Alprazolam
When ATH:
N05BA12
Characteristic.
Anxiolytic, benzodiazepine derivative. White or white with blue polka crystalline powder. Insoluble in water and slightly soluble in alcohol.
Pharmacological action.
Anxiolytic, sedation, miorelaksiruyuschee, central.
Application.
Neurosis and psychopathy, accompanied by fear, anxiously, concern; reactive depression (incl. against the background of systemic diseases), panic disorder, withdrawal symptoms in patients with alcoholism and drug addiction.
Contraindications.
Hypersensitivity, severe respiratory failure, glaucoma (acute attack), acute liver disease and kidney failure, myasthenia, pregnancy (especially I trimester), lactation, Age to 18 years.
Restrictions apply.
Otkrыtougolynaya glaucoma, sleep apnea, chronic renal and / or hepatic insufficiency, alcoholic liver disease.
Pregnancy and breast-feeding.
Category actions result in FDA - D. (There is evidence of the risk of adverse effects of drugs on the human fetus, obtained in research or practice, However, the potential benefits, associated with drugs in pregnant, may justify its use, in spite of the possible risk, if the drug is needed in life-threatening situations or severe disease, when safer agents should not be used or are ineffective.)
Side effects.
Drowsiness, fatigue, dizziness, unsteadiness of gait, mental retardation and motor responses, poor concentration, nausea, constipation, dysmenorrhoea, decreased libido, itching, paradoxical reactions (aggressiveness, excitation, irritability, anxiety, hallucinations), adaptation, drug dependence, withdrawal.
Cooperation.
It enhances the effect of alcohol, neuroleptics and hypnotics, narcotic analgesics, Central muscle relaxants.
Overdose.
Symptoms: CNS depression of varying severity (from drowsiness to coma) -drowsiness, confusion; In more severe cases, (particularly in patients receiving other drugs, CNS depressants, or alcohol) -ataxia, reduced reflexes, gipotenziya, coma.
Treatment: induction of vomiting, gastric lavage, simptomaticheskaya therapy, monitoring vital functions. When expressed hypotension is a norepinephrine. Specific antidote-BZ antagonist Flumazenil receptors (introduction only in the hospital).
Dosing and Administration.
Inside. The mode set individually, depending on the disease, portability, etc.. Treatment should start with the lowest effective dose. The initial dose for adults-0.25-0.5 mg 3 once a day, with good endurance (in case of need) may increase the dose every 3-4 days. The maximum daily dose is 3-4 mg.
Precautions.
It should be taken into account, that anxiety or stress, associated with daily stress, usually does not require treatment with anxiolytics.
In the event of paradoxical reactions need to stop taking the drug. In the period of treatment is unacceptable consumption of alcoholic beverages. Be wary of during the drivers of vehicles and people, skills relate to the high concentration of attention.
Cooperation
| Active substance | Description of interaction |
| Azelastin | FMR: synergism. Strengthens (mutually) deprimatsiyu (It degrades the performance of the central nervous system and reduces the speed of psychomotor reactions). |
| Acrivastine | FMR: synergism. Strengthens (mutually) deprimatsiyu (It degrades the performance of the central nervous system and reduces the speed of psychomotor reactions). |
| Buprenorphine | FMR: synergism. Strengthens (mutually) CNS depression. |
| Buspirone | FMR: synergism. Strengthens (mutually) CNS depression. |
| Sodium valproate | FMR: synergism. Strengthens (mutually) CNS depression. |
| Valproic Acid | FMR: synergism. Strengthens (mutually) CNS depression. |
| Haloperidol | FMR: synergism. Strengthens (mutually) CNS depression; the combined appointment of caution. |
| Gidroksizin | FMR: synergism. Strengthens (mutually) CNS depression; against the backdrop of the / m dose of alprazolam should reduce to 50% (possible cardiac arrest and death). |
| Desogestrel | FKV. Reduces clearance, With increasesmax (almost 20%) and T1/2 (on 30%). |
| Diazepam | FMR: synergism. Strengthens (mutually) CNS depression, It increases the risk of apnea (at / in the introduction). |
| Digoxin | FKV. Against the backdrop of increased alprazolam plasma concentration, reduced clearance and / or volume of distribution, increased risk of toxicity. |
| Diltiazem | FKV. Perhaps greater effect; the combined appointment of caution. |
| Difengidramin | FMR: synergism. Strengthens (mutually) deprimatsiyu (It degrades the performance of the central nervous system and reduces the speed of psychomotor reactions). |
| Droperidol | FMR: synergism. Strengthens (mutually) CNS depression; the combined appointment of caution. |
| Zolpidem | FMR: synergism. Strengthens (mutually) CNS depression. |
| Isoniazid | Perhaps greater effect; the combined appointment of caution. |
| Imipramine | FKV. Against the background of increasing alprazolam (a third) equilibrium plasma concentration. |
| Itraconazole | FKV. FMR: synergism. As an inhibitor of CYP3A4 slows the biotransformation, significantly reduces the clearance, Increases concentration of plasma, enhances the effects of, incl. side; concomitant use is contraindicated. |
| Carbamazepine | FMR: synergism. Strengthens (mutually) CNS depression. |
| Quetiapine | FMR: synergism. Strengthens (mutually) CNS depression; the combined appointment of caution. |
| Ketamine | FMR: synergism. Strengthens (mutually) CNS depression. |
| Ketoconazole | FKV. CYP3A inhibitors can significantly reduce ground clearance; concomitant use is contraindicated. |
| Clarithromycin | FKV. Slows elimination, Increases in blood; the combined appointment of caution. |
| Clemastine | FMR: synergism. Strengthens (mutually) deprimatsiyu (It degrades the performance of the central nervous system and reduces the speed of psychomotor reactions). |
| Klozapyn | FMR: synergism. Strengthens (mutually) CNS depression; the combined appointment of caution. |
| Clonazepam | FMR: synergism. Strengthens (mutually) CNS depression. |
| Codeine | FMR: synergism. Strengthens (mutually) CNS depression. |
| Lamotrigine | FMR: synergism. Strengthens (mutually) CNS depression. |
| Levetiracetam | FMR: synergism. Strengthens (mutually) CNS depression. |
| Levonorgestrel | FKV. Reduces clearance, With increasesmax (almost 20%) and T1/2 (on 30%). |
| Lorazepam | FMR: synergism. Strengthens (mutually) CNS depression. |
| Midazolam | FMR: synergism. Strengthens (mutually) CNS depression. |
| Morphine sulfate | FMR: synergism. Strengthens (mutually) CNS depression. |
| Oxazepam | FMR: synergism. Strengthens (mutually) CNS depression. |
| Olanzapine | FMR: synergism. Strengthens (mutually) CNS depression; the combined appointment of caution. |
| Paroxetine | FMR: synergism. Strengthens (mutually) CNS depression; the combined use caution. |
| Perfenazyn | FMR: synergism. Strengthens (mutually) CNS depression; the combined appointment of caution. |
| Pramipexole | FMR: synergism. Strengthens (mutually) sedation; In sharing caution. |
| Prymydon | FMR: synergism. Strengthens (mutually) CNS depression. |
| Promethazine | FMR: synergism. Strengthens (mutually) deprimatsiyu (It degrades the performance of the central nervous system and reduces the speed of psychomotor reactions). |
| Propofol | FMR: synergism. Strengthens (mutually) CNS depression. |
| Risperidone | FMR: synergism. Strengthens (mutually) CNS depression; the combined appointment of caution. |
| Sertraline | FMR: synergism. Strengthens (mutually) CNS depression; the combined use caution. |
| Tioridazin | FMR: synergism. Strengthens (mutually) CNS depression; the combined appointment of caution. |
| Topiramate | FMR: synergism. Strengthens (mutually) CNS depression. |
| Trifluoperazine | FMR: synergism. Strengthens (mutually) CNS depression; the combined appointment of caution. |
| Fexofenadine | FMR: synergism. Strengthens (mutually) deprimatsiyu (It degrades the performance of the central nervous system and reduces the speed of psychomotor reactions). |
| Phenytoin | FMR: synergism. Strengthens (mutually) CNS depression. |
| Phenobarbital | FMR: synergism. Strengthens (mutually) CNS depression. |
| Fentanyl | FMR: synergism. Strengthens (mutually) CNS depression. |
| Fluvoxamine | FKV. FMR. Increases (almost 2 times) Cmax and T1/2, reduces Cl (half), reduces the speed of psychomotor reactions. |
| Fluconazole | FKV. As an inhibitor of CYP3A slow biotransformation and reduces clearance; co-administration is not recommended. |
| Fluoxetine | FKV. FMR. Increases Withmax (in half) and T1/2 (insignificantly), reduces Cl (on 20%), reduces the speed of psychomotor reactions. |
| Flufenazin | FMR: synergism. Strengthens (mutually) CNS depression; the combined appointment of caution. |
| Xlordiazepoksid | FMR: synergism. Strengthens (mutually) CNS depression. |
| Chlorpromazine | FMR: synergism. Strengthens (mutually) CNS depression; the combined appointment of caution. |
| Chlorprothixene | FMR: synergism. Strengthens (mutually) CNS depression; the combined appointment of caution. |
| Cetirizine | FMR: synergism. Strengthens (mutually) deprimatsiyu (It degrades the performance of the central nervous system and reduces the speed of psychomotor reactions). |
| Cyclosporine | FKV. Perhaps greater effect, incl. byproduct; the combined appointment of caution. |
| Ciprogeptadin | FMR: synergism. Strengthens (mutually) deprimatsiyu (It degrades the performance of the central nervous system and reduces the speed of psychomotor reactions). |
| Erythromycin | FKV. Slows elimination; the combined appointment of caution. |
| Ethanol | FMR: synergism. Against the background of enhanced alprazolam effect on the CNS; at the time of treatment should abandon spirits. |
| Ethinylestradiol | FKV. Reduces clearance, With increasesmax (almost 20%) and T1/2 (on 30%). |
| Ethosuximide | FMR: synergism. Strengthens (mutually) CNS depression. |
