Ativan Tablets Side Effects

Please note - some side effects for Ativan Tablets may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

Side Effects by Body System - for Healthcare Professionals

Applies to: compounding powder; injectable solution; intravenous solution; oral concentrate; oral tablet

Nervous system

Nervous system side effects have been common and have included drowsiness, fatigue, confusion, impaired cognition, daytime anxiety, asthenia, amnesia, headache, dizziness, and ataxia. Orofacial dyskinesias have been observed rarely.

One study has suggested that the amnestic effects of lorazepam may be increased in patients who consume a large amount of ethanol.

The manufacturer has stated that elderly patients may be associated with a greater incidence of central nervous system depression.

Respiratory

Respiratory side effects including depression have been observed rarely with parenteral administration of lorazepam.

Equipment for resuscitation should be immediately available when parenteral lorazepam is used.

The manufacturer has stated that elderly patients may be associated with more respiratory depression.

Other

Other side effects have included withdrawal symptoms after abrupt cessation of lorazepam. Withdrawal symptoms have included agitation, restlessness, anxiety, insomnia, convulsions, tremor, abdominal cramps, vomiting, and sweating. Mania and delusional depression have also been observed rarely.

Local

The vehicle for the injectable form of lorazepam is propylene glycol, which can cause hyperlactatemia and elevated osmolar gaps. Propylene glycol may also interfere with renal tubular function and may blunt renal compensation for respiratory acidosis. While some guidelines seem to indicate that propylene glycol toxicity occurs at high dose (>18 mg/hr) lorazepam infusions, multiple instances of propylene glycol toxicity from far lower dose (4 to 6 mg/hr) lorazepam infusions have also been reported.

Local side effects at the site of intramuscular injection (pain, burning, local irritation and swelling) occur in about 8% of patients. Rarely, vascular impairment after inadvertent intra-arterial injection has occurred, sometimes with severe consequences.

Hematologic

Hematologic side effects including hemolytic anemia, pancytopenia, neutropenia, and aplastic anemia have been reported.

Endocrine

Endocrine side effects including the syndrome of inappropriate secretion of ADH have been reported rarely in association with lorazepam use.

Musculoskeletal

Musculoskeletal side effects including myopathy and one case of rhabdomyolysis have been reported.

Renal

Renal side effects have been reported including a case of hyperlactatemia, increased osmolar gap, and renal dysfunction during continuous lorazepam infusion.

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