Lorazepam

Do not drink alcohol while taking lorazepam

• If you drink alcohol, do not drink alcohol while taking lorazepam because having the two together might make you very sleepy.
• Taking alcohol and lorazepam together could also affect your breathing.
• If you need to drive a car or ride a bike, or use machines at work, taking alcohol and lorazepam together could be dangerous to yourself and other people.

Do not drive a car or ride a bike just after you start taking lorazepam

• Taking lorazepam may make you feel dizzy, sleepy or forgetful, and you may find it difficult to concentrate.
• It may also cause blurred vision and muscle weakness.
• This could affect you if you drive a car, ride a bike, or do anything else that needs a lot of focus.
• If you are not sleeping well, this could also make driving dangerous for yourself and other people.
• It might be best to stop doing these things for the first few days, until you know how it affects you.

• There is a new ‘drug driving’ offence coming into force in summer 2014 where someone driving dangerously, who has taken lorazepam, could be arrested.
• It is important to stick to the dose on the prescription, and to check that you can drive safely while taking it.

Try not to take lorazepam for the first time just before your exams

• You may feel forgetful, very sleepy, and find it difficult to concentrate, when you start taking lorazepam.
• You should talk to your doctor about any future exams if you are starting lorazepam.
• You might decide together to delay starting it until you have done them.
• If they are more than a few days away, however, you might find that it is better to start lorazepam to improve your sleep and your ability to study.
• Try not to drink caffeine drinks to stay awake for exam revision – they stop the lorazepam working.

Lorazepam can make it hard to concentrate 

• Lorazepam might make you forgetful, and make it difficult to concentrate.
• After the first few days you will know how it affects you.

Lorazepam is not a banned substance in sport, but it may affect your ability to do sport needing a lot of focus

• Lorazepam is not a banned substance in sport.
• Lorazepam has many side-effects, however, that might make you less able to take part in sports that need a lot of focus.
• These side-effects include feeling sleepy, blurred eyesight, being forgetful, muscle weakness and finding it difficult to concentrate.
• The good effects of lorazepam may have a good effect on your sporting performance as your symptoms settle, and you sleep better.

Lorazepam does not usually affect your weight

• Lorazepam has not been shown to affect weight in most people.
• It can affect the appetite, but this is rare (happens in up to 1 in 10,000 people).
• Talk to your doctor about this if it worries you.

Lorazepam may make you feel very sleepy, but may also make it hard to get to sleep

• Lorazepam is used to help people who cannot sleep, so you would expect it to make you feel sleepy.
• Lorazepam can, however, make people feel sleepy during the day.
• If lorazepam makes it more difficult for you to get to sleep, or gives you strange nightmares, you should go back to your doctor as soon as possible.

Let your family and friends know you are taking lorazepam so they can support you and help you look out for side effects

• The side-effects of lorazepam might put a strain on your friendships and relationships, especially in the first few days of taking it.
• It can cause confusion, and can bring on a low mood, or make you feel ‘numb’ to your normal emotions. If you get these side effects, you should see your doctor.
• It can also make you feel irritable, restless, or angry and looking for a fight. If you get these side effects, you should see your doctor.
• Many side effects of lorazepam get better after a few days. If the side effects don’t get better, then see your doctor.
• The good effects of lorazepam will help improve your relationships.
• It might actually be a great idea to choose a good friend to tell about your medicine when you start taking it. (Or - even better - to take one with you to the doctor before you start taking it!)
• They could look at the medicine leaflet, or at this website.
• They could help you to understand whether the medicine changes your behaviour, or gives you side-effects (sometimes it is hard for us to see it ourselves).

Lorazepam can have side-effects that might affect your sex life

The good effects of lorazepam may have a good effect on your sex life as your symptoms settle, you sleep better, and you can concentrate on your relationships.

There are some side-effects that include:

• Losing interest in sex, or sometimes feeling more like having sex
• Feeling ‘numb’ to your normal emotions
• Feeling less inhibited about sex
• Finding it difficult to come (orgasm)
• For men, finding it difficult to get an erection

These effects should pass after the first couple of weeks. If they do not, and this is a problem for you, go back to the doctor and see what else you could try.

Lorazepam is not thought to affect fertility

• There is no evidence that lorazepam affects the fertility of men or women.
• If you want to get pregnant, however, you should not take lorazepam (please see more information below).

Is it safe to take lorazepam during pregnancy?

• Lorazepam can affect the developing baby, and cause symptoms in a newborn baby.
• For this reason, it is usually recommended to avoid taking lorazepam during pregnancy.
• However, the risks to the developing baby from taking lorazepam will need to be weighed up against the risks of not taking lorazepam to your mental health.
• If you take lorazepam and are considering becoming pregnant, or discover that you are pregnant, you should speak to your doctor. The doctor will help you to weigh up your options.
• If you and your doctor decide that you need to take lorazepam during the pregnancy, then this will be at the lowest dose that works for you and for the shortest period of time that is necessary. This is to minimise the amount of lorazepam that the developing baby is exposed to.
• If you are taking lorazepam in the last three months of pregnancy, you should tell your midwife and doctor so that they can look out for symptoms in the newborn baby.
• Your baby 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 affected for a while.
• Your baby may develop withdrawal symptoms after birth.

Is it safe to take lorazepam when breastfeeding?

• Lorazepam is passed to the baby in breast milk.
• It can make the baby sleepy and unable to feed.
• If you have to take lorazepam, bottle feeding with formula may be better.
• If you are planning on breastfeeding your newborn baby, you should discuss your medicines with the doctor.
• It is important that you remain well whilst you are bonding with your newborn baby.
• For this reason, you may need to keep taking some medicines on your doctor’s advice.
• With some medicines, such as lorazepam, this will mean that bottle feeding with formula milk is recommended instead of breastfeeding.

If you start or stop smoking while you are taking lorazepam, you may have to change your dose

• Cigarette smoke affects the amount of lorazepam in your body.
• If you smoke, you will probably need a higher dose of lorazepam than someone who does not smoke.
• Tell your doctor if you smoke, so that you get the right dose for you.
• If you stop smoking, the body lorazepam level rises and you might need to reduce your dose of lorazepam slowly over one week
• If you (re)start smoking, you will probably need to increase it again
• Go to your doctor for advice if you stop or start smoking.

Try not to drink caffeine drinks while you are taking lorazepam

• Caffeine has the opposite effect of lorazepam in your body, and stops it working.
• Try not to drink caffeine drinks (like coffee, cola or energy drinks) while you are taking lorazepam.
• Caffeine can cause anxiety and sleep loss – stopping these drinks might help to improve your symptoms.

You could become more uninhibited while taking lorazepam, and this might cause problems in your relationships

• A side-effect that can happen with lorazepam is called disinhibition.
• It means that someone might forget the normal way we act in society, and become very impulsive.
• You might become less inhibited about sex, and more likely to do it when you do not really want to.
• This happened more with young people than in adults in tests.
• If you have a good friend or family member to talk to, ask them to watch out for this for you.

Reference sources

• Genus lorazepam 1mg tablet SPC last updated 5/9/16
  http://www.medicines.org.uk/emc/medicine/26011 Accessed 17/1/17
• Genus lorazepam tablets PIL last updated 24/10/16
  http://www.medicines.org.uk/emc/medicine/23794 Accessed 17/1/17
• Taylor D, Paton C, Kapur S. Maudsley Prescribing Guidelines in Psychiatry, 12th edition. Oxford: John Wiley & Sons, 2015
• British National Formulary (BNF) 72nd edition. London: BMJ Group / Pharmaceutical Press, 2016
• British National Formulary for Children (BNFc) 2016-2017. London: BMJ Group / Pharmaceutical Press, 2016
• WADA Prohibited List 2014. Available at http://www.wada-ama.org/Documents/World_Anti-Doping_Program/WADP-Prohibited-list/2014/WADA-prohibited-list-2014-EN.pdf
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• Royal Pharmaceutical Society of Great Britain. Medicines Ethics and Practice (37th edition). London: RPS, 2013
• www.choiceandmedication.org (accessed 30/10/2016; content usually available for free via your mental health trust)