What is the generic name of Ativan?

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Lorazepam is the Generic Name for Ativan

Lorazepam is the generic pharmaceutical name, and Ativan is the brand name for this intermediate-acting benzodiazepine. 1

Pharmacological Classification

Lorazepam belongs to the benzodiazepine class of medications and functions as a positive allosteric modulator of GABA-A receptors, enhancing the inhibitory effects of gamma-aminobutyric acid (GABA) in the central nervous system. 1, 2

Key Pharmacokinetic Properties

  • Elimination half-life: 8-15 hours in adults, with no active metabolites, making it safer in patients with renal insufficiency compared to other benzodiazepines like diazepam. 1

  • Metabolism: Lorazepam undergoes direct glucuronide conjugation without requiring cytochrome P450 enzymes, which distinguishes it from midazolam and diazepam. 2

  • Duration of action: Classified as intermediate-acting, with a clinical duration approximately six times longer than midazolam in pediatric patients. 1

Clinical Applications

  • Alcohol withdrawal syndrome: Lorazepam is specifically recommended for patients with severe AWS, advanced age, recent head trauma, liver failure, respiratory failure, or other serious medical comorbidities, typically started at 6-12 mg/day and tapered following resolution of withdrawal symptoms. 3

  • Procedural sedation: Lorazepam is preferred for acute agitation due to its rapid and complete absorption and lack of active metabolites. 1

  • Acute agitation (refractory cases): Lorazepam 0.5-2 mg every 4-6 hours is recommended specifically for agitation that is refractory to high-dose antipsychotics, not as first-line treatment. 4

Important Safety Considerations

  • Elderly patients: In geriatric populations, lorazepam should be limited to 0.25-0.5 mg orally with a maximum of 2 mg per 24 hours due to substantially higher risk of delirium, falls, fractures, cognitive decline, and paradoxical agitation. 4

  • Avoid as first-line for delirium: Benzodiazepines including lorazepam should not be used as first-line treatment for agitated delirium except in cases of alcohol or benzodiazepine withdrawal, as they increase delirium incidence and duration and cause paradoxical agitation in approximately 10% of elderly patients. 4

  • Maximum daily dose: For acute agitation in non-elderly adults, the maximum recommended dose is 4 mg per 24 hours. 4

References

1
Guideline

Benzodiazepines: Mechanism of Action, Receptor Affinity, and Clinical Effects

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

2
Research

Midazolam and other benzodiazepines.

Handbook of experimental pharmacology, 2008

3
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

4
Guideline

Management of Aggressive Behavior in Geriatric Patients

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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