RX Patient Tools
Use these quick guides before reading the article, or return to them when you need help preparing questions for a doctor.
Alprazolam is a triazolobenzodiazepine agent with anxiolytic, sedative-hypnotic and anticonvulsant activities. Alprazolam binds to a specific site distinct from the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) binding site on the benzodiazepine-GABA-A-chloride ionophore receptor complex located in the limbic, thalamic and hypothalamic regions of the central nervous system (CNS). This binding causes an allosteric modification of the receptor and enhances the affinity of GABA to the receptor leading to an increase in the frequency of chloride-channel opening events. This leads to an increase in chloride ion conductance, neuronal hyperpolarization, inhibition of the action potential and leads to a decrease in neuronal excitability.
Alprazolam is a potent, short-acting benzodiazepine anxiolytic a minor tranquilizer.It is commonly used for the treatment of anxiety disorders, especially of panic disorder, but also in the treatment of generalized anxiety disorder (GAD) or social anxiety disorder.A triazolobenzodiazepine compound with antianxiety and sedative-hypnotic actions, that is efficacious in the treatment of panic disorders, with or without agoraphobia, and in generalized anxiety disorders.It was the 12th most prescribed medicine in the United States in 2010.
Mechanism of Action of Alprazolam
Benzodiazepines bind nonspecifically to benzodiazepine receptors BNZ1, which mediates sleep, and BNZ2, which affects muscle relaxation, anticonvulsant activity, motor coordination, and memory. As benzodiazepine receptors are thought to be coupled to gamma-aminobutyric acid-A (GABAA) receptors, this enhances the effects of GABA by increasing GABA affinity for the GABA receptor. Binding of the inhibitory neurotransmitter GABA to the site opens the chloride channel, resulting in a hyperpolarized cell membrane that prevents further excitation of the cell.
or
Indications of Alprazolam
1st choice sleeping pill for insulin is low or not working well. সহজ বাংলা: রক্তে চিনি বেশি থাকার রোগ।" data-rx-term="diabetes" data-rx-definition="Diabetes is a condition where blood sugar stays too high because insulin is low or not working well. সহজ বাংলা: রক্তে চিনি বেশি থাকার রোগ।">diabetes & constipation induce anxiety & insomnia disorder
- Generalized Anxiety Disorder
- Panic Disorders
- Management of anxiety disorder or the short-term relief of symptoms of anxiety
- Agoraphobia.
- Feeling Anxious
- Treatment in combination with other medications for chemotherapy-induced nausea and vomiting.
- Tinnitus
- Borderline Personality Disorder
- Dysautonomia
- Panic Disorder
- Depression
- Rapid eye movement sleep disorder
- Restless legs syndrome
- Tardive dyskinesia
- Tremor
- Acute manic episode
- Myoclonic seizures
- Refractory absence Seizures
- The treatment of acute and chronic akathisia induced by neuroleptics, also called antipsychotics.
- Spasticity related to amyotrophic lateral sclerosis.
- Alcohol withdrawal syndrome
- For the management of anxiety disorder or the short-term relief of symptoms of anxiety and for the treatment of panic disorder, with or without agoraphobia.
Contra Indications of Alprazolam
- Abnormal liver function tests
- Susceptible to breathing fluid into the lungs
- Pregnancy
- kidney disease with a likely reduction in kidney function
- Having thoughts of suicide
- Alcohol intoxication
- Drug abuse
- Wide-angle glaucoma
- Closed angle glaucoma
- Decreased lung function
- Chronic lung disease
- Liver problems
- Severe liver disease
- Temporarily stops breathing while wleeping.
Dosage of Alprazolam
Strengths: 0.5 mg, 1 mg, 2 mg, 3 mg
The dose of this medicine will be different for different patients. Follow your doctor’s orders or the directions on the label. The following information includes only the average doses of this medicine.
Anxiety
Adults—At first, 0.25 to 0.5 milligram (mg) 3 times a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 4 mg per day.
- Older adults—At first, 0.25 mg 2 or 3 times a day. Your doctor may increase your dose as needed.
- Children—Use and dose must be determined by your doctor.
Panic disorder
- Adults—At first, 0.5 to 1 milligram (mg) taken in the morning once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 10 mg per day.
- Older adults—At first, 0.5 mg taken in the morning once a day. Your doctor may increase your dose as needed.
- Children—Use and dose must be determined by your doctor.
Depression or Insomnia
- Adults—At first, 0.5 milligram (mg) 3 times a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 10 mg per day.
- Older adults—At first, 0.25 mg 2 or 3 times a day. Your doctor may increase your dose as needed.
- Children—Use and dose must be determined by your doctor.
or
Immediate-release tablet, orally disintegrating tablet, or oral solution
- Typical starting dosage: 0.5 mg three times daily.
- Dosage increases: Your doctor may increase your dosage every 3–4 days in amounts of no more than 1 mg/day.
- Maximum dosage: 10 mg daily, in divided doses.
- Dosage reduction: When you’re stopping treatment, your dosage should be decreased slowly. Your doctor may decrease it by no more than 0.5 mg every 3 days.
Side Effects of Alprazolam
The most common
- Headache
- Anxiety
- Drowsiness
- Dry mouth
- Abdominal or stomach pain
- cold or flu symptoms such as stuffy nose, sore throat, fever;
- Constipation
- dizziness or lightheadedness
- blurred vision
- hiccups
- coughing
- pain, redness, or hardening of the skin at the injection site
- Nausea ,vomiting,
- painful or swollen gums
- numbness or heavy feeling in the jaw
- stomach pain,
- headache,
- reversible hair loss or thinning, and
- fever
Common
- chills or fever
- headache, severe and throbbing
- joint or back pain
- muscle aching or cramping
- muscle pains or stiffness
- chest pressure or squeezing pain in chest
- excessive sweating
- sudden drowsiness or need to sleep
- coughing up blood
- liver problems–nausea, upper stomach pain, itching, tired feeling, loss of appetite,
Rare
- Anxiety
- change in vision
- chest pain or tightness
- confusion
- cough
- Agitation
- arm, back, or jaw pain
- blurred vision
- chest pain or discomfort
- convulsions
- extra heartbeats
- hallucinations
- headache
- irritability
- lightheadedness
- cold and clammy skin
- fast and shallow breathing
- swelling of your feet, legs, or hands purple spot on your skin caused by internal bleeding
- fast or abnormal heart rate or palpitations
- loss of appetite
- lower back, side, or stomach pain
- mental depression
- muscle pain or cramps
- Swelling of your feet or ankles
- Shortness of breath
- Nausea, fever, dark urine, loss of appetite
- Depression
- Ataxia
- Somnolence (difficulty staying awake)
- Mental confusion
- Hypotension
- Respiratory arrest
- Vasomotor collapse
Drug Interactions of Alprazolam
Alprazolam may interact with following drugs, supplements, & may change the efficacy of drugs
- Antacids
- antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
- aripiprazole
- “azole” antifungals (e.g., itraconazole, ketoconazole, voriconazole)
- baclofen
- barbiturates (e.g., butalbital, phenobarbital)
- benzodiazepines (e.g.diazepam, lorazepam)
- calcium channel blockers (e.g., amlodipine, diltiazem, nifedipine, verapamil)
- carbamazepine
- estradiol (birth control pills)
- gabapentin
- macrolide antibiotics (e.g., clarithromycin, erythromycin)
- mirtazapine
- Oral contraceptives (birth control pills)
- muscle relaxants
- phenytoin
- proton pump inhibitors (e.g., lansoprazole, omeprazole)
- quinolone antibiotics (e.g., ciprofloxacin, ofloxacin)
- selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, duloxetine, fluoxetine, paroxetine, sertraline)
- tapentadol
- theophylline
- tramadol
- tricyclic antidepressants (e.g., amitriptyline, clomipramine, desipramine, trimipramine)
If you take one of these drugs with alprazolam, you may have increased drowsiness or other side effects.
Pregnancy & Lactation of Alprazolam
FDA Pregnancy Category D
Pregnancy
This drug should not be used unless there are no safer alternatives, especially during the first trimester of pregnancy. The patient should be warned of the potential risks to the fetus and instructed to discontinue the drug prior to becoming pregnant.
Lactation
This drug may pass into breast milk and may cause side effects in a child who is breastfed. Your child may become lethargic (drowsy) and lose weight. Talk to your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.T his medication has not been studied in children. It should not be used in people younger than 18 years.
References
