Ativan with the birth control pill
Many women of reproductive age take a combined or progestogen-only oral contraceptive while also using a chronic medication such as Ativan (Lorazepam). The combination is generally fine at 0.5mg, 1mg, 2mg, but a small number of medications can reduce contraceptive efficacy meaningfully and need either a backup method or a switch.
How Ativan can affect contraceptive efficacy
Combined and progestogen-only contraceptives are metabolised through CYP3A4. Strong CYP3A4 inducers (some antiepileptics, rifampicin, St John's Wort) lower contraceptive plasma levels and reduce efficacy. Whether Lorazepam acts on CYP3A4 determines whether Ativan affects contraception. Most agents in Anti-anxiety Medications have no clinically meaningful effect on the pill at 0.5mg, 1mg, 2mg.
Practical guidance
According to the prescribing information for Lorazepam, women on hormonal contraception should review Ativan with the prescribing pharmacist or doctor. Where an interaction is documented, additional barrier contraception or switching to a non-oral method (IUD, implant) for the duration of Ativan therapy is the standard mitigation.
Frequently asked questions
Will Ativan make my pill less effective? ▾
Most Anti-anxiety Medications medications at 0.5mg, 1mg, 2mg do not affect oral contraceptive efficacy. The exceptions are CYP3A4-inducing drugs and a small number of others. The prescribing information for Lorazepam states whether the interaction is meaningful.
Do I need a backup contraceptive on Ativan? ▾
Backup contraception is needed only when there is a documented interaction between Ativan and the contraceptive method. For most users at 0.5mg, 1mg, 2mg, no backup is required. The pharmacist confirms whether Lorazepam interacts with hormonal contraception.
More on Ativan
- With alcoholAtivan and alcohol — is it safe to drink?
- With foodShould Ativan be taken with food?
- Side effectsAtivan side effects: common, rare and warning signs
- Dosage guideAtivan dosage guide: how much to take and when
- OnsetHow fast does Ativan start working?
- DurationHow long does Ativan last?
The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.