Generic
Alprazolam
28 brands available in the market
At a glance
Alprazolam is a benzodiazepine used for the treatment of anxiety and panic disorders. It calms the brain by increasing the inhibitory effect of GABA on neuronal excitability.
Description
Alprazolam is a triazole analog of the 1,4-benzodiazepine class of drugs. It is an anxiolytic with hypnotic and anticonvulsive properties. Alprazolam produces its effects via interacting with the GABA-benzodiazepine receptor complex. Like all benzodiazepines, it causes dose-related CNS depressant activity varying from mild impairment of task performance to hypnosis.
Indications
Anxiety disorders; short-term relief of anxiety; anxiety associated with depression; panic disorder with or without agoraphobia.
Therapeutic class
Benzodiazepine Sedatives
Pharmacological class
Benzodiazepine (Anxiolytic)
Pharmacology
Alprazolam is a triazole analog of the 1,4-benzodiazepine class. It is an anxiolytic with hypnotic and anticonvulsive properties. Alprazolam produces its effects via interacting with the GABA-benzodiazepine receptor complex. Like all benzodiazepines, it causes dose-related CNS depressant activity varying from mild impairment of task performance to hypnosis.
Mechanism of action
Alprazolam binds to GABA-benzodiazepine receptors in the brain, enhancing the inhibitory effect of GABA. This increases chloride ion permeability in neurons, causing hyperpolarization and stabilization, which reduces anxiety and panic symptoms.
Dosage
Initial dose: 0.25-0.5 mg 3 times daily.
Dose escalation: May be increased every 3-4 days in increments of no more than 1 mg/day based on response.
Maximum dose: 4 mg/day (some panic disorder patients may require up to 10 mg/day).
Elderly & liver disease: Starting dose 0.25 mg 2-3 times daily; increase gradually if needed.
Discontinuation: Reduce by no more than 0.5 mg every 3 days (gradual withdrawal).
Administration
May be taken with or without food (take immediately after meals to reduce sleepiness/drowsiness). Swallow tablet whole; do not crush or chew. Take as per the dose and duration advised by your doctor.
Missed dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose.
Side effects
Common side effects (at the beginning of therapy): Drowsiness (somnolence), lightheadedness, dizziness, confusion, dry mouth, constipation, depression, headache.
Serious (rare): Dependence (habit-forming), withdrawal symptoms (nausea, anxiety, agitation, flu-like symptoms, sweating, tremor, confusion).
Precautions & warnings
- Dependence (habit-forming): This medicine has a very high potential for addiction. Take only as per the dose and duration advised by your doctor.
- Do not stop suddenly: May cause nausea, anxiety, agitation, flu-like symptoms, sweating, tremor, and confusion. Gradual dose reduction is required.
- Driving: May cause dizziness and sleepiness; do not drive or operate machinery.
- Alcohol: Increases drowsiness and dizziness; avoid completely.
- Pregnancy & lactation: Do not use; consult your doctor.
- Liver disease: Caution required; dose adjustment may be needed.
Contraindications
- Acute narrow-angle glaucoma
- Pre-existing CNS depression or coma
- Respiratory depression
- Acute pulmonary insufficiency or sleep apnea
- Severe hepatic impairment
- Pregnancy and lactation
- Under 18 years of age
Drug interactions
- Other psychotropic drugs: Increased CNS depression
- Anticonvulsants: Increased CNS depression
- Antihistamines: Increased CNS depression
- Alcohol: Increased CNS depression (potentially fatal)
- Oral contraceptives: May increase alprazolam levels
- Ketoconazole, itraconazole: May increase alprazolam levels
Food interactions
Alcohol consumption is strictly prohibited (increases drowsiness and dizziness).
Use in pregnancy
Pregnancy Category: D. Alprazolam is highly unsafe during pregnancy (definite evidence of risk to the fetus). Discontinue immediately if pregnancy is detected and consult your doctor.
Pregnancy Category: D — always consult a doctor before taking during pregnancy.
Use in lactation
Alprazolam is excreted in breast milk; do not use during breastfeeding.
Pediatric use
Safety and efficacy have not been established in children under 18 years of age.
Geriatric use
Elderly patients: Starting dose 0.25 mg 2-3 times daily; increase gradually.
Renal / hepatic impairment
Renal impairment: Probably safe; dose adjustment may not be needed.
Hepatic impairment: Caution required; dose adjustment may be needed (especially in severe liver disease).
Overdose effects
Overdose symptoms: somnolence, confusion, impaired coordination, diminished reflexes, coma. Treatment: gastric lavage and general supportive measures.
Storage conditions
Store below 30°C, protected from light and moisture. Keep out of reach of children.
Chemical structure
C₁₇H₁₃ClN₄ (Molecular weight: 308.76 g/mol)