Is 5 mg of Lorazepam a Lot? Lorazepam Dosage Explanations & Considerations

What you will learn

• Lorazepam dosages typically range from 0.5 mg to 2 mg, depending on the condition being treated.
• 5 mg of lorazepam is a high dose that’s typically only used in hospital settings.
• Individual factors, such as age, tolerance, and health, affect dosages.
• High doses of lorazepam increase the risk of dependence, overdose, and serious side effects.
• Always consult your doctor about adjusting your lorazepam dose.

Lorazepam is a benzodiazepine medication sold under the brand Ativan. It’s commonly prescribed for anxiety, insomnia, seizures, and agitation, acting quickly to calm the central nervous system (CNS). However, lorazepam is also a potent sedative with a high potential for misuse and dependence, so it needs proper dosage for safety and effectiveness.

Is 5 mg of lorazepam a high dose? Several factors contribute to dosing, including age, health, and tolerance level. Find out how lorazepam dosing works, whether 5 mg is an appropriate dose, and the considerations that inform safe prescribing.

What Is Lorazepam?

Lorazepam, commonly known by its brand name Ativan, is a prescription medication that belongs to the benzodiazepine class. It’s a CNS depressant that enhances the effects of the neurotransmitter gamma-aminobutyric acid (GABA) in the brain, slowing nerve activity and producing a calming effect.[1] Lorazepam is used to promote relaxation and reduce anxiety.

While lorazepam is generally safe and well tolerated, it is classified as a Schedule IV controlled substance by the Drug Enforcement Administration (DEA) because of its potential for dependence and misuse.[2] There are risks of interactions and side effects as well, which is why lorazepam should be taken exactly as prescribed.

Lorazepam Dosage

Lorazepam is available as an oral tablet and a liquid for intravenous (IV) and intramuscular (IM) injection. Oral tablets come in 0.5 mg, 1 mg, and 2 mg, while liquid solutions come in 2 mg per milliliter (2 mg/mL) and 4 mg per milliliter (4 mg/mL).[3]

Lorazepam is typically prescribed in doses ranging from 0.5 mg to 2 mg, taken up to three times a day, depending on the condition being treated.[4] It usually starts at a lower dosage and is adjusted over time to find symptom relief with minimal side effects. The maximum daily dose typically ranges from 2 mg to 6 mg, although dosages may exceed this range with a doctor’s supervision.[5]

These dosages are the common range for different conditions, but you should only take your medication as prescribed by your doctor.

Anxiety or Stress

Lorazepam may be used to treat anxiety in the short term. The typical lorazepam dosage for adults is 2 mg to 6 mg daily in divided doses, but it can range from 1 mg to 10 mg per day.[6]

Short-term treatment of anxiety often has a starting dose of 2 mg to 3 mg per day taken in two or three doses.[7] The maximum daily dose is 10 mg per day.

Seizures

Lorazepam can be effective for treating certain seizures. It may be given as an IV or IM injection at a dosage of 4 mg given slowly.[8] Another 4 mg dose may be needed if seizures continue after 10 or 15 minutes.

Anxiety- or Stress-Related Sleep Problems

Lorazepam may be used to treat insomnia caused by anxiety or stress. The dose is usually 2 mg to 4 mg taken daily, usually before bedtime.[9]

Pre-Surgical Use

IM injections of lorazepam are sometimes used to induce relaxation before surgery. It’s dosed by body weight at 0.05 mg per kilogram (kg) with a maximum dose of 4 mg.[10] IV injections may also be used, at a dose of 0.02 mg per pound (0.044 mg/kg) or 2 mg total, whichever is smaller.[11]

Lorazepam is not intended for long-term use. Its effects after months of consecutive treatment haven’t been researched. It’s only approved for use in adults, not children.

Is 5 mg of Lorazepam a Lot?

Yes, for most outpatient uses, 5 mg in a single dose is a fairly high dose and usually reserved for acute conditions like panic, severe agitation, or as a pre-anesthesia medication. The initial dose of lorazepam is usually 0.5 mg to 1 mg, and most people are not started above 2 mg per dose.

Lorazepam Dosage Adjustments

Some health conditions may require dose adjustment or avoiding lorazepam altogether:[12]

• Liver or kidney problems: Lorazepam is broken down by the liver and excreted through the kidneys. People with kidney or liver problems can accumulate lorazepam with regular use, increasing the risk of side effects.
• Older adults: Adults 65 or older may start with a lower dosage because of their increased sensitivity to lorazepam side effects that increase the risk of falls or injuries.
• Potential drug interactions: Lorazepam can interact with different medications, causing an increase in the amount of lorazepam in the body.

How to Take Lorazepam

Lorazepam is given as an IV or IM injection by a doctor or as an oral tablet you can take at home. It can be taken with or without food. Lorazepam tablets may be cut or crushed for people who struggle to swallow pills.

Lorazepam Overdose

It’s possible to overdose on lorazepam if you take too much or combine it with drugs that affect its elimination. Some of the symptoms of lorazepam overdose include confusion, drowsiness, lethargy, breathing difficulty, and coma.[13]

A lorazepam overdose is a medical emergency. If you suspect someone is overdosing, call 911 immediately and wait for help to arrive.

Determining the Right Lorazepam Dosage

Lorazepam dosage is unique to the individual. Doctors determine the right dosage based on many factors and considerations:

People new to lorazepam, people with existing medical conditions, and older adults are started on the lowest effective dose.

Side effects such as dizziness, drowsiness, weakness, and confusion are common and may subside as your body adjusts to the medication.[14] More serious effects like dependence or respiratory depression can occur with prolonged or high dosages, so side effects should be monitored.

Lorazepam and other benzodiazepines are prescribed for short-term relief, ideally 2-4 weeks.[15]

People with a history of substance use disorder, benzodiazepine misuse, or other addictions should be prescribed benzos with extreme caution.

If lorazepam is taken longer than 2-4 weeks, stopping suddenly can cause withdrawal symptoms like insomnia, anxiety, seizures, or delirium. Gradual tapering is recommended to slowly wean the body off of lorazepam and reduce withdrawal symptoms.

Lorazepam Dosage Requires Doctor Supervision

Lorazepam is available in several forms with recommended dosages; however, the proper dosage for your health and condition requires a doctor’s supervision. Never change your dosage without your doctor’s recommendation – even reducing it – and discuss any concerns or side effects you’re experiencing.

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