thoughtscape NP Psychiatry · Patient education
Lorazepam
Ativan / Loreev XR
Fast relief can be useful when anxiety is overwhelming. Know your formulation, dose limits, and review plan.
Draft for review · Clinical content has not been revalidated for this website.
Use only your prescribed schedule. Do not add doses, change formulations, or share medicine.
What it is used for
IR tablets treat anxiety, sometimes briefly while a longer-term treatment starts. Your team may prescribe them for another specific reason.
Loreev XR is for adults already stable on equal IR doses three times daily. Injection uses differ; oral doses are not a seizure-rescue plan.
How it works
It strengthens GABA, a calming brain signal. IR tablets often begin helping within about an hour, but effects vary. XR is not an immediate rescue medicine.
The same action can slow thinking, memory, balance, and breathing. Your body can adapt with regular use, so sudden stopping can cause serious withdrawal.
What to expect over time
FIRST DOSES
Watch for sleepiness, fogginess, or poor balance.
FIRST FEW WEEKS
Review relief, alertness, and how often you use it.
EACH RENEWAL
Revisit the need for treatment and the stop plan.
Taking your medication
Use IR only as prescribed: scheduled or as needed. Take XR each morning, with or without food. Never crush or chew XR or its contents.
If told to open XR, swallow all contents on a tablespoon of applesauce within two hours, without chewing; drink water. Do not divide or save the contents.
Never stop regular use suddenly. Get a written taper and call before running out. For liquid, use the pharmacy measuring device and mixing directions.
When to get help
Call 911: slow/stopped breathing, collapse, inability to wake, a seizure, or throat/tongue swelling with breathing trouble.
Get urgent help: severe confusion, hallucinations, dangerous agitation, or suicidal thoughts. Call 911 for immediate danger.
Call your team promptly: falls, memory gaps, increasing sedation, yellow skin/eyes, or unusual bruising. Symptoms after a dose cut may be withdrawal, not returning anxiety.
Early side effects
Drowsiness, dizziness, weakness, unsteadiness, slowed thinking, dry mouth, and stomach upset can occur.
Other effects to discuss
Memory problems and falls may persist despite less sleepiness. Do not drive or use dangerous machinery until cleared for your situation; never while impaired.
What to keep track of
Track benefit, alertness, balance, memory, and doses. Report extra use. Long-term treatment needs periodic blood counts and liver tests, not routine drug levels. Keep reviews and update the stopping plan.
Before you start
Discuss glaucoma, breathing problems, or sleep apnea, falls, liver/kidney disease, depression, previous withdrawal, and all substance use. Tell your team about pregnancy or nursing: late pregnancy exposure can affect the newborn. IR use while breastfeeding may be considered with infant monitoring; Loreev XR labeling advises against breastfeeding. Get a coordinated plan rather than stopping suddenly. Avoid bed-sharing when sedated.
Medicines & interactions
Alcohol & opioids
Avoid alcohol. Opioids can dangerously add to breathing suppression. Ask about naloxone if opioids are involved; it does not reverse lorazepam itself. Do not stop methadone or buprenorphine yourself.
Valproate & probenecid
These can raise lorazepam exposure. Your prescriber may lower the IR dose or change XR to adjusted IR dosing. Do not make that conversion yourself.
Other sedating products
Sleep aids, muscle relaxants, gabapentin/pregabalin, clozapine, and sedating cold/allergy remedies can add impairment. Check every OTC product, especially codeine or antihistamines.
Cannabis, CBD & changes
These may add sedation or interactions. Tell your team about them and check before starting or stopping any medicine or supplement. Fewer CYP interactions does not mean no interactions.
Everyday tips
Pair symptom relief with treatment for the underlying problem.
Coordinate anxiety medicine with your therapist's plan.
Keep a dose record and arrange safe transport.
Plan refills or tapering before the supply runs out.
Your questions, answered
What if I miss a dose?
For scheduled use, skip the missed dose and resume the usual schedule unless your prescriber gave different instructions. Never double. For as-needed use, there is no dose to make up; stay within your prescribed limits.
Will it change how I feel or think?
It can. Report fogginess, flatness, memory problems, unusual irritability, or worsening mood. Do not assume these effects are simply your personality or that they will always disappear.
Is dependence the same as addiction?
No. Physical dependence means the body has adapted and may need a gradual taper. Addiction involves a different pattern, such as loss of control or use despite harm. Both deserve care without blame.
Can I stop once I feel better?
Not suddenly after regular use. Withdrawal can include severe anxiety, shaking, confusion, or seizures. A gradual plan may take months or longer and should change with your symptoms. Never use skipped days as your own taper.
Storage & safety
Keep tablets/capsules in their original closed container, away from heat and moisture, secure from children, pets, and others. Liquid products may need different storage: follow your pharmacy label. Use medicine take-back. For overdose call Poison Control, 1-800-222-1222; call 911 for severe symptoms.
About this information
For general information only; not a substitute for individualized medical advice. This sheet does not cover every risk or interaction. Ask your prescriber or pharmacist before changing how you take this medication.
Sources
Educational inclusion does not mean this medication or its indications are treated at this practice. Review the guide for your exact product with your prescriber or pharmacist.