What are the different forms and strengths of lorazepam. How is lorazepam used for sleep and anxiety. What is the maximum safe dosage of lorazepam. How is lorazepam administered for seizures and surgery.

Understanding Lorazepam: An Overview of Ativan

Lorazepam, commonly known by its brand name Ativan, is a versatile prescription medication approved by the Food and Drug Administration (FDA) for various medical purposes. This benzodiazepine drug plays a crucial role in managing several conditions, including anxiety, sleep disorders, and certain types of seizures. It’s also used in medical settings to induce sleep before surgical procedures.

As a member of the benzodiazepine class, lorazepam works by enhancing the effects of gamma-aminobutyric acid (GABA), a neurotransmitter that helps calm brain activity. This mechanism of action makes it effective in treating conditions characterized by excessive nervous system stimulation.

Lorazepam Forms and Strengths: A Detailed Breakdown

Lorazepam is available in multiple forms and strengths to accommodate various medical needs and dosing requirements. Understanding these options is crucial for both healthcare providers and patients to ensure proper administration and efficacy.

Oral Tablets

Ativan oral tablets are the most common form of lorazepam prescribed for outpatient use. They come in three distinct strengths:

• 0.5 milligrams (mg)
• 1 mg
• 2 mg

These varying strengths allow for precise dosing and easy dose adjustments based on individual patient needs and responses to treatment.

Injectable Solution

For situations requiring rapid onset of action or when oral administration is not feasible, lorazepam is available as an injectable solution. This form is typically used in hospital settings for emergency seizure management or pre-surgical sedation. The injectable solution comes in two concentrations:

• 2 mg per 1 milliliter (mL) of liquid solution (2 mg/mL)
• 4 mg/mL

Healthcare professionals can administer this form either through intravenous (IV) injection or intramuscular (IM) injection, depending on the specific medical situation and urgency of treatment.

Dosage Guidelines for Various Medical Conditions

The appropriate dosage of lorazepam varies significantly depending on the condition being treated, the patient’s age, weight, and overall health status. It’s crucial to follow the prescribing physician’s instructions carefully and never adjust the dosage without medical supervision.

Treating Anxiety-Related Sleep Problems

For individuals experiencing sleep disturbances due to anxiety or stress, the typical dosage range for Ativan tablets is 2 mg to 4 mg, taken once daily at bedtime. This dosing regimen helps promote relaxation and facilitate sleep onset without causing excessive daytime drowsiness.

Managing Seizures

In cases of acute seizure management, lorazepam is administered via IV or IM injection by healthcare professionals. The standard protocol involves an initial dose of 4 mg given slowly over about 2 minutes. If seizure activity persists after 10 to 15 minutes, an additional 4 mg dose may be administered.

Anxiety Treatment

For the treatment of anxiety disorders, Ativan tablets are prescribed within a dosage range of 1 mg to 10 mg daily. This total daily dose is usually divided into two or three separate administrations throughout the day. A typical regimen might involve 2 mg to 6 mg total, split into morning and evening doses.

Pre-Surgical Sedation

When used to induce sleep before surgical procedures, lorazepam dosing is weight-based and administered via IM injection. The standard dose is 0.05 mg per kilogram (kg) of body weight, with a maximum dose of 4 mg. In some cases, IV administration may be preferred, with a recommended dose of either 2 mg or 0.02 mg per pound (0.044 mg/kg) of body weight, whichever is smaller.

Maximum Safe Dosage and Long-Term Use Considerations

The maximum recommended dose of Ativan in a 24-hour period is 10 mg for most indications treated with oral tablets. This upper limit helps minimize the risk of adverse effects and potential dependence. For pre-surgical sedation, the maximum single dose is capped at 4 mg.

It’s important to note that lorazepam is not intended for long-term use. Clinical studies have not evaluated its safety and efficacy beyond 4 months of continuous use. Healthcare providers typically reassess the need for ongoing treatment periodically to ensure the benefits continue to outweigh any potential risks.

Pediatric Use and Special Populations

Ativan is not approved for use in children, as its safety and efficacy have not been established in pediatric populations. For special populations, such as elderly patients or those with liver or kidney impairment, dosage adjustments may be necessary. These individuals often require lower doses due to altered drug metabolism and increased sensitivity to the effects of benzodiazepines.

Frequently Asked Questions About Lorazepam Dosages

Understanding the nuances of lorazepam dosing can be challenging for patients and caregivers. Here are some common questions and their answers to provide clarity:

What is considered a ‘normal’ dosage of Ativan?

A typical or “normal” dosage of Ativan for anxiety treatment ranges from 2 mg to 6 mg total daily, usually divided into two or three doses. For example, a common regimen might involve taking 2 mg twice daily, resulting in a total daily dose of 4 mg. However, it’s crucial to remember that the optimal dosage can vary significantly between individuals based on their specific medical needs and response to the medication.

How quickly does lorazepam take effect?

The onset of action for lorazepam depends on the route of administration. Oral tablets typically begin to take effect within 20 to 30 minutes, with peak effects occurring around 1 to 2 hours after ingestion. Injectable forms of lorazepam act more rapidly, with effects often noticeable within 5 to 15 minutes when given intravenously.

Can lorazepam dosage be adjusted based on symptoms?

While it may be tempting to adjust lorazepam dosage based on symptom severity, it’s crucial to only modify the dose under the guidance of a healthcare provider. Abrupt changes in dosage can lead to withdrawal symptoms or increased side effects. If you feel your current dosage is inadequate or causing problems, consult your prescribing physician for a proper evaluation and potential adjustment.

Potential Side Effects and Safety Considerations

Like all medications, lorazepam can cause side effects, and the risk may increase with higher doses. Common side effects include:

• Drowsiness and sedation
• Dizziness
• Weakness
• Unsteadiness
• Memory problems

More severe side effects, while rare, can include respiratory depression, especially when combined with other central nervous system depressants. It’s crucial to inform your healthcare provider of all medications you’re taking to avoid potentially dangerous interactions.

Monitoring and Adjusting Lorazepam Treatment

Regular monitoring is essential when using lorazepam, especially during the initial treatment period or after dosage adjustments. Your healthcare provider may schedule follow-up appointments to assess the medication’s effectiveness and any potential side effects. They may also perform periodic evaluations to determine if continued treatment is necessary or if a gradual tapering of the medication is appropriate.

Patients should be aware of the potential for dependence and tolerance with long-term use of benzodiazepines like lorazepam. If you’ve been taking Ativan for an extended period, never attempt to stop the medication abruptly without medical supervision, as this can lead to withdrawal symptoms.

Alternatives to Lorazepam and Complementary Therapies

While lorazepam can be highly effective for managing anxiety, insomnia, and seizures, it’s not the only treatment option available. Depending on your specific condition and medical history, your healthcare provider may consider alternative medications or complementary therapies, such as:

• Other benzodiazepines with different durations of action
• Selective serotonin reuptake inhibitors (SSRIs) for long-term anxiety management
• Cognitive-behavioral therapy (CBT) for anxiety and insomnia
• Mindfulness and relaxation techniques
• Lifestyle modifications to improve sleep hygiene and reduce stress

These alternatives may be used in conjunction with or as a replacement for lorazepam, depending on individual patient needs and responses to treatment.

Conclusion: The Importance of Personalized Lorazepam Treatment

Lorazepam, available as Ativan and in generic forms, is a potent medication that requires careful consideration and individualized dosing. The wide range of available strengths and formulations allows healthcare providers to tailor treatment to each patient’s specific needs. However, this versatility also underscores the importance of close medical supervision and adherence to prescribed dosages.

Patients prescribed lorazepam should maintain open communication with their healthcare providers, reporting any concerns or changes in symptoms promptly. By working closely with medical professionals and following prescribed guidelines, individuals can maximize the benefits of lorazepam while minimizing potential risks and side effects.

As research in pharmacology and mental health continues to advance, our understanding of medications like lorazepam and their optimal use evolves. Staying informed about current best practices and engaging in ongoing dialogue with healthcare providers ensures that patients receive the most appropriate and effective treatment for their conditions.

Forms, strengths, for sleep, and more

Ativan (lorazepam) is a prescription brand-name medication. The Food and Drug Administration (FDA) has approved it to:

• treat sleep problems caused by anxiety or stress
• treat certain seizures
• treat anxiety
• make you fall asleep before surgery

Ativan contains the active drug lorazepam and belongs to a drug class called benzodiazepines. Lorazepam is also the name of the generic form of Ativan.

Ativan comes as oral tablets and injections.

For information about the dosage of Ativan, including its forms, strengths, and how to take the medication, keep reading. For a comprehensive look at Ativan, see this article.

This article describes typical dosages for Ativan provided by the drug’s manufacturer. When taking Ativan, always follow the dosage prescribed by your doctor.

If your doctor prescribes Ativan, you may have questions about the drug’s dosage, such as:

• What’s Ativan’s dosage range?
• What are the usual dosage amounts of Ativan?
• What’s considered a safe dose of Ativan?

Below is a basic dosage chart for Ativan (“mg” refers to milligrams).

Ativan forms and strengths

Ativan comes as oral tablets and a vial that contains a liquid solution. The solution is given as an intravenous (IV) injection or intramuscular (IM) injection.

Here are the strengths for each form of Ativan:

• Oral tablets: 0.5 mg, 1 mg, 2 mg
• Liquid solution for injection: 2 mg per 1 milliliter (mL) of liquid solution (2 mg/mL), 4 mg/mL

Typical dosages

Depending on what you’re taking Ativan to treat and the dosage form your doctor prescribes, they may start you on a low dosage. Then they may adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly taken or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Dosage for sleep problems caused by anxiety or stress

To treat sleep problems caused by anxiety or stress, your doctor will prescribe Ativan tablets. The dosage range for this use is 2 mg to 4 mg once per day, taken at bedtime.

Dosage for certain seizures

To treat certain seizures, a healthcare professional will typically give you Ativan as an IV injection. In some cases, they may give you an IM injection.

The usual dosage is 4 mg given slowly (about 2 minutes). If the seizures continue after 10 to 15 minutes, you may be given another 4-mg dose.

Dosage for anxiety

To treat anxiety, your doctor will prescribe Ativan tablets. The dosage range for this use is 1 mg to 10 mg, which is usually split into two or three doses per day.

The typical dose is 2 mg to 6 mg, divided into two or three doses per day. For example, if your daily dosage is 4 mg, you would take 2 mg once in the morning and once in the evening.

Dosage for surgery

To make you sleep before surgery, a healthcare professional will typically give you an IM injection of Ativan.

For this use, Ativan is dosed based on body weight. You’ll likely receive an IM injection of 0.05 mg per kilogram (kg) of body weight, up to a maximum dose of 4 mg. (One kilogram equals about 2.2 pounds.)

Ativan may also be given by IV injection to make you sleep before surgery. The recommended dose for this use is either 2 mg or 0.02 mg per pound (0.044 mg/kg) of body weight, whichever is smaller.

The healthcare professional will determine what dose is right for you.

Long-term use

Using Ativan for more than 4 months in a row hasn’t been studied. Ativan is not meant to be taken as a long-term treatment. Your doctor will typically check from time to time whether you still need to take Ativan.

Children’s dosage

Ativan is not approved for children to take. The drug has not proven to be safe and effective to treat conditions in this group.

The maximum dose of Ativan in 24 hours is 10 milligrams (mg). This dose is typically taken for conditions that are treated with Ativan tablets, such as anxiety.

The 10-mg maximum dose is usually divided into two or three doses. For example, you may take 2 mg in the morning, 2 mg in the afternoon, and 6 mg before bed.

For making you sleep before surgery, the maximum dose of Ativan is 4 mg.

For more information about Ativan dosages, including what’s a safe dose of Ativan, see the “Ativan dosage” section just above.

Below are answers to some frequently asked questions about Ativan dosages.

What’s considered a ‘normal’ dosage of Ativan?

The “normal” (usual) dosage of Ativan is 2 milligrams (mg) to 6 mg total, divided into two or three doses. For example, to treat anxiety, you may take Ativan tablets at a dosage of 2 mg twice per day, for a total daily dosage of 4 mg.

For more information about Ativan dosages, including what’s a safe dose of Ativan, see the “Ativan dosage” section above. You can also speak with your doctor or pharmacist.

What’s the Ativan dosage for panic and anxiety attacks?

Ativan is not approved to treat panic or anxiety attacks. But the drug may be prescribed off-label for this use. Off-label use is when a drug is prescribed to treat a condition it isn’t approved to treat.

To learn more about using Ativan for panic or anxiety attacks and what the dosage would be, talk with your doctor or pharmacist.

Is Ativan used for dogs? If so, what’s the dosage for dogs?

Ativan is not approved for use in dogs, but your veterinarian might recommend Ativan for your dog in some situations. Ativan may be used in dogs to help reduce anxiety or stress, to sedate your dog during a surgery, or to treat seizures.

Do not give your dog Ativan unless your veterinarian recommends this. Your veterinarian can recommend whether this drug is safe for your dog and what dosage your dog might need. If you think your pet has eaten your Ativan medication, contact your veterinarian right away.

The Ativan dosage your doctor prescribes will depend on several factors. These include:

• the type and severity of the condition you’re using Ativan to treat
• the form of Ativan you take
• your age
• your body weight, depending on the form of the drug and what it’s treating

Other medical conditions you have can also affect your Ativan dosage.

Dosage adjustments

If you’re an older adult, you may need a lower dose of Ativan than usual. This is because Ativan affects your body differently as you age.

You may also need a dosage adjustment if you have kidney or liver problems. Your doctor will typically decrease your dose based on the severity of your liver or kidney condition.

Your doctor or pharmacist can tell you more about Ativan dosage adjustments.

How you take Ativan depends on the form of the drug you’re prescribed.

One form is oral tablets that you swallow. You can take them with or without food.

Ativan’s other form is a liquid solution that’s given as an intravenous (IV) injection or intramuscular injection. A healthcare professional will give you Ativan injections.

Be sure to take Ativan exactly as your doctor prescribes. You should not take more or less Ativan than prescribed without first speaking with them.

If you miss a dose of Ativan, take it as soon as you remember. But if it’s almost time for your next dose, skip the missed dose. Then take your next dose at your regular scheduled time.

You should not take more than one dose to try and make up for the missed dose. This can increase your risk for side effects from Ativan. (For more about Ativan’s side effects, see this article.)

To help make sure that you do not miss a dose, try using a medication reminder. This can include setting an alarm or timer on your phone or downloading a reminder app. A kitchen timer can work, too.

Ativan has a boxed warning regarding misuse and addiction. A boxed warning is the most serious warning given to a medication by the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.

Taking Ativan can lead to misuse and addiction, even when you take an approved dosage. Misusing Ativan can cause serious side effects such as trouble breathing or coma. This risk increases if you take Ativan with certain other drugs or substances, including alcohol. Although rare, misusing Ativan can be fatal.

Misusing Ativan can also increase your risk for overdose. (To learn more, see the “Ativan and overdose” section below.

Because of the risk for misuse, Ativan is a controlled substance. This means its use is regulated by the government to prevent possible misuse. You should not share your Ativan prescription with anyone else. Be sure to take Ativan exactly as your doctor prescribes.

Also, it’s recommended that you store Ativan in a safe place, away from children.

If you take more Ativan than your doctor prescribes, you may develop serious side effects.

It’s important that you do not take more Ativan than your doctor advises.

Symptoms of an overdose

Overdose symptoms of Ativan can include:

• confusion
• drowsiness
• low blood pressure
• problems with coordination or balance
• slowed reflexes
• coma
• in rare cases, death

If you take more than the recommended amount of Ativan

Call your doctor right away if you believe you’ve taken too much Ativan. Another option is to call the American Association of Poison Control Centers at 800-222-1222 or use its online tool. If you have severe symptoms, immediately call 911 or your local emergency number, or go to the nearest emergency room.

Ativan has a boxed warning regarding physical dependence and withdrawal. A boxed warning is the most serious warning given to a medication by the Food and Drug Administration. It alerts doctors and patients about drug effects that may be dangerous.

Using Ativan can lead to physical dependence. This could lead to withdrawal if you suddenly stop taking the drug, even if you take an approved dosage.

You should not suddenly stop taking Ativan. Doing so could cause serious or, rarely, life-threatening side effects that can include:

• seizures
• unusual movements, expressions, or responses
• depression
• hallucinations (seeing or hearing things that aren’t there)
• losing touch with reality

In some people, withdrawal symptoms from benzodiazepines such as Ativan can cause symptoms that last for up to 12 months, such as:

• anxiety
• trouble remembering or concentrating
• depression
• trouble sleeping
• feeling like insects are crawling under your skin
• muscle weakness or twitching
• tinnitus (ringing in your ears)

Instead of suddenly stopping Ativan treatment, your doctor will help you with a drug taper. This involves gradually lowering the dosage of the medication over time. A drug taper can help decrease your risk for withdrawal symptoms or make them less severe.

If you’re interested in stopping treatment with Ativan, be sure to talk with your doctor first. You should not suddenly stop taking the drug on your own.

The dosages in this article are typical dosages provided by the drug manufacturer. If your doctor recommends Ativan for you, they will prescribe the dosage that’s right for you. Always follow the dosage that your doctor prescribes for you.

As with any drug, never change your dosage of Ativan without your doctor’s recommendation. If you have questions about the dosage of Ativan that’s right for you, talk with your doctor.

Besides learning about dosage, you may want other information about Ativan. These additional articles might be helpful:

• More about Ativan. For information about other aspects of Ativan, refer to this article.
• Drug comparison. To find out how Ativan compares with Xanax, read this article.
• Side effects. To learn about side effects of Ativan, see this article. You can also look at the prescribing information for Ativan tablets and solution.
• Interactions. For details about what Ativan interacts with, see this article.
• Details about your condition. For details about sleep problems, refer to our sleep hub and list of sleep articles. For more information about mental health and anxiety, see our mental health hub and list of anxiety articles. To learn more about the other conditions Ativan is prescribed for, talk with your doctor.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Forms, strengths, for sleep, and more

Ativan (lorazepam) is a prescription brand-name medication. The Food and Drug Administration (FDA) has approved it to:

• treat sleep problems caused by anxiety or stress
• treat certain seizures
• treat anxiety
• make you fall asleep before surgery

Ativan contains the active drug lorazepam and belongs to a drug class called benzodiazepines. Lorazepam is also the name of the generic form of Ativan.

Ativan comes as oral tablets and injections.

For information about the dosage of Ativan, including its forms, strengths, and how to take the medication, keep reading. For a comprehensive look at Ativan, see this article.

This article describes typical dosages for Ativan provided by the drug’s manufacturer. When taking Ativan, always follow the dosage prescribed by your doctor.

If your doctor prescribes Ativan, you may have questions about the drug’s dosage, such as:

• What’s Ativan’s dosage range?
• What are the usual dosage amounts of Ativan?
• What’s considered a safe dose of Ativan?

Below is a basic dosage chart for Ativan (“mg” refers to milligrams).

Ativan forms and strengths

Ativan comes as oral tablets and a vial that contains a liquid solution. The solution is given as an intravenous (IV) injection or intramuscular (IM) injection.

Here are the strengths for each form of Ativan:

• Oral tablets: 0.5 mg, 1 mg, 2 mg
• Liquid solution for injection: 2 mg per 1 milliliter (mL) of liquid solution (2 mg/mL), 4 mg/mL

Typical dosages

Depending on what you’re taking Ativan to treat and the dosage form your doctor prescribes, they may start you on a low dosage. Then they may adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly taken or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Dosage for sleep problems caused by anxiety or stress

To treat sleep problems caused by anxiety or stress, your doctor will prescribe Ativan tablets. The dosage range for this use is 2 mg to 4 mg once per day, taken at bedtime.

Dosage for certain seizures

To treat certain seizures, a healthcare professional will typically give you Ativan as an IV injection. In some cases, they may give you an IM injection.

The usual dosage is 4 mg given slowly (about 2 minutes). If the seizures continue after 10 to 15 minutes, you may be given another 4-mg dose.

Dosage for anxiety

To treat anxiety, your doctor will prescribe Ativan tablets. The dosage range for this use is 1 mg to 10 mg, which is usually split into two or three doses per day.

The typical dose is 2 mg to 6 mg, divided into two or three doses per day. For example, if your daily dosage is 4 mg, you would take 2 mg once in the morning and once in the evening.

Dosage for surgery

To make you sleep before surgery, a healthcare professional will typically give you an IM injection of Ativan.

For this use, Ativan is dosed based on body weight. You’ll likely receive an IM injection of 0.05 mg per kilogram (kg) of body weight, up to a maximum dose of 4 mg. (One kilogram equals about 2.2 pounds.)

Ativan may also be given by IV injection to make you sleep before surgery. The recommended dose for this use is either 2 mg or 0.02 mg per pound (0.044 mg/kg) of body weight, whichever is smaller.

The healthcare professional will determine what dose is right for you.

Long-term use

Using Ativan for more than 4 months in a row hasn’t been studied. Ativan is not meant to be taken as a long-term treatment. Your doctor will typically check from time to time whether you still need to take Ativan.

Children’s dosage

Ativan is not approved for children to take. The drug has not proven to be safe and effective to treat conditions in this group.

The maximum dose of Ativan in 24 hours is 10 milligrams (mg). This dose is typically taken for conditions that are treated with Ativan tablets, such as anxiety.

The 10-mg maximum dose is usually divided into two or three doses. For example, you may take 2 mg in the morning, 2 mg in the afternoon, and 6 mg before bed.

For making you sleep before surgery, the maximum dose of Ativan is 4 mg.

For more information about Ativan dosages, including what’s a safe dose of Ativan, see the “Ativan dosage” section just above.

Below are answers to some frequently asked questions about Ativan dosages.

What’s considered a ‘normal’ dosage of Ativan?

The “normal” (usual) dosage of Ativan is 2 milligrams (mg) to 6 mg total, divided into two or three doses. For example, to treat anxiety, you may take Ativan tablets at a dosage of 2 mg twice per day, for a total daily dosage of 4 mg.

For more information about Ativan dosages, including what’s a safe dose of Ativan, see the “Ativan dosage” section above. You can also speak with your doctor or pharmacist.

What’s the Ativan dosage for panic and anxiety attacks?

Ativan is not approved to treat panic or anxiety attacks. But the drug may be prescribed off-label for this use. Off-label use is when a drug is prescribed to treat a condition it isn’t approved to treat.

To learn more about using Ativan for panic or anxiety attacks and what the dosage would be, talk with your doctor or pharmacist.

Is Ativan used for dogs? If so, what’s the dosage for dogs?

Ativan is not approved for use in dogs, but your veterinarian might recommend Ativan for your dog in some situations. Ativan may be used in dogs to help reduce anxiety or stress, to sedate your dog during a surgery, or to treat seizures.

Do not give your dog Ativan unless your veterinarian recommends this. Your veterinarian can recommend whether this drug is safe for your dog and what dosage your dog might need. If you think your pet has eaten your Ativan medication, contact your veterinarian right away.

The Ativan dosage your doctor prescribes will depend on several factors. These include:

• the type and severity of the condition you’re using Ativan to treat
• the form of Ativan you take
• your age
• your body weight, depending on the form of the drug and what it’s treating

Other medical conditions you have can also affect your Ativan dosage.

Dosage adjustments

If you’re an older adult, you may need a lower dose of Ativan than usual. This is because Ativan affects your body differently as you age.

You may also need a dosage adjustment if you have kidney or liver problems. Your doctor will typically decrease your dose based on the severity of your liver or kidney condition.

Your doctor or pharmacist can tell you more about Ativan dosage adjustments.

How you take Ativan depends on the form of the drug you’re prescribed.

One form is oral tablets that you swallow. You can take them with or without food.

Ativan’s other form is a liquid solution that’s given as an intravenous (IV) injection or intramuscular injection. A healthcare professional will give you Ativan injections.

Be sure to take Ativan exactly as your doctor prescribes. You should not take more or less Ativan than prescribed without first speaking with them.

If you miss a dose of Ativan, take it as soon as you remember. But if it’s almost time for your next dose, skip the missed dose. Then take your next dose at your regular scheduled time.

You should not take more than one dose to try and make up for the missed dose. This can increase your risk for side effects from Ativan. (For more about Ativan’s side effects, see this article.)

To help make sure that you do not miss a dose, try using a medication reminder. This can include setting an alarm or timer on your phone or downloading a reminder app. A kitchen timer can work, too.

Ativan has a boxed warning regarding misuse and addiction. A boxed warning is the most serious warning given to a medication by the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.

Taking Ativan can lead to misuse and addiction, even when you take an approved dosage. Misusing Ativan can cause serious side effects such as trouble breathing or coma. This risk increases if you take Ativan with certain other drugs or substances, including alcohol. Although rare, misusing Ativan can be fatal.

Misusing Ativan can also increase your risk for overdose. (To learn more, see the “Ativan and overdose” section below.

Because of the risk for misuse, Ativan is a controlled substance. This means its use is regulated by the government to prevent possible misuse. You should not share your Ativan prescription with anyone else. Be sure to take Ativan exactly as your doctor prescribes.

Also, it’s recommended that you store Ativan in a safe place, away from children.

If you take more Ativan than your doctor prescribes, you may develop serious side effects.

It’s important that you do not take more Ativan than your doctor advises.

Symptoms of an overdose

Overdose symptoms of Ativan can include:

• confusion
• drowsiness
• low blood pressure
• problems with coordination or balance
• slowed reflexes
• coma
• in rare cases, death

If you take more than the recommended amount of Ativan

Call your doctor right away if you believe you’ve taken too much Ativan. Another option is to call the American Association of Poison Control Centers at 800-222-1222 or use its online tool. If you have severe symptoms, immediately call 911 or your local emergency number, or go to the nearest emergency room.

Ativan has a boxed warning regarding physical dependence and withdrawal. A boxed warning is the most serious warning given to a medication by the Food and Drug Administration. It alerts doctors and patients about drug effects that may be dangerous.

Using Ativan can lead to physical dependence. This could lead to withdrawal if you suddenly stop taking the drug, even if you take an approved dosage.

You should not suddenly stop taking Ativan. Doing so could cause serious or, rarely, life-threatening side effects that can include:

• seizures
• unusual movements, expressions, or responses
• depression
• hallucinations (seeing or hearing things that aren’t there)
• losing touch with reality

In some people, withdrawal symptoms from benzodiazepines such as Ativan can cause symptoms that last for up to 12 months, such as:

• anxiety
• trouble remembering or concentrating
• depression
• trouble sleeping
• feeling like insects are crawling under your skin
• muscle weakness or twitching
• tinnitus (ringing in your ears)

Instead of suddenly stopping Ativan treatment, your doctor will help you with a drug taper. This involves gradually lowering the dosage of the medication over time. A drug taper can help decrease your risk for withdrawal symptoms or make them less severe.

If you’re interested in stopping treatment with Ativan, be sure to talk with your doctor first. You should not suddenly stop taking the drug on your own.

The dosages in this article are typical dosages provided by the drug manufacturer. If your doctor recommends Ativan for you, they will prescribe the dosage that’s right for you. Always follow the dosage that your doctor prescribes for you.

As with any drug, never change your dosage of Ativan without your doctor’s recommendation. If you have questions about the dosage of Ativan that’s right for you, talk with your doctor.

Besides learning about dosage, you may want other information about Ativan. These additional articles might be helpful:

• More about Ativan. For information about other aspects of Ativan, refer to this article.
• Drug comparison. To find out how Ativan compares with Xanax, read this article.
• Side effects. To learn about side effects of Ativan, see this article. You can also look at the prescribing information for Ativan tablets and solution.
• Interactions. For details about what Ativan interacts with, see this article.
• Details about your condition. For details about sleep problems, refer to our sleep hub and list of sleep articles. For more information about mental health and anxiety, see our mental health hub and list of anxiety articles. To learn more about the other conditions Ativan is prescribed for, talk with your doctor.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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Warning

All editions:

• This drug is a strong pain reliever that can be habit-forming, abused or misused. Misuse or abuse of this drug can lead to overdose and death. Consult with your doctor.
• You will be closely monitored to avoid misuse, abuse, or dependence on this drug.
• This drug can cause very bad and sometimes deadly breathing problems. Call your doctor right away if breathing is slow, shallow, or difficult.
• The risk of serious and sometimes deadly respiratory problems may be increased when this drug is started or the dose is increased.
• Even one dose of this drug, taken by another person or by mistake, can be deadly, especially in children. If this drug has been taken by another person or by mistake, get medical help right away.
• Keep all medicines in a safe place. Keep all medicines out of the reach of children and pets.
• Long-term use of this drug during pregnancy may cause withdrawal symptoms in the newborn. This can be life threatening. Consult your doctor.
• This drug contains an opioid. Serious side effects have occurred when using opioids with benzodiazepines, alcohol, marijuana, or other forms of cannabis, as well as prescription or over-the-counter drugs that can cause drowsiness or slow action. These effects include slow or labored breathing and death. Benzodiazepines include drugs such as alprazolam, diazepam, and lorazepam. Benzodiazepines can be used to treat many health conditions such as anxiety, sleep disorders, or seizures. If you have any questions, please consult your doctor.
• Many drugs interact with this drug and may increase the risk of side effects such as life-threatening breathing problems. Check with your doctor and pharmacist to make sure it is safe to use this drug with all your other drugs.
• Do not take with alcohol or products containing alcohol. Dangerous, sometimes deadly, effects may develop.
• Seek immediate medical attention if you feel very drowsy, severely dizzy, or if you lose consciousness. Caregivers or others should seek immediate medical attention if the patient does not respond, does not respond, or does not respond in the usual way, or if he sleeps and does not wake up.

Extended release tablets:

• Swallow whole. Do not chew, break, grind or dissolve before swallowing. These actions can cause very severe side effects and death.

What is this drug used for?

• Used to relieve pain.

What should I tell my doctor BEFORE taking this drug?

• If you have an allergy to this drug, any of its ingredients, other drugs, foods or substances. Tell your doctor about your allergies and how they have manifested.
• If you have any of the following health conditions: Lung or breathing problems such as asthma, shortness of breath, or sleep apnea; high levels of carbon dioxide in the blood; gastrointestinal obstruction or narrowing.
• If you have liver disease.
• If you have taken medications for depression or Parkinson’s disease in the past 14 days. These include isocarboxazid, phenelzine, tranylcypromine, selegiline, or rasagiline. An episode of very high blood pressure may occur.
• If you are taking any of the following drugs: buprenorphine, butorphanol, linezolid, methylene blue, nalbuphine, or pentazocine.

This list of drugs and conditions that may interact with this drug is not exhaustive.

Tell your doctor and pharmacist about all medicines you take (both prescription and over-the-counter, natural products and vitamins) and any health problems you have. You need to make sure that this drug is safe for your conditions and in combination with other drugs you are already taking. Do not start or stop taking any drug or change the dosage without your doctor’s advice.

What do I need to know or do while taking this drug?

• Tell all your health care workers that you are taking this drug. These are doctors, nurses, pharmacists and dentists.
• Avoid driving and other activities that require increased attention until you see how this drug affects you.
• To reduce the risk of dizziness or loss of consciousness, get up slowly from a lying or sitting position. Walking up and down stairs should be done with care.
• Do not take the drug in higher doses than prescribed by your doctor. Taking more than the prescribed amount of the drug increases the risk of serious side effects.
• Do not take this drug with other strong pain medications or if you are using a pain patch without talking to your doctor first.
• If this drug is taken for a long time or at high doses, its effectiveness may be reduced and a higher dose may be needed to achieve the same effect. The so-called tolerance to the drug develops. Talk to your doctor if this drug stops working as you want. Do not take the drug in higher doses than prescribed by your doctor.
• Long-term or regular use of opioid medications like this can lead to addiction. Reducing the dose or stopping this drug suddenly can cause a serious risk of withdrawal reactions or other serious problems. Talk to your doctor before reducing your dose or stopping this drug. You must follow the doctor’s instructions. Tell your doctor if you have severe pain, mood changes, suicidal thoughts, or any other side effects.
• Long-term use of an opioid medicine can lead to a decrease in the level of sex hormones. If you have a decreased interest in sex, fertility problems, no menstruation, or problems with ejaculation, see your doctor.
• This drug may increase the risk of seizures in some people, including people who have had seizures in the past. Talk to your doctor to find out if your risk of seizures is increased with this drug.
• If you are 65 years of age or older, use this drug with caution. You may experience more side effects.
• When used during pregnancy, the drug may have a harmful effect on the fetus. If you are pregnant or become pregnant while taking this drug, call your doctor right away.
• If you are breastfeeding or planning to breastfeed, tell your doctor. This drug passes into breast milk and may harm your baby.

What side effects should I report to my doctor immediately?

WARNING. In rare cases, this drug can cause serious and sometimes deadly side effects in some patients. Contact your doctor or seek medical attention right away if you have any of the following signs or symptoms that may be associated with serious side effects:

• Signs of an allergic reaction such as rash, hives, itching, red and swollen skin with blisters or peeling with or without fever, wheezing, tightness in the chest or throat, trouble breathing, swallowing or speaking, unusual hoarseness, swelling in the mouth, face, lips, tongue or throat. Some allergic reactions in rare cases have become life-threatening.
• Signs of high or low blood pressure, such as a very severe headache or dizziness, fainting, or changes in vision.
• Labored, slow or shallow breathing.
• Noisy breathing.
• Breathing disorders during sleep (sleep apnea syndrome).
• Confusion of consciousness.
• Severe constipation or abdominal pain. These may be signs of a severe bowel disorder.
• Pain or pressure in the chest or a fast heartbeat.
• Heat.
• Hallucinations (a person sees or hears something that is not in reality).
• Mood changes.
• Seizures.
• Obstruction of the urinary tract.
• Inflammation.
• Vision change.
• Impairment or loss of memory.
• When this drug is taken with certain other drugs, a bad and sometimes deadly condition called serotonin syndrome can develop. Call your doctor right away if you experience agitation, balance problems, confusion, hallucinations, high fever, tachycardia or abnormal heart rhythms, flushing, muscle twitching or stiffness, seizures, tremors or tremors, excessive sweating, severe diarrhea, nausea or vomiting , severe headache.
• Taking opioids like this can cause a rare but severe adrenal disorder. If you feel very tired or weak, pass out, or have severe dizziness, severe nausea, vomiting, or loss of appetite, call your healthcare provider right away.

What are some other side effects of this drug?

Any medicine can have side effects. However, for many people, side effects are either minor or non-existent. Talk to your doctor or get medical help if these or any other side effects bother you or don’t go away:

All editions:

• Constipation.
• Feeling dizzy, drowsy, tired or weak.
• Dry mouth.
• Gas formation.
• Headache.
• Itching.
• Nausea or vomiting.
• Excessive sweating.
• Pain in the intestines.

Extended release tablets:

• The shell of the tablet can sometimes be seen in the stool. This is normal and does not cause concern.

This list of possible side effects is not exhaustive. If you have any questions about side effects, please contact your doctor. Talk to your doctor about side effects.

You can report side effects to the National Health Board.

You can report side effects to the FDA at 1-800-332-1088. You can also report side effects at https://www. fda.gov/medwatch.

What is the best way to take this drug?

Use this drug as directed by your doctor. Read all the information provided to you. Strictly follow all instructions.

All forms:

• Take this drug on an empty stomach. This drug should be taken no later than 1 hour before and no earlier than 2 hours after a meal.
• Take internally only.
• This drug should not be injected or breathed in through the nose. Any of these actions can lead to very serious side effects such as difficulty breathing and death due to an overdose.

Extended release tablets:

• Swallow whole. Do not chew, break or crush.
• If your prescribed dose consists of several tablets of the drug, use one tablet at a time. Do not lick or wet the tablet before putting it in your mouth. After you put the tablet in your mouth, swallow it with plenty of water.
• If you have difficulty swallowing, check with your doctor.
• Do not use the drug for immediate pain relief or as needed.
• Do not use this drug to relieve pain after surgery if you have not previously taken drugs of this kind.

What if I miss a dose of a drug?

• Take the missed dose as soon as you can.
• If it’s time for your next dose, don’t take the missed dose and then go back to your regular dosing schedule.
• Do not take 2 doses or an additional dose at the same time.
• Some drugs are taken to reduce pain as needed. If you are taking this drug as needed, do not take it more often than your doctor has recommended.

How do I store and/or discard this drug?

• Store at room temperature in a dry place. Do not store in the bathroom.
• Keep this medicine in a protected place out of sight and reach of children and out of the reach of other people. A box or room that is locked with a key can act as a secure storage place for the drug. Keep all medicines out of the reach of pets.
• Dispose of unused or expired drugs. Do not empty into a toilet or sewer unless instructed to do so. If you have any questions about disposing of medicines, ask your pharmacist. Drug disposal programs may be in place in your area.

General information about medicines

• If your health does not improve or even worsens, see your doctor.
• Do not give your medicine to anyone and do not take other people’s medicines.
• Some medicines may come with other patient information leaflets. If you have questions about this drug, talk with your doctor, nurse, pharmacist, or other health care professional.
• A separate instruction for patients is attached to the drug. Please read this information carefully. Reread it each time you refill your supply. If you have any questions about this drug, ask your doctor, pharmacist, or other health care professional.
• An overdose of this drug can be treated with a medicine called naloxone. Your doctor may prescribe naloxone to keep you with you while you are taking this drug. If you have any questions about buying or using naloxone, talk to your doctor or pharmacist. If you think you have overdosed, seek medical attention immediately, even if you have taken naloxone.
• If you think you have overdosed, call a poison control center or get medical help right away. Be prepared to tell or show what drug you took, how much, and when it happened.

Consumer Use of Information and Limitation of Liability

This summary information includes a summary of the diagnosis, treatment, and/or drug product. It is not intended to be a comprehensive source of data and should be used as a tool to help the user understand and/or evaluate potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a particular patient. It should not be considered medical advice or a substitute for medical advice, diagnosis or treatment provided by a physician based on a medical examination and assessment of the patient’s specific and unique circumstances. Patients should consult with their physician for full information about their health, medical issues, and treatment options, including any risks or benefits regarding the use of medications. This information is not a guarantee that a treatment or drug is safe, effective, or approved for a particular patient. UpToDate, Inc. and its subsidiaries disclaim any warranties or liabilities related to this information or its use. The use of this information is subject to the Terms of Use found at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

Last revision date

2020-07-16

Copyright

© UpToDate, Inc. and its affiliates and/or licensors, 2023. All rights reserved.

Date last updated

Monday, December 12, 2022

Chlorpheniramine, Pseudoephedrine, and Codeine | Memorial Sloan Kettering Cancer Center

Adult Medication

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This document, provided by Lexicomp ^® , contains all the information you need to know about this medicine, including indications, directions for use, side effects, and when your healthcare provider should be contacted.

Trade names: USA

Phenylhistine DH [OTC] [DSC]

Warning

For all patients taking this drug:

• This drug contains an opioid. Treatment with opioids can be associated with risks such as dependence, abuse or misuse of these drugs. Misuse or abuse of this drug can lead to overdose and death. If you have any questions, ask your doctor.
• This drug contains an opioid. Serious side effects have occurred when using opioids with benzodiazepines, alcohol, marijuana, or other forms of cannabis, as well as prescription or over-the-counter drugs that can cause drowsiness or slow action. These effects include slow or labored breathing and death. Benzodiazepines include drugs such as alprazolam, diazepam, and lorazepam. Benzodiazepines can be used to treat many health conditions such as anxiety, sleep disorders, or seizures. If you have any questions, please consult your doctor.
• Many drugs interact with this drug and may increase the risk of side effects such as life-threatening breathing problems. Check with your doctor and pharmacist to make sure it is safe to use this drug with all your other drugs.
• Avoid alcohol, marijuana or other forms of cannabis, and prescription or over-the-counter drugs that can slow you down.
• Seek immediate medical attention if you feel very drowsy, severely dizzy, or if you lose consciousness. Caregivers or others should seek immediate medical attention if the patient does not respond, does not respond, or does not respond in the usual way, or if he sleeps and does not wake up.
• Very bad and sometimes deadly breathing problems have happened with this drug. Consult your doctor.
• Seek immediate medical attention if you experience slow breathing, shallow breathing, or difficulty breathing.

Children:

• This drug is not intended for use in children under 18 years of age. The benefits of using this drug for an allergic cough, cold, or other infection do not outweigh the risks for the baby. If your child has been treated with this drug or if you have any questions, contact your child’s doctor.

What is this drug used for?

• The drug is used to treat blockage of the nasal valve.
• It is used to relieve the symptoms of allergies.
• Used to relieve cough.

What should I tell my doctor BEFORE taking this drug?

• If you have an allergy to chlorpheniramine, pseudoephedrine, codeine, or any other part of this drug.
• If you have an allergy to this drug, any of its ingredients, other drugs, foods or substances. Tell your doctor about your allergies and how they have manifested.
• If you have any of the following health conditions: Lung or breathing problems such as asthma, shortness of breath, or sleep apnea; high levels of carbon dioxide in the blood; gastrointestinal obstruction or narrowing.
• If you have any of these health problems: heart disease or high blood pressure.
• If you have a cough with a lot of mucus.
• If you have a prolonged cough caused by your smoking, smoking in close proximity to you, or lung problems such as asthma or emphysema.
• If you have taken medications for depression or Parkinson’s disease in the past 14 days. These include isocarboxazid, phenelzine, tranylcypromine, selegiline, or rasagiline. An episode of very high blood pressure may occur.
• If you are taking any of the following drugs: linezolid or methylene blue.
• If you are taking any of the following drugs: buprenorphine, butorphanol, nalbuphine, or pentazocine.
• If your doctor has told you that your body metabolizes certain drugs faster.
• If you are breastfeeding. Do not breastfeed while taking this drug.

This list of drugs and conditions that may interact with this drug is not exhaustive.

Tell your doctor and pharmacist about all medicines you take (prescription and over-the-counter, natural products and vitamins) and any health problems you have. You need to make sure that this drug is safe for your conditions and in combination with other drugs you are already taking. Do not start or stop taking any drug or change the dosage without your doctor’s advice.

What do I need to know or do while taking this drug?

• Tell all your health care workers that you are taking this drug. These are doctors, nurses, pharmacists and dentists.
• Do not take the drug in higher doses than prescribed by your doctor. Taking more than the prescribed amount of the drug increases the risk of serious side effects.
• Do not take this drug for longer than the length of time your doctor has prescribed.
• This drug may be habit-forming with long-term use.
• Avoid driving and other activities that require increased attention until you see how this drug affects you.
• To reduce the risk of dizziness or loss of consciousness, get up slowly from a lying or sitting position. Walking up and down stairs should be done with care.
• Do not take this drug with other strong pain medications or if you are using a pain patch without talking to your doctor first.
• This drug may affect the results of some lab tests. Tell all your health care workers and laboratory staff that you are taking this drug.
• Children may have a higher risk of very serious side effects. This risk may be more likely in children with respiratory failure. Some children have experienced life-threatening respiratory problems when using codeine. Consult your doctor.
• If you are 65 years of age or older, use this drug with caution. You may experience more side effects.
• When used during pregnancy, the drug may have a harmful effect on the fetus. If you are pregnant or become pregnant while taking this drug, call your doctor right away.
• Long-term use of this drug during pregnancy may cause withdrawal symptoms in the newborn. This can be life threatening. Consult your doctor.

What side effects should I report to my doctor immediately?

WARNING. In rare cases, this drug can cause serious and sometimes deadly side effects in some patients. Contact your doctor or seek medical attention right away if you have any of the following signs or symptoms that may be associated with serious side effects:

• Signs of an allergic reaction, such as rash, hives, itching, red and swollen skin with blisters or peeling, possibly accompanied by fever, wheezing or wheezing, tightness in the chest or throat, difficulty breathing, swallowing or speaking, unusual hoarseness, swelling in the mouth, face, lips, tongue or throat.
• Severe dizziness or fainting.
• Pain or pressure in the chest or a fast heartbeat.
• Labored, slow or shallow breathing.
• Noisy breathing.
• Strong drowsiness.
• Confusion of consciousness.
• Feeling of abnormal heartbeat.
• Hallucinations (a person sees or hears something that is not in reality).
• Mood changes.
• Seizures.
• Severe pain in the abdomen.
• Strong headache.
• Obstruction of the urinary tract.
• Shiver.
• Vision change.
• Severe nausea or vomiting.
• Severe constipation.
• Feeling extremely tired or weak.

What are some other side effects of this drug?

Any medicine can have side effects. However, for many people, side effects are either minor or non-existent. Talk to your doctor or get medical help if these or any other side effects bother you or don’t go away:

• Dizziness.
• Nervous tension and agitation.
• Insomnia.
• Drowsiness.
• Constipation.
• Nausea or vomiting.
• Excessive sweating.
• Feeling tired or weak.

This list of possible side effects is not exhaustive. If you have any questions about side effects, please contact your doctor. Talk to your doctor about side effects.

You can report side effects to the National Health Board.

You can report side effects to the FDA at 1-800-332-1088. You can also report side effects at https://www.fda.gov/medwatch.

What is the best way to take this drug?

Use this drug as directed by your doctor. Read all the information provided to you. Strictly follow all instructions.

All editions:

• Take with or without food. Take with food if medicine causes nausea.

Liquid:

• Liquid doses should be measured with caution. Use the dispenser that comes with the medication. If the dispenser is not provided in the package, ask the pharmacist for a dosing agent for this drug.

Liquid (suspension):

• Shake well before use.
• Carefully measure liquid doses. Use the measuring container that comes with the medicine.

What if I miss a dose of a drug?

• If you take the drug regularly, take the missed dose as soon as you can.
• If it’s time for your next dose, don’t take the missed dose and then go back to your regular dosing schedule.
• Do not take 2 doses or an additional dose at the same time.
• In most cases, this drug is used as needed. Do not take the drug more often than prescribed by your doctor.

How do I store and/or discard this drug?

• Store at room temperature, protected from light. Store in a dry place. Do not store in the bathroom.
• Keep this medicine in a protected place out of sight and reach of children and out of the reach of other people. A box or room that is locked with a key can act as a secure storage place for the drug. Keep all medicines out of the reach of pets.
• Dispose of unused or expired drugs. Do not empty into a toilet or sewer unless instructed to do so. If you have any questions about disposing of medicines, ask your pharmacist. Drug disposal programs may be in place in your area.

General information about medicines

• If your health does not improve or even worsens, see your doctor.
• Do not give your medicine to anyone and do not take other people’s medicines.
• Some medicines may come with other patient information leaflets. If you have questions about this drug, talk with your doctor, nurse, pharmacist, or other health care professional.
• Some medicines may come with other patient information leaflets. Check with your pharmacist. If you have questions about this drug, talk with your doctor, nurse, pharmacist, or other health care professional.
• If you think you have overdosed, call a poison control center or get medical help right away. Be prepared to tell or show what drug you took, how much, and when it happened.

Consumer Use of Information and Limitation of Liability

This summary information includes a summary of the diagnosis, treatment, and/or drug product. It is not intended to be a comprehensive source of data and should be used as a tool to help the user understand and/or evaluate potential diagnostic and treatment options.