From the Research
Sublingual (SL) Ativan (lorazepam) typically begins to take effect within 5-10 minutes after administration, with peak effects occurring around 60-90 minutes after dosing. This rapid onset makes it useful for acute anxiety and seizure management. The sublingual route allows the medication to be absorbed directly into the bloodstream through the blood vessels under the tongue, bypassing first-pass metabolism in the liver that occurs with oral administration 1. This results in faster onset compared to swallowed tablets, which may take 30-60 minutes to begin working. For optimal absorption, patients should place the tablet under the tongue and allow it to dissolve completely without swallowing.
The duration of action is approximately 6-8 hours for most patients, with a half-life of around 12.9 hours 1. Common doses range from 0.5-2 mg, depending on the indication and patient characteristics. Elderly patients and those with liver impairment may experience effects more quickly and for longer periods, so dose adjustments are often necessary in these populations. It's worth noting that while lorazepam is effective for anxiety and seizure management, other benzodiazepines like clonazepam and midazolam may also be suitable alternatives in certain situations 2, 3.
Key points to consider when administering SL Ativan include:
- Rapid onset of action within 5-10 minutes
- Peak effects occurring around 60-90 minutes after dosing
- Duration of action approximately 6-8 hours
- Common doses range from 0.5-2 mg
- Potential for increased sensitivity in elderly patients and those with liver impairment
- Alternative benzodiazepines like clonazepam and midazolam may be suitable in certain situations.