Can you take Lorazepam and Diazepam together? (3+ ADRs)

In this article, we will discuss whether Diazepam and Lorazepam can be taken together on the same day or not. We will further explore the potential interactions and risk of side effects by their concomitant use, the potential benefits of combining them and precautions and medications when taking both medications simultaneously.

Can you take Lorazepam and Diazepam together?

You may or may not take Lorazepam and Diazepam together on the same day. The decision should be made by your healthcare provider as both medications are CNS depressants and their concomitant use may exacerbate the risk of CNS depressant side effects. (1)

Diazepam and Lorazepam, both belong to the benzodiazepine class of drugs. They are commonly prescribed for the treatment of various medical conditions including anxiety disorders, muscle spasms, and seizures and may also be used for alcohol withdrawal. (1,2)

Your doctor might prescribe you take both medications together in certain situations, however, it’s important to keep in mind that everyone responds differently and this combination might not suit everyone. So, proper monitoring is required.

Are there any interactions between Lorazepam and Diazepam? 

Lorazepam and Diazepam, both being benzodiazepines, when taken together can interact with each other and increase the risk of side effects. Both of these medications have similar mechanisms of action as they exert their effects by stimulating the activity of GABA (gamma amino butyric acid) which is an inhibitory neurotransmitter and produces calming and sedative effects on the nervous system. (1,2)

Their concomitant use may result in additive effects, heightening the risk of adverse reactions. Some potential drug interactions may include: (2)

Increased sedation: Combing Lorazepam and Diazepam can intensify the sedative effects, leading to excessive drowsiness and impaired cognitive and motor functions. 

Respiratory depression: The combination may increase the risk of respiratory depression, especially in individuals who already have respiratory disorders. 

Drug dependency and withdrawal: combing benzodiazepines like Lorazepam and Diazepam may enhance the potential for drug dependence and withdrawal symptoms. 

CNS depression: Both mendicants are considered CNS depressants and their concomitant use may heighten the CNS-related side effects like increased sedation and disruption of focus and alertness in a person. (4)

What does research suggest?

According to a research study, scientists performed a randomised clinical trial to determine the possible interactions between Zopiclone (sleeping pill) and two commonly used benzodiazepines, Diazepam (5mg) and Lorazepam (1mg). (3)

The researchers observed psychomotor performance in individuals after administrating these medications and noted the results and different intervals such as 1,6,8,12 and 24 hours after giving the drugs. They also took their blood samples to find out how much drug was in their body. (3)

The results showed that combining these drugs made people’s performance worse and severely affected their psychomotor skills, especially at 1 hour after ingesting the medication. The adverse effects were noticed to decline after 6-8 hours. (3)

The researchers concluded that concomitant use of benzodiazepines can make people more sleepy and dissociate from reality for a short time. The person starts to regain focus once the drugs start to leave the symptom. (3)

What are the key differences between Lorazepam and Diazepam?

Some key distinctions between Lorazepam and Diazepam are discussed in the table below: (1,2)

 What are the potential benefits of using Lorazepam and Diazepam together? 

In certain medical situations, your healthcare provider may prescribe a combination of benzodiazepines for specific reasons. The decision of their concomitant use depends on the individual patient’s needs, medical conditions and the judgement of the prescribing doctor.

Here I’m discussing some potential scenarios where a combination of the two drugs might be considered: (1,2)

• Severe anxiety or Panic disorders: In some cases, individuals with severe anxiety and panic disorders may not respond adequately to a single benzodiazepine. Combing medications might be considered for a more robust and immediate calming effect. 
• Seizure management: For certain types of seizures especially in the case of status epilepticus (a prolonged seizure), a combination of benzodiazepines may be used to achieve rapid and more effective seizure control. 
• Sedation for medical procedures: In situations where severe sedation is required for medical procedures or interventions, a combination of benzodiazepines like Diazepam and Lorazepam might be used to achieve the desired level of sedation. 

What are the other side effects of Lorazepam and Diazepam? 

Both of these medications, being benzodiazepines, share common side effects though the severity and prevalence can vary from person to person and their concomitant use may heighten the risk of addive effects. (1,2)

Common side effects:

• Drowsiness
• Dizziness
• Fatigue
• Blurred vision

Less common side effects:

• Memory impairment
• Gastrointestinal disturbances (nausea, vomiting or changes in appetite)
• Changes in libido
• Dry mouth or excessive salivation

Serious side effects:

• Respiratory depression
• Dependence and withdrawal
• Paradoxical reactions (in some cases, people may experience increased anxiety, agitation or aggression instead of relaxation)

How to safely co-administer Lorazepam and Diazepam? 

The co-administration of Lorazepam and Diazepam should only be done under a qualified healthcare professional. They will determine the appropriateness of co-administering these two medications based on your specific medical conditions and needs. (1)

Your doctor will access your detailed medical history including any pre-existing conditions, medications you’re currently taking and potential risk factors for adverse effects. If your doctor decides that the co-administration is necessary, close monitoring is required. Regular follow-up appointments must be scheduled to evaluate your response to the medications and make necessary adjustments if needed. (2)

The dosage of each medication will likely be carefully titrated to achieve the desired therapeutic effect with the least risk of side effects. Individualization of the treatment plan is crucial as responses to medications can vary widely among individuals. (4)

It’s important to remember that the co-administration of Lorazepam and Diazepam is suitable for only short-term use in specific medical situations, their long-term management should be avoided. 

Avoid excessive drinking of alcohol and intake of other CNS depressants while you’re under benzodiazepine use as it may exacerbate the risk of interactions and potential side effects like excessive sedation and respiratory depression. (1,2)

Final thoughts on the co-administration of Lorazepam and Diazepam:

As a pharmacist, I would suggest not using these medications concurrently unless and until the medical condition is crucial and your healthcare provider has evaluated the benefit-to-risk ratio profile.

Also, I would strongly suggest you not to self-prescribe yourself with benzodiazepines because of their addictive and CNS-depressant nature. Must be sure to follow your doctor’s instructions and inform them in case you experience any unusual or troublesome symptoms. Do not stop taking these medications on your own abruptly as it will result in consequential withdrawal side effects.

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