Benzodiazepines are commonly prescribed for treating conditions such as anxiety, insomnia, and seizures in patients.  One of the popular drugs of this category is Lorazepam, in use since FDA approval more than four decades ago.  The drug, available under different brand names is known to be short acting in nature, and is also known to clear swiftly. With sedative and anxiety treating properties it is effective as an anxiolytic, and is also used in the management of seizures. Additionally, the medication is also used to help patients prior to surgeries with powerful sedative effects. Following subsections offer a detailed information, including possible side effects of Ativan. This will help patients and caregivers identify and prevent undesirable after effects of the medication.

Overview of Ativan

As outlined above, Ativan is a brand name prescription drug of Lorazepam, a benzodiazepine. The drug is available as a tablet and also as a solution to be administered either through IV injections or through intramuscular injections. The mechanism of action of the drug is attributed to the binding action on the benzodiazepine receptors in various locations in the CNS, acronym for central nervous system. As a result of this binding action, the medication helps individuals with different outcomes, depending on the site of binding of the drug. For instance, when the binding occurs in the amygdala, patients with anxiety receive desired outcomes. Whereas, when the binding occurs in the cerebral cortex, patients with seizures, receive desired outcomes.

Ideal dosage of the benzodiazepine

One of the most common reasons for possible effects of drugs is incorrect dosage, as excessive dosage is likely to cause undesirable effects. Similarly, when the dosage is less, the desired outcomes may not be achieved. Another commonly reported problem is the attempt by individuals to make up for missed doses by taking a double dose. This typically occurs when the prescribed drug is intended to be taken on a long-term basis. Individuals are likely to miss a dose at some point of the treatment, and on noticing the missed dose, may attempt to take a double dose. This could lead to toxic levels of the drug and may cause undesirable effects.

Here is a compilation of the ideal dosage of medication for different conditions. It is to be borne in mind that this is only a compilation of ideal dosage and is not intended to be reference for the actual dosage. The actual dosage of the drug will be determined by the treating specialist, and will hinge on various factors. For instance, the age of the patient, the condition being treated, the overall health of the patient, presence of other ailments and other medications in use. Therefore, the actual dosage may be different from the ideal dosage outlined below.  The drug is generally started off on a lower strength and this is gradually increased to the desired level, depending on the reported outcomes, and other effects experienced by the patient.

The oral tablets are available in strengths of 0.5 milligrams, 1 milligram and 2 milligrams. The solution is available in strengths of 2 milligrams per milliliter, and 4 milligrams per milliliter. The dosage of the tablets generally recommended to be taken are between 2 milligrams to 6 milligrams every day, and in most instances, the dosage is split into two or three equal doses every day. When prescribed for anxiety the dosage is generally lower, below 2 milligrams daily. When prescribed for insomnia the dosage slightly increases to 4 mg daily. Elderly patients and individuals with specific medical conditions may be prescribed lower doses to prevent undesirable outcomes.

Drug interactions of Ativan

Drugs are known to have interactions, when taken in combination with other medications. This may include medications of the same category or may also be experienced when taken with drugs of different categories. The outcomes of interactions are generally of three different types. The first type of interaction refers to the increase in potency or desired outcome of either of the two drugs that are taken together. The second type of interaction is the decrease in potency or outcomes of either of the two drugs taken together. The third category of interactions refers to the increase in possible side effects of Ativan, where the usual effects may get aggravated due to the interaction.

Here is a short compilation of some of the possible drug interactions of Ativan with other medications. This is neither exhaustive nor complete and is intended to only serve as a broad reference of the categories of drugs that may interact with Ativan. Interactions are not limited to prescription medications, but could also be experienced with OTC medicines, supplements, herbal remedies and alternative medicines.

Patients on the benzodiazepine are not to consume alcohol, as this could trigger various adverse effects including difficulty in breathing and complications such as coma. Categories of drugs that should not be taken with Ativan include opioids, sedatives, medications for gout, and seizure medications, among others. Drug interactions as a result of intake with these medications could include possible drowsiness, difficulty in breathing and possible respiratory complications. Specialists typically prescribe alternative medications wherever possible and when it is necessary that both medications have to be taken, the dosage is altered. Additionally, the intake schedule may also be modified so as to reduce possibility of interaction.

When Ativan is taken alongside herbs and supplements with similar outcomes, there could be adverse reactions. It is therefore necessary to avoid taking the medication with herbs like chamomile, lavender etc.

Commonly reported side effects of Ativan

With all the necessary information about the drug, it is now time to look at the possible undesirable outcomes from the medication. All medicines come with the possibility of undesirable effects. These effects could be either mild in nature, or could be serious in outcomes. The mild or moderate outcomes are typically commonly occurring, and may not require medical intervention. However, the serious effects may require intervention, and in some instances, cold require emergency treatment. There are users who may not experience any kind of side effect whatsoever, and therefore it is wrong to assume that all medications cause effects in all users or patients.

The actual effect may depend on various factors, such as the dosage of the medication, the form of intake or administration, and the frequency of intake. Other factors that determine the effects include the condition being treated, the intensity of the condition, the gender and age of the patient. The overall health of the individual, and the presence of other ailments are also contributing factors to the side effects. Medications in use for existing health conditions may also have an impact on the effects. Here is a compilation of commonly reported and adverse effects of Ativan. This is not complete, and is not exhaustive, but is mainly for the purpose of helping users understand the broad types of effects.

Frequently occurring or reported effects

Effects that have been frequently reported or experienced include drowsy feelings when on the medication. This is relatively common and is actually one of the desired outcomes of the medication at certain strengths. The patient may feel dizzy when on the drug and could also experience fatigue. This is generally temporary in nature and may resolve as the patient uses the medication regularly. Due to the nature of this effects, patients are advised not to take up tasks or responsibilities that require increased alertness or reflexes. Driving and operating heavy machinery or working in hazardous environments is to be avoided as the effects could turn disastrous. Other effects that are not known to be as frequent as this include possible confusion and a lack of coordination. The patient may feel depressed and could experience frequent headaches in addition to feeling tired. Individuals on the medication are known to experience distinct changes in sexual appetite, apart from a possible impact on memory.

Effect on patients on the injection form of Ativan

Patients receiving Ativan as an injection may find the color of the skin changing to a darker or reddish hue. This could be accompanied by pain at the site of the injection. These effects are also temporary in nature and are not a cause for concern. Most individuals who witness a change in skin color may immediately feel insecure, or may be apprehensive of possible serious outcomes. However, this is not a serious effect, and is attributed to the effect of injecting the medicine.

Effects that are serious in nature

Effects that are serious in nature include a reduction in breathing rate, with a clear reduction in breath rate. Respiratory failure is another effect that may be experienced, although this does not commonly occur with all patients. The blood pressure levels of the patient may also reduce, and this could in turn result in possible fainting or the patient may fall without any other reason. Serious effects of Ativan include seizures and convulsions, with clear tell-tale symptoms. Individuals who witness the patient suddenly moving arms or legs are to initiate remedial measures immediately. The individual may lose consciousness and may not be aware of the surroundings or circumstances.

Other effects include a stiffening of the muscles, and the patient may also abnormally end up staring at objects, with a distant look. Certain effects that are the opposite of what is to be expected from the medication may also be experienced.  For instance, the patient is expected to experience sedative effects, and dulled senses, however, the opposite may sometimes be seen. The patient may turn aggressive, and could be either agitated or restless.

Effects due to nature of drug

By virtue of bring a benzodiazepine, the medication is known to cause withdrawal symptoms, and could also be addictive in nature. The possible long-term use of the drug, the effects of the medication combine to create possible addiction. Alternatively, the medication may also be abused, to meet off label outcomes. When taken alongside alcohol, it could cause severe intoxication and could also trigger adverse outcomes. Caregivers are advised to carefully observe the patient and take suitable remedial measures when withdrawal or addictive symptoms are observed. For instance, if there is profuse sweating, or of the patient reports severe body ache, this could indicate possible withdrawal effects. Other symptoms include depression, weakness in the muscles and possible nightmares.

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