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Updated 11 February 2013

Alprazolam

Alprazolam is a relatively fast-acting tranquiliser with a short duration of action. The drug is indicated for the treatment of moderate to severe anxiety and panic disorders.

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Alprazolam is the active ingredient of Alzam, Azor, CPL Alliance Alprazolam, Merck-Alprazolam, Xanor and Zopax.

General Information

Alprazolam is a relatively fast-acting tranquiliser with a short duration of action. The drug is indicated for the treatment of moderate to severe anxiety and panic disorders. Some prescribers also apply alprazolam in the treatment of depression, social phobias, premenstrual syndrome (PMS) and irritable bowel syndrome (IBS). This benzodiazepine should in most cases not be used for longer than 8 weeks, as tolerance and physical and psychological dependence can occur. Anxiety and tension related to everyday life are therefore not treated with alprazolam. If prescribed for longer than 8 weeks, your prescriber should periodically reassess the need for alprazolam.

How does Alprazolam work?

Alprazolam has an effect on gamma-aminobutyric acid (GABA). GABA is the brain's quieting or tranquilising neurotransmitter, possessing an inhibitive effect on the transmission of nerve signals. Alprazolam, and other benzodiazepines, enhance the effect of GABA, thus slowing down the transmission of nerve signals and decreasing nervousness.

Fast facts

Drug schedule: Schedule 5

Available as: Tablets

What does it do? Alprazolam is a tranquiliser and relieves anxiety and tension

Overdose risk: High

Dependence risk: High

Available as a generic? Yes

Available on prescription only? Yes

User information

Onset of effect: Fast - within 2 hours.

Duration of action: Up to 6 hours.

Dietary advice: Alprazolam may be taken with or without food.

Stopping this medicine: Alprazolam should not be stopped abruptly. Sudden discontinuation may lead to withdrawal symptoms. The dosage of alprazolam should be gradually reduced according to the advice of your doctor.

Prolonged use: Short-term therapy - 6weeks or less - is advised. Do not take alprazolam for longer periods unless strictly instructed by your doctor.

Special precautions

Never exceed the prescribed dose of alprazolam.

Consult your doctor before using this drug if:

  • You have kidney or liver disease,
  • You have myasthenia gravis,
  • You have a chronic lung disease,
  • You have had a stroke or suffer from any CNS condition,
  • You have been diagnosed as being hyperactive,
  • You have a mental illness or depression,
  • You suffer from epilepsy,
  • You have sleep apnoea, or
  • You have a history of alcohol or drug abuse.

Pregnancy: Avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant

Breastfeeding: Avoid. This medication is passed through breast milk and may affect your baby adversely. Consult your doctor before use.

Porphyria: Avoid. It is unknown how this medication may affect your condition. Consult your doctor before use.

Infants and children: Do not use in children under the age of 18.

Elderly: Use with caution, as side effects may be emphasised.

Driving and hazardous work: Caution is advised as use of this medication may lead to dizziness, light-headedness and/or sedation. Avoid such activities until you know how it affects you.

Alcohol: Alprazolam may intensify the effect of alcohol and vice versa. Do not consume alcohol while taking this medication, as side effects may be drastically pronounced.

Possible side effects

Side effect

Frequency

Consult your doctor

Common

Rare

Only if severe

In all cases

Drowsiness

x

x

Loss of coordination / dizziness

x

x

Slurred speech

x

x

Change in libido

x

x

Fever/chills

x

x

Extreme fatigue

x

x

Nausea/vomiting

x

x

Rash/itching

x

x

Anger/behaviour changes

x

x

Yellow tinge to eyes / skin

x

x

Bruising/bleeding

x

x

Memory impairment

x

x

Interactions:

Drug interactions:

Alcohol, antihistamines, antidepressants, other benzodiazepines, narcotics

Increased depression of central nervous system (CNS)

Digoxin

Increased possibility of digoxin toxicity

Disulfiram

Increased possibility of alprazolam toxicity

Ketoconazole and other related antifungals

Increased possibility of alprazolam toxicity

Cimetidine

Increased possibility of alprazolam toxicity

Isoniazid

Increased possibility of alprazolam toxicity

Oral contraceptive

Increased possibility of alprazolam toxicity

Propranolol

Increased possibility of alprazolam toxicity

Valproic acid

Increased possibility of alprazolam toxicity

Isoniazid

Increased possibility of alprazolam toxicity

Levodopa

Decreases levodopa's anti-Parkinson effect

Probenecid

Increased possibility of alprazolam toxicity

Rifampicin

May decrease the effect of alprazolam

Theophylline

May counteract the sedative effects of alprazolam

Disease interactions

Consult your doctor before using this drug if you have kidney or liver disease, myasthenia gravis, chronic lung disease, have had a stroke or suffer from any CNS condition, epilepsy, sleep apnoea or if you have a mental illness or depression.

Overdose action

An overdose of alprazolam can be serious. Seek immediate emergency medical attention. Symptoms may include poor coordination, slow breathing, tremors, drowsiness, slurred speech, confusion, slow reflexes and loss of consciousness.

Recommended dosage

Adults: 0.25-05mg/day in 2-3 divided doses (May be increased to a maximum of 4mg/day)

Children: Not recommended

Elderly: 0.25mg/day in 2-3 divided doses (may be increased to a maximum of 2mg/day)

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.

 
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