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
Klonopin
Ativan vs. Klonopin Dosage
Ativan
Klonopin
| 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 |
| 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
| 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
| 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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