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Anti-anxiety Medications

Ativan with antibiotics: interactions and safety

Antibiotic courses are common, short-term and often combined with chronic medications such as Ativan (Lorazepam). Most antibiotics do not interfere meaningfully with Lorazepam at 0.5mg, 1mg, 2mg, but a few classes do, and a small number of combinations are best avoided.

Common antibiotic interactions

Macrolides (clarithromycin, erythromycin) and certain antifungals can inhibit hepatic metabolism (CYP3A4) and raise plasma levels of many medications including some Anti-anxiety Medications agents. Rifampicin has the opposite effect, accelerating metabolism. Most penicillins, cephalosporins, fluoroquinolones and tetracyclines have no clinically meaningful interaction with Lorazepam at 0.5mg, 1mg, 2mg.

Practical guidance

According to the prescribing information for Lorazepam, an antibiotic course should be reviewed by the prescriber or pharmacist for known interactions before Ativan is co-administered. Adjusted 0.5mg, 1mg, 2mg dosing or temporary substitution is sometimes preferred for the duration of the antibiotic course.

Frequently asked questions

Can I take Ativan during an antibiotic course?

For most common antibiotics, yes. A few classes — notably macrolides and azole antifungals — alter how Lorazepam is metabolised and may need a temporary 0.5mg, 1mg, 2mg adjustment. The prescribing pharmacist should review any new antibiotic against the existing Ativan regimen.

Will antibiotics make Ativan stop working?

Most antibiotics do not affect Ativan efficacy. Rifampicin and a few others can lower Lorazepam levels and reduce effect; in those cases the prescriber may adjust the dose during and shortly after the antibiotic course.

More on Ativan

The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.