Lorazepam and Levonorgestrel Intrauterine System: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Lorazepam
Levonorgestrel Intrauterine System
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Decreased lorazepam effectiveness
Interaction Deep Dive
Combination contraceptives may increase benzodiazepine metabolism by glucuronidation of lorazepam152. Women taking combination contraceptives may require a higher dose of lorazepam 6.
Why it happens (mechanism)
Increased hepatic metabolism of lorazepam
Literature reports
3 reports — tap to read
a) Some data indicate that oral contraceptives can enhance the metabolism and reduce serum levels of lorazepam, which undergoes glucuronide conjugation 23. In seven healthy women receiving oral contraceptives containing norethindrone 1 mg and ethinyl estradiol 50 mcg for at least six months, the administration of intravenous lorazepam 2 mg resulted in a 55% decrease in the half-life and a 50% increase in the volume of distribution of lorazepam. The total clearance of lorazepam was increased 3.7-fold as compared with that of eight healthy control females 4.
b) The half-life resulting from intravenous lorazepam 2 mg was reduced (from 13.4 hours to 4.8 hours) and the clearance was higher (302 mL/minute vs 78 mL/minute) in eight women while receiving oral contraceptives compared with nine women who were not taking oral contraceptives 1.
c) Another report indicates that the metabolic clearance of lorazepam (and oxazepam) was not significantly affected by concurrent oral contraceptive therapy (50 mcg or less of estrogen) 5. The differences observed in these reports might be explained by differences in patient sample size or characteristics; the number of patients (controls and lorazepam-treated patients) was greater in the Abernethy report.
Common questions
Can I take Lorazepam and Levonorgestrel Intrauterine System together?
Decreased lorazepam effectiveness Always confirm with your pharmacist or prescriber before making any change.
How serious is the Lorazepam and Levonorgestrel Intrauterine System interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "delayed". Effects tend to build up gradually over days to weeks.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Lorazepam or Levonorgestrel Intrauterine System need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (6)
- Stoehr GP, Kroboth PD, Juhl RP, et al: Effect of oral contraceptives on triazolam, temazepam, alprazolam, and lorazepam kinetics. Clin Pharmacol Ther 1984; 36:683-690. PubMed
- Patwardhan RV, Mitchell M, Johnson R, et al: Induction of glucuronidation by oral contraceptive steroids (abstract). Clin Res 1981; 29:861A.
- Patwardhan RV, Mitchell MC, Johnson RF, et al: Differential effects of oral contraceptive steroids on the metabolism of benzodiazepines. Hepatology 1983; 3:248-253. PubMed
- Product Information: Ativan(R), lorazepam. Wyeth Laboratories Inc. Philadelphia, PA, 1997. DailyMed
- Abernethy DR, Greenblatt DJ, Ochs HR, et al: Lorazepam and oxazepam kinetics in women on low-dose oral contraceptives. Clin Pharmacol Ther 1983; 33:628-632. PubMed
- Product Information: Ativan(R), lorazepam. Wyeth Laboratories Inc. Philadelphia, PA, 1997. DailyMed
Keep reading about Lorazepam
Keep reading about Levonorgestrel Intrauterine System
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
Check another combination
Our instant two-drug interaction checker is almost here.
Still have questions about this combination?
Every question gets a real answer from a licensed pharmacist — free, and usually within a day.
Ask the pharmacist