Ativan Dosage Guide

What Is Ativan (Lorazepam) & How Is It Used?

Ativan, containing the active ingredient lorazepam, is a benzodiazepine most often used for the treatment of anxiety.¹ It works by increasing the levels of a chemical called GABA that plays a major role in brain activity. Increasing GABA produces a calming effect on the brain, alleviating symptoms of anxiety. Lorazepam is FDA-approved to treat adults with anxiety, insomnia, and seizures.

Ativan may also be used off-label. This means the medication is being used to treat a disorder not approved by the FDA. A healthcare provider may choose to use a medication off-label if they believe it may still benefit an individual. Off-label uses of Ativan include alcohol withdrawal symptoms, panic disorder, delirium, nausea/vomiting due to chemotherapy, and vertigo.²

Ativan is only available through prescription by a licensed healthcare professional. It is a controlled substance that has a risk of addiction and misuse.

Ativan Forms & Strengths

Ativan is available in several strengths to meet the needs of each individual. It is commonly prescribed in oral tablet form with strengths ranging from 0.5 to 2 mg. Ativan is also available as an injectable medication, typically for hospital use.³ Ativan brands are only available as an immediate-release tablet. However, generic lorazepam is also available as a liquid. Extended-release lorazepam is available under the brand name Loreev XR.⁴

Ativan is available in the following form/s and strengths:¹

• 0.5 mg oral tablet
• 1 mg oral tablet
• 2 mg oral tablet

Always take Ativan as prescribed by your healthcare provider. Ativan is typically taken two or three times per day. If taken for insomnia, the medication is usually taken at bedtime. For Ativan oral tablets, swallow the medication whole with or without food.

What Factors Can Affect Ativan Dosage?

Factors that may affect Ativan dosage include an individual’s unique health factors, which means individual responses will vary. The severity of symptoms does not necessarily correlate with the prescribed dosage of Ativan.

Factors affecting Ativan dosage may include:

• Age
• Condition being treated
• Weight
• Underlying health conditions
• History of medication use
• Potential drug interactions
• Risk of dependency

How to Take Ativan

Ativan tablets should be swallowed whole with or without food. Always take the medication as recommended by your healthcare provider and pharmacist.

Dosages for FDA-Approved Treatments

The dosages for Ativan, an FDA-approved medication, vary by the disorder and the individuals taking them. Ativan may be prescribed to adults for the following conditions as an FDA-approved treatment.

Ativan Dosage for Adults With Anxiety Symptoms

Ativan may be prescribed for adults experiencing symptoms of anxiety disorders or seeking short-term relief from anxiety. The usual dosage range for Ativan is 2-6 mg per day, given in divided doses.

Here is Ativan dosage information for adults with generalized anxiety disorder:¹

• Typical starting dosage: The typical starting dosage for adults with anxiety is 2 to 3 mg per day, split between 2-3 doses per day.
• Dosage increases:  The dosage of Ativan should be increased gradually to avoid adverse effects. The nighttime dosage is usually increased before daytime doses. The doses can be increased by 0.5-1 mg.
• Maximum dosage:  The daily maximum dosage is typically 10 mg.

Ativan Dosage for Adults with Insomnia

Ativan is often used as a treatment for insomnia due to anxiety, and it has also been used for insomnia due to situational stress. The dosage for this is typically 2 to 4 mg taken at bedtime.¹

Ativan Dosage for Adults Before Medical Procedures

Ativan is sometimes prescribed for adults before medical procedures to help alleviate anxiety symptoms and promote relaxation.² This is often given via injection into the muscle or through an IV. If given through a muscular injection, it is typically given 2 hours before surgery. If given through an IV, it is given 15-20 minutes before surgery.

Ativan Dosage for Adults With Status Epilepticus (Life-threatening Seizure)

Ativan is often administered as an emergency treatment for status epilepticus, a life-threatening condition characterized by a prolonged seizure. ² Ativan can work rapidly to stop the seizure and prevent further complications. In these cases, Ativan is given through a muscular or IV injection.

Ativan Dosage for Adults with Alcohol Withdrawal Syndrome or Delirium

Ativan is occasionally used off-label for the management of alcohol withdrawal syndrome and Alcohol Withdrawal Delirium. In these cases, Ativan can be given orally or through muscular or IV injections.

Ativan Dosage Restrictions

Dosage restrictions or adjustments for Ativan may be necessary due to various factors related to a person’s health and medication use. Individuals taking other sedative medications may need adjustments in their dose to avoid severe side effects. Individuals with liver or kidney problems may require a lower dose to reach effectiveness and lower the risk of side effects.

Can Children Take Ativan?

Ativan is approved for use in individuals aged 12 years and older. Its effects on children under 12 years of age have not been studied.

What If I Miss a Dose of Ativan?

If you miss a dose of Ativan, skipping the dose and continuing your regular dosing schedule is typically recommended. You should never take a double dose to make up for a missed one.

*You should never suddenly stop taking your medication. Talk with your healthcare provider if you would like to stop taking your medication. They will help you create a plan to taper (slowly reduce) the medication to reduce the risk of Ativan withdrawal.

Ativan Dosage FAQs

Individuals often have questions regarding Ativan dosage, its uses, and long-term effects. Below are commonly asked questions and answers.

Here are some frequently asked questions about Ativan dosage:

Are There Any Risks to Taking Ativan Long-term?

Ativan can be taken long-term, but the safety and effectiveness of using Ativan for longer than four months is not known. Taking Ativan long-term may also impact the liver and kidneys, and frequent testing to monitor liver and kidney function may be necessary.²

Taking Ativan long-term may increase the risk of tolerance and dependence. Tolerance is when higher doses are required to achieve the same effect. Dependence means the body has become physically dependent on the presence of a substance for normal functioning, which can lead to withdrawal symptoms when a person stops using it.

Can Ativan Be Used for Sleeping Disorders?

Ativan is FDA-approved for the treatment of insomnia associated with anxiety. It may also be used off-label for general insomnia. Its soothing properties help promote relaxation and may help individuals fall asleep.² Ativan should only be used for sleep disorders under the guidance of a healthcare provider.

What’s Considered a Normal Dose of Ativan?

The appropriate dosage of Ativan will vary depending on several factors, including the individual’s age, weight, medical history, and response to treatment. The usual range is 2 to 6 mg daily, with doses taken two to three times daily.¹ The dose can be adjusted gradually based on the person’s response to the medication.

What’s the Maximum Dose of Ativan in 24 Hours?

The maximum dose of Ativan is 10 mg daily.¹ This is taken in doses divided two to three times per day. The higher divided dose is often taken at bedtime to help with sleep.

Is Ativan Safe to Take During Pregnancy?

Taking Ativan late in pregnancy may lead to sedative effects and withdrawal symptoms in newborns.¹ The effects of Ativan on a developing fetus are not fully known. Continuing to take Ativan during pregnancy should be made in consultation with a healthcare professional.

Is Ativan Safe to Take While Breastfeeding?

Ativan is excreted in breast milk, and there are reports of this causing sedation, poor feeding, and poor weight gain in infants.¹ The decision to continue taking Ativan while breastfeeding should be made in consultation with a healthcare professional.

Can You Overdose on Ativan?

You can overdose on Ativan, especially when taken in excessive amounts or in combination with other medications. An overdose occurs when the amount of Ativan taken is more than the body’s ability to eliminate the drug, leading to toxic effects. Overdosing on Ativan may be life-threatening and requires immediate medical attention.

Signs of an overdose on Ativan include:

• Drowsiness
• Coma
• Confusion
• Slowed breathing
• Difficulty speaking
• Decreased muscle tone
• Decreased reflexes

What Should You Do If You Take Too Much Ativan?

Call 9-1-1 if serious Ativan overdose symptoms occur, such as seizures, difficulty breathing, or the inability to be awakened.

Can You Become Addicted to Ativan?

You can become addicted to Ativan and other benzodiazepines if taken improperly or for an extended period of time. Ativan can have a calming effect on the brain, and this may lead to tolerance and dependence on the medication. Because of this, it carries a high risk for addiction.

To decrease the risk of dependency and misuse, healthcare providers often have special protocols when prescribing benzodiazepines like Ativan. This may include limiting how much can be prescribed at one time and requiring regular follow-up visits to monitor for signs of misuse.

For individuals experiencing addiction or withdrawal symptoms, medical detoxification or supervised medical discontinuation may be necessary. This may involve the gradual reduction and discontinuation of Ativan in an inpatient setting under medical supervision to minimize withdrawal symptoms and ensure the safety of the individual.

Questions to Ask Your Healthcare Provider About Ativan Dosage

Individuals with questions about Ativan and Ativan dosage should make an appointment with their healthcare professional. This may include talking with their doctor, psychiatrist, and therapist. Having a list of questions can help individuals prepare for these appointments.

For individuals looking for a new healthcare provider, online psychiatry services are a good option. These convenient services allow individuals to access licensed psychiatrists and therapists from their homes.

Questions to ask your care team about Ativan dosage include:

• How long will it take for me to adjust to taking Ativan?
• Am I at risk for more serious side effects of Ativan if I am already taking other anxiety /depression medications?
• What is the best dosage to ensure fewer side effects?
• Is there anything I should tell my therapist about this new medication?
• How often should I follow up to monitor my progress?
• How long will I need to take Ativan?
• Are there substances I should avoid when taking Ativan?
• What is the recommended dosage for my specific symptoms or condition?