How To Take Lorazepam (Ativan) Intensol

In our latest question and answer, our pharmacist discusses how to properly take the medication lorazepam (Ativan) Intensol solution.

Nov 22, 2017

Morgan asked

What is the proper way to take lorazepam intensol liquid? The directions are take 2mg every 6 hours as needed and the medication has a concentration of 2mg per ml. I’ve heard that you are supposed to mix it with something like juice or water or semi solid food. Do I have to do that or can I take it as it is?

Answer

The manufacturer of Lorazepam Intensol Oral Concentrate (Ativan), West-Ward Pharmaceuticals, does recommend that the product “be mixed with liquid or semi-solid food such as water, juices, soda or soda-like beverages, applesauce and puddings.” Below, I will describe the potential reason why the manufacturer has made these recommendations.

 

What Might Happen If I Take Lorazepam Intensol Without Mixing It?

Again, I would recommend to always follow the administration instructions as listed by the manufacturer. The manufacturer has observed and studied patients taking their drug and have evidence to support their claims. In this case, it may be inconvenient to always have something to mix the medication with, but in order to ensure that the product works as intended, taking the medication as directed is critical.

The package insert for Lorazepam Intensol Oral Concentrate does not state a particular reason why the product must be mixed other than the fact that it is a concentrated version of the medication. A couple of potential reasons why the manufacturer may have deemed it critical to mix the medication are palatability and absorption.

Palatability, or taste, is essential when manufacturing a drug. If the medication is too distasteful, viscous, or bitter, patients will not be compliant with their drug regimen. Lorazepam is a drug that is not particularly water-soluble and must be dissolved in polyethylene glycol and propylene glycol. Because the Intensol formulation is in a concentrated form, it may be particularly bitter and viscous without mixing it and the package insert states that it should blend quickly and completely.

Absorption of the medication is important to ensure that the medication has the desired effect in the body. In this case, lorazepam is generally absorbed fine with or without food. I would not expect the absorption of the Intensol formulation to be significantly impacted by not mixing the medication in food or liquid.

In this case--a spoonful of sugar makes the medicine go down. Mixing the medication with food or liquid will help dilute the medication to make it easier to take. Other important tips are to only mix what you will take immediately as the product may not be stable for long once diluted. Additionally, the medication should be stored in the fridge, kept in it’s original container to protect from light, and should be discarded 90 days after its opened. 

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