Ativan Dosing Considerations

Initial Dosing and Administration

• The British Medical Journal recommends starting with 0.5-1 mg orally for anxiety or agitation, with a maximum of 2 mg in 24 hours for elderly or debilitated patients 1
• For severe anxiety requiring more frequent dosing, the British Medical Journal suggests using 0.25-0.5 mg four times daily (maximum 2 mg in 24 hours) in elderly patients, compared to 0.5-1 mg four times daily (maximum 4 mg in 24 hours) in younger adults 1
• Oral tablets can be used sublingually for faster onset when patients have difficulty swallowing, as recommended by the British Medical Journal 1
• The British Medical Journal also recommends considering switching to subcutaneous midazolam 2.5-5 mg every 2-4 hours (reduced to 5 mg over 24 hours if eGFR <30 mL/min) for patients unable to swallow 1