From the Guidelines
A recommended taper schedule for a patient taking Ativan (lorazepam) 1mg for 2 weeks is to reduce the dose by 25% every 1-2 weeks, as suggested by the CDC guideline for prescribing opioids for chronic pain - United States, 2016 1. To implement this schedule, the patient can decrease their dose from 1mg to 0.75mg daily for 1-2 weeks, then to 0.5mg daily for 1-2 weeks, and finally to 0.25mg daily for 1-2 weeks before stopping completely. Some key points to consider during the taper include:
- Monitoring for potential withdrawal symptoms such as anxiety, irritability, insomnia, or headaches
- Slowing down the taper if severe symptoms occur
- Completing the full taper rather than stopping midway
- Avoiding alcohol during this period as it affects similar brain receptors
- Discussing the taper schedule with the prescribing healthcare provider to personalize it based on individual factors, as they can provide guidance on managing any withdrawal symptoms that may arise 1.
From the FDA Drug Label
To reduce the risk of withdrawal reactions, use a gradual taper to discontinue lorazepam or reduce the dosage If a patient develops withdrawal reactions, consider pausing the taper or increasing the dosage to the previous tapered dosage level. Subsequently decrease the dosage more slowly
A recommended taper schedule for a patient taking Ativan (lorazepam) 1mg for 2 weeks is not explicitly stated in the FDA drug label. However, it is recommended to use a gradual taper to discontinue lorazepam or reduce the dosage.
- The label suggests that if a patient develops withdrawal reactions, the taper should be paused or the dosage increased to the previous level, and then decreased more slowly.
- A patient-specific plan should be used to taper the dose.
- It is also recommended to monitor patients closely for signs and symptoms of withdrawal reactions. 2 2
From the Research
Taper Schedule for Ativan (Lorazepam)
- The recommended taper schedule for Ativan (lorazepam) is not directly stated in the provided studies, but we can look at the taper schedules for other medications to get an idea of how to proceed.
- A study on tapering clonazepam, another benzodiazepine, suggests reducing the dosage by 0.5 mg per 2-week period until 1 mg per day is reached, followed by a decrease of 0.25 mg per week 3.
- This taper schedule can be used as a guideline for tapering Ativan (lorazepam), but it's essential to note that the dosage and taper schedule may need to be adjusted based on individual patient needs and tolerance.
- Another study suggests that tapering should be done gradually, over months or years, and in a hyperbolic manner to reduce the risk of relapse 4.
- For patients taking Ativan (lorazepam) 1mg for 2 weeks, a possible taper schedule could be:
- Reduce the dosage by 0.25 mg every 2-4 weeks
- Alternatively, reduce the dosage by 0.5 mg every 4-6 weeks
- It's crucial to monitor the patient's response to the taper schedule and adjust as needed to minimize withdrawal symptoms.
Considerations
- The taper schedule should be individualized based on the patient's medical history, current dosage, and tolerance to the medication.
- Patients should be closely monitored for withdrawal symptoms, and the taper schedule should be adjusted accordingly.
- The use of a taper schedule can help minimize the risk of withdrawal symptoms, but it's essential to be aware of the potential for withdrawal symptoms to occur even with a gradual taper 5, 6.