What Drugs Should You Avoid While Taking Lorazepam? Alcohol, Opioids, and Supplement Interactions

What drugs should you avoid while taking lorazepam? The short list is alcohol, opioids, and anything else that slows the central nervous system: sleep medications, muscle relaxants, sedating antihistamines, and herbal supplements such as valerian root. Lorazepam, sold as Ativan, is a benzodiazepine, and its boxed warning is blunt about the worst pairing: “Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death” [1]. A second group of prescription medications changes how strongly lorazepam works, and a third group of medical conditions makes the drug itself unsafe. If lorazepam has stopped being a medication and started being a habit, Ativan addiction treatment in Minnesota can address the dependence and the anxiety together. The key takeaways:

• Alcohol and opioids are dangerous combinations; each one plus lorazepam can stop breathing.
• Other CNS depressants add up: sleep aids, muscle relaxants, antipsychotic medications, gabapentin, and drowsy antihistamines each increase drowsiness.
• Probenecid and valproate raise lorazepam levels; theophylline can blunt its effect; several antibiotics, antifungals, and HIV medicines need a pharmacist’s review.
• Never stop taking lorazepam abruptly to avoid an interaction; withdrawal symptoms can be life-threatening on their own.

Why Lorazepam Drug Interactions Are Dangerous

Lorazepam enhances the effects of GABA, the brain’s main inhibitory neurotransmitter, which reduces central nervous system activity and produces its calming and sedating effects. That same CNS depression can slow reaction time, impair coordination and judgment, and, especially when combined with opioids, alcohol, or other sedatives, contribute to dangerous respiratory depression [1]. The parent guide explains what benzodiazepines are and how they work. Risk generally rises with higher exposure, older age, underlying respiratory problems, and the number of other CNS depressants being used.

Timing matters too. Lorazepam’s sedating effects can last for hours, and the drug remains in the body after the strongest effects are no longer noticeable. That means taking lorazepam earlier in the day does not automatically make alcohol or another sedative safe later. Our chapter on lorazepam duration covers onset, peak effects, and how long the medication remains in the body.

Mixing Lorazepam and Alcohol

Alcohol is one of the clearest substances to avoid with lorazepam. The Ativan prescribing information lists alcohol among the CNS depressants that can intensify lorazepam’s effects, and the Medication Guide warns that alcohol can make sleepiness and dizziness much worse [1]. Combining the two can increase sedation, impair balance and reaction time, worsen coordination and memory, and in severe cases contribute to respiratory depression [1][2].

There is no established number of drinks that can be considered safe while lorazepam is still affecting you. Cleveland Clinic advises avoiding alcohol for at least 48 hours after a single lorazepam dose [2], but that is clinical guidance rather than a universal cutoff and may not apply to someone taking lorazepam regularly or clearing it more slowly. Anyone who drinks regularly should tell the prescriber before starting lorazepam because alcohol can also worsen ordinary Ativan side effects such as drowsiness, dizziness, and impaired coordination.

Opioids and Other CNS Depressants

Opioids

Opioids are the reason behind the boxed warning. The FDA required the boxed warning on every benzodiazepine and every opioid in 2016 because of overdose deaths from the combination [3], and in 2021 nearly 14 percent of opioid overdose deaths in the United States also involved a benzodiazepine [4]. That includes prescribed pain medications such as oxycodone, hydrocodone, morphine, tramadol, and methadone, and opioid cough medicines with codeine. If both drugs are medically necessary, the label calls for the lowest doses for the shortest time and close monitoring for sedation and respiratory depression [1]. Lorazepam is not an opioid, and the two classes act on different receptors; the confusion between them is covered here.

Other CNS Depressants

The Ativan label groups the rest: barbiturates, antipsychotic medications, other sedative-hypnotics, anxiolytics, antidepressants, sedative antihistamines, anticonvulsants, and anesthetics all produce “increased CNS-depressant effects” with lorazepam [1]. In practice, watch for the following interactions: sleep medications such as zolpidem, muscle relaxants such as baclofen and tizanidine, gabapentin and pregabalin, other benzodiazepines, and drowsy allergy medicines. One antipsychotic gets its own warning: clozapine with lorazepam has produced “marked sedation, excessive salivation, hypotension, ataxia, delirium, and respiratory arrest” [1]. Extreme sedation, low blood pressure, and trouble breathing are the signs the combination has gone wrong.

Prescription Medication That Changes How Lorazepam Works

A second set of certain medications does not add sedation directly but changes lorazepam’s level in the body. Probenecid, a gout medication, and valproate, used for epilepsy and bipolar disorder, both slow lorazepam’s clearance and raise its concentration, so the label calls for a lower lorazepam dose alongside either one [1]. Theophylline and aminophylline, asthma medications, can do the opposite and reduce lorazepam’s sedative effects [1]. The NHS adds a longer list to raise with a doctor: certain antibiotics such as rifampicin and isoniazid, antifungal medicines such as fluconazole, HIV medicines such as ritonavir, proton pump inhibitors, and disulfiram, the alcohol-dependence medication [5].

Lorazepam has fewer of these metabolic interactions than alprazolam, because it is cleared by a pathway that most antibiotics and antifungals do not block. That difference is one of several covered in the difference between lorazepam and Xanax.

Over the Counter Medicines and Herbal Supplements

Over the counter does not mean interaction-free. Diphenhydramine and doxylamine, the sedating antihistamines in many allergy pills and “PM” pain relievers and sleep aids, increase drowsiness with lorazepam, and cough and cold products can contain codeine or other sedating ingredients [5]. MedlinePlus advises telling the doctor and pharmacist about every nonprescription medication, vitamin, nutritional supplement, and herbal product [6].

Herbal supplements marketed for sleep or anxiety are the ones to watch. The NHS advises against “herbal remedies for anxiety or insomnia, such as valerian or passionflower” because they intensify drowsiness, and notes there is not enough safety data on other herbal remedies with lorazepam [5]. Valerian root, kava, and CBD products fall in that category. Anyone hoping to replace the prescription with something from the health-food aisle should read our chapter on natural alternatives to Ativan first, then talk to the prescriber.

Who Should Not Take Lorazepam: Allergic Reaction, Acute Narrow Angle Glaucoma, and Other Conditions

Some interactions are with the body rather than other drugs. The label lists two contraindications: hypersensitivity to benzodiazepines, meaning a prior allergic reaction, and acute narrow-angle glaucoma, a contraindication shared across the class [1]. Lorazepam should also be used with caution in people with compromised breathing, such as COPD or sleep apnea, and elderly or debilitated patients are more susceptible to its sedative effects [1]. Lorazepam is present in breast milk, and there are reports of sedation, poor feeding, and poor weight gain in infants exposed through breastfeeding [1]. People with a history of substance use carry a higher risk of misuse and dependence; our chapter on Ativan dependence and addiction explains how quickly it develops.

How to Prevent Interactions

Many interaction risks can be reduced by keeping one current list of every prescription medicine, over-the-counter product, vitamin, and supplement you use and showing it to each healthcare provider and pharmacist. Using one pharmacy when possible can also make interaction screening easier, although no automated system catches every risk. Read the Medication Guide and instructions for the specific lorazepam product you take, because formulations and directions can differ. Ask a healthcare professional before adding another sedating medication or supplement, and avoid alcohol unless your prescriber specifically tells you otherwise.

One rule matters more than the rest: do not stop lorazepam suddenly because you are worried about an interaction. After continued use, abrupt discontinuation or rapid dose reduction can cause acute withdrawal reactions that may be life-threatening [1]. Benzodiazepine withdrawal symptoms can include seizures. Call the prescriber instead. If someone taking lorazepam becomes impossible to wake, has very slow or stopped breathing, develops blue or gray lips, or has severe confusion, call 911. If opioid exposure is possible, give naloxone if it is available.

Frequently Asked Questions About Lorazepam Interactions

Final Thoughts: Getting Help for Lorazepam Use in Minnesota

If lorazepam has become difficult to use safely, or if you are combining it with alcohol, opioids, or other substances, talk with a healthcare professional before making any changes. Physical dependence can occur even when lorazepam is taken as prescribed, and abrupt discontinuation can be dangerous. Northwoods Haven’s intensive outpatient program provides treatment for substance use alongside anxiety, insomnia, and other mental health concerns on a schedule designed around work and family. Reach out for a confidential conversation about where to begin.

Sources

1. U.S. Food and Drug Administration, ATIVAN (lorazepam) tablets prescribing information, revised January 2023. https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/017794s049lbl.pdf
2. Cleveland Clinic, “The Dangers of Mixing Lorazepam and Alcohol,” Health Essentials, March 12, 2025. https://health.clevelandclinic.org/lorazepam-and-alcohol
3. U.S. Food and Drug Administration, “New Safety Measures Announced for Opioid Analgesics, Prescription Opioid Cough Products, and Benzodiazepines,” August 31, 2016. https://www.fda.gov/drugs/food-and-drug-administration-overdose-prevention-framework/new-safety-measures-announced-opioid-analgesics-prescription-opioid-cough-products-and
4. National Institute on Drug Abuse, “Benzodiazepines and Opioids,” accessed September 24, 2026. https://nida.nih.gov/research-topics/opioids/benzodiazepines-opioids
5. National Health Service (UK), “Taking Lorazepam With Other Medicines and Herbal Supplements,” page last reviewed February 14, 2023. https://www.nhs.uk/medicines/lorazepam/taking-lorazepam-with-other-medicines-and-herbal-supplements/
6. MedlinePlus (National Library of Medicine), “Lorazepam,” last revised November 15, 2025. https://medlineplus.gov/druginfo/meds/a682053.html