Ativan vs. Klonopin

See how Ativan and Klonopin compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Ativan and Klonopin are both benzodiazepines, but Ativan is approved for anxiety while Klonopin is approved for seizure disorders and panic disorder.

  • Klonopin's long half-life allows once-daily maintenance dosing, while Ativan typically needs multiple doses a day for sustained anxiety relief.

  • Both carry boxed warnings for abuse, dependence, and dangerous interactions with opioids, so neither should be stopped abruptly or mixed with opioids without medical guidance.

Ativan vs. Klonopin Drug Summary

Ativan

Ativan (lorazepam) is a benzodiazepine used to treat anxiety disorders and provide short-term relief of anxiety symptoms, including anxiety linked to depression. It comes as an oral tablet, an oral concentrate, and an injection, with the injectable form also used for preanesthetic sedation.

Klonopin

Klonopin (clonazepam) is a benzodiazepine approved for certain seizure disorders and for panic disorder, with or without agoraphobia. It comes as an oral tablet or an orally disintegrating wafer, and its long half-life allows once-daily maintenance dosing after initial titration.

Ativan vs. Klonopin Side Effects

Ativan

Most common
sedation (up to 15.9%)
dizziness (up to 6.9%)
weakness (up to 4.2%)
unsteadiness (up to 3.4%)

Klonopin

Most common
drowsiness (up to 50%)
ataxia (up to 30%)
behavior problems (approximately 25%)
dizziness (up to 12%)

Ativan vs. Klonopin Dosage

Ativan

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 0.05 mg/kg IM At the start
Maximum dose 1 to 10 mg/day If needed
Dose changes 2 increases As tolerated

Klonopin

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 0.01-0.03 mg/kg/day At the start
Maximum dose up to 20 mg/day If needed
Dose changes 5 increases Every 3 days

Ativan vs. Klonopin Indications

Ativan

Ativan is FDA-approved for anxiety disorders and short-term relief of anxiety symptoms, including anxiety tied to depression. The injectable form is also approved for preanesthetic sedation before procedures. It is sometimes used off-label for status epilepticus and for insomnia related to anxiety or stress.

  • Management of anxiety disorders

  • Short-term relief of anxiety symptoms

  • Anxiety associated with depressive symptoms

  • Preanesthetic sedation (injection form)

Klonopin

Klonopin is FDA-approved for certain seizure disorders, including Lennox-Gastaut syndrome and absence seizures, as well as for panic disorder with or without agoraphobia. It is not FDA-approved for generalized anxiety disorder, though it is sometimes used off-label for that purpose. Other off-label uses include restless legs syndrome, insomnia, and tardive dyskinesia.

  • Certain seizure disorders (Lennox-Gastaut, absence)

  • Panic disorder, with or without agoraphobia

  • Off-label: generalized anxiety disorder

  • Off-label: restless legs syndrome and insomnia

Ativan vs. Klonopin Pros and Cons

Ativan

Ativan works quickly and comes in multiple forms, including an injectable option for acute sedation before procedures. It costs substantially less than Klonopin on average, though it is not approved for seizures or panic disorder and generally needs more frequent dosing.

Pros

  • Available as an oral tablet, concentrate, or injection for rapid use

  • Roughly $10 to $40 per month without insurance, before savings programs

  • FDA-approved specifically for short-term anxiety and preanesthetic sedation

  • Extended-release option (Loreev XR) allows once-daily dosing

Cons

  • Not FDA-approved for seizure disorders or panic disorder

  • Shorter duration of action often means multiple daily doses

  • Not recommended for people with significant liver or kidney impairment

  • Sedation and unsteadiness risk rises notably with age

Klonopin

Klonopin's long half-life gives steadier drug levels and allows once-daily maintenance dosing, and it covers both seizure disorders and panic disorder under FDA approval. It typically costs more than Ativan and is not approved for generalized anxiety disorder, a common reason it gets prescribed off-label.

Pros

  • FDA-approved for several seizure disorders and panic disorder

  • Long half-life of 20 to 50 hours provides steadier blood levels

  • Available as an orally disintegrating tablet for easier swallowing

  • Maintenance dosing can drop to once daily after initial titration

Cons

  • Roughly $100 to $300 per month without insurance, before savings programs

  • Not FDA-approved for generalized anxiety disorder, a common off-label use

  • Long half-life can lead to accumulation, especially in older adults

  • Brand-name product is largely discontinued, so only generic is available

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