Drugs Q & A

How Long Does Ativan Last?

When our body begins to metabolize a medication, different organs process the ingredients before they are finally released into the bloodstream. While the process may sound straightforward, different drugs dissolve at different rates, different formulas, and dosages break down differently – and, everybody’s body metabolizes medication uniquely. These are just a few of the many complexities behind the nature of drug absorption and metabolism.

The vast majority of medications are taken orally and are broken down within the gastrointestinal tract. Once the medication arrives, it is broken down by stomach acids before it passes through the liver and then enters the bloodstream. Certain medications may stay in the bloodstream longer – it all depends on the dosage and drug family consumed.

There are several factors at play when determining the overall time required for medication to fully digest. The following factors all impact an individual’s sensitivity to and absorption of medication:

•          Age

•          Weight

•          Gender

•          Time of day taken

•          Level of physical activity

•          Level of stress

•          Content of stomach and PH level

•          Presence of other medications

Gastric acids may prevent or slow the breakdown of certain medications. Additionally, when a medication is metabolized in the liver, its potency will decrease along with its effectiveness before the medicine reaches the bloodstream.

What is Ativan?

Ativan is a brand of lorazepam, a sedative-hypnotic or anxiolytic medication. Ativan belongs to a class of medications called benzodiazepines.

Ativan is used to treat anxiety symptoms, insomnia (trouble sleeping), and status epilepticus (a type of severe seizure). It’s also given before surgery to make you sleep.

Ativan comes in two forms:

•          tablets

•          solution for intramuscular injection or intravenous (IV) injection

How does Ativan work?

Ativan belongs to a group of medicines called benzodiazepines. It works by increasing the levels of a calming chemical, gamma-amino-butyric acid (GABA), in your brain. Depending on your health condition, this can make you feel calmer, relieve anxiety, or stop a seizure or fit.

How is Ativan metabolized in the body?

The drug is metabolized primarily by the liver and then eliminated from the body by the kidneys through urine. Ativan may be present up to nine days past the last use. The excretory half-life of Ativan is 12 hours and about 95% of a dose of Ativan is excreted via the urine and feces over a period of 5 days because it takes five half-lives for a drug to be removed from your body.

Ativan is present in breast milk at low levels and because it has a short half-life relative to many other benzodiazepines, it can safely be administered directly to infants. Evidence from nursing mothers indicates that Ativan does not cause any adverse effects in breastfed infants with usual maternal dosages.

How does Ativan make you feel?

Ativan influences how you feel by slowing the activity of the brain and nerves, Ativan also affects physical functions and responses. As a tranquilizer, Ativan can make the user feel calm and physically relaxed. Ativan can also stop painful spasms in muscles, or prevent life-threatening seizures when taken correctly.

How Long Does Ativan Last

How long do the effects of Ativan last?

The effect of Ativan kicks in almost immediately (20 to 30 minutes) after taking the drug and can last for up to 8 hours. Peak concentrations in plasma occur approximately 2 hours following administration. The peak plasma level of lorazepam from a 2 mg dose is approximately 20 ng/mL.

What side effects will I experience while taking Ativan?

Ativan can cause mild or serious side effects. The following list contains some of the key side effects that may occur while taking Ativan. This list doesn’t include all possible side effects.

More common side effects

The more common side effects of Ativan include:

•          drowsiness or sleepiness

•          dizziness

•          weakness

Some people may also experience less frequent side effects such as:

•          confusion

•          lack of coordination

•          depression

•          fatigue

•          headache

•          restlessness

•          changes in libido (sex drive)

•          memory problems

In people who receive the Ativan injection, redness or deepening of skin color and pain at the injection site can commonly occur.

Some of these side effects may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Ativan aren’t common, but they can occur. Call your doctor right away if you have any serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include the following:

•          Breathing effects. Symptoms can include:

o          slowed breathing

o          respiratory failure, which is rare

•          Low blood pressure, which may be severe enough to cause fainting or falls.

•          Convulsions or seizures. Symptoms can include:

o          uncontrollable, sudden movements in your arms or legs

o          loss of consciousness or awareness

o          stiff muscles

o          staring spells

•          Paradoxical reactions (reactions that cause effects opposite of those expected with the drug), such as aggression, hostility, agitation, or rage.

•          Dependence, misuse, and addiction, which are more likely in people who take higher doses of Ativan or use it long term, or those who misuse alcohol or drugs.*† Symptoms of physical dependence can include:

o          anxiety

o          depression

o          muscle weakness

o          nightmares

o          body aches

o          sweating

o          nausea

o          vomiting

•          Serious allergic reactions. Symptoms can include:

o          severe rash or hives

o          trouble breathing or swallowing

o          swelling of your lips, tongue, or face

o          rapid heartbeat

•          Suicidal thoughts. (Because of this, Ativan should be avoided by people with depression that’s not treated.)

•          Life threatening side effects if taken with opioid medications

Ativan may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

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Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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