Does Ativan Need To Be Tapered?

In our latest question and answer, the pharmacist discusses whether or not Ativan (lorazepam), a benzodiazepine, should be slowly tapered before discontinuing.

Question

The doctor prescribed 2 months worth of Lorazepam 0.5mg twice daily due to grief. The first month I followed orders. I Moved to taking 1.5mg for a few weeks as the symptoms worsened. Now that crisis has passed but noticed a bit of trouble sleeping and tingling in toes. What they did not tell me was that I needed to taper. I am running out and no refills. I frankly do not want to be on them anymore. How do I use my last 10 pills of 0.5mg to taper. Am I in danger?

Asked by Ric On Jul 13, 2018

Answered by
Medical Content Reviewed By PharmacistAnswers Staff

On Jul 13, 2018

Yes, Ativan (lorazepam) is generally recommended to be tapered down slowly before discontinuing to lessen the severity of the potential withdrawal symptoms that can occur. This is a general recommendation for all benzodiazepine medications, of which Ativan is included.


Not everyone may need to taper the drug, but there are certain risk factors that can make certain individuals more susceptible to withdrawal reactions. They include:

  • Use of benzodiazepine over one year.
  • Use of high doses.
  • Use of short duration of action benzodiazepines (which includes lorazepam).


Withdrawal effects can vary greatly by person and the from factors listed above. Nevertheless, potential withdrawal reactions include:

  • Relapse or rebound of condition being treated
  • Sweating
  • Increased heart rate
  • Muscle cramps
  • Tremor
  • Insomnia
  • Anxiety
  • Agitation
  • Nausea
  • Vomiting
  • Hallucinations
  • Seizure


There is no single recommended way to taper off Ativan, but one source suggests to:

  • Taper benzodiazepines like Ativan by no more than 10% every week.


If you have been on the drug for a short period of time, a quicker taper may be recommended, such as:

  • Decrease your dose by 10-25% every week and adjust based on tolerability.


As there are many factor to consider, you should discuss with your doctor the best way to taper (if it is necessary in your situation) with your doctor as they have your complete medical history. If you and your doctor decide to taper your medication over a longer period of time, they should be able to prescribe you the appropriate amount of pills.

About the Pharmacist

Dr. Brian Staiger Pharm.D

Dr. Brian Staiger is a licensed pharmacist in New York State and the founder of PharmacistAnswers.com. He graduated from the University At Buffalo with a Doctor of Pharmacy degree in 2010. He has been featured in numerous publications including the Huffington Post as well as a variety of health and pharmacy-related blogs. Please feel free to reach out to him directly if you have any inquiries or want to connect! He's answered thousands of medication and pharmacy-related questions and he's ready to answer yours! Brian.Staiger@PharmacistAnswers.com Office: 716-389-3076

About Ativan (lorazepam)

Ativan (lorazepam) is a benzodiazepine that is available as both an oral tablet and injection. It is considered a short duration of action benzodiazepine and is preferred in those with liver disease as it is not metabolized via CYP metabolizing enzymes. In addition, it does not have active metabolites and is therefore one of the preferred benzodiazepines in the elderly. After taking by mouth, it has a rapid onset of action, with effects occurring in as little as 15-30 minutes. The usual duration of action is around 6 to 12 hours per dose.

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