Carbamazepine
Adverse Effect: decreased alprazolam effectiveness
Clinical Management: Monitor for signs of alprazolam clinical effectiveness. Concurrent use of carbamazepine and alprazolam may require higher doses of alprazolam.
Cimetidine
Adverse Effect: an increased risk of alprazolam toxicity (CNS depression) Clinical Management: Monitor for signs of alprazolam intoxication (eg, sedation, dizziness, ataxia, weakness, decreased cognition or motor performance).
Clarithromycin
Adverse Effect: increased alprazolam toxicity (CNS depression, ataxia, lethargy) Clinical Management: Observe patients receiving Clarithromycin and alprazolam for enhanced CNS effects.Dose reduction by 50% to 75% may be required.
Dextropropoxyphene
Adverse Effect: an increased risk of alprazolam toxicity (CNS depression) Clinical Management: Monitor for signs of benzodiazepine intoxication (eg, sedation, dizziness, ataxia, weakness, decreased cognition or motor performance). If symptoms are present, reduce Alprazolam dose or consider switching to lorazepam.
Digoxin
Adverse Effect: digoxin toxicity (nausea, vomiting, arrhythmias) Clinical Management: Monitor for signs of digoxin intoxication (eg, nausea, vomiting, diarrhea, persistent headache, confusion, fainting, visual disturbances).
Erythromycin
Adverse Effect: increased alprazolam toxicity (CNS depression, ataxia, lethargy) Clinical Management: Observe patients receiving Erythromycin and alprazolam for enhanced CNS effects.
Fluconazole
Adverse Effect: increased alprazolam serum concentrations and potential alprazolam toxicity (sedation, slurred speech, CNS depression) Clinical Management: The concomitant administration of fluconazole and alprazolam is not recommended.
Fluoxetine
Adverse Effect: an increased risk of alprazolam toxicity (somnolence, dizziness, ataxia, slurred speech, hypotension, psychomotor impairment) Clinical Management: Monitor patients for signs and symptoms of alprazolam intoxication.
Fluvoxamine
Adverse Effect: Prolongation of Alprazolam clearance, which may lead to its accumulation and adverse effects Clinical Management: Monitor for the adverse effects due to Alprazolam accumulation and adjust the dosage accordingly.
Itraconazole
Adverse Effect: increased alprazolam serum concentrations and potential alprazolam toxicity (sedation, slurred speech, CNS depression) Clinical Management: The concomitant administration of alprazolam and itraconazole is contraindicated.
Ketoconazole
Adverse Effect: increased alprazolam serum concentrations and potential alprazolam toxicity (sedation, slurred speech, CNS depression) Clinical Management: The concomitant administration of fluconazole and alprazolam is not recommended.
Omeprazole
Adverse Effect: alprazolam toxicity (CNS depression, ataxia, lethargy) Clinical Management: With concurrent administration, monitor patients for CNS depression.Consider switching to lorazepam, oxazepam, temazepam.
Roxithromycin
Adverse Effect: increased alprazolam toxicity (CNS depression, ataxia, lethargy) Clinical Management: Observe patients receiving Roxithromycin and alprazolam for enhanced CNS effects. Warn patients regarding potential for drug hangover.
Sertraline
Adverse Effect: An increased risk of psychomotor impairment and sedation Clinical Management: Caution is warranted if alprazolam and sertraline are to be coadministered. Monitor patients for signs of psychomotor impairment or excessive sedation. Alprazolam doses may need to be reduced.
Theophylline
Adverse Effect: decreased alprazolam effectiveness Clinical Management: Monitor the patient for alprazolam clinical effectiveness. |