Alprazolam

Listed in Dosage.

Adult: PO Short-term management of anxiety In patients with moderate or severe anxiety states, or anxiety associated with depression: As conventional tab, orally-disintegrating tab, oral solution: 0.25-0.5 mg tid, may be increased if as necessary every 3-4 days to a total of 3 or 4 mg/day. Treatment duration: 8-12 weeks, including a tapering off process. Panic disorder with or without agoraphobia As conventional tab, orally-disintegrating tab, oral solution: Initially, 0.5 mg tid, may be increased in increments of not more than 1 mg/day every 3-4 days; if required, doses of up to 10 mg/day may be used. As extended-release tab: Initial: 0.5-1 mg once daily, may be increased in increments of not more than 1 mg/day every 3-4 days; doses of up to 3-6 mg/day may be used.

May be taken with or without food. Side effects eg sleepiness/drowsiness may be reduced if taken immediately after meals.

Myasthenia gravis, severe respiratory insufficiency, sleep apnoea syndrome, acute narrow-angle glaucoma. Severe hepatic impairment. Concomitant use with potent CYP3A4 inhibitors (e.g. ketoconazole, itraconazole).

Patients with depression, suicidal tendencies, psychiatric or personality disorder, respiratory disease, history of drug abuse or acute alcoholism. Patients who are debilitated, obese, smoker, or at risk of falls. Concomitant use with opioids. Avoid abrupt withdrawal. Renal and mild to moderate hepatic impairment. Elderly. Pregnancy and lactation. Patient Counselling This drug may cause drowsiness, sedation, amnesia, impaired concentration or muscle function, if affected, do not drive or operate machinery. Monitoring Parameters Monitor CV and respiratory status.

Significant: Suicidal ideation, CNS depression, anterograde amnesia, psychiatric and paradoxical reactions, interdose symptoms (e.g. early morning anxiety, breakthrough anxiety), sleep-related activities (e.g. sleep-driving, cooking, eating or making phone calls while asleep), tolerance, abuse, psychological and physical dependence; rebound or withdrawal symptoms including seizures. Cardiac disorders: Palpitations, chest pain. Endocrine disorders: Hyperprolactinaemia. Eye disorders: Blurred vision. Gastrointestinal disorders: Constipation, dry mouth, nausea, vomiting, increased salivation. General disorders and administration site conditions:Ataxia, lethargy, fatigue, irritability. Hepatobiliary disorders: Jaundice, abnormal hepatic function, hepatitis. Investigations: Weight increased or decreased, increased intraocular pressure. Metabolism and nutrition disorders: Decreased or increased appetite. Musculoskeletal and connective tissue disorders: Muscle weakness, arthralgia, myalgia. Nervous system disorders: Sedation, somnolence, headache, dizziness, memory impairment, balance disorder, abnormal coordination, tremor. Psychiatric disorders: Depression, insomnia, confusional state, anxiety, disorientation, nervousness, dysarthria, disturbance in attention, hypersomnia, decreased or increased libido. Renal and urinary disorders: Incontinence, difficulty in micturition. Reproductive system and breast disorders: Sexual dysfunction, irregular menstruation. Respiratory, thoracic and mediastinal disorders: Nasal congestion, dyspnoea, rhinitis. Skin and subcutaneous tissue disorders: Dermatitis, rash, pruritus. Vascular disorders: Hypotension.

Enhanced CNS depressant effects with other anxiolytics or sedatives, antipsychotics (neuroleptics), hypnotics, antidepressants, narcotic analgesics, antiepileptic drugs, anaesthetics, sedative antihistamines. Increased plasma concentrations with CYP3A4 inhibitors (e.g. nefazodone, fluvoxamine, cimetidine, fluoxetine, propoxyphene, oral contraceptives, sertraline, paroxetine, diltiazem, isoniazid, macrolide antibiotics such as erythromycin, clarithromycin, troleandomycin). May enhance metabolism with CYP3A4 inducers (e.g. ritonavir, carbamazepine). May increase plasma concentrations of digoxin.

Anxiolytics

N05BA12 - alprazolam ; Belongs to the class of benzodiazepine derivatives anxiolytics. Used in the management of anxiety, agitation or tension.