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Can you take Ativan Injection with Orphenadrine?

1 drug interaction and 25 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

LORazepam orphenadrine

Applies to: Ativan Injection (lorazepam) and orphenadrine

Using LORazepam together with orphenadrine may increase side effects such as:

  • dizziness
  • drowsiness
  • confusion
  • difficulty concentrating

Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination.

What to do: You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you.

Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Food/lifestyle interactions

Moderate food/lifestyle interactions

Moderate:

LORazepam Food/Lifestyle

Applies to: Ativan Injection (lorazepam)

Alcohol can increase the nervous system side effects of LORazepam such as:

  • dizziness
  • drowsiness
  • difficulty concentrating

Some people may also experience impairment in thinking and judgment.

You should avoid or limit the use of alcohol while being treated with LORazepam.

Do not use more than the recommended dose of LORazepam, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you.

Talk to your doctor or pharmacist if you have any questions or concerns.

Moderate:

orphenadrine Food/Lifestyle

Applies to: orphenadrine

Alcohol can increase the nervous system side effects of orphenadrine such as:

  • dizziness
  • drowsiness
  • difficulty concentrating

Some people may also experience impairment in thinking and judgment.

You should avoid or limit the use of alcohol while being treated with orphenadrine.

Do not use more than the recommended dose of orphenadrine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you.

Talk to your doctor or pharmacist if you have any questions or concerns.

Disease interactions

23 potential interactions Applies to: 21 conditions, including Depression, GERD, Weight Loss, Seizures, and Psychosis.

Acute Alcohol Intoxication

Major:

Ativan Injection

The LORazepam in Ativan Injection has a major potential interaction with Acute Alcohol Intoxication.

The use of benzodiazepines with alcohol is not recommended. Patients with acute alcohol intoxication exhibit depressed vital signs. The central nervous system depressant effects of benzodiazepines may be additive with those of alcohol, and severe respiratory depression and death may occur. Therapy with benzodiazepines should be administered cautiously in patients who might be prone to acute alcohol intake.

Altered Consciousness

Major:

Ativan Injection

The LORazepam in Ativan Injection has a major potential interaction with Altered Consciousness.

Benzodiazepines should not be administered by injection to patients in shock or coma. The hypnotic and hypotensive effects of these agents may be prolonged and intensified in such patients.

Asphyxia

Major:

Ativan Injection

The LORazepam in Ativan Injection has a major potential interaction with Asphyxia.

Benzodiazepines may cause respiratory depression and apnea, usually when given in high dosages and/or by intravenous administration. However, some patients may be susceptible at commonly used dosages, including the elderly, debilitated or severely ill patients, those receiving other CNS depressants, and those with limited ventilatory reserve, chronic pulmonary insufficiency or other respiratory disorders. Therapy with benzodiazepines should be administered cautiously in these patients. Appropriate monitoring and individualization of dosage are particularly important, and equipment for resuscitation should be immediately available if the parenteral route is used. Benzodiazepines, especially injectable formulations, should generally be avoided in patients with sleep apnea, severe respiratory insufficiency, or hypoxia.

Depression

Moderate:

Ativan Injection

The LORazepam in Ativan Injection has a moderate potential interaction with Depression.

Benzodiazepines depress the central nervous system and may cause or exacerbate mental depression and cause suicidal behavior and ideation. Episodes of mania and hypomania have also been reported in depressed patients treated with some of these agents. Therapy with benzodiazepines should be administered cautiously in patients with a history of depression or other psychiatric disorders. Patients should be monitored for any changes in mood or behavior. It may be prudent to refrain from dispensing large quantities of medication to these patients.

Drug Dependence

Major:

Ativan Injection

The LORazepam in Ativan Injection has a major potential interaction with Drug Dependence.

Benzodiazepines have the potential to cause dependence and abuse. Tolerance as well as physical and psychological dependence can develop, particularly after prolonged use and/or excessive dosages. However, abrupt cessation following continual use of as few as 6 weeks at therapeutic levels has occasionally precipitated withdrawal symptoms. Addiction- prone individuals, such as those with a history of alcohol or substance abuse, should be under careful surveillance when treated with benzodiazepines. It may be prudent to refrain from dispensing large quantities of medication to these patients. After prolonged use or if dependency is suspected, withdrawal of benzodiazepine therapy should be undertaken gradually using a dosage- tapering schedule. If withdrawal symptoms occur, temporary reinstitution of benzodiazepines may be necessary.

Esophageal Obstruction

Major:

orphenadrine

Orphenadrine has a major potential interaction with Esophageal Obstruction.

Orphenadrine has mild anticholinergic activity, to which elderly patients are particularly sensitive. The manufacturer considers the use of orphenadrine to be contraindicated in patients with glaucoma, pyloric or duodenal obstruction, achalasia, prostatic hypertrophy, bladder neck obstruction, or myasthenia gravis. Orphenadrine should be used cautiously in other conditions that are likely to be exacerbated by anticholinergic activity, such as urinary retention and gastrointestinal obstructive disorders.

Gastrointestinal Obstruction

Major:

orphenadrine

Orphenadrine has a major potential interaction with Gastrointestinal Obstruction.

Orphenadrine has mild anticholinergic activity, to which elderly patients are particularly sensitive. The manufacturer considers the use of orphenadrine to be contraindicated in patients with glaucoma, pyloric or duodenal obstruction, achalasia, prostatic hypertrophy, bladder neck obstruction, or myasthenia gravis. Orphenadrine should be used cautiously in other conditions that are likely to be exacerbated by anticholinergic activity, such as urinary retention and gastrointestinal obstructive disorders.

GERD

Moderate:

Ativan Injection

The LORazepam in Ativan Injection has a moderate potential interaction with GERD.

The manufacturer recommends the use of caution when prescribing lorazepam for prolonged periods in patients with upper gastrointestinal disease, especially in the elderly. The appearance or worsening of upper gastrointestinal symptoms should be monitored.

Glaucoma/Intraocular Hypertension

Major:

Ativan Injection

The LORazepam in Ativan Injection has a major potential interaction with Glaucoma/Intraocular Hypertension.

The manufacturers consider the use of benzodiazepines to be contraindicated in patients with acute angle-closure glaucoma or untreated open-angle glaucoma. These agents do not possess anticholinergic activity but have very rarely been associated with increased intraocular pressure.

Major:

orphenadrine

Orphenadrine has a major potential interaction with Glaucoma/Intraocular Hypertension.

Orphenadrine has mild anticholinergic activity, to which elderly patients are particularly sensitive. The manufacturer considers the use of orphenadrine to be contraindicated in patients with glaucoma, pyloric or duodenal obstruction, achalasia, prostatic hypertrophy, bladder neck obstruction, or myasthenia gravis. Orphenadrine should be used cautiously in other conditions that are likely to be exacerbated by anticholinergic activity, such as urinary retention and gastrointestinal obstructive disorders.

Hyperkinetic Syndrome of Childhood

Moderate:

Ativan Injection

The LORazepam in Ativan Injection has a moderate potential interaction with Hyperkinetic Syndrome of Childhood.

Paradoxical reactions, including excitability, irritability, aggressive behavior, agitation, nervousness, hostility, anxiety, sleep disturbances, nightmares and vivid dreams, have been reported with the use of benzodiazepines in psychiatric patients and pediatric patients with hyperactive aggressive disorders. Such patients should be monitored for signs of paradoxical stimulation during therapy with benzodiazepines. The manufacturers do not recommend the use of benzodiazepines for the treatment of psychosis.

Liver Disease

Major:

Ativan Injection

The LORazepam in Ativan Injection has a major potential interaction with Liver Disease.

The use of some benzodiazepines such as clonazepam and diazepam (oral tablets), is considered by the manufacturer to be contraindicated in patients with clinical or biochemical evidence of significant liver disease. These drugs are primarily metabolized by the liver and there is a risk of excess accumulation. Although all benzodiazepines may worsen hepatic encephalopathy, the manufacturer specifically recommends that lorazepam should be avoided in these patients.

Myasthenia Gravis

Major:

orphenadrine

Orphenadrine has a major potential interaction with Myasthenia Gravis.

Orphenadrine has mild anticholinergic activity, to which elderly patients are particularly sensitive. The manufacturer considers the use of orphenadrine to be contraindicated in patients with glaucoma, pyloric or duodenal obstruction, achalasia, prostatic hypertrophy, bladder neck obstruction, or myasthenia gravis. Orphenadrine should be used cautiously in other conditions that are likely to be exacerbated by anticholinergic activity, such as urinary retention and gastrointestinal obstructive disorders.

Prematurity/Underweight in Infancy

Major:

Ativan Injection

The LORazepam in Ativan Injection has a major potential interaction with Prematurity/Underweight in Infancy.

Parenteral medications formulated in multidose vials often contain benzyl alcohol as a preservative. Their use is considered by drug manufacturers to be contraindicated in neonates, particularly premature infants and infants of low birth weight. When used in bacteriostatic saline intravascular flush and endotracheal tube lavage solutions, benzyl alcohol has been associated with fatalities and severe respiratory and metabolic complications in low-birth-weight premature infants. Thus, single-dose formulations should always be used in infants whenever possible. However, many experts feel that, in the absence of benzyl alcohol-free equivalents, the amount of the preservative present in these formulations should not necessarily preclude their use if they are clearly indicated. The American Academy of Pediatrics considers benzyl alcohol in low doses (such as when used as a preservative in some medications) to be safe for newborns. However, the administration of high dosages of these medications must take into account the total amount of benzyl alcohol administered. The level at which toxicity may occur is unknown.

Psychosis

Moderate:

Ativan Injection

The LORazepam in Ativan Injection has a moderate potential interaction with Psychosis.

Benzodiazepines depress the central nervous system and may cause or exacerbate mental depression and cause suicidal behavior and ideation. Episodes of mania and hypomania have also been reported in depressed patients treated with some of these agents. Therapy with benzodiazepines should be administered cautiously in patients with a history of depression or other psychiatric disorders. Patients should be monitored for any changes in mood or behavior. It may be prudent to refrain from dispensing large quantities of medication to these patients.

Moderate:

Ativan Injection

The LORazepam in Ativan Injection has a moderate potential interaction with Psychosis.

Paradoxical reactions, including excitability, irritability, aggressive behavior, agitation, nervousness, hostility, anxiety, sleep disturbances, nightmares and vivid dreams, have been reported with the use of benzodiazepines in psychiatric patients and pediatric patients with hyperactive aggressive disorders. Such patients should be monitored for signs of paradoxical stimulation during therapy with benzodiazepines. The manufacturers do not recommend the use of benzodiazepines for the treatment of psychosis.

Pulmonary Impairment

Major:

Ativan Injection

The LORazepam in Ativan Injection has a major potential interaction with Pulmonary Impairment.

Benzodiazepines may cause respiratory depression and apnea, usually when given in high dosages and/or by intravenous administration. However, some patients may be susceptible at commonly used dosages, including the elderly, debilitated or severely ill patients, those receiving other CNS depressants, and those with limited ventilatory reserve, chronic pulmonary insufficiency or other respiratory disorders. Therapy with benzodiazepines should be administered cautiously in these patients. Appropriate monitoring and individualization of dosage are particularly important, and equipment for resuscitation should be immediately available if the parenteral route is used. Benzodiazepines, especially injectable formulations, should generally be avoided in patients with sleep apnea, severe respiratory insufficiency, or hypoxia.

Renal Dysfunction

Moderate:

Ativan Injection

The LORazepam in Ativan Injection has a moderate potential interaction with Renal Dysfunction.

Benzodiazepines are excreted by the kidneys and should be used with caution in patients with impaired renal function and end-stage kidney disease.

Respiratory Arrest

Major:

Ativan Injection

The LORazepam in Ativan Injection has a major potential interaction with Respiratory Arrest.

Benzodiazepines may cause respiratory depression and apnea, usually when given in high dosages and/or by intravenous administration. However, some patients may be susceptible at commonly used dosages, including the elderly, debilitated or severely ill patients, those receiving other CNS depressants, and those with limited ventilatory reserve, chronic pulmonary insufficiency or other respiratory disorders. Therapy with benzodiazepines should be administered cautiously in these patients. Appropriate monitoring and individualization of dosage are particularly important, and equipment for resuscitation should be immediately available if the parenteral route is used. Benzodiazepines, especially injectable formulations, should generally be avoided in patients with sleep apnea, severe respiratory insufficiency, or hypoxia.

Seizures

Major:

Ativan Injection

The LORazepam in Ativan Injection has a major potential interaction with Seizures.

The use of benzodiazepines in patients with seizure disorders may increase the incidence or precipitate the onset of generalized tonic-clonic seizures (grand mal). Appropriate anticonvulsant medication might need to be initiated or the dosage increased. Abrupt cessation of benzodiazepine therapy may precipitate seizures and other withdrawal symptoms, particularly after prolonged use and/or excessive dosages. Status epilepticus may occur in patients with a history of seizures withdrawn rapidly from benzodiazepine therapy. Following chronic administration, cessation of benzodiazepine therapy should occur gradually with incrementally reduced dosages. Patients should be advised not to discontinue medication without first consulting with the physician.

Shock

Major:

Ativan Injection

The LORazepam in Ativan Injection has a major potential interaction with Shock.

Benzodiazepines should not be administered by injection to patients in shock or coma. The hypnotic and hypotensive effects of these agents may be prolonged and intensified in such patients.

Urinary Retention

Major:

orphenadrine

Orphenadrine has a major potential interaction with Urinary Retention.

Orphenadrine has mild anticholinergic activity, to which elderly patients are particularly sensitive. The manufacturer considers the use of orphenadrine to be contraindicated in patients with glaucoma, pyloric or duodenal obstruction, achalasia, prostatic hypertrophy, bladder neck obstruction, or myasthenia gravis. Orphenadrine should be used cautiously in other conditions that are likely to be exacerbated by anticholinergic activity, such as urinary retention and gastrointestinal obstructive disorders.

Weight Loss

Moderate:

Ativan Injection

The LORazepam in Ativan Injection has a moderate potential interaction with Weight Loss.

The plasma half-lives of benzodiazepines may be prolonged in obese patients, presumably due to increased distribution into fat. Marked increases in distribution (> 100%) have been reported for diazepam and midazolam, and moderate increases (25% to 100%) for alprazolam, lorazepam, and oxazepam. Therapy with benzodiazepines should be administered cautiously in obese patients, with careful monitoring of CNS status. Longer dosing intervals may be appropriate. When dosing by weight, loading doses should be based on actual body weight, while maintenance dose should be based on ideal body weight to avoid toxicity.

More resources

Ativan Injection

A total of 415 drugs are known to interact with Ativan Injection.

orphenadrine

A total of 407 drugs are known to interact with orphenadrine.

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.