Ativan Drug Interactions

by on May 7, 2012

Ativan can work differently when taken along with other drugs, medications or herbal products. Concurrent use of drugs that are known to cause interactions with Ativan increases your risk for developing adverse effects.

Inform your healthcare provider if you are taking other medications.  Here are some drugs that are known to interact with Ativan:

Anticonvulsant and seizure medications

  • divalproex sodium (Depakote, Depakote ER)
  • valproic acid (Depakene)
  • lamotrigine (Lamictal)

ACE Inhibitors

  • Lisinopril

Antidepressant medications

  • amitriptyline (Elavil, Etrafon)
  • citalopram (Celexa)
  • duloxetine (Cymbalta)
  • escitalopram (Lexapro)
  • fluoxetine (Prozac)
  • paroxetine (Paxil)
  • sertraline (Zoloft)

Antihistamine medications

  • diphenhydramine (Benadryl, Tylenol PM)

Antipsychotic medications, such as:  

  • aripiprazole (Abilify)
  • chlorpromazine (Thorazine)
  • haloperidol (Haldol)
  • loxapine (Loxitane)
  • olanzapine (Zyprexa, Symbyax)
  • quetiapine (Seroquel)
  • risperidone (Risperdal)
  • ziprasidone (Geodon)

Narcotics or opiates, such as

  • morphine, oxycodone (OxyContin)
  • hydrocodone (Lortab, Vicodin)

Sedatives particularly barbiturates, including:  

  • amobarbital (Amytal)
  • butalbital (Fioricet, Fiorinal)
  • pentobarbital (Nembutal)
  • phenobarbital (Luminal)
  • secobarbital (Seconal)

Sleep medications

  • zolpidem (Ambien)

Muscle relaxants

  • cyclobenzaprine (Flexeril)

Other benzodiazepines, including:

  • alprazolam (Xanax)
  • chlordiazepoxide (Librium)
  • clobazam (Onfi)
  • clonazepam (Klonopin)
  • clorazepate (Tranxene)
  • diazepam (Valium)
  • estazolam (ProSom)
  • flurazepam (Dalmane)
  • Midazolam (Versed)
  • temazepam (Restoril)
  • triazolam (Halcion)

Diuretics (water pills)

  • furosemide (Lasix)

In general, Ativan and other drugs belonging to the benzodiazepine class of medications interact with other central nervous system (CNS) depressants such as antipsychotics, anti-anxiety, anticonvulsants, antihistamines, antidepressants, barbiturates, narcotic analgesics and tranquilizers. These medications slow down brain activity thereby potentiating the CNS depressant effect of Ativan. It can result in serious side effects such as confusion, drowsiness, difficulty breathing and memory loss.

Patients taking clozapine while on Ativan may experience severe symptoms of CNS depression that include excessive salivation, low blood pressure, lightheadedness, loss of coordination, marked sedation, and even delirium and difficulty breathing (respiratory arrest).

When taken in conjunction with valproate, Ativan clearance is substantially reduced which can lead to increased plasma concentrations. Patients taking valproate should be given lower dose of lorazepam, usually half the usual dose.

Concurrent use of Ativan and probenecid results in a more rapid onset and prolonged effect of lorazepam. This is due to the increased half-life and decreased excretion of the drug. Patients taking probenecid should be given lower dose of lorazepam, usually half the usual dose.

It is thought that valproate and probenecid interferes with the metabolism of this, a process called glucuronidation.

On the other hand, drugs for asthma particularly aminophylline and theophylline reduce the desired effects of Ativan.

Make sure that you discuss with your healthcare provider the possible drug interactions that apply to you. Furthermore, avoid taking medications (both prescription and over-the-counter medications) while taking Ativan.