Drug Index

GENERIC NAME :
alprazolam
BRAND NAMES :
Xanax
STREET NAMES :
downers, benzo's, tranq's
BRIEF DESCRIPTION :
Alprazolam is categorized as a central nervous system sedative/hypnotic (tranquilizer). It belongs to a class of drugs known as benzodiazepines, which are the most widely prescribed medications that affect central nervous system function. Alprazolam is considered a short acting benzodiazepine. Peak concentrations in the bloodstream occur one to two hours following oral administration. The elimination half-life of alprazolam on averages 11.2 hours. Changes in the absorption, distribution, metabolism and excretion of benzodiazepines have been reported in disease states including alcoholism, impaired liver function, in impaired kidney function. Also, in geriatric patients the half-life of a limitation of the drug may be extended several hours, requiring careful monitoring and possibly a lower dosage range of prescribing medication. Also, it's peak concentrations and half-life are approximately 15 to 25% higher in Asians compared to Caucasians. Alprazolam tablets come in 0.25 mg, zero .5 mg, 1 mg, and 2 mg strengths.
INDICATIONS FOR USE :
It may be used therapeutically to produce sedation, induce sleep, relieve anxiety, relieve muscle spasms, and to prevent seizures.

ABUSE AND ADDICTIVE POTENTIAL :

Alprazolam has a strong potential for dependence (addiction). In general, short acting potentially addictive drugs (like alprazolam) pose a higher risk for developing addiction than longer acting drugs.This is especially true in individuals with a history of drug addiction or alcoholism. Dependence can occur even after relatively short term therapy in the recommended dosage range of 0.75 mg to 4.0 mg per day. Tolerance can occur in some individuals. This means that dosages prescribed for treatment for one of the conditions listed as indications may need to be increased some over time to achieve the therapeutic response. It also means that individuals who have become dependent on alprazolam will need to progressively increase the dosage of alprazolam to achieve the desired effect that the addict is seeking. Addicted individuals often times take several times the recommended dosage. Significantly adverse clinical events, some life-threatening, can be a direct consequence of physical dependence to alprazolam. Rebound (a return of symptoms of anxiety or panic disorder to a level substantially greater in frequency and are more severe in intensity than before taking alprazolam) are often observed after taking the medication for a few weeks or months. Some individuals have noted withdrawal symptoms after taking this medication for as little as one week. Symptoms noted in withdrawal from alprazolam may include:

• heightened sensory perception

• impaired concentration

• dysosmia (problems with smell or taste)

• clouded sensorium (confusion or difficulty thinking)

• paresthesias (tingling, pricking, or numbness of the skin)

• muscle cramps

• muscle twitching

• diarrhea

• blurred vision

• decrease appetite and weight loss

• anxiety

• insomnia (difficulty sleeping)

• seizure (convulsions)

Discontinuation of lorazepam should be done under the supervision of a physician often involves tapering the medication slowly and/or use of other medications to manage withdrawal symptoms.
OVERDOSAGE :

Manifestations of overdoseage may include:

• somnolence (extreme drowsiness or deep, prolonged sleep)

• confusion

• slurred speech

• impaired coordination

• diminished reflexes

• coma

• death

Emergency medical treatment is advised if overdose is suspected.
CAUTIONS :
Alprazolam is contraindicated in patients with acute narrow angle glaucoma. This medication causes central nervous system depressant effects. Individuals taking alprazolam should be cautioned about engaging in hazardous operations or activities that require complete mental alertness. Alprazolam should not be used simultaneously with alcohol or any other central nervous system depressant drugs. Taken together, these drugs can potentiate the potency and effect of each drug. Hypomania and mania have been reported in association with the use of alprazolam in patients with depression. Precaution should be observed in using this medication in patients who have impaired kidney, liver, or lung function. Also, in geriatric patients the half-life of elimination of the drug may be extended several hours, requiring careful monitoring and possibly a lower dosage range of prescribing medication. The primary pathway of metabolism of alprazolam is by cytochrome P450 3A (CYP3A). Patients taking other medications should consult with a physician or pharmacist before taking alprazolam. Certain drugs inhibit CYP3A causing increased blood levels of alprazolam. Examples include certain anti-fungal agents (such as ketoconazole and itraconazole), nefazodone, fluvoxamine, cimetadine, fluoxitine, propoxyphene, and oral contraceptives. This is not a complete list of drugs that affect the metabolism of alprazolam. Patients taking any other medications should consult with a physician or pharmacist before taking alprazolam. A child born of a mother who is taking benzodiazepines maybe at some risk for withdrawal symptoms following birth. Benzodiazepines are also known to be excreted in human milk.

SIDE EFFECTS :
Common side effects may include drowsiness, appetite changes, sleep changes, agitation, fatigue, irritability, thinking or memory impairment, or lightheadedness. Less common side effects that have been noted in association with use of alprazolam include hallucinations, depersonalization, taste alterations, dipoplia (double vision), and elevated liver enzymes. *This is not s complete list if side effects and others may occur. Tell your doctor or pharmacist about any unusual or bothersome side effect.

FOR MORE INFORMATION :
*This is a condensed description of alprazolam. For more details check with your physician, pharmacist, or resources such as The Physicians’ Desk Reference (PDR) or http://www.drugs.com.


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