakeothermedicalconditionsyoumayhaveTypically,yourdoctorwillstartyouonalowdosageandadjustitovertimetoreachthedosagethat’srightforyou.They’llultimatelyprescribethesmallestdosagethatprovidesthedesiredeffect.Thefollowinginformationdescribesdosagesthatarecommonlyusedorrecommended.However,besuretotakethedosageyourdoctorprescribesforyou.Yourdoctorwilldeterminethebestdosagetosuityourneeds.DrugformsandstrengthsAtivancomesasoraltabletsandasolutionthat’sgivenbyintramuscular(IM)injectionorintravenous(IV)injection.Theavailablestrengthsofeachformaredescribedbelow.Ativantabletstrengths:0.5mg,1mg,and2mgAtivantabletscomeinthefollowingstrengths:0.5milligrams(mg)1mg2mgAtivansolutionstrengths:2mg/mLand4mg/mLAtivansolutioncomesinthefollowingstrengths:2mgofdrugpermilliliter(mL)ofsolution4mg/mLGeneraldosageinformationforAtivantabletsTheusualoraldosageforAtivantabletsis2to6mgdaily.Thisdosageamountisusuallydividedandtakentwoorthreetimesdaily.DosageofAtivantabletsforanxietyTypicaldosage:2to3mgtakentwoorthreetimesdaily.DosageofAtivantabletsforinsomniaduetoanxietyorstressTypicaldosage:2to4mgatbedtime.DosageofAtivansolutionforIMorIVinjectionAtivansolutionwillbegivenasanIVorIMinjectionbyyourhealthcareprofessional.Yourdoctorwilldeterminethebestdosageforyourcondition.SpecialdosageconsiderationsOlderadultsandpeoplewithcertainphysicalconditionsmayneedtostartwithalowerdosage.Thismightbe1to2mg,takentwoorthreetimesdailyforanxietyoronceatbedtimeforinsomnia.WhatifImissadose?Ifyoumissadose,takeitassoonasyoucan.However,ifit’sjustafewhoursuntilyournextdose,skipthemisseddoseandtakethenextoneonschedule.Nevertrytocatchupbytakingtwodosesatatime.Thiscancausedangeroussideeffects.AtivanusesTheFoodandDrugAdministration(FDA)approvesdrugstotreatcertainconditions.Ativanisapprovedtotreatseveralconditions.Inaddition,it’ssometimesusedoff-labelforpurposesthataren’tapprovedbytheFDA.ApprovedusesforAtivanAtivanisFDA-approvedfortreatingseveraldifferentconditions.Theseconditionsaredescribedbelow.AtivanforanxietyAtivanisFDA-approvedformanaginganxietydisorders,includingtheshort-termtreatmentofanxietysymptoms.It’salsocommonlyusedoff-labelfortreatingpanicattacks.(Withoff-labeluse,adrugisprescribedforaconditionotherthanthoseit’sapprovedtotreat.)AtivanforsleeporinsomniaAtivanisFDA-approvedforshort-termtreatmentofinsomnia(troublesleeping)that’scausedbyanxietyorstress.Ativanisalsousedoff-labelforothertypesofinsomnia.However,accordingtotheAmericanAcademyofSleepMedicine,it’snotafirst-choicemedicationforthisuse.AtivanforseizuresTheliquidformofAtivanisFDA-approvedfortreatingaseveretypeofseizurecalledstatusepilepticus.Withthiscondition,seizuresdon’tstop,oroneseizurecomesafteranotherwithoutallowingthepersontimetorecover.AtivanforsedationduringsurgeryTheliquidformofAtivanisFDA-approvedtocausesleepbeforesurgery.Non-FDA-approvedusesAtivanisalsosometimesprescribedoff-label.Off-labeluseiswhenadrugisapprovedforoneusebutisprescribedforadifferentuse.AtivanfornauseafromvertigoAtivanissometimesusedoff-labelfortheshort-termtreatmentofsymptomsofvertigo.Thesesymptomsincludenauseaandvomiting.Insomecases,Ativanmaybeusedalongwithothermedicationsforthispurpose.AtivanfordepressionAtivanandothersimilarmedicationsaren’tprescribedtotreatdepressionitself.However,somepeoplewithdepressionalsohavesymptomsofanxietyorinsomnia.Inthesecases,yourdoctormayprescribeAtivantoreducethosesymptoms.Ifyouhavedepressiononly,yourdoctorwilllikelyprescribeadifferentmedication.AtivanforpainAtivanisn’ttypicallyusedtotreatpainitself.However,peoplewhohavesevere,long-lastingpainareoftenprescribedAtivanorsimilarmedications.Thismaybebecausetheyhaveanxietyortroublesleepingduetotheirpain.Peoplewithseverepainareoftentreatedwithopioidpainmedications.Ativanandotherbenzodiazepinemedicationsshouldn’tbeusedwithopioids.Thisisduetotheriskoflifethreateningsideeffectssuchasserioussedation,decreasedbreathing,coma,anddeath.Ifyou’retakinganopioidpainmedicationwithAtivan,talkwithyourdoctoraboutsaferoptions.AtivanformigraineAtivanisnotapprovedtotreatsymptomsofmigraine,suchasheadache.Butitmaybeprescribedoff-labelformigraineheadachesinsomecases.(Withoff-labeluse,adrugisprescribedforaconditionotherthanthoseit’sapprovedtotreat.)Also,keepinmindthatheadacheisapossiblesideeffectofthisdrug.Otheroff-labelusesforAtivanAtivanmayalsobeusedoff-labeltotreatotherconditionssuchas:agitationalcoholwithdrawalnauseaandvomitingrelatedtochemotherapyanxietywhenflyingAtivanvs.XanaxYoumaywonderhowAtivanandXanaxcompare,andwhetherAtivanisstrongerthanXanax.Thesemedicationsbothbelongtotheclassofdrugscalledbenzodiazepines.Theyworkinthesamewayandareverysimilarmedications.ThegenericnameofXanaxisalprazolam,whilethegenericnameofAtivanislorazepam.UsesAtivanandXanaxareusedforsimilaranddifferentpurposes.ApprovedusesforbothAtivanandXanaxOtherapprovedusesforAtivanOtherapprovedusesforXanaxOff-labelusesforAtivanOff-labelusesforboth•treatinganxietysymptoms•treatinginsomniaduetoanxietyorstress•treatingstatusepilepticus•providingsedationbeforesurgery•treatinggeneralizedanxietydisorder•treatingpanicdisorder•treatinggeneralizedanxietydisorder•treatingpanicdisorder•treatingothertypesofinsomniaDrugformsAtivanisavailableasanoraltabletandasasolutionthat’sgivenbyintramuscularinjectionorintravenousinjection.Theoraltabletisusuallytakenonetothreetimesperday.Thesolutionisgivenbyahealthcareprofessional.Xanaxisavailableasanoraltablet,whichisusuallytakenthreetimesdaily.It’salsoavailableasanextended-releasetablet,whichistakenjustoncedaily.SideeffectsandrisksAtivanandXanaxhavesomesimilarsideeffects,andsomethatdiffer.Belowareexamplesofthesesideeffects.MorecommonsideeffectsMorecommonsideeffectsthatAtivanandXanaxshareinclude:drowsinessdizzinessweaknesslackofcoordinationconfusiondepressionfatigueheadacheincreaseordecreaseinlibido(sexdrive)memoryproblemsconstipationInadditiontothese,othersideeffectsthatXanaxcancauseinclude:weightgainorlossirregularmenstruationSerioussideeffectsPossibleserioussideeffectsthatAtivanandXanaxshareinclude:physicaldependence,misuse,andaddiction*†lifethreateningsideeffectswhenusedwithopioidmedications*paradoxical(unexpected)reactions,suchasaggression,hostility,agitation,orragelowbloodpressure,whichmaybesevereenoughtocausefaintingorfallsconvulsionsorseizures*Ativantablets,Ativansolution,andXanaxhaveaboxedwarningregardingthisrisk.AboxedwarningisthestrongestwarningrequiredbytheFoodandDrugAdministration(FDA).Boxedwarningsalertdoctorsandpatientsaboutdrugeffectsthatmaybedangerous.†Withdependence,yourbodyneedsadruginordertofunctionlikeusual.Withmisuse,adrugistakeninawayotherthanhowit’sprescribed.Andwithaddiction,it’sdifficulttostoptakingadrug,eventhoughit’scausingharmfuloutcomes.EffectivenessAtivanandXanaxarebothusedtotreatanxietysymptoms.XanaxisalsoFDA-approvedtotreatgeneralizedanxietydisorderandpanicattacks.Ativanisusedoff-labeltotreatthoseconditions,too.Theyworkaboutequallywelltotreatallthreeconditions.It’simportanttonote,however,thatthesedrugsareusuallyconsideredsecond-choiceoptionsfortheseconditionsandshouldonlybeusedforshort-termtreatment.Thisisduetotheriskofsideeffectsanddependence.BothAtivanandXanaxworkquickly,butAtivanmaylastslightlylongerthanXanax.Whentheystartworking.Bothdrugsstarttowork15to30minutesafteryoutakethem.Howlongtheylast.Ativantabletshaveapeakeffectabout2to3hoursaftertakingadose,whileXanaxpeakswithin1to2hoursafteradose.However,AtivanmaylastslightlylongerthanXanax.CostsAtivanandXanaxarebothbrand-namemedications.They’realsobothavailableingenericform.Thegenericversionofadrugusuallycostslessthanthebrand-nameversion.ThegenericnameofXanaxiscalledalprazolam.Brand-nameAtivanusuallycostsmuchmorethanbrand-nameXanax.ThegenericversionsofAtivanandXanaxcostaboutthesame.Whicheverdrugorversionyouuse,theamountyoupaywilldependonyourinsurance.Ativanvs.otherdrugsYoumaywonderhowAtivancomparestoothermedicationsthatareprescribedforsimilaruses.BelowarecomparisonsbetweenAtivanandseveralmedications.Ativanvs.KlonopinAtivanandKlonopinworkinthesamewayandareverysimilarmedications.Theybothbelongtotheclassofdrugscalledbenzodiazepines.ThegenericnameofKlonopinisclonazepam,whilethegenericnameofAtivanislorazepam..UsesAlthoughAtivanandKlonopinaresimilarmedications,they’reFDA-approvedfordifferentuses.Ativanisapprovedfor:short-termtreatmentofsymptomsofanxietytreatinginsomnia(troublesleeping)duetoanxietyorstresstreatingaseveretypeofseizurecalledstatusepilepticusprovidingsedationbeforesurgeryKlonopinisapprovedfortreating:differenttypesofseizuressuchasLennox-GastautsyndromeandmyoclonicseizurepanicattacksKlonopinisusedoff-labelfortreatinganxietysymptoms,insomnia,andstatusepilepticus.DrugformsAtivanisavailableasanoraltabletandasasolutionthat’sgivenbyintramuscularinjectionorintravenousinjection.Theoraltabletisusuallytakenonetothreetimesaday.Thesolutionisgivenbyahealthcareprofessional.Klonopinisavailableasanoraltabletthat’susuallytakenonetothreetimesaday.SideeffectsandrisksAtivanandKlonopinhavesimilarsideeffects.Bothdrugscancausethesemorecommonsideeffects:drowsinessdizzinessweaknesslackofcoordinationconfusiondepressionfatigueheadacheBothcanalsocausetheseserioussideeffects:physicaldependence,misuse,andaddiction*†lifethreateningsideeffectswhenusedwithopioidmedications*paradoxical(unexpected)reactions,suchasaggression,hostility,agitation,orragelowbloodpressure,whichmaybesevereenoughtocausefaintingorfallsconvulsionsorseizures*Ativantablets,Ativansolution,andKlonopinhaveaboxedwarningregardingthisrisk.AboxedwarningisthestrongestwarningrequiredbytheFoodandDrugAdministration(FDA).Boxedwarningsalertdoctorsandpatientsaboutdrugeffectsthatmaybedangerous.†Withdependence,yourbodyneedsadruginordertofunctionlikeusual.Withmisuse,adrugistakeninawayotherthanhowit’sprescribed.Andwithaddiction,it’sdifficulttostoptakingadrug,eventhoughit’scausingharmfuloutcomes.EffectivenessWhileAtivanandKlonopinhavedifferentFDA-approveduses,they’rebothusedtotreatthefollowingconditions:Foranxietyandpanicattacks.AtivanandKlonopinusuallyworkaboutequallywellfortreatinganxietyandpanicattacks.However,they’retypicallyconsideredsecond-choiceoptionsfortheseconditionsandshouldonlybeusedforshort-termtreatment.Thisisduetotheriskofsideeffectsanddependence.Insomnia.Therehavebeennostudiescomparingthetwodrugs,butbothcanbeeffectivefortroublesleeping.However,they’reusuallyconsideredsecond-choiceoptionsandshouldonlybeusedforshort-termtreatment.Thisisduetotheriskofsideeffectsanddependence.Statusepilepticus.Bothdrugsareeffectivefortreatingstatusepilepticus,butonlyAtivanisconsideredafirst-choicetreatment.Thisconditionistreatedinthehospital,sothedrugusedwouldbechosenbythehospitaldoctor.BothAtivanandKlonopinworkquickly,butKlonopinmaylastlongerthanAtivan:Whentheystartworking.BothAtivanandKlonopinstarttoworkwithin15to30minutesofwhenyoutakethem.Howlongtheylast.Ativantabletshaveapeakeffectwithinabout2to3hoursofwhenyoutakethem.Klonopinhasapeakeffectwithin1to4hoursofwhenyoutakeit.CostsAtivanandKlonopinarebothbrand-namemedications.They’realsobothavailableingenericform.Thegenericversionofadrugusuallycostslessthanthebrand-nameversion.ThegenericnameofKlonopiniscalledclonazepam.Brand-nameAtivanusuallycostsmuchmorethanbrand-nameKlonopin.ThegenericversionsofAtivanandKlonopincostaboutthesame.Whicheverdrugorversionyouuse,theamountyoupaywilldependonyourinsurance.Ativanvs.ValiumAtivanandValiumbothbelongtotheclassofdrugscalledbenzodiazepines.Theyworkinthesamewayandareverysimilarmedications.ThegenericnameofValiumisdiazepam,whilethegenericnameofAtivanislorazepam.UsesAtivanandValiumareusedforsimilaranddifferentpurposes.ApprovedusesforbothAtivanandValiumOtherapprovedusesforAtivanOtherapprovedusesforValiumOff-labelusesforValium•short-termtreatmentofanxietysymptoms•providingsedationbeforesurgery•treatinginsomniaduetoanxietyorstress•treatingstatusepilepticus•treatingsymptomsofalcoholwithdrawal•treatingmusclespasmsandmusclespasticitycausedbyotherconditions(suchascerebralpalsyortetanus)•treatingcertaintypesofseizureswhenusedalongwithothermedications•treatinginsomniaduetoanxietyorstress•treatingstatusepilepticusDrugformsAtivanisavailableasanoraltabletandasasolutionthat’sgivenbyintramuscularinjectionorintravenousinjection.Theoraltabletisusuallytakenonetothreetimesperday.Thesolutionisgivenbyahealthcareprofessional.Valiumisalsoavailableasanoraltablet,whichistypicallytakenonetofourtimesdaily.SideeffectsandrisksAtivanandValiumhavesomesimilarsideeffects,andsomethatdiffer.Belowareexamplesofthesesideeffects.MorecommonsideeffectsMorecommonsideeffectsthatAtivanandValiumshareinclude:drowsinessdizzinessweaknesslackofcoordinationconfusiondepressionfatigueheadacheincreaseordecreaseinlibido(sexdrive)memoryproblemsInadditiontothese,othersideeffectsthatValiumcancauseinclude:weightgainorlossurinaryproblemssuchasincontinenceSerioussideeffectsPossibleserioussideeffectsthatAtivanandValiumshareinclude:physicaldependence,misuse,andaddiction*†lifethreateningsideeffectswhenusedwithopioidmedications*paradoxical(unexpected)reactions,suchasaggression,hostility,agitation,orragelowbloodpressure,whichmaybesevereenoughtocausefaintingorfallsconvulsionsorseizures*Ativantablets,Ativansolution,andValiumhaveaboxedwarningregardingthisrisk.AboxedwarningisthestrongestwarningrequiredbytheFoodandDrugAdministration(FDA).Boxedwarningsalertdoctorsandpatientsaboutdrugeffectsthatmaybedangerous.†Withdependence,yourbodyneedsadruginordertofunctionlikeusual.Withmisuse,adrugistakeninawayotherthanhowit’sprescribed.Andwithaddiction,it’sdifficulttostoptakingadrug,eventhoughit’scausingharmfuloutcomes.EffectivenessAtivanandValiumhavedifferentFDA-approveduses,buttheyarebothusedtotreatthefollowingconditions:Anxiety.Thesedrugsusuallyworkaboutequallywellfortreatinganxiety.However,they’retypicallyconsideredsecond-choiceoptionsandshouldonlybeusedforshort-termtreatment.Thisisduetotheriskofsideeffectsanddependence.Insomnia.Nostudieshavedirectlycomparedthesetwodrugsfortreatinginsomnia.However,bothdrugscanbeeffectiveforthiscondition.It’simportanttonotethatthey’rebothtypicallyconsideredsecond-choiceoptionsfortreatingthisconditionandshouldonlybeusedforshort-termtreatment.Thisisduetotheriskofsideeffectsanddependence.Statusepilepticus.Ativanisconsideredafirst-choicetreatmentforstatusepilepticus.ValiumworksaswellasAtivanandisalsoafirst-choicetreatment,butmaycausemoresideeffects,suchassleepiness.Valiumisalsoeffectivefortreatingotherkindsofseizures.However,itmaynotbeafirst-choicemedicationforthoseconditions,ormayonlybeusedincombinationwithothermedications.BothAtivanandValiumworkquickly.ValiummayworklongerthanAtivanforsomeuses,butnotaslongforotheruses:Whentheystartworking.Ativanstartsworkingwithin15to30minutes.Valiumstartsworkingwithinabout15minutes.Howlongtheylast.Ativantabletshaveapeakeffectwithinabout2to3hours.Theylastinthebodyforabout10to20hours.However,theireffectwearsoffmorequicklythanthatofValium.Ativan’seffectusuallywearsoffwithinafewhours.Valiumhasapeakeffectalittlemorethan1hourafteradoseistaken.Itremainsinthebodyforabout32to48hours,butitseffectsdon’tusuallylastthatlong.Someeffectsmaywearoffwithinafewhours.CostsAtivanandValiumarebothbrand-namemedications.Botharealsoavailableingenericform.Thegenericversionofadrugusuallycostslessthanthebrand-nameversion.ThegenericnameofValiumisdiazepam.Brand-nameAtivanusuallycostsmuchmorethanbrand-nameValium.ThegenericversionsofAtivanandValiumcostaboutthesame.Whicheverdrugorversionyouuse,theamountyoupaywilldependonyourinsurance.Ativanvs.AmbienAtivanandAmbienhavesomesimilareffectsinthebody.Bothareconsideredtoworkassedative-hypnoticdrugs.Thismeanstheybothcausesleepinessandsedation(relaxation).However,thesemedicationsbelongtodifferentdrugclasses.Ativanisabenzodiazepine,whileAmbienbelongstoaclassofdrugscallednon-benzodiazepinehypnotics.ThegenericnameofAmbieniszolpidem,whilethegenericnameofAtivanislorazepam.UsesAtivanisFDA-approvedformanyuses,including:short-termtreatmentofsymptomsofanxietytreatinginsomnia(troublesleeping)duetoanxietyorstresstreatingaseveretypeofseizurecalledstatusepilepticusprovidingsedationbeforesurgeryAmbienisonlyFDA-approvedforshort-termtreatmentofinsomnia.DrugformsAtivanisavailableasanoraltabletandasasolutionthat’sgivenbyintramuscularinjectionorintravenousinjection.Theoraltabletisusuallytakenonetothreetimesperday.Thesolutionisgivenbyahealthcareprofessional.Ambienisavailableasanoraltabletandasanextended-releasetabletcalledAmbienCR.Bothformsaretakenoncedailyjustbeforebedtime.SideeffectsandrisksAtivanandAmbienhavesomesimilarsideeffects,andsomethatdiffer.Belowareexamplesofthesesideeffects.AtivanandAmbienAtivanAmbienMorecommonsideeffects•daytimedrowsiness•dizziness•headache•depression•memoryproblems•lackofcoordination•confusion•weakness•fatigue•drymouth•backpain•abnormaldreams•rash•diarrheaSerioussideeffects•physicaldependence,misuse,andaddiction(morecommoninAtivan)*†•worseningofdepressionorsuicidalthoughtsandactionsinpeoplewithdepression•lifethreateningsideeffectswhenusedwithopioidmedications*•unusualbehaviorsduringsleepthataren’trememberedafterwaking‡*Ativantabletsandsolutionhaveaboxedwarningregardingthisrisk.AboxedwarningisthestrongestwarningrequiredbytheFoodandDrugAdministration(FDA).Boxedwarningsalertdoctorsandpatientsaboutdrugeffectsthatmaybedangerous.†Withdependence,yourbodyneedsadruginordertofunctionlikeusual.Withmisuse,adrugistakeninawayotherthanhowit’sprescribed.Andwithaddiction,it’sdifficulttostoptakingadrug,eventhoughit’scausingharmfuloutcomes.‡Ambienhasaboxedwarningforthissideeffect.Thesebehaviorscanincludesleepwalking,andeating,driving,makingphonecalls,orhavingsexwhileasleep.EffectivenessTheonlyconditionthatbothAtivanandAmbienareapprovedtotreatisinsomnia.Bothareeffectivefortreatingthiscondition,althoughtheyhaven’tbeencomparedinclinicalstudiesforthispurpose.It’simportanttonotethatAmbienistypicallyafirst-choiceoptionfortreatinginsomniabecauseitusuallycausesfewersideeffectsthanotherdrugs.Ativanisusuallyconsideredasecond-choiceoptionfortreatinginsomnia.It’stypicallyusedinpeopleforwhomfirst-choiceoptionssuchasAmbiendon’tworkwell.CostsAtivanandAmbienarebothbrand-namemedications.Botharealsoavailableingenericform.Thegenericversionofadrugusuallycostslessthanthebrand-nameversion.ThegenericnameofAmbieniszolpidem.Brand-nameAtivanusuallycostsmorethanbrand-nameAmbien.ThegenericversionsofAtivanandAmbiencostaboutthesame.Whicheverdrugorversionyouuse,theamountyoupaywilldependonyourinsurance.IsAtivanacontrolledsubstance?Yes,Ativanisacontrolledsubstance.It’sclassifiedasaSchedulefour(IV)prescriptiondrug.Thismeansthatithasanacceptedmedicalusebutmayalsocausephysicalorpsychologicaldependenceandmaybemisused.*Withdependence,yourbodyneedsadruginordertofunctionlikeusual.Withmisuse,adrugistakeninawayotherthanhowit’sprescribed.ThegovernmenthascreatedspecialrulesforhowScheduleIVdrugscanbeprescribedbyadoctoranddispensedbyapharmacist.Yourdoctororpharmacistcantellyoumore.*Ativantabletsandsolutionhaveaboxedwarningregardingthisrisk.AboxedwarningisthestrongestwarningrequiredbytheFoodandDrugAdministration(FDA).Boxedwarningsalertdoctorsandpatientsaboutdrugeffectsthatmaybedangerous.AtivanwithdrawalSomepeoplecanhavebothersomewithdrawalsymptomsafterstoppingAtivan.ThesecanoccuraftertakingAtivanforaslittleas1week.IfAtivanistakenlonger,withdrawalsymptomsaremorelikelytooccur.They’realsolikelytobemoresevere.Withdrawalsymptomscaninclude:headacheanxietytroublesleepingirritabilitytremorpanicattacksdepressionconvulsionssuicidalthoughtsorbehaviorshallucinationsTalkwithyourdoctorbeforestoppingAtivan.Yourdoctorcanhelpslowlyreduceyourdosagebeforeyoustoptakingthedrugcompletely.CommonquestionsaboutAtivanHereareanswerstosomefrequentlyaskedquestionsaboutAtivan.HowlongdoesAtivanlast?MostoftheeffectsofAtivantabletslastabout6to8hours.However,thiscanvaryfrompersontoperson.HowfastdoesAtivanwork?Ativanbeginstoworkwithinminutesafterit’staken.Butfortablets,themaximumeffectusuallyhappensabout2to3hoursafteryoutakethem.WhenstoppingAtivan,shouldyoutaperyourdosage?Ifyou’vebeentakingAtivanregularly,yes,you’lllikelyneedtoslowlytaperyourdosageofthemedication.Ifyoudon’ttaperyourdosage,youmayexperiencewithdrawalsymptoms.Insomecases,thetapermaylastseveralweeksorevenafewmonths.Howslowlyyoutaperthemedicationwilldependonhowmuchyou’vebeentakingandhowlongyou’vebeenusingAtivan.TalkwithyourdoctorbeforestoppingAtivantofindoutthebestwaytotaperthemedication.WhatarethewithdrawaleffectsofstoppingAtivan?Ativancancausewithdrawaleffectsinsomepeoplewhentheystoptakingthemedication.Theseeffectsaremorelikelytohappenifyou’vetakenhigherdosesortakenAtivanforalongperiodoftime.Symptomsofwithdrawalcaninclude:headacheanxietytroublesleepingirritabilitysweatingdizzinessForpeoplewithsevereAtivandependencewhoabruptlystoptakingit,moreseverewithdrawalsymptomscanoccur.Thesecaninclude:hallucinationsseizurestremorpanicattacksIsAtivanaddictive?Ativanmayleadtophysicalandpsychologicaldependenceandaddiction.*Withdependence,yourbodyneedsadruginordertofunctionlikeusual.Withaddiction,adrugistaken,evenifit’scausingharmfuloutcomes.BesuretotalkwithyourdoctoraboutyourriskofthesesideeffectswithAtivan.Yourdoctorcanrecommendifthismedicationisrightforyou.*Ativantabletsandsolutionhaveaboxedwarningregardingthisrisk.AboxedwarningisthestrongestwarningrequiredbytheFoodandDrugAdministration(FDA).Boxedwarningsalertdoctorsandpatientsaboutdrugeffectsthatmaybedangerous.Whataretheeffectsoflong-termuseofAtivan?Long-termuseofAtivancanincreaseyourriskofcertainsideeffects,especiallyphysicalandpsychologicaldependence.*Thiscanleadtowithdrawalsymptoms(seeabove)whenthemedicationisstopped.Ativanistypicallyprescribedforshort-termuseof2to4weeks.Ifyou’reconcernedthatyoumightneedtousethismedicationforlongerperiods,talkwithyourdoctor.*Ativantabletsandsolutionhaveaboxedwarningregardingthisrisk.AboxedwarningisthestrongestwarningrequiredbytheFoodandDrugAdministration(FDA).Boxedwarningsalertdoctorsandpatientsaboutdrugeffectsthatmaybedangerous.AtivanandalcoholIfyou’retakingAtivan,youshouldn’tdrinkalcohol.ConsumingalcoholwithAtivancanincreasetheriskofserioussideeffectssuchas:breathingproblemsrespiratoryfailurememoryproblemsexcessivesleepinessorsedationcomaIt’salsoimportanttonotethatAtivancanloweryourtolerancetoalcohol.Thismeansyou’llfeelmoreintoxicatedthanusualafterdrinkingsmalleramountsofalcohol.Italsomeansyou’reathigherriskforthesideeffectsmentionedaboveifyouconsumealcoholwhiletakingAtivan.AtivaninteractionsAtivancaninteractwithseveralothermedications.Itcanalsointeractwithcertainsupplementsandfoods.Differentinteractionscancausedifferenteffects.Forinstance,somecaninterferewithhowwelladrugworks,whileotherscancauseincreasedsideeffects.AtivanandothermedicationsBelowisalistofmedicationsthatcaninteractwithAtivan.Thislistdoesn’tcontainalldrugsthatmayinteractwithAtivan.BeforetakingAtivan,besuretotellyourdoctorandpharmacistaboutallprescription,over-the-counter,andotherdrugsyoutake.Alsotellthemaboutanyvitamins,herbs,andsupplementsyouuse.Sharingthisinformationcanhelpyouavoidpotentialinteractions.Ifyouhavequestionsaboutdruginteractionsthatmayaffectyou,askyourdoctororpharmacist.AtivanandopioidsTakingopioidswithAtivancancausedangeroussideeffects.*Theseincludeexcessivedrowsiness,breathingproblems,respiratoryfailure,andcoma.Examplesofthesedrugsinclude:morphine(DuramorphPF,MSContin,andothers)oxycodone(Percocet,Oxycontin,andothers)hydrocodone(HysinglaER)methadone(Methadose)fentanyl(Actiq,Subsys,others)OpioidsshouldonlybeusedwithAtivanwhentherearenoothertreatmentalternatives.*Ativantabletsandsolutionhaveaboxedwarningregardingthisrisk.AboxedwarningisthestrongestwarningrequiredbytheFoodandDrugAdministration(FDA).Boxedwarningsalertdoctorsandpatientsaboutdrugeffectsthatmaybedangerous.AtivanandsedativedrugsTakingsedativedrugswithAtivancancauseexcessivedrowsinessandbreathingproblems.Examplesofsedativedrugsinclude:anticonvulsantmedicationssuchascarbamazepine(Carbatrol,Epitol,Equetro,Tegretol),phenytoin(Dilantin,Phenytek),andtopiramate(QudexyXR,Topamax,TrokendiXR)antihistaminessuchasdiphenhydramine(Benadryl),cetirizine(Zyrtec),chlorpheniramine,anddoxylamine(Unisom),andalsofoundinover-the-counterandcombinationproductsantipsychoticdrugssuchasclozapine(Versacloz),haloperidol(Haldol),quetiapine(Seroquel),andrisperidone(Risperdal)anxietydrugssuchasbuspironebarbituratessuchasphenobarbitalotherbenzodiazepinessuchasalprazolam(Xanax),clonazepam(Klonopin),diazepam(Valium),andmidazolam(Nayzilam)AtivanandprobenecidTakingAtivanwithprobenecid(Probalan),adrugthatcanbeusedtotreatgout,canincreasethelevelsofAtivaninyourbody.ThiscanincreaseyourriskofAtivansideeffects.ForpeoplewhotakeprobenecidandAtivantogether,theAtivandosageneedstobereducedbyhalf.AtivanandvalproicacidordivalproexTakingAtivanwithvalproicacidordivalproex(Depakote),adrugusedtotreatseizuresandotherconditions,canincreasethelevelsofAtivaninyourbody.ThiscanincreaseyourriskofAtivansideeffects.ForpeoplewhotakevalproicacidordivalproexandAtivantogether,theAtivandosageneedstobereducedbyhalf.AtivanandZoloftZoloft(sertraline)canmakesomepeoplefeeltiredordrowsy.Ativancanalsocausedrowsiness.Takingthesemedicationstogethermaycauseyoutofeelevenmoretiredordrowsy.AtivanandAmbienAtivanandAmbien(zolpidem)shouldn’tbetakentogether.Bothmedicationsareusedtohelppromotesleep.Iftakentogether,theycancauseexcessivesleepinessandsedation.Takingthiscombinationofmedicationscanalsoincreasetheriskofoddbehaviorssuchassleep-driving(tryingtodrivewhileasleep).AtivanandTylenol(notaninteraction)TherearenoknowninteractionsbetweenAtivanandTylenol(acetaminophen).AtivanandherbsandsupplementsTakingAtivanwithherbsorsupplementsthathavesedativeeffectscancauseexcessivedrowsiness.Examplesofsedativeherbsandsupplementsthatcancausetheseeffectsinclude:chamomilekavalavendermelatoninvalerianAtivanandcannabisCannabisshouldnotbeusedwithAtivan.UsingcannabiswithAtivancancauseexcessivedrowsinessorsedation.AtivanclassificationAtivanisclassifiedasabenzodiazepine.Thesedrugsaretypicallyusedtotreatanxietyandinsomnia,butcanalsobeusedtotreatotherconditions.Benzodiazepinesareoftencategorizedbyhowfasttheywork(onsetofaction)andhowlongtheylastinthebody(duration).Thischartincludesexamplesoftheseclassifications.DrugOnsetofactionDurationalprazolam(Xanax)rapidshortclonazepam(Klonopin)rapidintermediateclorazepate(Tranxene)intermediatelongdiazepam(Valium)rapidlongflurazepamrapidlonglorazepam(Ativan)rapidintermediatemidazolam(Nayzilam)rapidshortoxazepamslowintermediatetemazepam(Restoril)intermediateintermediatetriazolam(Halcion)rapidshortAtivanoverdoseTakingtoomuchAtivancanincreaseyourriskofharmfulorserioussideeffects.Inextremecases,itcanevenbefatal.OverdosesymptomsSymptomsofoverdosecaninclude:drowsinessconfusionlethargylowbloodpressuretroublebreathingcomaWhattodoincaseofoverdoseIfyouthinkyouoryourchildhastakentoomuchofthisdrug,callyourdoctororseekguidancefromtheAmericanAssociationofPoisonControlCentersat800-222-1222orthroughtheironlinetool.Butifyoursymptomsaresevere,call911orgotothenearestemergencyroomrightaway.AtivanfordogsAtivanissometimesprescribedbyveterinarianstosedateananimalduringsurgeryortotreatseizures.It’salsousedtohelpreducestressorfears,especiallyrelatedtoloudnoises.Ifyouthinkyourdogorcatisindistress,seeyourveterinarianforanevaluationandtreatment.Don’tgiveyourpetanyAtivanthatyourdoctorhasprescribedforyou.IfyouthinkyourpethaseatenyourAtivan,callyourveterinarianimmediately.AtivanandpregnancyAtivancanharmafetuswhentakenbyapregnantperson.AvoidusingAtivanduringpregnancy.Ifyou’repregnantorplanningtobecomepregnant,talkwithyourdoctor.Ifyou’retakingAtivan,youmayneedtostop.AtivanandbreastfeedingYoushouldnotbreastfeedwhiletakingAtivan.Thismedicationcanpassthroughbreastmilkandcausesideeffectsinachildwhoisbreastfed.Tellyourdoctorifyou’rebreastfeeding.Youmayneedtodecidewhethertostopbreastfeedingorstoptakingthismedication.AtivanalternativesThereareothermedicationsthatareoftenusedtotreatthesameconditionsasAtivan.Somemaybebettersuitedforyouthanothers.Thebestchoicemaydependonyourage,thetypeandseverityofyourcondition,andprevioustreatmentsyou’veused.Tolearnmoreaboutothermedicationsthatmayworkwellforyou,talkwithyourdoctor.Note:Someofthedrugslistedhereareusedoff-labelfortreatingconditionsalsotreatedbyAtivan.MedicationalternativesExamplesofmedicationsthatcouldbeusedasalternativestoAtivaninclude:Antidepressantssuchas:duloxetine(Cymbalta)doxepin(Zonalon,Silenor)escitalopram(Lexapro)paroxetine(Paxil,PaxilCR,Pexeva,Brisdelle)venlafaxine(EffexorXR)Buspirone,ananxiolyticdrugBenzodiazepinessuchas:alprazolam(Xanax)diazepam(Valium)midazolam(Nayzilam)oxazepamHerbandsupplementalternativesSomepeopleusecertainherbsanddietarysupplementstohelpmanagetheiranxiety.Examplesinclude:kavalavenderlemonbalmpassionflowerrhodiolaSt.John’swortvalerianBesuretotalkwithyourdoctorbeforeusingherbsorsupplementstotreatyouranxiety.AtivananddrugtestingTakingAtivanmaycauseapositiveresultforbenzodiazepinesonurinedrugscreenings.Ifyou’retakingAtivan,considerdisclosingthisinformationbeforecompletingadrugscreening.ThelengthoftimeAtivanstaysinyoursystemvariesfrompersontoperson,butit’susually3to5days.HowtotakeAtivanAtivantabletsshouldbetakeninthewayyourdoctorprescribedthem.Don’ttakemoreorlessAtivanthanprescribedwithoutfirsttalkingwithyourdoctor.TimingAtivantabletsareusuallytakentwoorthreetimesdaily.Thesedosesareusuallyspreadoutatequalintervals.However,whenAtivanisusedforinsomnia,it’susuallytakenjustonceatbedtime.TakingAtivanwithfoodYoucantakeAtivanwithorwithoutfood.Ifitupsetsyourstomach,trytakingitwithfoodtohelpdecreasethissideeffect.CanAtivanbecrushed?Yes,Ativantabletscanbecrushed.SomeAtivantabletsmayalsobesplit.Ifyou’dliketosplityourtablets,askyourpharmacistifit’ssafetodoso.HowAtivanworksAtivanbelongstoaclassofmedicationscalledbenzodiazepines.Thesemedicationsworkbyboostingtheactivityofgamma-aminobutyricacid(GABA)withinyourbody.GABAisaneurotransmitterthattransmitsmessagesbetweencellsindifferentpartsofyourbody.IncreasingGABAinthebodyresultsinatranquilizingeffectthatreducesfeelingsofstressandanxiety.Howlongdoesittaketowork?BenzodiazepinessuchasAtivanarecategorizedbasedonhowfasttheywork.Ativanisclassifiedashavingarapidtointermediateonset(start)ofaction.Itbeginstoworkrightawayafterit’staken,butitspeakeffectoccurswithin2to3hours.AtivanprecautionsBeforetakingAtivan,talkwithyourdoctoraboutanymedicalconditionsyouhave.Ativanmaynotbeappropriateforyouifyouhavecertainmedicalconditions.FDAwarningsThisdrughasboxedwarnings.AboxedwarningisthemostseriouswarningfromtheFoodandDrugAdministration(FDA).Italertsdoctorsandpatientsaboutdrugeffectsthatmaybedangerous.UsingAtivanincombinationwithopioidmedicationscanresultinlifethreateningsideeffects.Theseeffectsincludeserioussedation,decreasedbreathing,coma,anddeath.Ativanandopioidsshouldonlybecombinedwhentherearenoothertreatmentoptions.Thelowestpossibledosageshouldbeusedfortheshortesttimeneeded.UsingAtivan,evenasprescribed,canleadtophysicaldependenceandwithdrawalifyoustoptakingthedrugsuddenly.(Withdependence,yourbodyneedsadruginordertofunctionlikeusual.)Withdrawalcanbelifethreatening.Takingthisdrugcanalsoleadtomisuseandaddiction.(Withmisuse,adrugistakeninawayotherthanhowit’sprescribed.Withaddiction,it’sdifficulttostoptakingadrug,eventhoughit’scausingharmfuloutcomes.)MisuseofAtivanincreasesyourriskofoverdoseanddeath.Onlytakethisdrugasyourdoctorprescribes.Talkwithyourhealthcareprofessionalifyouhaveanyconcernsaboutsafelytakingthisdrug.OtherwarningsBeforetakingAtivan,talkwithyourdoctoraboutyourhealthhistory.Thisdrugmaynotberightforyouifyouhavecertainmedicalconditionsorotherfactorsaffectingyourhealth.Theseinclude:Depression.Ativanandotherbenzodiazepinemedicationscanworsensymptomsofdepression.Ativanshouldnotbeusedbypeoplewithdepressionwhoaren’treceivingadequatetreatmentforthiscondition.Breathingdisorders.Ativancanslowbreathing.Peoplewithsleepapnea,chronicobstructivepulmonarydisease(COPD),orotherbreathingdisordersshoulduseAtivancautiouslyoravoidit.Acutenarrow-angleglaucoma.Ativanmayincreasethepressureinsidetheeye,worseningglaucoma.Duetothisrisk,doctorstypicallywon’tprescribeAtivantopeoplewithacutenarrow-angleglaucoma.Kidneyorliverproblems.HavingkidneyorliverproblemscanaffecthowyourbodybreaksdownAtivanafteryoutakeadose.YourdoctormayprescribeadifferentAtivandoseifyouhavekidneyorliverproblems.AtivanmisuseSomepeoplewhotakeAtivancanbecomephysicallyandpsychologicallydependentonthedrug.*(Withdependence,yourbodyneedsthedruginordertofunctionlikeusual.)TheriskofdependenceincreasesifAtivanisusedindosesthatarehigherthanprescribed,orforlongperiodsoftime.Insomecases,Ativandependencecanleadtomisuse(alsocalledabuse)ofthedrug.*Theriskishigherwithpeoplewhohavepreviouslymisusedalcoholordrugs.(Withmisuse,adrugistakeninawayotherthanhowit’sprescribed.)SymptomsofAtivanmisusecaninclude:confusionlossofcoordinationmemoryproblemssleepproblemsirritabilityunsteadinesswhenwalkingimpairedjudgment*Ativantabletsandsolutionhaveaboxedwarningregardingthisrisk.AboxedwarningisthestrongestwarningrequiredbytheFoodandDrugAdministration(FDA).Boxedwarningsalertdoctorsandpatientsaboutdrugeffectsthatmaybedangerous.AtivanexpirationWhenAtivanisdispensedfromthepharmacy,thepharmacistwilladdanexpirationdatetothelabelonthebottle.Thisdateistypicallyoneyearfromthedatethemedicationwasdispensed.Thepurposeofsuchexpirationdatesistoguaranteetheeffectivenessofthemedicationduringthistime.ThecurrentstanceoftheFoodandDrugAdministration(FDA)istoavoidusingexpiredmedications.However,anFDAstudyshowedthatmanymedicationsmaystillbegoodbeyondtheexpirationdatelistedonthebottle.Howlongamedicationremainsgoodcandependonmanyfactors,includinghowandwherethemedicationisstored.Ativanshouldbestoredatroomtemperatureinitsoriginalcontainer.Ifyouhaveunusedmedicationthathasgonepasttheexpirationdate,talkwithyourpharmacisttofindoutwhetheryoumightstillbeabletouseit.ProfessionalinformationforAtivanThefollowinginformationisprovidedforcliniciansandotherhealthcareprofessionals.MechanismofactionAtivanhasatranquilizingeffectinthecentralnervoussystem.Ativanbindstobenzodiazepinereceptors,whichincreasestheeffectsofgamma-aminobutyricacid.Thisresultsinsedation,skeletalmusclerelaxation,anticonvulsanteffects,andcoma.PharmacokineticsandmetabolismAtivanhasabioavailabilityof90percent.Peakplasmalevelsoccurabouttwohoursafteroraladministration.Ativanisconjugatedtoglucuronideandexcretedintheurine.Themeanhalf-lifeofAtivanisabout12hours;however,itcanrangefrom10to20hours.NursingimplicationsThefollowingshouldbeassessedormonitoredinpatientsreceivingAtivan:Monitorbloodpressure,heartrate,andrespiratoryfunction.Monitorsedationlevelincriticalcarepatients,olderadults,ordebilitatedpatients.Determinehistoryofaddiction.Long-termusecanleadtodependenceandaddiction,whichismorelikelywithpatientswhohaveahistoryofaddiction.Assessfallrisk.Topreventfalls,ambulationmayneedtobesupervisedinolderadultstakingAtivan.Assessneedforongoingorlong-termtreatment.Conductperiodiclabmonitoringofliverfunction,bloodcount,andrenalfunctionwithlong-termuseofAtivan.Evaluateformooddisorderssuchasdepressionandforimprovementinsymptomsofanxiety.ContraindicationsAtivaniscontraindicatedinpeoplewithhypersensitivitytobenzodiazepinesoranycomponentofAtivan.It’salsocontraindicatedinpeoplewithacutenarrow-angleglaucoma.MisuseanddependenceTheuseofAtivancancausepsychologicalandphysicaldependence.Theriskofdependenceincreaseswhenhigherdosesareusedorwhenit’susedforlongperiodsoftime.Theriskofdependenceisalsohigherinpeoplewithahistoryofdrugoralcoholmisuse.Theriskofdependenceandmisusecanbereducedbyusingappropriatedosesfortheshortesttimepossible.StorageAtivanshouldbestoredinatightcontaineratroomtemperatureof77°F(25°C).Temperatureexcursionsto59°Fto86°F(15°Cto30°C)arepermissible.Disclaimer:MedicalNewsTodayhasmadeeveryefforttomakecertainthatallinformationisfactuallycorrect,comprehensive,anduptodate.However,thisarticleshouldnotbeusedasasubstitutefortheknowledgeandexpertiseofalicensedhealthcareprofessional.Youshouldalwaysconsultyourdoctororanotherhealthcareprofessionalbeforetakinganymedication.Thedruginformationcontainedhereinissubjecttochangeandisnotintendedtocoverallpossibleuses,directions,precautions,warnings,druginteractions,allergicreactions,oradverseeffects.Theabsenceofwarningsorotherinformationforagivendrugdoesnotindicatethatthedrugordrugcombinationissafe,effective,orappropriateforallpatientsorallspecificuses.EpilepsyAnxiety/StressPharmacy/PharmacistSleep/SleepDisorders/InsomniaDrugsMedicallyreviewedbyAlexBrewer,PharmD,MBA—WrittenbyMNTMedicalNetwork—UpdatedonFebruary11,2022LatestnewsMonkeypoxtransmissionfromhumanstopets:Whattoknowaboutrisk,preventionDono-calorieartificialsweetenershaveanyeffectonguthealthormetabolism?Alzheimer’s:ScientistsfindwaytoswitchsomediseasedcellsbacktoahealthystateVitaminDsupplementationmayhelpreducedepressivesymptoms,studyfindsCutting1gramofsaltperdaymaylowerriskofheartdiseaseandstrokeRelatedCoverageEverythingyouneedtoknowaboutopioidsMedicallyreviewedbyAlyssaPeckham,PharmD,BCPPThisarticlewillexplorewhatopioidsare,thedifferenttypesofopioids,andhowtogethelpforaddictionoroverdose.READMOREAllaboutantidepressantsMedicallyreviewedbyNicoleWashington,DO,MPHFindoutaboutthedifferenttypesofantidepressants,howtheywork,adverseeffects,whenapersoncantakethem,andavailablealternatives.READMOREWhattoknowaboutsafeopioiduseMedicallyreviewedbyJennieOlopaade,PharmD,RPHSafeopioidusemeanstakingopioiddrugsfortheirintendedpurposefortheshortestpossibleamountoftime,atthedosagerecommendedbyadoctor…READMOREThebenefitsandrisksofbenzodiazepinesMedicallyreviewedbyAlanCarter,PharmDDoctorsprescribebenzodiazepinesforanxiety,insomnia,andotherpurposes.However,thereisariskofdependenceandinteractionswithotherdrugs…READMOREAtivanvs.Xanax:Whatarethedifferences?MedicallyreviewedbyDenaWestphalen,Pharm.D.AtivanandXanaxarebenzodiazepinedrugsthathelptreatanxietyandpanicdisorders.Thisarticlecomparesthetwo,includingtheiruses,benefits…READMORE