alprazolam, Xanax, Xanax XR, Niravam

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GENERIC NAME: alprazolam

BRAND NAME: Xanax, Xanax XR, Niravam

DRUG CLASS AND MECHANISM: Alprazolam is an anti-anxiety medication in the benzodiazepine family, the same family that includes diazepam (Valium), clonazepam (Klonopin), lorazepam (Ativan), flurazepam (Dalmane), and others. Alprazolam and other benzodiazepines act by enhancing the effects of gamma-aminobutyric acid (GABA) in the brain. GABA is a neurotransmitter (a chemical that nerve cells use to communicate with each other) that inhibits activity in the brain. It is believed that excessive activity in the brain may cause anxiety or other psychiatric disorders. The FDA approved alprazolam in October 1981.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS: Tablets: 0.25, 0.5, 1 and 2 mg. Tablets ER (extended release): 0.5, 1, 2 and 3 mg. Tablets (Orally disintegrating): 0.25, 0.5, 1 and 2 mg. Solution: 1 mg/ml

STORAGE: Alprazolam should be stored at room temperature, 15 C to 30 C (59 F to 86 F).

PRESCRIBED FOR: Alprazolam is used for the treatment of anxiety disorders and panic attacks. Anxiety disorders are characterized by unrealistic worry and apprehension, causing symptoms of restlessness, aches, trembling, shortness of breath, smothering sensation, palpitations, sweating, cold clammy hands, lightheadedness, flushing, exaggerated startle responses, problems concentrating, and insomnia. Panic attacks occur either unexpectedly or in certain situations (for example, driving), and can require higher dosages of alprazolam.

DOSING: Alprazolam may be taken with or without food.

The starting dose for treating anxiety is 0.25-0.5 mg 3 to 4 times daily using immediate release tablets. The dose may be increased every 3-4 days to a maximum dose of 4 mg daily.

The starting dose for treating panic attacks is 0.5 mg 3 times daily. Doses can be increased every 3-4 days but by no more than 1 mg daily. The effective dose for preventing panic attacks may be as high as 10 mg daily for some patients. The starting dose when using extended release tablets to treat panic disorder is 0.5 mg once daily and the average dose is 3-6 mg once daily.

DRUG INTERACTIONS: Ketoconazole (Nizoral), itraconazole (Sporanox), nefazodone (Serzone), cimetidine (Tagamet), and fluvoxamine (Luvox) increase concentrations in the blood of alprazolam and therefore may increase the side effects of alprazolam. Alprazolam interacts with alcohol and medications (for example, barbiturates, and narcotics) that suppress activity in the brain by suppressing activity more and causing sedation.

Carbamazepine (Tegretol, Tegretol XR, Equetro, Carbatrol) and rifampin reduce the effect of alprazolam by increasing metabolism and elimination of alprazolam in the liver.

PREGNANCY: Benzodiazepines, such as alprazolam, can cause fetal abnormalities and should not be used in pregnancy.

NURSING MOTHERS: Alprazolam is excreted in breast milk and can affect nursing infants. Therefore, it should not be used by women who are nursing.

Medically Reviewed by a Doctor on 4/5/2013



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