Lorazepam has possible interactions with alcohol, some other drugs, and certain supplements. Examples include gabapentin and opioids. Talk with your doctor to avoid potentially harmful effects from lorazepam interactions.Lorazepam oral tablet is a generic drug prescribed for anxiety disorders (such as generalized anxiety disorder) in adults and children ages 12 years and older. Lorazepam tablet is also approved for the short-term relief of the symptoms of anxiety or anxiety associated with depressive symptoms.Lorazepam is available as the brand-name drug Ativan.An interaction occurs when one substance causes another substance to have a different effect than expected.Lorazepam comes in different forms, and some may have different interactions. The forms are:oral tabletsextended-release oral capsules (available as the brand-name drug Loreev XR)oral liquid concentratesolution in vials for intramuscular or intravenous useExtended-release capsules slowly release the drug into your body over a long period of time. This article will focus on interactions for the oral tablet form of lorazepam. You can talk with your doctor to learn more about the interactions of other forms.By learning about possible lorazepam interactions and contraindications, you can work with your doctor to help ensure that lorazepam will be safe and effective for you to take.»Learn more about lorazepam oral tablet, including details about its uses.Lorazepam interactions with other drugsBefore you start treatment with lorazepam, tell your doctor and pharmacist about any prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. To learn whether lorazepam interacts with supplements, herbs, or vitamins, see the 'Lorazepam and other interactions' section.If you have questions about drug interactions that may affect you, such as what drugs you should not take with lorazepam, ask your doctor or pharmacist.Here's a table of drugs that can interact with lorazepam. Keep in mind that this table doesn't include all drugs that may interact with lorazepam. Some of these interactions are described in detail in 'Drug interactions in depth.'Drug class or drug nameDrug examplesInteraction result with Lorazepamopioids• fentanyl• oxycodone (OxyContin)can increase the risk of serious side effects of opioids and lorazepam (see 'Boxed warnings' at the start of this article)other benzodiazepines• alprazolam (Xanax)• clonazepam (Klonopin)can increase the risk of serious side effects of lorazepam and other benzodiazepinesantiepileptic medications• carbamazepine (Tegretol, others)• valproatecan increase the risk of central nervous system (CNS) depression as a side effect of lorazepam and antiepileptic medicationsantipsychotic medications• quetiapine (Seroquel)• clozapine (Clozaril)can increase the risk of CNS depression as a side effect of lorazepam and antipsychotic medicationsmedications for sleep disorders• zolpidem (Ambien and Ambien CR, others)• zaleplon (Sonata)can increase the risk of CNS depression as a side effect of lorazepam and sleep medicationsmuscle relaxants• carisoprodol (Soma)• cyclobenzaprine (Amrix)can increase the risk of CNS depression as a side effect of lorazepam and muscle relaxantstricyclic antidepressants (TCAs)• amitriptyline• nortriptylinecan increase the risk of CNS depression as a side effect of lorazepam and TCAscertain antihistamines• diphenhydramine (Benadryl)• doxylamine (Unisom)can increase the risk of CNS depression as a side effect of lorazepam and certain antihistaminesprobenecid (Probalan)—can increase the risk of side effects of lorazepamgabapentin (Neurontin)—can increase the risk of CNS depression as a side effect of lorazepam and gabapentinWhen to avoid lorazepam In some cases, factors or conditions could prevent your doctor from prescribing lorazepam due to the risk of harm. These are known as contraindications. The following information highlights some lorazepam contraindications.Note: Before you start treatment with lorazepam, it's important to tell your doctor if these contraindications apply to you. They can determine whether to prescribe lorazepam.Having acute narrow-angle glaucomaYou should not take lorazepam if you're experiencing an episode of acute narrow-angle glaucoma. This medical emergency requires immediate treatment to prevent permanent vision loss. Taking lorazepam during acute narrow-angle glaucoma can increase the pressure in your eye and worsen the condition. Symptoms include sudden blurry vision, severe pain in the eye, or seeing rainbow-like rings around lights.If you experience symptoms, seek immediate medical attention — call 911 or your local emergency number.Narrow-angle glaucoma can be acute (sudden) or chronic (long term). If you have chronic narrow-angle glaucoma, let your doctor know before you begin taking lorazepam. They can determine whether the drug is safe for you to take.Having had an allergic reaction to lorazepam or any of its ingredientsIf you have had an allergic reaction to lorazepam or any of its ingredients, your doctor will likely not prescribe lorazepam. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better options for you.Lorazepam interaction with alcohol Your doctor will likely recommend that you don't drink alcohol while taking lorazepam. Lorazepam and alcohol both cause CNS depression, slowing activity in the brain.Consuming alcohol and taking lorazepam may cause serious side effects, including:difficulty breathingsleepinessdecreased awarenessThe combination of alcohol and lorazepam also increases the risk of lorazepam overdose, which may also, in some cases, lead to coma or even death. If you have concerns about avoiding alcohol while you're taking lorazepam, talk with your doctor before starting treatment.Drug interactions in depth Here's a closer look at certain drug interactions of lorazepam.GabapentinLorazepam interacts with gabapentin. Gabapentin is an antiepileptic drug, but it's also prescribed for treating nerve pain and restless legs syndrome (RLS).Both lorazepam and gabapentin cause CNS depression. This nervous system effect is part of how these medications work. However, taking them together can raise your risk of symptoms of CNS depression, such as sleepiness, balance and coordination problems, and confusion.Steps you or your doctor may takeDue to the risk of potentially severe CNS depression symptoms, doctors may avoid prescribing lorazepam and gabapentin together if other treatments are available. However, if this combination of medications is what works best for your symptoms, your doctor will likely prescribe the lowest dose of lorazepam and gabapentin needed to treat your condition.If you take lorazepam and gabapentin together, let your doctor know right away if you develop symptoms of CNS depression.Medications for sleep disordersLorazepam interacts with medications prescribed for sleep disorders such as insomnia.Lorazepam and medications for sleep disorders cause CNS depression. Taking these medications together raises your risk for developing CNS depression symptoms that can be severe. Examples include memory loss, confusion, and difficulties with balance and coordination.Here are some medications for sleep disorders that may interact with lorazepam:zolpidem (Ambien and Ambien CR, others)zaleplon (Sonata)eszopiclone (Lunesta)suvorexant (Belsomra)ramelteon (Rozerem)Steps you or your doctor may takeBecause of the risk of severe symptomatic CNS depression, your doctor may avoid prescribing lorazepam with a sleep medication.If you have insomnia and take lorazepam, your doctor may suggest taking your lorazepam dose at night. Since lorazepam can cause drowsiness, taking your dose at night may help alleviate the symptoms of your sleep issue. (Lorazepam is FDA approved as a short-term treatment for insomnia due to anxiety or stress, but not as a long-term insomnia treatment.)If taking lorazepam and a medication for a sleep disorder is what works best for your symptoms, your doctor will likely prescribe the lowest possible dose for both medications. Immediately let your doctor know if you develop symptoms of CNS depression if you take this combination of drugs. »Learn about medications for chronic insomnia.Certain antihistaminesLorazepam interacts with certain antihistamines, which help treat allergy symptoms. Some also help treat motion sickness and cold or flu symptoms.Not all antihistamines are created equally. Some, called first-generation or sedating antihistamines, are more likely to cause symptoms of CNS depression. Examples of these symptoms include sedation (drowsiness and extreme sleepiness), confusion, and balance or coordination problems. Lorazepam is most likely to interact with sedating antihistamines because lorazepam can also cause CNS depression symptoms as a side effect.Here are some sedating antihistamines that may interact with lorazepam:diphenhydramine (Benadryl)doxylamine (Unisom)promethazinechlorphenaminehydroxyzine (Vistaril)cyproheptadineSteps you or your doctor may takeNewer antihistamines, called second- or third-generation antihistamines, are less likely to cause symptoms of CNS depression. Examples include fexofenadine (Allegra), loratadine (Claritin), and cetirizine (Zyrtec). If you're prescribed lorazepam, your doctor may suggest taking a newer antihistamine instead of a first-generation (sedating) antihistamine.If you have questions about taking lorazepam and antihistamines, talk with your doctor or pharmacist.Lorazepam and other interactionsLorazepam may have other interactions, such as with supplements, foods, vaccines, or lab tests. Here are some potential interactions with lorazepam. Keep in mind that the following information does not include all other possible lorazepam interactions.Lorazepam interactions with supplementsBefore you start treatment with lorazepam, tell your doctor and pharmacist about any supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.In addition to the following interactions, lorazepam can also interact with melatonin. Melatonin is a hormone that some people use as a supplement to help with sleep. Taking lorazepam and melatonin together can increase your risk of certain lorazepam side effects, including drowsiness, confusion, and memory loss.If you're taking lorazepam, your doctor may suggest avoiding this combination, especially if you're taking lorazepam for insomnia.Lorazepam interactions with herbsLorazepam can interact with an herb called valerian root, which some people use to treat symptoms of anxiety and insomnia. Both lorazepam and valerian root can cause CNS depression. Taking them together increases your risk of symptoms, including severe drowsiness, confusion, and problems with balance and coordination.Due to this risk, your doctor may suggest you avoid taking valerian root supplements if they prescribe lorazepam.Lorazepam interactions with vitamins There are no specific reports of vitamins interacting with lorazepam. However, that doesn't mean vitamin interactions won't occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with lorazepam.Lorazepam interactions with foodLorazepam may interact with caffeine. Consuming too much caffeine while taking lorazepam for insomnia can make lorazepam less effective. Foods and beverages that contain caffeine include:coffeeteachocolateenergy drinksBecause of this interaction, your doctor will likely recommend limiting how much caffeine you consume if you're taking lorazepam for insomnia.If you'd like to learn more about eating certain foods during treatment with lorazepam, talk with your doctor.Lorazepam interactions with vaccinesThere are no known interactions between lorazepam and vaccines. Talk with your doctor or pharmacist to check whether you're due for any vaccines.Lorazepam interactions with lab testsLorazepam is not known to interact with lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.LORAZEPAM INTERACTION WITH CANNABIS OR CBDCannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have been specifically reported to interact with Ativan, a brand-name version of lorazepam tablets.Both lorazepam and cannabis cause CNS depression. Using cannabis while taking lorazepam increases your risk for symptoms of CNS depression, including confusion, memory loss, and severe drowsiness.Before you start treatment with Lorazepam, tell your doctor and pharmacist if you use cannabis. By sharing this information with them, you may help prevent possible interactions.Note: Cannabis is illegal at the federal level, but is legal in many U.S. states to varying degrees.Lorazepam and health-related interactionsCertain medical conditions and other factors may increase the risk of interactions with lorazepam. Before you take this drug, be sure to talk with your doctor about your health history. Lorazepam may not be the right treatment option if you have certain medical conditions or other factors affecting your health.Health conditions or factors that might interact with lorazepam include:Breathing or lung condition, such as sleep apnea: Lorazepam can cause breathing-related side effects, including slow, shallow breathing. If you have a breathing or lung condition such as sleep apnea or asthma, your risk of breathing-related side effects of lorazepam may be higher. Ask your doctor if lorazepam is safe for you to take.Kidney condition: If you have chronic kidney disease or another kidney condition, you may have a higher risk of lorazepam side effects. Your doctor can help determine whether it's safe for you to take lorazepam based on your kidney health.Liver condition: If you have a liver condition such as cirrhosis, your body may not metabolize (break down) lorazepam as well. This can raise your risk for lorazepam side effects. Also, if you have a condition known as hepatic encephalopathy, taking lorazepam could worsen symptoms of this condition. Your doctor can help determine whether lorazepam is safe for you to take based on your liver health.Substance use disorder: Lorazepam has a boxed warning about the risks of misuse and addiction. To learn more about this risk, see 'Boxed warnings' near the top of this article. If you have a substance use disorder, your doctor may decide to prescribe a treatment other than lorazepam.Epilepsy or seizures due to another cause: Side effects of lorazepam include seizures. If you have already experienced seizures, taking lorazepam could worsen them or cause them to occur more frequently. You may also have a higher risk of seizures as a withdrawal symptom if you stop taking lorazepam. Talk with your doctor to learn more about whether lorazepam is safe for you to take.Allergic reaction: If you've had an allergic reaction to lorazepam or any of its ingredients, your doctor will likely not prescribe lorazepam. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be a better option for you.Breastfeeding: Your doctor will likely advise you to avoid breastfeeding while taking lorazepam. Lorazepam passes into breast milk and can cause symptoms in a breastfed child. If you're breastfeeding or planning to, talk with your doctor before taking lorazepam. They can talk with you about treatment options and ways to feed a child other than breastfeeding.Pregnancy: Your doctor will likely not prescribe lorazepam if you're pregnant or planning to become pregnant. If you're pregnant or planning to become pregnant, tell your doctor before starting lorazepam. They can advise you on the right treatment plan for you.Mental health condition, including depression or current or past suicidal thoughts and behaviors: Taking lorazepam can worsen depression and other mental health conditions (including anxiety, which lorazepam is prescribed to treat). Rarely, it can also cause suicidal thoughts or behaviors as a side effect. Be sure to discuss any mental health conditions you have with your doctor before you begin taking lorazepam.Help is out thereIf you or someone you know is in crisis and considering suicide or self-harm, please seek support:Call or text the 988 Lifeline at 988 or chat at 988lifeline.org. Caring counselors are available to listen and provide free and confidential support 24/7.Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.Not in the United States? Find a helpline in your country with Befrienders Worldwide.Call 911 or your local emergency services number if you feel safe to do so.If you're calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.If you're not in the same household, stay on the phone with them until help arrives.FAQ about lorazepam and interactions Here are some frequently asked questions about lorazepam and possible interactions.Does lorazepam interact with ibuprofen?No, lorazepam is not known to interact with ibuprofen. This combination is likely safe to take, especially if you take ibuprofen for occasional aches or pains.Talk with your doctor or pharmacist if you have questions about taking ibuprofen while you're taking lorazepam.Can I take lorazepam with milk?Lorazepam is not known to interact with milk. So you're likely OK to take lorazepam with milk.Milk contains calcium, which can interact with certain medications. But this isn't expected with lorazepam.To learn about lorazepam interactions with food, see the 'Lorazepam and other interactions' section.Preventing interactions You can take certain steps to help prevent interactions with lorazepam. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:Let them know if you drink alcohol or use cannabis.Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.Create a medication list, which your doctor and pharmacist can help you fill out.It's also important to read the lorazepam label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. The paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.If lorazepam doesn't come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.You can also help prevent interactions with lorazepam by taking it exactly as your doctor prescribes.»Get in-depth resources for anxiety symptoms, management, and treatment.Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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