Ativan for Chemotherapy-Induced Nausea and Vomiting

Ativan (lorazepam) is typically prescribed for treating anxiety. Less often, it is used to help reduce nausea and vomiting due to chemotherapy.

The drug, which is a benzodiazepine, comes as a pill, a liquid, a tablet taken sublingually (under the tongue), or in a form that's used intravenously (IV, within a vein).

This article will go over how Ativan is used during chemotherapy, its side effects, and facts you should know before or while you are taking it.

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Use of Ativan During Chemotherapy

The most common side effect of chemotherapy is nausea and vomiting. There are many treatments that can help reduce this side effect.

Ativan is not approved by the Food and Drug Administration (FDA) for treating nausea associated with chemotherapy, and there are other drugs more effective than Ativan that can prevent nausea.

Sometimes, Ativan is used in the following settings:

  • To prevent nausea and vomiting before chemotherapy
  • To treat nausea and vomiting after chemotherapy

This medication can also be helpful due to its sedating properties. During and following chemotherapy, some people value the mild drowsiness this medication can cause.

While Ativan can be effective, it should not be taken alone as an anti-nausea drug. It should be added to an anti-nausea regimen of at least two other drugs. Ativan is most often used with other medications designed to prevent and control nausea, especially steroids such as Ozurdex or Maxidex (dexamethasone).

Side Effects

You may experience fatigue, dizziness, and weakness while taking Ativan. Other side effects include feelings of depression, sleep problems, and sleepiness. Let your healthcare provider know what you are experiencing.

If the side effects become bothersome, other anti-nausea medications can be prescribed. Sometimes it takes trying out a few different medications before finding the best one for you, and there are many available.

Before stopping or changing the dosage of Ativan, speak with your healthcare provider.

Dosage

Available only by prescription, Ativan is most often prescribed in a tablet form that can be swallowed or dissolved under the tongue. It can also be administered intravenously or by injection, which is helpful if you have severe vomiting.

If you're taking Ativan to prevent nausea and vomiting, the typical dosage is:

  • A 0.5 or 1 milligram (mg) tablet taken orally the night before chemotherapy, or the day of treatment, about one to two hours beforehand

If you are taking Ativan to treat nausea and vomiting after chemotherapy, the dosage is:

  • A 0.5 or 1 mg tablet taken orally every eight hours as needed

Some anti-nausea drugs need to be taken on a regular schedule to prevent nausea and are much less effective if you wait until you have symptoms. For people who have nausea that's associated with cancer treatment, Ativan usually is prescribed "as needed," meaning you won't need to take the medication on a regular schedule.

What If It Doesn't Work?

If Ativan doesn't help with your nausea and vomiting, your healthcare provider may change the dosage or prescribe another anti-nausea medication. Don't despair—many new and very effective medications have been approved for both the prevention and treatment of chemotherapy-induced nausea in recent years.

Precautions

Follow the directions given by your healthcare provider to minimize your chance of having side effects or an adverse reaction.

Tell your healthcare provider if you have any of the following:

  • Any history of addiction or substance misuse/abuse: Ativan can become habit-forming. The risk of addiction when used for chemotherapy, however, is very small. Use it exactly as directed.
  • Any medical issues you may have: This includes breathing problems, kidney or liver disease, glaucoma, a history of depression, suicidal thoughts, or an addiction to drugs or alcohol.
  • Any other medications you are taking: This includes prescription drugs, herbal supplements and vitamins, and over-the-counter (OTC) medications.

Warnings

Before taking Ativan, you should be aware of the following:

  • Ativan has a sedative effect: Use caution when driving and operating heavy machinery. It's a good idea to have someone drive you to and from chemotherapy.
  • Do not drink alcohol while taking Ativan: It can increase the effects of alcohol, and the combination of these medications (benzodiazepines) and alcohol can lead to a fatal overdose.

Tips for Reducing Nausea During Chemotherapy

There are several simple steps you can take to reduce your risk of developing nausea during your treatment. Most people require preventative measures, as well as medications. Trying to tough it out is not advised.

Some lifestyle measures that others have found helpful include:

  • Eat several small meals throughout the day instead of fewer, larger meals.
  • Don't skip eating before your chemotherapy. Eat a light meal so you don't feel hungry (hunger can increase nausea).
  • Eat food that you like if that helps your appetite.
  • Some people recommend avoiding your favorite foods during chemotherapy so you won't develop a negative association with these foods.
  • Try to avoid sweets or fried or fatty foods.
  • Chemotherapy can cause significant cancer fatigue. Cooking your meals in advance and freezing them or accepting friends' offers to bring food to you can be a lifesaver.
  • Drink plenty of fluids throughout the day.
  • Wear loose-fitting clothing.
  • Practice relaxation techniques, such as meditation and deep breathing.

A Word From Verywell

Nausea and vomiting from chemotherapy can cause physical and emotional distress. While Ativan may be best known as an anti-anxiety drug, it can also help prevent and treat chemotherapy-associated nausea and vomiting, as well as anxiety that's associated with nausea or vomiting.

Frequently Asked Questions

  • How quickly does Ativan work for nausea?

    The tablets and liquid tend to work within 20 to 30 minutes. If it is given intravenously, you will feel the effects sooner.

  • How long does Ativan last?

    The peak concentration in plasma happens about two hours after administration, meaning its effects are strongest then. It then slowly tapers off over several hours, with sedation lasting a total of six to eight hours.

    However, even after the effects are gone, it stays in your system for a while longer. The average half-life of the drug (when it is halfway eliminated in your body) is about 12 hours.

  • Is Ativan addictive?

    It can be, yes. It is a benzodiazepine, and these drugs can be habit forming. If you have a personal or family history of addiction or prescription abuse, talk with your doctor. Always use the drug exactly as prescribed. If you find yourself having trouble sticking to the treatment regimen, talk with your healthcare provider about switching to an alternative drug.

  • Will insurance cover Ativan?

    Yes, it typically does. This drug, especially the generic version, is inexpensive. Even if your health insurance doesn't cover it, your out-of-pocket price may be cheaper than your insurance co-pay for a more costly drug.

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Additional Reading
Originally written by Lisa Fayed