Lorazepam Oral, IM, and IV (Ativan®)

Author: OncoLink Team
Last Reviewed: February 13, 2020

Pronounced: lor-A-ze-pam

Classification: Anticonvulsant; Benzodiazepine; Anxiolytic

About: Lorazepam Oral, IM, and IV (Ativan®)

Lorazepam is a benzodiazepine used for the treatment of anxiety disorders or for the short-term relief of the symptoms of anxiety or anxiety associated with depression. Benzodiazepines work by slowing the nervous system down. They do this by acting on neurotransmitters in the brain, including gamma-aminobutyric acid (GABA). By acting on GABA, lorazepam slows the activity of nerves in the brain and spinal cord. Because of this, lorazepam is also approved as an anticonvulsant (anti-seizure medication). 

Lorazepam may be used for reasons other than those listed above, such as in the prevention and/or treatment of nausea and vomiting caused by chemotherapy. Talk with your provider to see if lorazepam will be part of your treatment plan.

How this Medication Comes

This medication comes as tablets, an oral solution (liquid), sublingual (tablet that dissolves under the tongue), intramuscular (a shot) and intravenous (given in an IV) formulations.

How to Take Lorazepam

Lorazepam can be given on as needed or scheduled basis and should be taken as prescribed by your provider. The dose and how often you take lorazepam will depend on why you were prescribed it. You should not drink alcohol while taking lorazepam. You should not drive a car or operate heavy machinery until you know how lorazepam affects you. If you have been taking lorazepam on a regular basis, do not stop taking it without first talking with your provider.

Special care should be taken if you are also prescribed opioids to manage pain, as extreme drowsiness, trouble breathing, coma and even death can occur if taken together with lorazepam. Be sure to tell your healthcare provider about all medications and supplements you take. 

It is important to make sure you are taking the correct amount of medication every time. Before every dose, check that what you are taking matches what you have been prescribed. DO NOT share this medication or give it to someone else, as severe breathing problems and death can occur.

Storage and Handling

Store this medication in the original container. For tablets and sublingual formulations, store at room temperature. For liquid oral solutions, store in the refrigerator and safely throw out any solution not used after 3 months (see below). Due to the risk of diversion (someone else taking your medication to obtain a high, rather than for symptom relief), you may want to consider keeping your medication in a lock box or other secure location. Keep this medication out of reach of children and pets.

To prevent someone accidentally taking this medication, it should be disposed of when no longer needed through a medicine take-back program or by dropping them off at a DEA-authorized collector. For locations near you, check www.dea.gov. Ask your pharmacist or care team for assistance in the disposal of unused medications. Do not flush down a toilet or pour down a drain unless you are told to do so.

Where do I get this medication?

The oral form of lorazepam is available through retail/mail order pharmacy.  Your oncology team will work with your prescription drug plan to identify an in-network retail/mail order pharmacy for medication distribution.  You can work with your provider’s office if this medication needs a prior authorization. 

Insurance Information

Lorazepam may be covered under your prescription drug plan.  Patient assistance may be available to qualifying individuals without prescription drug coverage.  Co-pay cards, which reduce the patient co-pay responsibility for eligible commercially (non-government sponsored) insured patients, may also be available. Your care team can help you find these resources if they are available. 

Possible Side effects of Lorazepam

This medication is given to manage and/or prevent side effects of your cancer treatment. If you are having side effects from this medication you should talk to your team about if this medication is necessary to your treatment or if there are other options to help manage the side effect this medication is treating. These are some of the most common side effects:  

Respiratory Depression/Over-Sedation

In patients who have been prescribed both lorazepam and an opioid (pain medication), extra care must be taken to watch for serious interactions. Signs of respiratory depression are slow, shallow breaths, which causes low oxygen levels in your blood. Signs of over-sedation are mental confusion, having a hard time moving, muscle weakness, and having a hard time concentrating. If you or a caretaker notice any of these signs, call 911.

Central Nervous System (CNS) Effects

Because of how this medication works and its effects on neurotransmitters in the brain, lorazepam may cause drowsiness, fatigue, sedation, dizziness, and weakness. If these effects make it hard to carry out daily life, talk with your provider. If you or a caretaker notice you are having a hard time staying awake, or have shallow breathing, call 911 right away.

Sexual & Reproductive Concerns

You should consult with your healthcare team prior to becoming pregnant or breastfeeding while receiving this medication.  

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