alprazolam XANAX

Class: Benzodiazepine/​Triazolo
FDA Indications: Panic Disorder, Anxiety Disorders
Off-Label Use: Insomnia, Alcohol Withdrawal, Preanesthetic, PMDD, Depression
FDA Schedule IV
Forms: 0.25, 0.5, 1, 2mg tablet
Dose Range: 0.25-10 mg/day
Starting: 0.25-0.5 mg tid; titrate dose q3-4 days; Patients requiring doses >4 mg/day should be increased cautiously.
Stopping: Abrupt discontinuation should be avoided. Daily dose may be decreased by 0.5 mg q3 days; however, some patients may require a slower reduction.

NAMI drug fact sheet

Contraindications: Acute narrow angle glaucoma, sleep apnea
Serious Side Effects: Overdose can result in hypotension, respiratory depression, and coma
Side Effects: constipation, dysarthria, sedation/somnolence, dizziness, confusion, disequilibrium, ataxia, lightheadedness, weakness/asthenia, decreased libido, increased appetite, weight gain
Target: GABAA: α2, γ2 (high); α1, α3, β3 (low to moderate)
t½: 12 (9-20)° TMAX: 1-2°
Absorption Rate: Medium
Lipid Solubility: Moderate
Substrate of: 3A4; 1A2
Inhibits: ∅ ; Induces:
Active Metabolites:
  • - ↑ stage 2 and ↓ stages 1, 4 and REM sleep
  • - low degree of sedation
  • - withdrawal sx may be especially severe
  • - antidpressant effect
Special Populations

Category D—↑ risk of oral cleft by 0.01%, use just before delivery associated with floppy infant syndrome, 3rd trimester use can cause withdrawal in newborns

Low incidence of infant toxicity and AEs associated with benzodiazepine use during breastfeeding. Benzodiazepines with shorter half-lives (i.e., lorazepam, alprazolam, and oxazepam) have been found to be very low in breast milk

T½ ↑ ≈ 45%; initiate at 0.25 mg bid-tid

2019 BEE℞S Recommendation: Avoid. Older adults have increased sensitivity to benzodiazepines and decreased metabolism of long- acting agents; in general, all benzodiazepines increase risk of cognitive impairment, delirium, falls, fractures, and motor vehicle crashes in older adults. May be appropriate for seizure disorders, RBD, benzodiazepine withdrawal, EtOH withdrawal, severe GAD, and periprocedural anesthesia.

Renal insufficiency has a quantitatively small influence on pharmacokinetics; no dosage adjustments provided in the manufacturer's labeling

T½ ↑ ≈ 73% in patients with alcohol liver disease


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Last updated February 29 2024 20:54:18. Disclaimer: This website does not provide medical advice, nor is it a substitute for clinical judgment.