How Long Does Ativan (lorazepam) Stay in Your System?

Ativan (lorazepam) is the brand name of a drug called lorazepam, which is part of a class of drugs known as benzodiazepines. Ativan is a sedative, tranquilizer, anticonvulsant, and central nervous system depressant drug used to treat seizure disorders, like epilepsy. It’s commonly used before and after surgical procedures to relieve anxiety. Additionally, Ativan is used to treat insomnia, agoraphobia – a condition where a person feels fear of certain places and situations that may cause panic, embarrassment, or helplessness, labyrinthitis – inflammation of the inner ear or the nerves that connect the inner ear to the brain, as well as drug withdrawal – symptoms that occur after stopping or reducing drug intake. You must have a doctor’s prescription to obtain Ativan. It comes in liquid or tablet form, or can be injected. The medication is generally taken by mouth and with or without food, according to a doctor’s directions. The Drug Enforcement Administration has Ativan as a Schedule IV drug, meaning they believe it’s at a low potential for abuse and at a low risk for dependence. Other examples of Schedule IV drugs include Tramadol, Valium, Darvon, Xanax, Soma, and Ambien. Ativan is approved by the FDA to treat children age 12 and up for insomnia and anxiety, and to treat adults with anxiety, insomnia, epilepsy, and as premedication before an anesthetic procedure.
Packs of Ativan pills sitting on a table.
Lorazepam was first patented in 1963 and went on sale for the first time in the U.S. in 1977. It is on the World Health Organization’s list of essential medicines. According to the CDC, in 2012, prescribers wrote 37.6 benzodiazepine prescriptions per 100 people in the U.S. Alabama, Tennessee, and West Virginia were the three highest-prescribing states. Benzodiazepines, along with opioid pain relievers are the prescription drugs most often responsible for emergency room visits and drug-related deaths. Emergency department visits increased by 138 percent in 2011 for central nervous system depressants to 422,000 visits. Of those visits, 85 percent involved benzodiazepines like Ativan. In 2012, Pharmacy Times ranked lorazepam number 48 on the list of the 200 most frequently prescribed medications in the U.S.
The majority of central nervous system depressants act on the brain by increasing activity at receptors for the inhibitory neurotransmitter gamma-aminobutyric acid (GABA). Through this ability to increase GABA signaling, an increase of brain activity also occurs, producing a drowsy or calming effect. By calming excessive brain activity, Ativan helps relieve symptoms of anxiety like restlessness, tension, irrational fears, and irritability. The nervous system also adjusts to the effects of Ativan and a tolerance to the drug is able to develop. If a person continues use, higher doses of the drug may be needed to achieve the same sensations of relaxation and calm. Ativan does not affect the liver as much as most benzodiazepines, an important consideration for people who may be taking birth control pills, anti-abuse drugs, ulcer medications, and other drugs that affect the liver.

Side Effects of Ativan Use:

  • Drowsiness
  • Dizziness
  • Loss of coordination
  • Headache
  • Nausea
  • Blurred vision
  • Changes in sexual interest/ability
  • Constipation
  • Heartburn
  • Change in appetite

Interactions with other drugs may change how Ativan works or increase your risk for serious side effects. Some other substances that may interact with Ativan use include kava, clozapine, GHB, certain antihistamines, other medications for sleep or anxiety like diazepam, muscle relaxants, narcotic pain relievers, and psychiatric medications.

Even when prescribed by a doctor, Ativan can become habit-forming. Continued or long-term use of Ativan can lead to dependence and withdrawal when use is abruptly stopped or reduced. Due to the fact that Ativan slows brain activity, stopping use can cause a rebound effect resulting in seizures or other harmful consequences. Ativan dependency can turn into Ativan addiction over time. In 2013, 1.7 million Americans age 12 or older admitted to using tranquilizers like lorazepam for nonmedical reasons.

The warning signs of Ativan addiction include:

  • Needing large doses of the drug to get the same desired effects
  • Persistent misuse of the drug even when experiencing negative health effects and wellbeing consequences
  • Attempts to stop using Ativan without success
  • Preoccupation with getting and using Ativan at the expense of other relationships and important responsibilities
  • Buying or selling Ativan in a recreational manner

After months or years of Ativan misuse, the cumulative effects can result in serious health consequences. Many times Ativan is seen as a safer drug than heroin or meth because it is legal and prescribed by a doctor, but if used in the wrong way it can be just as harmful as any other substance. Although Ativan does not generally cause suppression of the respiratory or cardiovascular system, a fatal overdose can occur if the drug is mixed with other central nervous system depressants.

Long-term misuse of Ativan can have serious health consequences including:

  • Increased drowsiness or sedation
  • Memory loss
  • Learning difficulties
  • Slow, shallow breathing
  • Confusion or disorientation
  • Increased anxiety
  • Physical and mental fatigue
  • Kidney issues
  • Seizures
  • Tremors
  • Mouth sores
  • Bleeding in the digestive tract
  • Headaches
  • Loss of appetite
  • Dementia
The average half-life for Ativan is approximately 12 hours. This means that after taking your last dose, it may take around 2.75 days for the drug to be fully eliminated from your system. The active metabolite of lorazepam glucuronide has a longer half life of 18 hours. To fully eliminate this metabolite from your system will take longer than Ativan itself. Lorazepam glucuronide will stay in your system and can be detected in your urine for up to 4 days after you ingest the Ativan. An estimated 13.5 percent of lorazepam is eliminated as various minor metabolites. Within 5 days of taking the drug, nearly 95 percent of a lorazepam dose will have been fully eliminated.

Factors that Influence How Long Ativan (lorazepam) Stays in Your System

Individual factors can highly influence how long Ativan stays in your system and how quickly it can be eliminated.

  • Age – People who are older exhibit 22 percent slower clearance rates of Ativan when compared to younger people. There are a number of theories about why younger people clear Ativan quicker than older people including health conditions, metabolic rate, blood flow, and organ functionality.
  • Body height/weight – A person’s height and weight in relation to the dosage of Ativan take may greatly impact how long it stays in the system. There is evidence that being overweight can speed up Ativan clearance, while a short/light person make take longer to excrete the drug than a tall/heavy person when they’ve taken the same amount.
  • Genetics – Ability to metabolize Ativan may stem from genetic factors like specific liver enzymes and/or kidney function. People who are poor metabolizers of Ativan may take longer to clear it from the body.
  • Kidney function – Research shows that liver impairment does not have a significant impact on the body’s ability to clear Ativan, however it’s thought that kidney functionality could determine how quickly the drug is cleared. Renal issues could slow the excretion of Ativan from your body.
  • Metabolic rate – People with a fast metabolic rate may process Ativan quicker than those with slower rates.
  • Frequency of use – Someone who takes 3 Ativan pills a day will take longer to clear their system than someone who only takes one pill in the morning. Frequent/long-term users of Ativan are more likely to build a tolerance to the drug’s effects and will likely have to increase their dosage. This is why frequent users may require a longer term before Ativan is completely cleared from their system.
  • Other substances – Ingestion of other medications and drugs along with Ativan can impact its absorption, metabolism, and speed of clearance from your system. Drinking alcohol can reduce clearance rates by 18 percent.
There are several tests that can be administered to test the presence of Ativan or lorazepam.

  • Urine tests – Lorazepam can be detected in a person’s urine for 6 days after ingestion. In frequent users, the detection window for Ativan in urine could surpass a week. If a urinalysis aims to detect the metabolite lorazepam-glucuronide it may be detected for up to 9 days after ingestion.
  • Blood tests – Ativan can be detected in the bloodstream within 6 hours of ingestion and up to 3 days afterwards. For frequent users, it may take longer than 3 days to clear Ativan from the bloodstream.
  • Hair tests – To detect Ativan use over a longer time period, hair tests are utilized. A properly conducted hair test can reveal whether someone has used Ativan for up to 4 weeks after exposure.
  • Saliva tests – The detection window for lorazepam in saliva is approximately 8 hours. Saliva tests are rarely conducted to detect Ativan or other benzodiazepine use.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.