Brad asked
I take oxycodone 5mg and Ativan (lorazepam) 0.5mg when needed for anxiety. What are the interactions of these two and if there are any, what safe time apart can I take them??
Answer
Oxycodone and Ativan (lorazepam) should generally not be taken together. Both drugs are potent CNS (central nervous system) depressants and taking both together can increase the risk of side effects, such as:
- Sedation
- Confusion
- Impaired movement
- Respiratory depression
Respiratory depression is the most concerning side effect as high dose combinations of of drugs like Ativan (lorazepam) and oxycodone can cause breathing problems, which has led to death in many cases.
Oxycodone is an opioid pain medication and Ativan is a benzodiazpine. In 2016, the FDA released a safety statement with a strong warning against the combination of opioids and benzodiazpines. Per the FDA announcement:
"In an effort to decrease the use of opioids and benzodiazepines, or opioids and other CNS depressants, together, we [FDA] are adding Boxed Warnings, our strongest warnings, to the drug labeling of prescription opioid pain and prescription opioid cough medicines, and benzodiazepines."
If the combination of Ativan and oxycodone must be used, the lowest possible dose of each should be utilized for the shortest treatment time possible.
If you were prescribed both Ativan and oxcodone, you should ideally separate dosing from each other.
Ativan (lorazepam) has a duration of action of around 8-12 hours in the body. At the very least, you would want to wait at least 12 hours after taking Ativan to take a dose of oxycodone. However, the half-life of Ativan is around 12 hours and will last in the body for 2-3 days. If you want to completely avoid taking oxycodone while Ativan is in the body, you need to wait at least 2-3 days.
Oxycodone has a duration of action of around 4-6 hours in the body and a half-life of 3-5 hours. Oxycodone will be completely eliminated in the body within 24 hours. You should wait at least 6 hours after taking oxycodone to take Ativan and about a day if you want to have oxycodone completely eliminated from the body.
