Alprazolam

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General

  • Type: Benzodiazepines
  • Dosage Forms: ODT Immediate Release - 0.25, 0.5, 1, 2mg tablets. Extended Release - 0.5, 1, 2, 3mg tablets, Oral liquid, 1mg/mL
  • Common Trade Names: Xanax, Xanax XR, Niravam

Adult Dosing

Anxiety

0.25-0.5mg PO TID, Max: 4mg/day

Pediatric Dosing

<18 years old: Not recommended

Special Populations

  • Hepatic Dosing:
    • Start at min dose, slowly uptitrate dose amount and frequency to max of 4mg/day

Contraindications

  • Allergy to class/drug
  • Sleep apnea
  • Concomitant Alcohol use
  • Concominant CNS depressant use
  • Elderly
  • Abuse history
  • Hepatic disease (decreased clearance)

Adverse Reactions

Serious

Common

  • Altered mental status (drowsiness, fatigue, amnesia, impaired concentration, impaired coordination)
  • Urinary incontinence/retention

Pharmacology

  • Half-life:
  • Metabolism: Hepatic via CYP450:3A4 substrate
  • Excretion: Urine
  • Mechanism of Action: Enhances GABA effects by binding to specific benzodiazepine receptor

See Also

References

  1. Armstrong C. "ACOG Guidelines on Psychiatric Medication Use During Pregnancy and Lactation". Am Fam Physician. 2008 Sep 15;78(6):772-778.