Alprazolam
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
- Pregnancy Rating: D
- Lactation risk: L3[1]
- Renal Dosing: no adjustment
- Hepatic Dosing:
- Start at min dose, slowly up-titrate dose amount and frequency to max of 4mg/day
Contraindications
- Allergy to class/drug
- Sleep apnea
- Concomitant Alcohol use
- Concomitant CNS depressant use
- Elderly
- Abuse history
- Hepatic disease (decreased clearance)
Adverse Reactions
Serious
- Respiratory depression/arrest
- Abuse
- Hypotension
- Syncope
- Hepatotoxicity
- Angioedema
- Steven-Johnson Syndrome
Common
- Altered mental status (drowsiness, fatigue, amnesia, impaired concentration, impaired coordination)
- Urinary incontinence/retention
Pharmacology
- Half-life: ~11hr
- Metabolism: Hepatic via CYP450:3A4 substrate
- Excretion: Urine
- Mechanism of Action: Enhances GABA effects by binding to specific benzodiazepine receptor
See Also
References
- ↑ Armstrong C. "ACOG Guidelines on Psychiatric Medication Use During Pregnancy and Lactation". Am Fam Physician. 2008 Sep 15;78(6):772-778.