There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
Mode of Action
Alprazolam binds to stereospecific benzodiazepine receptors on the postsynaptic GABA neuron at several sites w/in the CNS, including the limbic system, reticular formation. Enhancement of the inhibitory effect of GABA on neuronal excitability results by increased neuronal membrane permeability to Cl ions, which results in hyperpolarisation (a less excitable state) and stabilisation. Benzodiazepine receptors and effects appear to be linked to the GABA-A receptors.
Interaction
Potentiates action of alcohol and CNS depressants. Reduced conc with cigarette smoking by 50%.
Potentially Fatal: Cimetidine and fluoxetine reduce the clearance of alprazolam. Alprazolam enhances activity of imipramine and desipramine.
Pregnancy Category Note
Pregnancy category: D
Lactation: Enters breast milk/not recommended
Minor tranquilizers should be avoided in first trimester of pregnancy due to increased risk of congenital malformations
Maternal use shortly before delivery is associated with floppy infant syndrome (good and consistent evidence)
Prenatal benzodiazepine exposure slightly increases oral cleft risk (limited or inconsistent evidence)
Adult Dose
Oral
Short-term management of anxiety
Adult: 0.25-0.5 mg tid, increased to 3-4 mg daily if necessary.
Elderly: Initially, 0.25 mg bid/tid.
Panic attacks
Adult
Immediate-release
0.5 mg PO q8hr; may increase q3-4Days by ?1 mg/day
Average dose: 5-6 mg/day PO
May require up to 10 mg/day PO divided q8hr
Extended-release
0.5-1 mg PO qDay; may increase q3-4Days by <1 mg/day
Average dose: 3-6 mg PO qDay
Anxiety Associated With Depression
1-4 mg/day PO divided q8hr
Hepatic impairment: Avoid in severe impairment.
Child Dose
<18 years old: Not recommended
Renal Dose
Renal impairment: Use caution; not studied
Administration
Administration May be taken with or without food. Side effects eg sleepiness/drowsiness may be reduced if taken immediately after meals.
Disclaimer
The information provided herein are for informational purposes only and not intended to be a substitute for professional medical advice, diagnosis, or treatment. Please note that this information should not be treated as a replacement for physical medical consultation or advice. Great effort has been placed to provide accurate and comprehensive data. However, Medicart along with its authors and editors make no representations or warranties and specifically disclaim all liability for any medical information provided on the site. The absence of any information and/or warning to any drug shall not be considered and assumed as an implied assurance of the Company.