ATIVAN

Ativan Generic Name & Formulations

Legal Class

CIV

General Description

Lorazepam 0.5mg, 1mg+, 2mg+; tabs; +scored.

Pharmacological Class

Benzodiazepine.

How Supplied

Tabs 0.5mg, 2mg—100; 1mg—100, 1000

Manufacturer

Bausch Health Companies Inc.

Generic Availability

YES

Mechanism of Action

Lorazepam has a tranquilizing action on the central nervous system (CNS) with no appreciable effect on the respiratory or cardiovascular systems.

Ativan Indications

Indications

Anxiety.

Ativan Dosage and Administration

Adult

Give in 2 or 3 divided doses, with largest dose taken at bedtime. Individualize. Initially 2–3mg daily; range: 1–10mg daily. Elderly or debilitated: initially 1–2mg daily; adjust gradually if needed.

Children

Not established.

Ativan Contraindications

Contraindications

Acute narrow-angle glaucoma.

Ativan Boxed Warnings

Boxed Warning

Risks from concomitant use with opioids. Abuse, misuse, and addiction. Dependence and withdrawal reactions.

Ativan Warnings/Precautions

Warnings/Precautions

Increased risk of drug-related mortality from concomitant use with opioids. Therapy for >4 months. Discontinue if paradoxical reactions occur. Primary depressive disorder or psychosis: not recommended. Suicidal tendencies (monitor). Renal or hepatic impairment. Compromised respiratory function. Seizure disorder. Reevaluate periodically. Monitor blood counts, liver function with long-term use. Assess patient's risk for abuse, misuse, addiction prior to and during therapy. Avoid abrupt cessation. Change dose gradually. Drug or alcohol abuse. Elderly. Debilitated. Neonatal sedation and withdrawal syndrome; monitor neonates exposed during pregnancy or labor. Pregnancy (esp. late stage). Nursing mothers: monitor infants.

Ativan Pharmacokinetics

Absorption

Absolute bioavailability: 90%. Peak concentrations in plasma occur in ~2 hours. Peak plasma level (from a 2mg dose): ~20 ng/mL.

Distribution

Plasma protein bound: ~85%.

Metabolism

Hepatic.

Elimination

Renal. Half-life: ~12 hours.

Ativan Interactions

Interactions

Increased sedation, respiratory depression, coma, and death with concomitant opioids; reserve use in those for whom alternative treatment options are inadequate; if needed, limit dosages/durations to minimum and monitor. Potentiates CNS depression with alcohol, other CNS depressants (eg, barbiturates, antipsychotics, sedatives/hypnotics, anxiolytics, others). Caution with clozapine. May be potentiated by probenecid or valproate (reduce lorazepam dose by 50%). May be antagonized by theophylline, aminophylline.

Ativan Adverse Reactions

Adverse Reactions

CNS depression (esp. sedation), dizziness, weakness, unsteadiness, transient memory impairment, confusion, disorientation, nausea, change in appetite, headache, sleep apnea; withdrawal reactions.

Ativan Clinical Trials

See Literature

Ativan Note

Not Applicable

Ativan Patient Counseling