Ativan Side Effects
Generic name: lorazepam
Medically reviewed by Drugs.com. Last updated on Apr 20, 2024.
Note: This document provides detailed information about Ativan Side Effects associated with lorazepam. Some dosage forms listed on this page may not apply specifically to the brand name Ativan.
Applies to lorazepam: injection solution.
Other dosage forms:
Important warnings
This medicine can cause some serious health issues
Injection route (solution)
Risks From Concomitant Use With Opioids; Abuse, Misuse, and Addiction; and Dependence and Withdrawal Reactions:Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death.
Reserve concomitant prescribing of these drugs in patients for whom alternative treatment options are inadequate.
Limit dosages and durations to the minimum required.
Follow patients for signs and symptoms of respiratory depression and sedation.The use of benzodiazepines, including lorazepam, exposes users to risks of abuse, misuse, and addiction, which can lead to overdose or death.
Abuse and misuse of benzodiazepines commonly involve concomitant use of other medications, alcohol, and/or illicit substances, which is associated with an increased frequency of serious adverse outcomes.
Before prescribing lorazepam and throughout treatment, assess each patient’s risk for abuse, misuse, and addiction.The continued use of benzodiazepines for several days to weeks may lead to clinically significant physical dependence.
The risks of dependence and withdrawal increase with longer treatment duration and higher daily dose.
Although lorazepam injection is indicated only for intermittent use, if used more frequently than recommended, abrupt discontinuation or rapid dosage reduction of lorazepam injection may precipitate acute withdrawal reactions, which can be life-threatening.
For patients using lorazepam injection more frequently than recommended, to reduce the risk of withdrawal reactions, use a gradual taper to discontinue lorazepam injection.
Precautions
It is very important that your doctor check your progress after you receive this medicine to make sure it is working properly and to check for any unwanted effects.
Tell your doctor if you are pregnant or planning to become pregnant. Using this medicine during the later pregnancy may cause problems in your newborn baby (eg, sedation or withdrawal symptoms). Tell your doctor right away if your baby has an abnormal sleep pattern, diarrhea, feeding problems, a high-pitched cry, irritability, low muscle tone, restlessness, shakiness or tremors, sluggishness, trouble breathing, weight loss, vomiting, or fails to gain weight. If you think you have become pregnant, tell your doctor right away.
This medicine contains benzyl alcohol which may cause serious reactions to newborn, premature, or low-birthweight infants. Discuss this with your doctor if you are concerned.
This medicine may cause drowsiness, trouble with thinking, trouble with controlling movements, or trouble with seeing clearly. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert or able to think or see well.
If you develop any unusual or strange thoughts and behavior while taking lorazepam (the active ingredient contained in Ativan) injection, be sure to discuss it with your doctor. Some changes that have occurred in people taking this medicine are like those seen in people who drink too much alcohol. Other changes might be confusion, agitation, and hallucinations (seeing, hearing, or feeling things that are not there).
Symptoms of an overdose include: blurred vision, change in consciousness, confusion, dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position, loss of consciousness, loss of strength or energy, muscle pain or weakness, shakiness and unsteady walk, sweating, unsteadiness, trembling, or other problems with muscle control or coordination, unusual excitement, nervousness, restlessness, or irritability, or unusual tiredness or weakness. Call your doctor right away if you notice these symptoms.
This medicine may cause respiratory depression (serious breathing problem that can be life-threatening), especially when used with narcotic pain medicines. Tell your doctor if you are using any narcotic medicine.
This medicine will add to the effects of alcohol and other central nervous system (CNS) depressants. CNS depressants are medicines that slow down the nervous system, which may cause drowsiness or make you less alert. Some examples of CNS depressants are antihistamines or medicine for hay fever, allergies, or colds, sedatives, tranquilizers, or sleeping medicine, prescription pain medicine or narcotics, barbiturates (used for seizures), muscle relaxants, or anesthetics (numbing medicines), including some dental anesthetics. This effect may last for a few days after you Stop taking lorazepam. Check with your doctor before taking any of the above while you are using this medicine.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
Serious side effects of Ativan
Along with its needed effects, lorazepam may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur while taking lorazepam:
More common side effects
- blue lips, fingernails, or skin
- blurred vision
- confusion
- difficult or trouble breathing
- dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
- irregular, fast or slow, or shallow breathing
- sleepiness or unusual drowsiness
- sweating
- unusual tiredness or weakness
Less common side effects
- decreased awareness or responsiveness
- not breathing
Rare side effects
- bleeding, blistering, burning, coldness, discoloration of skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
- bloody or cloudy urine
- blurred vision
- change in consciousness
- cough or hoarseness
- deep or fast breathing with dizziness
- difficult, burning, or painful urination
- dizziness
- extremely shallow or slow breathing
- false beliefs that cannot be changed by facts
- fever or chills
- frequent urge to urinate
- headache
- loss of consciousness
- lower back or side pain
- nervousness
- numbness of feet, hands and around mouth
- painful or difficult urination
- poor insight and judgement
- pounding in the ears
- problems with memory or speech
- problems with movement, walking, or speech
- seizures
- slow or fast heartbeat
- trouble thinking and planning
- vomiting
Incidence not known
- black, tarry stools
- bleeding gums
- chest pain or discomfort
- dark urine
- fast, pounding, or irregular heartbeat or pulse
- high fever
- light-colored stools
- loss of bladder control
- loss of memory
- paralysis
- pinpoint red spots on the skin
- sever muscle stiffness
- stomach pain or bloating
- sudden onset of severe breathing difficulty
- unusual bleeding or bruising
- unusually pale skin
- yellow eyes or skin
Get emergency help immediately if any of the following symptoms of overdose occur while taking lorazepam:
Symptoms of overdose
- agitation
- changes in patterns and rhythms of speech
- confusion
- excitement
- irritability
- loss of strength or energy
- muscle pain or weakness
- restlessness
- shakiness and unsteady walk
- slurred speech
- talkativeness
- trouble speaking
- unsteadiness, trembling, or other problems with muscle control or coordination
- unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
- unusual weak feeling
Other side effects of Ativan
Some side effects of lorazepam may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.
Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Rare side effects
- nausea
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For healthcare professionals
Applies to lorazepam: compounding powder, injectable solution, intravenous solution, oral capsule extended release, oral concentrate, oral tablet.
General adverse events
Oral: The most commonly reported side effects included sedation, dizziness, weakness, and unsteadiness.
Parenteral: The most commonly reported side effects included somnolence, respiratory failure, hypotension, and injection site reactions (pain and burning).[Ref]
Local
Parenteral:
- Very common (10% or more): Burning (up to 17%), pain (up to 17%)
- Common (1% to 10%): Painful response, redness
- Uncommon (0.1% to 1%): Injection site reaction
- Frequency not reported: Arteriospasm, gangrene, injection site tolerance[Ref]
Nervous system
Oral:
- Very common (10% or more): Sedation (up to 15.9%)
- Common (1% to 10%): Anterograde amnesia, ataxia, daytime drowsiness, dizziness, drowsiness, unsteadiness
- Rare (0.01% to 0.1%): Dysarthria, headache, memory impairment, reduced alertness, slurred speech, transient anterograde amnesia
- Very rare (less than 0.01%): Coma, extrapyramidal reactions/extrapyramidal symptoms, tremor
- Frequency not reported: Amnesia, autonomic manifestations, balance disorders, convulsions/seizures, extremity numbness/tingling, hyperreflexia, hypersensitivity to light/noise/sound, impaired perception, involuntary movements, prolonged response times, short-term memory loss, vertigo
Parenteral:
- Common (1% to 10%): Ataxia, coma, dizziness, drowsiness, excessive drowsiness/sleepiness, headache, sedation, somnolence, stupor
- Uncommon (0.1% to 1%): Brain edema, convulsion, myoclonus, tremor
- Frequency not reported: Amnesia, balance disorder, central nervous system effects, decreased ability to perform complex mental functions, dysarthria, extrapyramidal symptoms, memory impairment, seizures, slurred speech, transient anterograde amnesia, unsteady gait, vertigo
- Postmarketing reports: Neuroleptic malignant syndrome, paralysis[Ref]
Dose-dependent central nervous system depression, increased sedation, and unsteadiness were associated with increased age.[Ref]
Psychiatric
Oral:
- Common (1% to 10%): Confusion, depression, unmasking of depression
- Uncommon (0.1% to 1%): Change in libido, impotence, less intense orgasm/decreased orgasm
- Rare (0.01% to 0.1%): Change in libido, confusion, decreased orgasm, depression, disinhibition, euphoria, numbed emotions, sleep disturbances, unmasking of depression
- Frequency not reported: Aggression, aggressive behavior, aggressiveness, agitation/states of agitation, anxiety, behavioral disorder, catatonia, delirium, delusion, dependence, depersonalization, derealization, disorientation, drug withdrawal symptoms, dysphoria, excitement/excitation, hallucinations, hostility, impaired attention/concentration, impotence, inappropriate behavior, increased dreaming, inner restlessness, insomnia, irritability, loss of reality, nightmares, panic attacks, psychoses, rage, restlessness, sexual arousal, sleep disorders, stimulation, suicidal attempt/ideation, tension/states of tension,, withdrawal phenomena
Parenteral:
- Common (1% to 10%): Confusion, delirium, depression, restlessness, unmasking of depression, visual hallucinations
- Uncommon (0.1% to 1%): Abnormal thinking, agitation, ataxia, change in libido, decreased orgasm, hallucinations
- Frequency not reported: Aggression, agitation, anxiety, disinhibition, excitation, euphoria, hostility, impaired attention/concentration, inappropriate behavior, insomnia, irritability, mania, psychosis, rage, sexual arousal, sleep disturbances, stimulation, suicidal attempt/ideation
- Postmarketing reports: Acute brain syndrome, nervousness[Ref]
Other
Oral:
- Common (1% to 10%): Asthenia, fatigue, lassitude, weakness
- Uncommon (0.1% to 1%): Chills
- Very rare (less than 0.01%): Hypothermia
- Frequency not reported: Hyperacusis, hyperthermia, paradoxical reactions, rebound phenomena
Parenteral:
- Common (1% to 10%): Asthenia, crying, fatigue, sobbing
- Uncommon (0.1% to 1%): Chills
- Frequency not reported: Depressed hearing, enhanced sensitivity to alcoholic beverages, falls, hypothermia, paradoxical reactions, tinnitus
- Postmarketing reports: Fatalities[Ref]
Respiratory
Oral:
- Rare (0.01% to 0.1%): Apnea, respiratory depression, worsening of obstructive pulmonary disease, worsening of sleep apnea
Parenteral:
- Common (1% to 10%): Apnea, hypoventilation, respiratory disorder, respiratory failure
- Uncommon (0.1% to 1%): Hyperventilation
- Frequency not reported: Airway obstruction, worsening of obstructive pulmonary disease, worsening of sleep apnea
- Postmarketing reports: Lung edema, lung hemorrhage, pneumothorax, pulmonary hypertension, respiratory arrest[Ref]
Cardiovascular
Oral:
- Rare (0.01% to 0.1%): Hypotension
- Frequency not reported: Palpitations, small decreases in blood pressure, tachycardia
Parenteral:
- Common (1% to 10%): Hypotension
- Frequency not reported: Decreased blood pressure
- Postmarketing reports: Arrhythmia, bradycardia, heart arrest/failure, heart block, pericardial effusion, tachycardia, ventricular arrhythmia[Ref]
Musculoskeletal
Oral:
- Frequency not reported: Muscle pain, myalgia
Parenteral:
- Common (1% to 10%): Muscle weakness[Ref]
Gastrointestinal
Oral:
- Uncommon (0.1% to 1%): Nausea
- Rare (0.01% to 0.1%): Constipation, salivation changes
- Frequency not reported: Abdominal cramps, abdominal spasms, diarrhea, dry mouth, gastrointestinal symptoms, hypersalivation, vomiting
Parenteral:
- Uncommon (0.1% to 1%): Increased salivation, nausea, vomiting
- Frequency not reported: Constipation
- Postmarketing reports: Gastrointestinal hemorrhage[Ref]
Metabolic
Oral:
- Rare (0.01% to 0.1%): Change in appetite, increase in alkaline phosphatase
- Very rare (less than 0.01%): Hyponatremia
- Frequency not reported: Loss of appetite
Parenteral:
- Uncommon (0.1% to 1%): Acidosis, increased alkaline phosphatase
- Frequency not reported: Hyponatremia[Ref]
Dermatologic
Oral:
- Rare (0.01% to 0.1%): Allergic dermatitis, rash
- Frequency not reported: Allergic skin reactions, alopecia, dermatological symptoms, sweating
Parenteral:
- Uncommon (0.1% to 1%): Hypertension, hypotension
- Frequency not reported: Allergic skin reactions, alopecia, skin rash[Ref]
Hepatic
Oral:
- Rare (0.01% to 0.1%): Abnormal liver function test values, increase in bilirubin, increase in liver transaminases, jaundice
Parenteral:
- Uncommon (0.1% to 1%): Abnormal liver function tests
- Frequency not reported: Increased bilirubin, increased liver transaminases, jaundice
- Postmarketing reports: Liver damage[Ref]
Genitourinary
Oral:
- Rare (0.01% to 0.1%): Impotence
Parenteral:
- Uncommon (0.1% to 1%): Impotence
- Postmarketing reports: Urinary incontinence[Ref]
Immunologic
Parenteral:
- Uncommon (0.1% to 1%): Infection[Ref]
Renal
Parenteral:
- Uncommon (0.1% to 1%): Cystitis[Ref]
Ocular
Oral:
- Rare (0.01% to 0.1%): Blurred vision, diplopia, eye function/visual disturbance
Parenteral:
- Frequency not reported: Blurred vision, diplopia, visual disturbances[Ref]
Hematologic
Oral:
- Very rare (less than 0.01%): Agranulocytosis, leukopenia, pancytopenia, thrombocytopenia
Parenteral:
- Frequency not reported: Agranulocytosis, hypochromic anemia, leukocytosis, pancytopenia, thrombocythemia, thrombocytopenia
- Postmarketing reports: Coagulation disorder[Ref]
Hypersensitivity
Oral:
- Very rare (less than 0.01%): Anaphylactoid reactions, anaphylaxis, hypersensitivity
- Frequency not reported: Angioedema, hypersensitivity reactions
Parenteral:
- Frequency not reported: Anaphylactic reactions, anaphylactoid reactions, angioedema, hypersensitivity reactions[Ref]
Endocrine
Oral:
- Very rare (less than 0.01%): Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
Parenteral:
- Frequency not reported: SIADH
- Postmarketing reports: Aggravation of pheochromocytoma[Ref]
References
1. (2002) "Product Information. Ativan (lorazepam)." Wyeth-Ayerst Laboratories
2. Cerner Multum, Inc. "UK Summary of Product Characteristics."
3. Cerner Multum, Inc. "Australian Product Information."
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Further information
Ativan side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.