How Long Does Lorazepam Last?

What you will learn

• Lorazepam is a benzodiazepine medication
• Lorazepam’s elimination half-life averages about 14 hours, but the drug is generally cleared from the body within about 60 hours (after about 4–5 half-lives).
• In urine, lorazepam can be detected for up to 7 days

Lorazepam, also known as Ativan, is an FDA-approved medication given for anxiety, sleep, and seizure disorders.[1] Lorazepam’s elimination half-life averages about 14 hours, but the drug is generally cleared from the body within about 60 hours (after about 4–5 half-lives).[2] It can be detected in urine for an average of 6 days.[3]

Lorazepam is a GABA agonist that acts as a throttle on nerve activity in the nervous system, slowing down activity and calming overactive nerves.[4]

How Does Lorazepam Work?

Lorazepam’s brand name is Ativan. It is a Schedule IV drug, as are all benzodiazepines. All benzos slow the nervous system. Ativan enhances the effects of the neurotransmitter gamma-aminobutyric acid (GABA). GABA slows brain activity, which is why Ativan works so well for reducing anxiety and producing a calming effect.[5]

Ativan is prescribed for several conditions, with anxiety relief being the most common.[6] Doctors use it for short periods to help people relax during extreme stress or panic. Sometimes physicians give lorazepam to reduce alcohol withdrawal symptoms.

How Long Does Lorazepam Last In Your Body?

The duration for which lorazepam remains in the body is expressed as its half-life. This is the time it takes 50 percent of a drug to leave your body.[7] Most drugs are eliminated within 4 or 5 half-lives.

Lorazepam takes effect within  20 to 30 minutes when taken orally.[8] Its effectiveness lasts 6 to 8 hours, and its half-life is approximately 14 hours.[9] However, its half-life may range from as brief as 10 to as long as 20 hours.

That’s because lorazepam produces breakdown products (metabolites) that may take up to 20 hours to leave your system entirely.[10] After about five half-lives, more than 97% of lorazepam will have been eliminated from your system. This means it will typically take about 60 hours for complete elimination.[11]

Lorazepam Drug Test Detection Windows

The duration for which any substance remains detectable varies significantly from person to person. Lorazepam is metabolized by the liver and eliminated by the kidneys through the urine.[12]

Lorazepam’s drug test detection windows can be affected by:

• Age
• Liver and kidney health
• Overall health
• Other substances in the body

Lorazepam has different detection times depending on the substances tested.

• Urine: Urine screening tests can detect Ativan up to six days after the last use. With chronic misuse, it might be detectable for a week or longer. Some of its metabolites can be found for up to seven days.[13]
• Blood: Lorazepam remains generally detectable in blood for about 3 days.[14]
• Hair: Hair samples may be able to detect the presence of lorazepam for 90 days or longer after ingestion.[15]
• Saliva: The use of saliva tests may reveal the presence of Ativan for up to eight hours after use.[16]

Factors Affecting How Long Lorazepam Lasts

Some foods and medications can change how long lorazepam stays in your body. One example is grapefruit. Grapefruit blocks the enzyme CYP3A4, which slows the body’s ability to metabolize lorazepam.[17] The result is that lorazepam will be detectable for a longer period.

Lorazepam and Drug Interactions

Lorazepam interacts with several types of drugs, and some of those interactions are very dangerous. Alcohol should never be consumed with lorazepam, nor should opioids. These combinations can be deadly. [18]

Lorazepam and Alcohol

Lorazepam is a central nervous system depressant, like alcohol. Together, their sedating effects combine and are magnified. When mixed, they can cause a person’s breathing to become dangerously slow. Slow breathing reduces oxygen to the brain. Even a short interruption in oxygen to the brain can cause lifelong impairments or death.

Symptoms of a Lorazepam and Alcohol Overdose

These are the most common signs of a dangerous interaction between lorazepam and alcohol:[19]

• Extreme drowsiness or sedation
• Shallow, slow, or irregular breathing
• Bluish lips or fingertips (cyanosis)
• Poor coordination, clumsiness
• Confusion or disorientation
• Loss of consciousness (you can’t rouse the person)
• Vomiting

What To Do For A Lorazepam and Alcohol Overdose

If someone shows any of the above symptoms:

• Call 911
• Do not leave them alone: monitor their breathing and responsiveness
• Place in Recovery Position: If unconscious, turn them onto their side to prevent choking if they vomit

Lorazepam and Opioid Drugs

Lorazepam and opioids should never be mixed.[20] Any combination of lorazepam and an opioid can be lethal. That’s because they both powerfully suppress a person’s central nervous system. The result is respiratory arrest.

Understanding Lorazepam Misuse, Abuse, and Addiction

Lorazepam is a prescription drug often used to treat anxiety or help with sleep in the short term. However, this medication has a high potential for misuse, abuse, and addiction.[21] People who use lorazepam for too long, or at higher doses than prescribed, can quickly become dependent on it, both physically and emotionally.

Signs of Lorazepam Addiction

Addiction to lorazepam can happen gradually. At first, someone may need it to sleep or relax. Over time, they may feel like they can’t sleep or calm down without it.[22] They may begin to take larger doses or take it more often than the doctor ordered. Some may also lie about symptoms to get more pills or visit multiple doctors, a practice known as “doctor shopping.”

Other signs of lorazepam addiction include:

• Taking the drug to get high rather than for medical reasons
• Needing more of the drug to get the same effect (tolerance)
• Urges to consume lorazepam
• Spending a lot of time thinking about, getting, or using the drug
• Avoiding family, work, or social activities
• Secrecy
• Poor work or school performance
• Failing responsibilities
• Feeling unable to stop using lorazepam, even when they want to
• Mood changes, including irritability or depression, occur when not using

Signs of Lorazepam Withdrawal

When someone has taken lorazepam regularly over a long period, suddenly stopping it can lead to serious withdrawal symptoms.[23] This is one reason why medical supervision is important when trying to quit.

Withdrawal symptoms may include:

• Anxiety or panic attacks
• Trouble sleeping (insomnia)
• Sweating or shaking
• Nausea or stomach pain
• Irritability or restlessness
• Muscle cramps
• Fast heartbeat
• Seizures (in severe cases)

Symptoms can start within hours to a few days after the last dose. They may last several days or even weeks, depending on how long the person has been using the drug and at what dose.

Treating Lorazepam Addiction

After medical detox, counseling and therapy are key parts of recovery. Cognitive behavioral therapy (CBT) can help people make sense of their addiction and how to avoid triggers.[24] Support groups like Narcotics Anonymous (NA) or therapy with addiction specialists can also provide long-term support.[25]

Recovery from lorazepam addiction takes time, but it is possible. With medical help, support, and the right plan, people can learn to manage anxiety and stress in healthier ways, without depending on benzodiazepines.

Amanda is a prolific medical content writer specializing in eating disorders and addiction treatment. She graduated Magna Cum Laude from Purdue University with a B.S. in Social Work. Read more