Ativan and opioids are a risky duoAtivan manufacturer warns that the combination can cause respiratory arrest
Ativan (lorazepam) is a medication in a class of drugs called benzodiazepines.
The Food and Drug Administration (FDA) approved Ativan to treat anxiety, sleep disturbances, and seizures. It’s also sometimes administered shortly before anesthesia.
This common drug has been in the news from time to time over claims that it’s been involved in causing patients to commit self-harm or suicide. For example, in 2017, rock star Chris Cornell was found dead from suicide.
His family filed a medical malpractice wrongful death lawsuit against the doctor who gave Chris a prescription for Ativan. They contended that he over-prescribed it without even performing a proper examination of Chris.
Eventually, the Cornell family and the physician reached a confidential settlement.
Ativan side effects
In the product label, the manufacturer of Ativan warns that using the medication with opioids “may result in profound sedation, respiratory depression, and death.” Opioids are a class of powerful painkillers.
The warning advised prescribing physicians, physician assistants, and nurse practitioners to reserve using Ativan, when patients are also on opioids, only when alternative treatment options are inadequate.
Further, the product label warns that studies have shown that giving overlapping opioid painkillers and Ativan increases the risk of drug-related death. If it’s absolutely necessary to give both types of drugs simultaneously, the manufacturer of Ativan recommends giving a lower initial dose and then making adjustments carefully based on the patient’s response.
One type of medical malpractice claim involving Ativan involves a physician or provider writing a prescription for a patient who has primary depressive disorder or psychosis. Studies show that patients with pre-existing depression may worsen after being given Ativan or another benzodiazepine. Some experts link this to suicides.
Another type of medical negligence claim involves the failure to closely monitor a patient who’s given both Ativan and opioid pain medications. Both the manufacturer and the standard of care require following patients closely for signs and symptoms of respiratory depression and sedation in these circumstances.
This was the problem for one of our clients in the Dallas area. Let’s call him Kevin. Kevin went to a hospital emergency room (ER) because he was having problems breathing. Imaging showed that he had a pneumothorax that would a procedure for decompression. Pneumothorax is an abnormal collection of air in the chest that interferes with normal lung function.
Over the course of his ER encounter, the emergency physician and nursing staff felt he was becoming anxious. Looking back, it seems obvious that the cause of his anxiety was his difficulty breathing. Instead of expediting treatment to address the underlying cause and help Kevin breathe, the doctor ordered Ativan—despite the fact that Kevin had already received multiple opiate pain medications.
The hospital’s medication computer system issued a warning, which the ER nurse overrode. She gave a dose of Ativan to Kevin. Inconsistent with the standard of care and manufacturer recommendations, no one monitored Kevin closely for signs and symptoms of respiratory depression and sedation.
Within 30 minutes of receiving Ativan, Kevin went into respiratory distress and arrested. Because of a delayed response in resuscitating him, Kevin was left with a permanent hypoxic brain injury.
If you’ve been seriously injured because of poor medication management in Texas, then contact a top-rated, experienced Texas medical malpractice attorney for free consultation about your potential case.
Robert Painter is an award-winning medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits all over Texas. Contact him by calling 281-580-8800 or emailing him right now.
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