Lorazepam with Levonorgestrel Interaction Details
Brand Names Associated with Lorazepam
- Ativan®
- Lorazepam
- Lorazepam Intensol®
- Loreev XR®
Brand Names Associated with Levonorgestrel
- Fallback Solo®
- Levonorgestrel
- Next Choice® One Dose
- Opcicon® One-Step
- Plan B® One-Step
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 13, 2023
Interaction Effect
Decreased lorazepam effectiveness
Interaction Summary
Combination contraceptives may increase benzodiazepine metabolism by glucuronidation of lorazepam. Women taking combination contraceptives may require a higher dose of lorazepam .
Severity
Moderate
Onset
Delayed
Evidence
Probable
How To Manage Interaction
Monitor patients receiving concurrent combination contraceptives and lorazepam therapy for a reduced response to the benzodiazepine.
Mechanism Of Interaction
Increased hepatic metabolism of lorazepam
Literature Reports
A) Some data indicate that oral contraceptives can enhance the metabolism and reduce serum levels of lorazepam, which undergoes glucuronide conjugation . 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 .
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 .
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) . 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.
Lorazepam Overview
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Lorazepam is used to relieve anxiety. Lorazepam is also used to treat insomnia caused by anxiety or temporary situational stress. Lorazepam is in a class of medications called benzodiazepines. It works by slowing activity in the brain to allow for relaxation.
Levonorgestrel Overview
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Levonorgestrel is used to prevent pregnancy after unprotected sexual intercourse (sex without any method of birth control or with a birth control method that failed or was not used properly [e.g., a condom that slipped or broke or birth control pills that were not taken as scheduled]). Levonorgestrel should not be used to prevent pregnancy on a regular basis. This medication is to be used as an emergency contraceptive or backup in case regular birth control fails or is used incorrectly. Levonorgestrel is in a class of medications called progestins. It works by preventing the release of an egg from the ovary or preventing fertilization of the egg by sperm (male reproductive cells). It also may work by changing the lining of the uterus (womb) to prevent development of a pregnancy. Levonorgestrel may prevent pregnancy, but it will not prevent the spread of human immunodeficiency virus (HIV, the virus that causes acquired immunodeficiency syndrome [AIDS]) and other sexually transmitted diseases.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.