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Midazolam vs. Ativan

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Midazolam (Seizalam, Versed) and Lorazepam (Ativan) are both benzodiazepines, but they are used for different purposes and have different forms. Midazolam is used for sedation before surgeries and to treat long-lasting seizures. It comes as an injection, oral syrup, and nasal solution and is typically administered by a healthcare provider. Lorazepam, on the other hand, is mainly used for short-term treatment of anxiety and can also be used to control seizures. It is available in oral tablets, oral solution, and as an injection. Midazolam works quickly and is often used in a monitored setting due to its risk of severe breathing problems, while Lorazepam can be taken at home but has a risk of dependence and withdrawal symptoms if used long-term. Both medications can cause drowsiness and should not be mixed with alcohol. Midazolam is not safe to use late in pregnancy, while Lorazepam can harm your baby if taken during pregnancy.

Midazolam

 

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Lorazepam

(Ativan)

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Summary for Midazolam

Prescription only

Midazolam is used for sedation before surgery and other medical procedures in children and adults, as well as treatment for status epilepticus (long-lasting seizures) in adults. It comes as an injection and oral syrup. The medication is typically given by a healthcare provider in a monitored setting and can't be used at home. Some side effects of midazolam include nausea, agitation, drowsiness, and pain at the injection site for the injection form. And although the brand name Versed has been discontinued, there are many generics still available.

Indications for Midazolam

  • Sedation for surgery or other medical procedure
  • Long-lasting seizure (status epilepticus) - Seizalam

Pros and Cons for Midazolam

Pros

  • Works within minutes to help you relax and feel calm before a medical procedure
  • Available as an injection and an oral syrup
  • Can be used in young children for sedation before a procedure

Cons

  • Risk of severe breathing problems so it should only be used in a healthcare facility
  • Can cause hangover effect and raise the risk of falls
  • Not safe to use late in pregnancy

Common Side Effects for Midazolam

Oral syrup

  • Vomiting (8%)
  • Nausea (4%)

Injection for sedation

  • Pain at injection site (4-5%)
  • Hiccups (4%)
  • Nausea (3%)
  • Vomiting (3%)

Injection for long-lasting seizure

  • Upper airway blockage (5%)
  • Agitation (4%)
  • Fever (4%)
  • Confusion (3%)

Warnings for Midazolam

  • Severe difficulty breathing
  • Continued memory problems after procedure
  • Harm to unborn baby if used in late pregnancy
  • Worsening of glaucoma

Summary for Ativan

Prescription only

Lorazepam (Ativan) is a benzodiazepine used for short-term treatment of anxiety. The oral tablets and solution are taken by mouth, typically 1 to 3 times daily, depending on the formulation. Lorazepam is also available as an injectable medication that's given by healthcare professionals in a hospital setting to control seizures. Sleepiness and dizziness are the most common side effects of lorazepam (Ativan).

Indications for Ativan

Pros and Cons for Ativan

Pros

  • Taken by mouth
  • Might start to work within 30 minutes to manage anxiety symptoms
  • Available as oral solution, good option for those who can't swallow tablets
  • Some forms available as a lower-cost generic

Cons

  • Short-term use only because risk of dependence and memory problems
  • Can drowsiness, and dizziness
  • Can cause withdrawal symptoms if stopped suddenly
  • Can't take with alcohol

Common Side Effects for Ativan

  • Sleepiness (16%)
  • Dizziness (7%)
  • Weakness (4%)
  • Unsteadiness (3%)

Warnings for Ativan

  • Sedation and difficulty breathing
  • Misuse, dependence, and withdrawal
  • Depression and suicidal thoughts or behaviors
  • Effect on driving and concentration
  • Trouble breathing
  • Risk of agitation and restlessness
  • Harm to babies
  • Serious allergic reaction (Loreev XR only)

Prices with our coupons for Midazolam vs. Ativan

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Midazolam1 vial / 2ml of 5mg/ml
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Lorazepam30 tablets / 1mg
$11.41$18.44
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