Alprazolam(al prah’ zoe lam)
Alprazolam Extended ReliefDNC, Alprazolam Intensol, Apo-Alpraz (CAN), Apo-Alpraz TS (CAN), Gen-Alprazolam (CAN), Niravam, Novo-Alprazol (CAN), Xanax, Xanax TS (CAN), Xanax XRDNC
PREGNANCY CATEGORY D
CONTROLLED SUBSTANCE C-IV
Drug Classes
Anxiolytic
Benzodiazepine
Therapeutic Actions
Exact mechanisms of action not understood; main sites of action may be the limbic system and reticular formation; increases the effects of GABA, an inhibitory neurotransmitter; anxiety blocking effects occur at doses well below those necessary to cause sedation, ataxia.
Indications
Management of anxiety disorders, short-term relief of symptoms of anxiety; anxiety associated with depression
Treatment of panic attacks with or without agoraphobia (Niravam, Xanax, Xanax XR)
Contraindications and Cautions
Contraindicated with hypersensitivity to benzodiazepines, psychoses, acute narrow-angle glaucoma, shock, coma, acute alcoholic intoxication with depression of vital signs, pregnancy (crosses the placenta; risk of congenital malformations, neonatal withdrawal syndrome), labor and delivery (“floppy infant” syndrome), lactation (secreted in breast milk; infants become lethargic and lose weight).
Use cautiously with impaired liver or renal function, debilitation.
Available Forms
Tablets—0.25, 0.5, 1, 2 mg; ER tabletsDNC—0.5, 1, 2, 3 mg; oral solution—1 mg/mL; rapidly disintegrating tablets—0.25, 0.5, 1, 2 mg
Dosages
Individualize dosage; increase dosage gradually to avoid adverse effects; decrease dosage gradually (no more than 0.5 mg q 3 days) when discontinuing drug.
Adults
Anxiety disorders: Initially, 0.25–0.5 mg PO tid; adjust to maximum daily dose of 4 mg/day in divided doses at intervals of 3–4 days or extended-release form once per day in the AM once dosage is established (immediate release, intensol solution).
Panic disorder: Initially, 0.5 mg PO tid; increase dose at 3- to 4-day intervals in increments of no more than 1 mg/day; ranges of 1–10 mg/day have been needed. ER tablets—Initially, 0.5–1 mg/day; dosage range, 3–6 mg/day.
Geriatric patients or patients with advanced hepatic or debilitating disease
Initially, 0.25 mg bid–tid PO; gradually increase if needed and tolerated; ER tablets—0.5 mg PO once each day; gradually increase if needed and tolerated.
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