Lorazepam, which is also known by its brand name Ativan, is a benzodiazepine drug commonly taken to treat conditions like anxiety and insomnia. Different factors can affect the prescribed dosage of lorazepam, including why you’re taking it, your age, other health conditions, and how well you tolerate the treatment.

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How Do You Take Lorazepam?

Lorazepam comes in the following tablet strengths:   

• 0.5 milligrams (mg)
• 1 mg
• 2 mg

It is also available in medical settings as an oral solution (liquid) and as an injection, either intravenously (into the vein) or intramuscularly (into the muscle).

The starting dose of lorazepam depends on several factors, such as the condition treated, your age, and your overall health.

For oral forms (taken by mouth), the typical dosage ranges between 2 and 6 milligrams (mg) daily, often divided into separate doses. However, dosages may actually vary from 1 to 10 mg per day. Your response and how well you tolerate the medication can influence whether your healthcare provider increases or decreases your dose.

Proper Dosage Based on Your Condition

The following are recommended dosages based on condition:

• Anxiety: For anxiety, a typical dose range is 2 to 6 mg per day, divided into two to three doses to provide relief throughout the day.
• Insomnia (trouble sleeping): For insomnia, a typical dose range is 2 to 4 mg taken at bedtime.
• Anxiety before a procedure: The dosing of lorazepam before a procedure varies from person to person and depends on the form given. If given intravenously (into the vein), you’d receive it about 15 to 20 minutes before surgery. When given intramuscularly (injection into the muscle), you’ll take it about two hours beforehand.
• Status epilepticus (prolonged or repetitive seizures): A healthcare provider will give an IV dose of 4 mg of lorazepam, followed by another dose if seizures continue.

Who Needs a Different Dose?

Certain groups may need special dosing in order to take lorazepam safely, including:

• Older adults (65 and older): For older adults, a starting dose of 1 to 2 mg per day in divided doses is recommended. This is because older adults can be more sensitive to the sedative effects of lorazepam. Dose increases should happen slowly and gradually as tolerated to minimize side effects.
• People with liver dysfunction: Lorazepam is a preferred benzodiazepine for those with liver dysfunction because the liver does not break it down as extensively as it breaks down others. However, lorazepam can still build up in those with severe liver problems. The recommended starting dose is half a normal dose that you then gradually increase based on response and how well you tolerate the medication.
• Children: The U.S. Food and Drug Administration (FDA) has not approved lorazepam for use in children 12 years or younger, although it may sometimes be prescribed off-label (for a non-FDA-approved use). Adolescents ages 12 to 18 may need a lower initial dosage, depending on why they’re taking it.

Tips for Taking Your Dose  

To get the most benefit from taking lorazepam while minimizing risks, keep the following in mind:

• Follow your prescription exactly: Take your medication exactly as instructed by your healthcare provider. Do not try to increase or decrease your dosage on your own.
• Don’t double up on doses: If you miss a dose, take it as soon as you remember, unless it is close to your next scheduled dose. Do not take extra doses to make up for a missed dose.
• Don’t stop taking it suddenly: Avoid stopping your treatment suddenly. Talk to your healthcare provider first if you’re having trouble with your medication.
• Take it with or without food: You can take lorazepam without regard to meals.

Warnings and Precautions

Though lorazepam is safe when taken properly, there are important safety warnings and precautions to know before taking it:

• Long-term use can lead to dependence: Long-term use of lorazepam may lead to physical dependence on the medication and difficulty concentrating and thinking.
• Avoid driving or using heavy machinery: You should not drive or operate heavy machinery until you know the full effects of this medication on you.
• Be cautious with drug interactions: Lorazepam can interact with other medications that cause sleepiness (e.g., opioids, sedatives, and antihistamines), tricyclic antidepressants (e.g., amitriptyline), and alcohol.

You should also not take lorazepam if you have certain conditions, including
acute narrow-angle glaucoma (a severe eye condition) or an allergy to benzodiazepines or any ingredients in the formulation.

Side Effects

Common side effects of lorazepam include:

• Sedation
• Unsteadiness
• Weakness
• Dizziness

  Severe but rare side effects that can occur with high doses include:

What to Do if You Take Too Much

Taking too much lorazepam can be dangerous and potentially fatal. Signs and symptoms of a lorazepam overdose include but are not limited to:

• Excessive sedation
• Slowed breathing
• Mental confusion
• Difficulty keeping steady

Key Takeaways

• Your lorazepam dosage can depend on factors such as age, medical condition, liver function, and response to treatment. Doses may range from 1 to 10 mg per day, with lower starting doses recommended for older adults and those with liver issues.
• For safety, adhere to your prescribed dosage and do not adjust your dose on your own.
• Lorazepam carries serious risks, especially with long-term or improper use. These include dependence, drowsiness, dangerous interactions with other sedatives, and potentially life-threatening overdose.