Ativan (generic: lorazepam) is a prescription medication used to treat a seizure emergency called status epilepticus. It is also used to help you relax before having surgery. Ativan injection belongs to a group of drugs called benzodiazepines, which slow brain activity to cause relaxation by enhancing the effects of a brain chemical called gamma-aminobutyric acid (GABA).
Ativan comes in tablet, oral liquid and injectable forms. This med page contains information about the injectable form which is injected in either the muscle or the vein.
Common side effects of Ativan include drowsiness, confusion, dizziness, and nausea. Do not drive or use machinery on Ativan. Do not drink alcohol while taking this medication.
Ativan injection is a prescription medication used to treat a seizure emergency called status epilepticus. It is also used to help you relax before having surgery.
This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.
It is very important that you immediately contact your doctor if you develop any of the following symptoms:
- Anaphylactic (severe allergic) reactions
- A serious allergic reaction which causes swelling of your face or throat (angioedema)
- Develop signs of jaundice (yellowing of the skin or the whites of the eyes)
- Difficulty breathing
- Thoughts of harming or killing yourself
- Changes in your mental state
Tell your doctor or pharmacist if you develop any of the following side effects:
- Confusion, depression, unmasking of depression
- Lack of muscle coordination
- Muscle weakness
- Lack of energy
- Changes in sex drive, impotence, decreased orgasm.
The following side effects have also been reported with this class of medicine:
- Blood disorders which can include lower levels of red blood cells, white blood cells and platelets (known as blood dyscrasias). Symptoms of this include unexplained bruising, bleeding, pale skin, weakness and/or breathlessness, mouth ulcers and/or frequent infections.
- Abnormally concentrated urine
- Low levels of sodium in the blood
- Loss of inhibitions, euphoria, thoughts or attempts of suicide
- Anxiety, agitation, excitation, hostility, aggression, rage, sleep disturbances/insomnia, sexual arousal, and hallucinations
- Involuntary trembling, vertigo, visual disturbances (including double vision and blurred vision), slurred speech, headache, vomiting, convulsions/seizures, memory loss, coma
- Low blood pressure
- Reduced breathing rate, shortness of breath, temporary cessation of breathing, including during sleep
- Worsening of chronic obstructive lung disease
- Increase in specific liver enzymes (bilirubin, liver transaminases and alkaline phosphatase)
- Allergic skin reactions, hair loss
If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor.
- You should tell your doctor or pharmacist if you are taking any other medicines, including those which have not been prescribed by a doctor, since they may affect the way Ativan Injection works. Ativan Injection may also affect the way other drugs work.
- In particular, you should tell your doctor if you are taking any other sedative, anti-anxiety drugs, antidepressants, strong pain killers (eg methadone), drugs for epilepsy, antihistamines, drugs for mood or mental disorders (eg chlorpromazine, clozapine and haloperidol), drugs for respiratory diseases, drugs for gout (probenecid). The dose of these drugs may need to be reduced before you can take Ativan Injection.
- You should also tell your doctor if you are taking a drug called scopolamine, which may be used for gut problems or before an operation.
You should not receive Ativan Injection if:
- You have severe breathing or chest problems.
- You are allergic to benzodiazepines or any of the ingredients in Ativan Injection.
- You have myasthenia gravis (a disease causing weakened muscles and excessive tiredness).
- You have serious liver problems.
- You suffer from sleep apnoea (breathing problems when you are asleep).
- If you are an out-patient you should not be given Ativan Injection unless you have somebody to take you home.
- Ativan Injection contains benzyl alcohol and should not be used in infants or young children up to 3 years old.
You should avoid alcohol for at least 24 to 48 hours after receiving Ativan Injection. Do not drive or use machinery within 24 to 48 hours of receiving Ativan Injection. Some people feel sleepy or dizzy during the day when taking Ativan Injection.
Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of Ativan Injection there are no specific foods that you must exclude from your diet when receiving Ativan Injection.
Tell your doctor or pharmacist if:
- You are pregnant or trying to become pregnant.
- You are breastfeeding, since Ativan Injection may pass into breast milk.
- You abuse or have in the past abused drugs or alcohol.
- You have a personality disorder. If so, you have a greater chance of becoming dependent on Ativan.
- You have any kidney or liver problems.
- You have suffered from depression in the past since it could re-occur during treatment with Ativan.
- You are currently suffering from depression, since lorazepam may increase any suicidal feelings, which you may have.
- You suffer from breathing problems.
- You suffer from an eye problem called glaucoma.
- You enter hospital for treatment.
If you are pregnant or might become pregnant do not take this medicine without consulting your doctor first. Benzodiazepines, including Ativan Injection, may harm your unborn baby if taken during early pregnancy. If you take this medicine during late pregnancy or during labor, your baby, when born, may be less active than other babies, have a low body temperature, be floppy or have breathing or feeding difficulties for a while. Your baby’s response to the cold might be temporarily impaired also. If this medicine is taken regularly in late pregnancy, your baby may develop withdrawal symptoms after birth.
Tell your doctor if you are breastfeeding or are planning to breastfeed. It is not known if Ativan Injection will harm your baby.
To help withdrawal of solution from the ampule of Ativan Injection, 1 mL of sterile water for injection or normal saline for injection may be added to the ampule immediately before injection. For intramuscular administration, inject deeply into the upper outer quadrant of the gluteal region with a 21 gauge needle. For intravenous administration, inject with a 21-23 gauge needle. Ativan Injection should not be injected intra-arterially.
- Before an operation or investigation, you will usually be given 0.05 mg of Ativan Injection for each kilogram that you weigh (e.g. if you weigh 70 kilograms you will receive 3.5 mg of Ativan Injection).
- For anxiety or excitement, the usual dose is 0.025 to 0.03 mg for each kilogram that you weigh (e.g. if you weigh 70 kilograms you will probably receive 1.75 to 2.1 mg of Ativan Injection).
- When Ativan Injection is used to control convulsions a dose of 4 mg is usually given intravenously to adults. A lower dose of 2 mg given intravenously is usually given to control convulsions in children.
- Your doctor may prescribe a different dose or length of treatment, especially if you are elderly.
- Some people feel sleepy after receiving Ativan Injection. Therefore, you may need to stay in hospital for at least 8 hours, or overnight, after receiving your injection. If you are to leave hospital shortly after receiving Ativan Injection you should have someone with you.
- Ativan Injection is usually only prescribed for one or two doses, or for a short course of treatment. This reduces the risk of becoming dependent on Ativan Injection, or suffering unpleasant effects when you stop taking it.
Symptoms of overdose include sleepiness, confusion, coma, respiratory and cardiovascular depression, and hypotension. Emergency medical treatment is required.
Each mL of Ativan Inection contains 4 mg lorazepam (active ingredient), with 80% propylene glycol, 18% polyethylene glycol and 2% benzyl alcohol.
- Ativan Injection is supplied in small clear glass bottles (called ampoules) and each ampoule contains 1 ml of Ativan Injection.
- Ativan Injection is supplied in packs of 10 ampoules.
- Ativan Injection should be stored and transported under refrigeration.
- Keep ampule in the outer carton to protect from light.
- Keep out of the reach and sight of children.
- Do not use Ativan Injection after the expiration date, which is stated on the carton. The expiration date refers to the last day of that month.