Supplements and Lorazepam.
Lorazepam, sold under the brand name Ativan, is a benzodiazepine: it potentiates GABA at the GABA-A receptor.
Lorazepam is a benzodiazepine. The class potentiates GABA at the GABA-A receptor, producing sedation, anxiolysis, muscle relaxation, and anticonvulsant effects. UK general practice now prescribes mostly short courses for acute anxiety or sleep. Longer prescriptions are managed via specialist psychiatry, given the tolerance and dependence profile that emerges within four to six weeks of regular use. The supplement interactions that matter are additive sedation. Kava (where available, MHRA suspended 2003), valerian, magnesium glycinate at high doses (the glycine half rather than the magnesium drives the sedation), and CBD all stack on benzodiazepine effect. Alcohol is the combination most flagged in BNF and MHRA materials, given the additive respiratory depression. Lorazepam and temazepam are metabolised by glucuronidation rather than CYP, so most CYP-active supplements do not change their plasma levels. Diazepam runs through CYP3A4, so the standard 3A4 supplement interactions apply.
Below are the 7 documented pairs we have explicitly assessed against Lorazepam in the Distil database: 1 red, 5 amber, and 1 green. The pairs cluster around 3 mechanisms: Additive CNS depression, Additive CNS sedation, and Glucuronidation (no CYP interaction). Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not on this list is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by supplement, and the missing-item form at the bottom of the page routes any uncatalogued supplement into our next curation pass.
Documented interactions
Additive CNS depression
Kava and lorazepam both depress the central nervous system, and kava is independently linked to liver injury. Combining the two raises the risk of excessive sedation. We treat this as a do-not-combine pair.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Ashwagandha can have a mild sedating effect on top of its main anti-stress action. Combined with lorazepam, the sedation can stack.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Lemon balm and lorazepam both calm the nervous system through overlapping pathways. Combining them may mean stronger drowsiness and slower reactions than either tends to give on its own.
Passionflower and lorazepam both calm the nervous system through overlapping pathways. Combining them can mean stronger drowsiness and slower reactions.
Valerian and lorazepam both promote sedation through overlapping pathways. Combining them can mean stronger drowsiness, slower reaction time, and a heavier morning hangover than either gives on its own.
Additive CNS sedation
Melatonin and lorazepam can both promote drowsiness, so taking them together may add to the sedation and slow your reaction time more than either does alone. Use with care, particularly around driving.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Glucuronidation (no CYP interaction)
Lorazepam is broken down by a different enzyme system (glucuronidation) than the one St John's Wort affects. We treat this pair as no expected interaction.
What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope (food-supplement interactions only; for drug-drug interactions, the BNF is authoritative). Use the checker below to surface any supplement, and submit a missing item if you take something we have not catalogued.
How we grade severity, choose what's in scope, and what we exclude.
Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.
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This page checks the pairs you enter. The personalised Distil report goes further:
- the same graded, cited interaction check across your whole stack, not just the pairs you thought to type in
- where your current routine may be leaving you short of your goals
- the evidence-backed compounds worth adding, and the ones worth dropping
It's a paid report: £79, or £49 for the first 25 customers. The interactions check is one section of it, and you can read a real one in full before you buy.
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