Lorazepam

Please do not be worried by the side effects listed on this page. Many people take lorazepam without any side effects or only a few mild side effects. If you think you might be getting a side effect from lorazepam, then you should discuss this with your doctor, nurse, or pharmacist.

Lorazepam can be used for a number of conditions

• Anxiety
• Insomnia
• To help to reduce the side-effects of antidepressant medicines when you start them.

If you have any thoughts of suicide, or of other ways of hurting yourself, go straight to a hospital with your tablets.

This may be a side-effect, and you need urgent help.

Lorazepam can make some people think about hurting themselves or have suicidal thoughts.

You must go straight to hospital with your tablets if you have any of these thoughts. You must tell the doctor that you are taking lorazepam. There are other things you can take instead.

You should take lorazepam as agreed with your doctor

• Make sure that you know your dose. If it is not written on the label, check it with your pharmacist or doctor.
• You may have to take it a few times each day.
• If you are taking it to help you sleep, you should take it an hour before bedtime.
• Choose a time to take it that you can remember. This could be a mealtime, or when you brush your teeth.
• You can take it before or after food.
• Swallow the tablet with a drink of water - if you chew it, it tastes bitter.
• Avoid eating grapefruit or drinking grapefruit juice if you are taking lorazepam because this can increase the effect of the lorazepam.
• Avoid drinks containing caffeine (like coffee or cola) if you are taking lorazepam because this can decrease the effect of the lorazepam.

If you forget to take a dose then just take it as soon as possible

What to do if you miss a dose:

• If you remember later during the day, take it as soon as possible.
• If you forget to take it by more than 3 hours after you would normally take it, just start again on the next day.
• If you take it for sleeping, you must allow yourself 7-8 hours sleep after taking it, so – for example – do not take it if you have only got 5 hours left to sleep.
• Do not take a double dose.

 What might happen?

• If you forget to take your tablets for a few days, you may start getting your old symptoms back. This means that you should talk to your doctor about it.

You must go to A&E if you take too much 

What to do if you take too much:

• If you have taken more lorazepam than it said on the label, you must get help quickly – even if you do not feel any different.
• Go to A&E. Take your medicine with you, to show to the doctors. Tell them how much you have taken.
• Get a friend or family member to go with you, if you can, just in case you feel ill on the way.
• You might feel tired or confused, get strange movements of your eyes, or have problems with your balance, co-ordination or speech.
• Your breathing might get very slow, and you could fall into a coma.
•  If you have taken lorazepam with other drugs, including alcohol, you could get more serious side-effects. You must get help quickly.
• Tell the doctors everything you have taken, so they can help you.

It only takes a few hours for lorazepam to start helping

• Lorazepam starts to work very quickly in your body
• You should get the calming effects from lorazepam in a few hours

It is not recommended to take lorazepam for more than four weeks at a time

You and your doctor should talk about how long you need to take lorazepam.

• You will get the effects within a few hours of taking it
• People can become dependent on the effects of lorazepam if they take it for more than a month, and then when they stop they get withdrawal symptoms
• If you take lorazepam for anxiety or sleeping you will probably take it for 2-4 weeks, to get you into a new routine, and then stop it so that you do not get withdrawal symptoms.

Tell your doctor or pharmacist before you take lorazepam if you have any of these conditions

You need to talk to your doctor or pharmacist if any of the following apply to you:

• if you have severe breathing or chest problems
• if you are allergic to benzodiazepines or any of the other ingredients in lorazepam Tablets
• if you have myasthenia gravis (very weak or tired muscles)
• if you have serious liver problems
• if you have sleep apnoea (breathing problems when you are asleep)
• if you are breast-feeding, since the drug may pass into breast milk
• if you are planning a pregnancy or are pregnant
• if you have ever misused drugs or alcohol
• if you have a personality disorder (you have a greater chance of becoming dependent on lorazepam)
• if you have any kidney or liver problems
• if you have depression, as lorazepam may increase any feelings of hurting or killing yourself
• if you have had depression before (it could come back during treatment with lorazepam)
• if you have an eye problem called glaucoma (high pressure within the eye)

Lorazepam has some rare but serious side effects. If you get these, then you will need help from a doctor

Go to a doctor straight away if you get any of the following symptoms:

• Thoughts of harming yourself or suicidal thoughts
• Impaired consciousness (which could lead to coma)
• Breathing difficulties
• Confusion, numbed emotions
• Low mood (depression)
• Restlessness, agitation, irritability, aggressiveness, violent anger, hallucinations, personality changes
• Sleeping difficulties, nightmares
• Sexual arousal, abnormal behaviour, or false beliefs
• Unexplained bleeding and/or bruising
• Increased risk of infections e.g. frequent sore throats, mouth ulcers, weakness and pale skin
• Difficulty in breathing, swelling of the lips, mouth, tongue, throat, hands, feet and /or severe faintness or dizziness as this may be an allergic reaction
• Symptoms of jaundice like yellowing of the skin, eyes, nose, mouth, pale coloured poo (faeces) and dark coloured urine.
• Skin problems such as rashes and inflammation.

Some other side-effects that do appear should get better after a few days.

If they do not, you should go back to your doctor

Some side-effects of lorazepam may – strangely – seem like symptoms of other mental health symptoms. Some side-effects here are also the opposites of each other. The balance of chemicals in the brain is very fragile, and hard to control! If they do not get better after a few days on the tablets, go back to the doctor.

• daytime drowsiness, tiredness, sleep problems
• dizziness , feeling less alert, headache
• poor muscle control, muscle weakness
• a feeling of well-being for no reason
• appetite changes
• changes in sex drive, less likely to have an orgasm, difficulty getting an erection
• slurred speech
• memory loss or forgetfulness
• trembling or shaking
• problems with vision including double vision or blurred vision
• stomach upsets, feeling sick, constipation (hard to poo)
• changes in the amount of saliva in the mouth

Do not stop taking the tablets until you talk to your doctor, or you may get withdrawal symptoms as well.

Lorazepam does not mix well with some other medicines and drugs 

Lorazepam may affect the way other drugs work. Tell your doctor if you are taking any of the following medicines:

• any other sedative (like barbiturates)
• other anti-anxiety medicines or antidepressants
• strong pain killers (like methadone)
• medicines for epilepsy (like phenobarbital or valproate)
• antihistamines (which may be bought over the counter for hayfever)
• medicines for mood or mental health, or to treat delusions or hallucinations (like chlorpromazine, loxapine or clozapine)
• medicines for cataplexy (muscle weakness brought on by strong emotions)
• medicines to treat HIV / AIDS
• medicines to help with indigestion (like cisapride or omeprazole)
• muscle relaxants (like baclofen and tizanidine)
• medicines for addiction treatment (like lofexidine and disulfram)
• TB medicines like isoniazid
• antibiotics like erythromycin
• medicines to treat high blood pressure
• medicines to treat Parkinson's disease (like levodopa)
• oestrogen-containing contraceptives
• medicines for asthma (like theophylline).

The dose of these drugs may need to be reduced before you can take lorazepam.

You have to be most careful when you are starting or stopping any of these medicines.

Always talk to the doctor if you are taking other medicines.

Tell the pharmacist you are taking lorazepam if you buy medicines (including things you put on your skin) for common illnesses.

You may need to change your dose of lorazepam if you stop or start smoking

• Cigarette smoke makes your liver break down lorazepam faster than normal.
• 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 level of lorazepam in your body rises and you might need to reduce your dose of lorazepam slowly over one week. Discuss this with your doctor.
• 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.

Lorazepam does not mix well with drugs 

• It is very easy, and serious, to overdose with any combination of lorazepam and drugs.
• Using cannabis with lorazepam will make its sedative effect worse. You could go into a very deep sleep where you do not breathe properly and have difficulty waking up.
• Using heroin or methadone with lorazepam will increase their combined sedative effects. You could go into a very deep sleep where you do not breathe properly and have difficulty waking up.
• Methadone levels in your body might increase when mixed with lorazepam.
• Using cocaine or other stimulants (like ecstasy, amphetamines, MDA, 6-APB) with lorazepam can lead to over-sedation.

Stopping lorazepam quickly may cause withdrawal symptoms

You can stop taking it safely with your doctor’s help

Do not stop taking lorazepam all at once. This could lead to serious symptoms, including:

• loss of the sense of reality, feeling unreal or detached from life, and unable to feel emotion, hallucinations
• numbness or tingling of the arms or legs
• tinnitus (ringing sounds in the ears)
• oversensitivity to light, sound and touch
• uncontrolled or overactive movements
• twitching, shaking
• feeling sick, being sick, stomach upsets or stomach pain
• loss of appetite
• agitation, panic attacks
• fast heartbeats
• dizziness or feeling that you are about to fall
• memory loss
• feeling stiff and unable to move easily
• feeling very warm
•  having fits (more likely in people who have epilepsy or who take antidepressants)

Your doctor will help you to reduce lorazepam slowly over a few days at the end of your treatment. Even when you do this, you may get some symptoms:

• headaches
• muscle pain
• anxiety, tension, depression, restlessness, irritability or confusion
• sweating
• Your original sleeplessness may also return

If you suffer from any of these symptoms, go back to your doctor for advice.

Reference sources

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• Genus lorazepam tablets PIL last updated 7/2/12
  http://www.medicines.org.uk/emc/medicine/23794/PIL/Lorazepam+1mg+and+2.5mg+Tablets/ Accessed 13/2/14
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