Learn which medications, supplements, and foods interact with Lorazepam, what makes these interactions dangerous, and what to tell your doctor.
If you take Lorazepam (brand name Ativan), it's critical to know which other medications, supplements, and substances can interact with it. Some interactions can cause dangerous side effects — including slowed breathing, extreme sedation, and even death.
This guide covers the most important Lorazepam interactions, what to avoid, and what to tell your doctor to stay safe.
Lorazepam is a benzodiazepine that enhances the effects of GABA, a calming neurotransmitter in the brain. The main risk with Lorazepam interactions is additive CNS (central nervous system) depression — when two or more substances slow down the brain and body at the same time.
This can lead to:
Because Lorazepam is metabolized primarily through glucuronidation (not the liver's CYP enzyme system), it has fewer metabolism-based interactions than some other benzodiazepines. However, the additive sedation risk remains very real.
The FDA has issued a Boxed Warning — the most serious type of warning — about combining benzodiazepines like Lorazepam with opioids. This combination can cause profound sedation, respiratory depression, coma, and death.
Opioids that interact with Lorazepam include:
What to do: If you take any opioid medication, make absolutely sure your doctor knows. If both medications are necessary, your doctor should prescribe the lowest effective doses for the shortest possible time and monitor you closely.
Alcohol is a CNS depressant, and combining it with Lorazepam is extremely dangerous. Even moderate amounts of alcohol can cause severe sedation, loss of coordination, slowed breathing, and loss of consciousness.
What to do: Do not drink any alcohol while taking Lorazepam. This includes beer, wine, and spirits.
Taking Lorazepam with other benzodiazepines (such as Alprazolam, Clonazepam, or Diazepam) doubles up on sedation and increases the risk of respiratory depression. Your doctor should not prescribe multiple benzodiazepines at the same time.
Medications like Zolpidem (Ambien), Eszopiclone (Lunesta), and Suvorexant (Belsomra) can dangerously increase sedation when combined with Lorazepam.
Sodium oxybate (Xyrem) is contraindicated — meaning it should never be taken with Lorazepam.
Barbiturates like Phenobarbital add to the CNS depression caused by Lorazepam and can cause life-threatening respiratory depression.
Medications like Quetiapine (Seroquel), Olanzapine (Zyprexa), and Clozapine (Clozaril) can increase sedation when combined with Lorazepam. Clozapine in particular carries a risk of cardiorespiratory collapse.
SSRIs, SNRIs, and tricyclic antidepressants can increase sedation when taken with Lorazepam. This doesn't mean you can't take both — many people do safely — but your doctor should be aware of the combination and may adjust doses.
Over-the-counter antihistamines like Diphenhydramine (Benadryl) and prescription antihistamines like Hydroxyzine can increase drowsiness and sedation when combined with Lorazepam.
Medications like Cyclobenzaprine (Flexeril) and Tizanidine (Zanaflex) add to the sedating effects of Lorazepam.
While Lorazepam has fewer metabolism-based interactions than other benzodiazepines, a few medications can increase its levels in your body:
Some supplements and OTC products can interact with Lorazepam:
Worth repeating: absolutely avoid alcohol while taking Lorazepam. This is the most dangerous food/drink interaction.
Good news — unlike many other benzodiazepines, Lorazepam has minimal interaction with grapefruit juice. This is because Lorazepam is metabolized through glucuronidation rather than the CYP enzymes that grapefruit affects. You don't need to avoid grapefruit while taking Lorazepam.
Caffeine doesn't have a dangerous interaction with Lorazepam, but it can work against the medication's calming effects. If you're taking Lorazepam for anxiety, excessive caffeine intake may reduce its effectiveness.
Before starting Lorazepam — or at any appointment while you're taking it — make sure your doctor knows about:
It's also a good idea to use one pharmacy for all your medications. Your pharmacist can catch potential interactions that individual doctors might miss.
For more on what to expect when taking Lorazepam, see our guides on Lorazepam side effects and what Lorazepam is and how to take it.
Lorazepam is a safe and effective medication when used properly, but it can be dangerous when combined with the wrong substances. The most critical interactions are with opioids, alcohol, and other sedating medications.
The best way to stay safe is simple: keep an up-to-date list of everything you take and share it with every healthcare provider you see. When in doubt, ask your doctor or pharmacist before taking anything new alongside Lorazepam.
If you're having trouble finding Lorazepam at your pharmacy, Medfinder can help you find pharmacies with it in stock near you.
You focus on staying healthy. We'll handle the rest.
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