Xanax
Generic Name
alprazolam
Manufacturer
Pfizer (original brand), various generic manufacturers
Country
USA (original brand)
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Description
Overview of the medicine
Alprazolam is a benzodiazepine used to treat anxiety disorders, panic disorder, and anxiety associated with depression. It works by enhancing the effects of a certain natural chemical in the body (GABA).
Uses & Indications
Dosage
Adults
Anxiety: Initially 0.25 mg to 0.5 mg, three times daily. Max 4 mg/day. Panic Disorder: Initially 0.5 mg three times daily. Max 10 mg/day.
Elderly
Initially 0.25 mg, two to three times daily. Dosage should be limited to the lowest effective dose to prevent the development of oversedation or ataxia.
Renal_impairment
No specific dose adjustment guidelines; use with caution in patients with severe renal impairment due to potential for accumulation of metabolites.
How to Take
Oral administration. May be taken with or without food. Extended-release tablets should be swallowed whole; do not crush, chew, or break them.
Mechanism of Action
Alprazolam binds to specific benzodiazepine receptors on the gamma-aminobutyric acid-A (GABA-A) receptor complex, which are widely distributed in the central nervous system. This binding enhances the inhibitory effects of GABA, leading to CNS depression, anxiolysis, sedation, and muscle relaxation.
Pharmacokinetics
Onset
Anxiolytic effects typically begin within 15-30 minutes.
Excretion
Excreted primarily in the urine, mainly as metabolites, with less than 20% excreted as unchanged drug.
Half life
Mean elimination half-life is approximately 11.2 hours (ranging from 6.3 to 26.9 hours) in healthy adults.
Absorption
Rapidly and well absorbed after oral administration. Peak plasma concentrations are achieved within 1 to 2 hours for immediate-release tablets.
Metabolism
Extensively metabolized in the liver, primarily by cytochrome P450 3A4 (CYP3A4) to two major active metabolites: alpha-hydroxyalprazolam and 4-hydroxyalprazolam.
Side Effects
Contraindications
- •Hypersensitivity to alprazolam or other benzodiazepines
- •Acute narrow-angle glaucoma
- •Concomitant use with strong CYP3A inhibitors (e.g., ketoconazole, itraconazole)
Drug Interactions
Opioids
Increased risk of respiratory depression, profound sedation, coma, and death.
CNS Depressants (e.g., alcohol, other benzodiazepines, hypnotics, antipsychotics, antidepressants)
Additive CNS depressant effects.
CYP3A4 Inhibitors (e.g., ketoconazole, itraconazole, fluconazole, grapefruit juice, cimetidine, fluvoxamine, nefazodone)
Increased plasma concentrations of alprazolam, leading to enhanced effects.
Storage
Store at room temperature (20-25°C or 68-77°F). Keep away from moisture, heat, and direct light. Keep out of reach of children and pets.
Overdose
Symptoms of overdose include somnolence, confusion, impaired coordination, diminished reflexes, and coma. Treatment is primarily supportive, including monitoring vital signs. Flumazenil, a benzodiazepine receptor antagonist, may be used with caution.
Pregnancy & Lactation
Pregnancy Category D. Alprazolam can cause fetal harm when administered to a pregnant woman. Not recommended during pregnancy. Excreted in breast milk, avoid during lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
2-3 years, depending on the manufacturer and specific product formulation.
Availability
Pharmacies, Hospitals
Approval Status
FDA Approved
Patent Status
Expired
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Global Brand Names
International brand names for this medicine
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