Can You Take Ibuprofen with Lorazepam?
A plain-English look at the major interaction between Ibuprofen (APO-Ibuprofen 400) and Lorazepam (ATIVAN Lorazepam 1mg tablet blister pack) — what it means, why it happens, and what to talk to your doctor or pharmacist about.
Taking Ibuprofen (APO-Ibuprofen 400) with Lorazepam (ATIVAN Lorazepam 1mg tablet blister pack) is a major drug interaction that should be avoided. Life-threatening respiratory depression, overdose, coma, and death. Additive CNS and respiratory depression. Both drug classes suppress breathing through different mechanisms, creating synergistic respiratory depression that can be fatal.
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Key Takeaways
- Interaction severity: Major
- Risk: Life-threatening respiratory depression, overdose, coma, and death.
- Mechanism: Additive CNS and respiratory depression. Both drug classes suppress breathing through different mechanisms, creating synergistic respiratory depression that can be fatal.
- Ibuprofen: S2 in Australia, low risk
- Lorazepam: S4 in Australia, moderate risk
- Claims action: Flag for immediate prescriber review. Document intervention in claim file.
Ibuprofen vs Lorazepam at a Glance
| Property | Ibuprofen | Lorazepam |
|---|---|---|
| Brand names | APO-Ibuprofen 400, WGR-IBUPROFEN 400, Brufen | ATIVAN Lorazepam 1mg tablet blister pack, ATIVAN Lorazepam 2.5mg tablet blister pack, ATIVAN lorazepam 1mg tablet bottle |
| Drug class | opioid | benzo |
| Risk level | low | moderate |
| TGA Schedule (AU) | S2 | S4 |
Why Is This Combination Dangerous?
Additive CNS and respiratory depression. Both drug classes suppress breathing through different mechanisms, creating synergistic respiratory depression that can be fatal.
Regulatory Guidance by Jurisdiction
Australia TGA / SIRA / WorkSafe
The TGA and Australian Medicines Handbook classify this as a major drug interaction requiring immediate intervention.
All Australian state workers compensation schemes (SIRA NSW, WorkSafe VIC, WorkCover QLD) flag concurrent opioid and benzodiazepine prescribing as high-risk. SIRA best practice guidelines explicitly recommend avoiding this combination except in exceptional circumstances with specialist oversight.
United Kingdom NICE / MHRA / FPM
NICE NG193 (Chronic Pain) recommends against initiating opioids for chronic primary pain. The Faculty of Pain Medicine (FPM) Opioids Aware guidelines strongly advise against concurrent opioid and benzodiazepine prescribing. For personal injury claims in the UK, this combination should be flagged for specialist review. Costs for medication review may be recoverable as a disbursement.
United States FDA / CDC / State WC
The FDA requires a Boxed Warning on all opioid and benzodiazepine products about the risks of concurrent use. The CDC Clinical Practice Guideline (2022) recommends clinicians avoid prescribing opioids and benzodiazepines concurrently whenever possible. Most state workers compensation drug formularies flag or restrict this combination.
What Claims Professionals Should Do
- Flag immediately as a high-risk prescribing pattern in the claim file
- Request urgent prescriber review with documented clinical justification for the combination
- Consider an independent medical examination if the prescriber cannot provide adequate justification
- Assess work capacity impact as the combination significantly increases sedation and impairment risk
- Document all interventions for audit trail and compliance purposes
- Check Reasonable and Necessary status for both medications against the compensable injury
Clinical reference
A clinical summary of Ibuprofen and Lorazepam drawn from regulator advisories, national guidelines, and authoritative drug references. Read this if you want the deeper clinical picture before talking to your prescriber or pharmacist.
Severity assessment
Informational. No direct drug-drug interaction has been identified between ibuprofen and lorazepam in available regulatory documents or major drug interaction databases.
Mechanism (plain English)
Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) that works by reducing the production of prostaglandins, which are chemicals in the body that cause pain and inflammation. Lorazepam is a benzodiazepine that works by enhancing the effects of a natural brain chemical called gamma-aminobutyric acid (GABA), which helps to calm nerve activity in the brain, leading to reduced anxiety and sedation.
Evidence level
Theoretical. Major regulatory bodies (TGA, MHRA, FDA) do not specifically flag an interaction between ibuprofen and lorazepam. The assessment is based on the lack of reported direct interaction and the distinct pharmacological mechanisms of each drug.
Top regulator advisories (cite verbatim or close paraphrase)
- TGA (Australia): No pair-specific public advisory found. Applicable product information for ibuprofen (TGA, OTC Medicine Monograph: Ibuprofen for oral use) lists interactions with anticoagulants, lithium, ACE inhibitors, beta-blockers, diuretics, methotrexate, cardiac glycosides, corticosteroids, zidovudine, probenecid, antidiabetic medicines, and phenytoin, but not lorazepam [1].
- MHRA / NICE (UK): No specific guidance found for ibuprofen and lorazepam interaction. The Summary of Product Characteristics (SmPC) for lorazepam (Medicines.org.uk) highlights risks from concomitant use with opioids and other CNS depressants due to profound sedation and respiratory depression, but does not mention ibuprofen [2].
- FDA / CDC (US): No specific FDA label or safety communication found for this pair. The FDA label for lorazepam (Ativan) warns about risks from concomitant use with opioids and other CNS depressants, but does not list ibuprofen as an interacting drug [3].
- EMA (Europe): No specific advisory found for this drug pair.
Clinical risk factors that elevate the danger
While there is no direct interaction, caution is advised if other central nervous system (CNS) depressants (e.g., alcohol, opioids, other sedatives) are taken concurrently with lorazepam, as this could lead to additive sedative effects. Ibuprofen carries risks of gastrointestinal bleeding, especially with prolonged use, higher doses, or in patients with a history of ulcers, and can interact with other medications like anticoagulants.
What a patient should be told
- You can generally take ibuprofen and lorazepam together, as there's no known direct interaction between them.
- Be aware that lorazepam can cause drowsiness and affect your ability to concentrate. Avoid alcohol and other sedating medications while taking lorazepam, as this can worsen these effects.
- If you experience unusual drowsiness, difficulty breathing, or any new or worsening symptoms, contact your doctor or pharmacist immediately.
- Always inform your doctor or pharmacist about all medications you are taking, including over-the-counter drugs and supplements, to ensure safe use.
- Do not stop taking lorazepam suddenly without consulting your doctor, as this can lead to withdrawal symptoms.
Top 3 sources (with full citation)
- Therapeutic Goods Administration. OTC Medicine Monograph: Ibuprofen for oral use. TGA. Available at: https://www.tga.gov.au/sites/default/files/otc-template-pi-ibuprofen.rtf (Accessed: June 1, 2026).
- Medicines.org.uk. Lorazepam 1mg Tablets - Summary of Product Characteristics (SmPC). Available at: https://www.medicines.org.uk/emc/product/6137/smpc (Accessed: June 1, 2026).
- U.S. Food and Drug Administration. Ativan (lorazepam) Tablets, C-IV Label. FDA. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/017794s044lbl.pdf (Accessed: June 1, 2026).
Notes for the reviewing pharmacist
While direct interaction between ibuprofen and lorazepam is not reported by major regulators, the potential for additive CNS depression should always be considered if lorazepam is co-administered with other CNS depressants. Ibuprofen's primary concerns revolve around gastrointestinal and cardiovascular risks, and interactions with other drug classes (e.g., anticoagulants, antihypertensives). The absence of a specific interaction warning for this pair in authoritative sources suggests a low direct risk, but a comprehensive patient medication review remains crucial to identify other potential interactions or contraindications based on individual patient factors and concomitant medications. Patient education should focus on lorazepam's CNS effects and the importance of avoiding other CNS depressants, as well as general NSAID precautions. The Drugs.com entry also supports the lack of a direct interaction, stating "no interactions found" but with the caveat that this doesn't necessarily mean no interactions exist.
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Related Resources
Important: This page is general health information, not personal medical advice. If you have questions about your medication — including starting it, stopping it, changing the dose, or combining it with something else — speak with your doctor or pharmacist. For an emergency or suspected overdose, call your local emergency number or poison information service immediately. Information is drawn from regulator and clinical guideline sources (TGA, FDA, MHRA, NICE, PBS, CDC); see our methodology for details.