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Alprazolam mg: Alprazolam: Uses, Dosage, Side Effects

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Alprazolam Dosage Guide + Max Dose, Adjustments

Medically reviewed by Drugs.com. Last updated on Jan 5, 2021.

Applies to the following strengths: 0.25 mg; 0.5 mg; 1 mg; 2 mg; 3 mg; 0.5 mg/5 mL; 1 mg/mL

Usual Adult Dose for:

Usual Geriatric Dose for:

Additional dosage information:

Usual Adult Dose for Anxiety

Immediate-release tablets/orally disintegrating tablets (ODT): 0.25 to 0.5 mg orally administered 3 times a day
-Maximum dose: 4 mg/day

Comments:
-The lowest possible effective dose should be administered and the need for continued treatment reassessed frequently.
-Dosage should be reduced gradually when discontinuing therapy or when decreasing the daily dosage.
-The daily dosage may be decreased by no more than 0.5 mg every 3 days; however, some patients may require an even slower dosage reduction.
-The dose may be increased at intervals of 3 to 4 days in increments of no more than 1 mg per day.
-The times of administration should be distributed as evenly as possible throughout the waking hours

Uses:
-Treatment of generalized anxiety disorder
-Management of anxiety disorder or APA DSM-III-R diagnosis of generalized anxiety disorder
-Short-term relief of symptoms of anxiety

Usual Adult Dose for Panic Disorder

Immediate-release tablets/ODTs: 0.5 mg orally administered 3 times a day
-Maximum dose: 10 mg/day

Extended-release tablets:
-Initial dose: 0.5 to 1 mg orally once a day
-Maintenance dose: 3 to 6 mg orally per day, preferably in the morning
-Maximum dose: 10 mg/day

Comments:
-The lowest possible effective dose should be administered and the need for continued treatment reassessed frequently.
-Dosage should be reduced gradually when discontinuing therapy or when decreasing the daily dosage.
-The daily dosage may be decreased by no more than 0.5 mg every 3 days; however, some patients may require an even slower dosage reduction.
-The dose of extended-release tablets may be increased at intervals of 3 to 4 days in increments of no more than 1 mg per day.
-The times of administration should be distributed as evenly as possible throughout the waking hours

Use: Treatment of panic disorder, with or without agoraphobia

Usual Geriatric Dose for Anxiety

Elderly or debilitated patients:
Immediate-release tablets/ODTs: 0.25 mg orally administered 2 or 3 times a day

Comments:
-If side effects develop, the dose may be lowered.
-The lowest possible effective dose should be administered and the need for continued treatment reassessed frequently.
-Dosage should be reduced gradually when discontinuing therapy or when decreasing the daily dosage.

Uses:
-Treatment of generalized anxiety disorder
-Management of anxiety disorder
-Short-term relief of symptoms of anxiety

Usual Geriatric Dose for Panic Disorder

Elderly or debilitated patients:
Immediate-release tablets/ODTs:
-Initial dose: 0. 25 mg orally administered 2 or 3 times a day

Extended-release tablets:
-Initial dose: 0.5 mg orally once a day

Comments:
-If side effects develop, the dose may be lowered.
-The lowest possible effective dose should be administered and the need for continued treatment reassessed frequently.
-Dosage should be reduced gradually when discontinuing therapy or when decreasing the daily dosage.

Use: Treatment of panic disorder, with or without agoraphobia

Renal Dose Adjustments

-Impaired renal function: Use with caution

Liver Dose Adjustments

Immediate-release tablets/ODTs:
-Mild to moderate liver dysfunction: Use with caution
-Severe liver dysfunction: 0.25 mg orally 2 or 3 times a day

Extended-release tablets:
-Mild to moderate liver dysfunction: Use with caution
-Severe liver dysfunction: 0.5 mg orally once a day

Dose Adjustments

Patients with debilitating disease (e. g., severe pulmonary disease):
Immediate-release tablets/ODTs:
-Initial dose: 0.25 mg orally 2 or 3 times a day

Extended-release tablets:
-Initial dose: 0.5 mg orally once a day

Switching Between Immediate and Extended-release Formulations:
-Patients who are currently being treated with divided doses of immediate-release tablets, for example 3 to 4 times a day, may be switched to extended-release tablets at the same total daily dose taken once a day.

Dose Reduction:
Immediate-release tablets/ODTs:
-Extended-release tablets: Doses should be decreased gradually, with dose decreases of no more than 0.5 mg every 3 days.

Precautions

US BOXED WARNINGS:
RISK FROM CONCOMITANT USE WITH OPIOIDS:
-Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death.
-Reserve concomitant prescribing of these drugs for use in patients for whom alternative treatment options are inadequate.
-Limit dosages and durations to the minimum required.
-Follow patients for signs/symptoms of respiratory depression and sedation.

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

US Controlled Substance: Schedule IV

Dialysis

Data not available

Other Comments

Administration advice:
-Extended-release Tablets: Tablets should not be chewed, crushed, or broken.
-ODTs:
—Immediately upon opening the blister, using dry hands, remove the tablet and place it on top of the tongue.
—Tablet disintegration occurs rapidly in saliva so it can be easily swallowed with or without water.

Storage requirements:
-ODTs: Protect from light and moisture.
-Oral solution: Protect from light; discard 90 days after opening.
-Tablets: Protect from light.

General:
-This drug is not recommended for the primary treatment of depression and psychotic illness.

Monitoring:
-Genitourinary: Periodic urinalysis
-Hematologic: Periodic blood counts during long-term treatment (e.g., longer than 4 weeks)
-Hepatic: Periodic liver function tests during long-term treatment (e.g., longer than 4 weeks)
-Metabolic: Periodic blood chemistry analyses

Patient advice:
-This medicine may increase the risk of suicidal thoughts and behavior. Patients should be alert for the emergence or worsening of symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts, behavior, or thoughts about self-harm. Patients should report any behavior of concern to their healthcare provider as soon as possible.
-This drug may cause drowsiness and dizziness and reduce alertness. Patients should not drive a car or operate dangerous machinery until they know how this drug affects them.
-Patients should avoid drinking alcohol or taking other drugs that may cause sleepiness or dizziness while taking this drug until they talk to their healthcare provider.
-Patients should be told to contact their healthcare provider before increasing/decreasing the dose or discontinuing treatment.
-Advise patients to speak to their healthcare provider if they become pregnant, intend to become pregnant, or are breastfeeding.

Frequently asked questions

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

Side Effects of Xanax (Alprazolam), Warnings, Uses

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oval, white, imprinted with GG 256

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Alprazolam 0. 25 mg 694520110

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Alprazolam 0.25 mg-ACT

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Alprazolam 0.25 mg-GG

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Alprazolam 0.25 mg-MAJ

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Alprazolam 0.25 mg-MYL

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Alprazolam 0.5 mg 694520111

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Alprazolam 0.5 mg-GG

oval, orange, imprinted with GG 257

Alprazolam 0.5 mg-GS

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Alprazolam 0.5 mg-MAJ

round, peach, imprinted with MYLAN A3

Alprazolam 0.5 mg-MYL

round, peach, imprinted with MYLAN A3

Alprazolam 0.5 mg-PP

round, peach, imprinted with 029, LOGO

Alprazolam 1 mg 694520112

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Alprazolam 1 mg-ACT

round, blue, imprinted with 031, R

Alprazolam 1 mg-GG

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Alprazolam 1 mg-MYL

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Alprazolam 2 mg 694520113

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Alprazolam 2 mg-GG

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Alprazolam 2 mg-MYL

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Alprazolam ER 0. 5 mg-AMN

round, green, imprinted with IP 9

Alprazolam ER 1 mg-AMN

round, yellow, imprinted with IP 10

Alprazolam ER 1 mg-MYL

round, orange, imprinted with M, A22

Alprazolam ER 2 mg-AMN

round, blue, imprinted with IP 12

Alprazolam ER 2 mg-MYL

round, purple, imprinted with M, A23

Alprazolam ER 3 mg-AMN

round, white, imprinted with IP 13

Alprazolam ER 3 mg-MYL

round, pink, imprinted with M, A24

Alprazolam XR 0.5 mg-EON

round, white, imprinted with E 195

Alprazolam XR 0.5 mg-GRE

pentagonal, peach, imprinted with G, 0.5

Alprazolam XR 0.5 mg-MYL

round, white, imprinted with A21, M

Alprazolam XR 1 mg-BAR

round, yellow, imprinted with b 492, 1

Alprazolam XR 1 mg-EON

oblong, yellow, imprinted with E196

Alprazolam XR 2 mg-BAR

round, blue, imprinted with b 493, 2

Alprazolam XR 2 mg-EON

oblong, blue, imprinted with E197

Alprazolam XR 3 mg-EON

round, yellow, imprinted with E 198

Alprazolam XR 3 mg-GRE

triangular, green, imprinted with G, 3

Niravam 0. 25 mg

round, yellow, orange, imprinted with SP 321

Niravam 0.5 mg

round, yellow, orange, imprinted with SP 322, 0.5

Niravam 1 mg

round, white, orange, imprinted with SP 323, 1

Niravam 2 mg

round, white, orange, imprinted with SP 324, 2

Xanax 0.25 mg

oval, white, imprinted with XANAX 0.25

Xanax 0.5 mg

oval, orange, imprinted with XANAX 0.5

Xanax 1 mg

oval, blue, imprinted with XANAX 1.0

Xanax 2 mg

rectangular, white, imprinted with X A N A X, 2

Xanax XR 1 mg

square, yellow, imprinted with X, 1

Xanax XR 2 mg

round, blue, imprinted with X, 2

Xanax XR 3 mg

triangular, green, imprinted with X, 3

Alprazolam (Oral Route) Proper Use

Proper Use

Drug information provided by: IBM Micromedex

Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. If too much of this medicine is used for a long time, it may become habit-forming (causing mental or physical dependence) or cause an overdose.

This medicine should come with a Medication Guide. Read and follow the instructions carefully. Ask your doctor if you have any questions.

Swallow the extended-release tablet or tablet whole with a full glass of water. Do not break, crush, or chew it.

If you are using the orally disintegrating tablet, make sure your hands are dry before you handle the tablet. Do not remove the tablets from the bottle until you are ready to take it. Place the tablet immediately on the top of your tongue. It should melt quickly and be swallowed with saliva.

If you are using the oral liquid, measure the dose with a marked measuring spoon, oral syringe, or medicine cup.

Do not eat grapefruit or drink grapefruit juice while you are using this medicine.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor’s orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.


  • For anxiety:


    • For oral dosage forms (solution, tablets, or orally disintegrating tablets):


      • Adults—At first, 0.25 to 0.5 milligram (mg) 3 times a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 4 mg per day.

      • Older adults—At first, 0.25 mg 2 or 3 times a day. Your doctor may increase your dose as needed.

      • Children—Use and dose must be determined by your doctor.

  • For panic disorder:


    • For oral dosage form (extended-release tablets):


      • Adults—At first, 0.5 to 1 milligram (mg) taken in the morning once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 10 mg per day.

      • Older adults—At first, 0.5 mg taken in the morning once a day. Your doctor may increase your dose as needed.

      • Children—Use and dose must be determined by your doctor.

    • For oral dosage forms (solution, tablets, or orally disintegrating tablets):


      • Adults—At first, 0.5 milligram (mg) 3 times a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 10 mg per day.

      • Older adults—At first, 0.25 mg 2 or 3 times a day. Your doctor may increase your dose as needed.

      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

It is very important to protect the orally disintegrating tablets from moisture. Remove and throw away any cotton packaging from the medicine bottle when you first use the medicine.

Portions of this document last updated: June 01, 2021

Copyright © 2021 IBM Watson Health. All rights reserved. Information is for End User’s use only and may not be sold, redistributed or otherwise used for commercial purposes.


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Xanax, Niravam (alprazolam) dosing, indications, interactions, adverse effects, and more

  • abametapir

    Serious – Use Alternative (1)abametapir will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. If not feasible, avoid use of abametapir.

  • albuterol

    Monitor Closely (1)alprazolam increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • alfentanil

    Monitor Closely (1)alprazolam and alfentanil both increase sedation. Use Caution/Monitor.

  • amitriptyline

    Monitor Closely (1)alprazolam and amitriptyline both increase sedation. Use Caution/Monitor.

  • amobarbital

    Monitor Closely (2)amobarbital will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

    amobarbital and alprazolam both increase sedation. Use Caution/Monitor.

  • amoxapine

    Monitor Closely (1)alprazolam and amoxapine both increase sedation. Use Caution/Monitor.

  • apalutamide

    Serious – Use Alternative (1)apalutamide will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.

  • apomorphine

    Monitor Closely (1)alprazolam and apomorphine both increase sedation. Use Caution/Monitor.

  • aprepitant

    Monitor Closely (1)aprepitant will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • arformoterol

    Monitor Closely (1)alprazolam increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • aripiprazole

    Monitor Closely (1)alprazolam and aripiprazole both increase sedation. Use Caution/Monitor.

  • armodafinil

    Monitor Closely (2)armodafinil will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

    alprazolam increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • artemether/lumefantrine

    Monitor Closely (1)artemether/lumefantrine will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • atazanavir

    Monitor Closely (1)atazanavir will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • avapritinib

    Monitor Closely (1)alprazolam will increase the level or effect of avapritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • azelastine

    Monitor Closely (1)azelastine and alprazolam both increase sedation. Use Caution/Monitor.

  • baclofen

    Monitor Closely (1)alprazolam and baclofen both increase sedation. Use Caution/Monitor.

  • belladonna and opium

    Monitor Closely (1)alprazolam and belladonna and opium both increase sedation. Use Caution/Monitor.

  • benperidol

    Monitor Closely (1)alprazolam and benperidol both increase sedation. Use Caution/Monitor.

  • benzhydrocodone/acetaminophen

    Serious – Use Alternative (1)benzhydrocodone/acetaminophen, alprazolam.
    Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

  • benzphetamine

    Monitor Closely (1)alprazolam increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • bosentan

    Monitor Closely (1)bosentan will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • brexanolone

    Monitor Closely (1)brexanolone, alprazolam.
    Either increases toxicity of the other by sedation. Use Caution/Monitor.

  • brimonidine

    Minor (1)brimonidine increases effects of alprazolam by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

  • brompheniramine

    Monitor Closely (1)brompheniramine and alprazolam both increase sedation. Use Caution/Monitor.

  • budesonide

    Monitor Closely (1)budesonide will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • buprenorphine

    Monitor Closely (1)alprazolam and buprenorphine both increase sedation. Use Caution/Monitor.

  • buprenorphine buccal

    Monitor Closely (1)alprazolam and buprenorphine buccal both increase sedation. Use Caution/Monitor.

  • buprenorphine subdermal implant

    Monitor Closely (1)alprazolam increases toxicity of buprenorphine subdermal implant by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Studies have shown that the combination of benzodiazepines and buprenorphine altered the usual ceiling effect on buprenorphine-induced respiratory depression, making the respiratory effects of buprenorphine appear similar to those of full opioid agonists. There have been postmarketing reports of coma and death with coadministration of buprenorphine and benzodiazepines. In many, but not all of these cases, buprenorphine was misused by self-injection. If a benzodiazepine must be used for an indication other than seizures, lower the benzodiazepine initial dose and cautiously titrate to clinical response.

  • buprenorphine, long-acting injection

    Monitor Closely (1)alprazolam increases toxicity of buprenorphine, long-acting injection by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of buprenorphine and benzodiazepines or other CNS depressants increases risk of adverse reactions including overdose, respiratory depression, and death. Cessation of benzodiazepines or other CNS depressants is preferred in most cases. In some cases, monitoring at a higher level of care for tapering CNS depressants may be appropriate. In others, gradually tapering a patient off of a prescribed benzodiazepine or other CNS depressant or decreasing to the lowest effective dose may be appropriate.

  • butabarbital

    Monitor Closely (2)butabarbital will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

    butabarbital and alprazolam both increase sedation. Use Caution/Monitor.

  • butalbital

    Monitor Closely (2)butalbital will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

    butalbital and alprazolam both increase sedation. Use Caution/Monitor.

  • butorphanol

    Monitor Closely (1)alprazolam and butorphanol both increase sedation. Use Caution/Monitor.

  • caffeine

    Monitor Closely (1)alprazolam increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • calcium/magnesium/potassium/sodium oxybates

    Serious – Use Alternative (1)alprazolam, calcium/magnesium/potassium/sodium oxybates.
    Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

  • carbamazepine

    Serious – Use Alternative (1)carbamazepine will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

  • carbinoxamine

    Monitor Closely (1)carbinoxamine and alprazolam both increase sedation. Use Caution/Monitor.

  • carisoprodol

    Monitor Closely (1)alprazolam and carisoprodol both increase sedation. Use Caution/Monitor.

  • cenobamate

    Monitor Closely (2)cenobamate, alprazolam.
    Either increases effects of the other by sedation. Use Caution/Monitor.

    cenobamate will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate.

  • chloral hydrate

    Monitor Closely (1)alprazolam and chloral hydrate both increase sedation. Use Caution/Monitor.

  • chloramphenicol

    Serious – Use Alternative (1)chloramphenicol will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

  • chlordiazepoxide

    Monitor Closely (1)alprazolam and chlordiazepoxide both increase sedation. Use Caution/Monitor.

  • chlorpheniramine

    Monitor Closely (1)chlorpheniramine and alprazolam both increase sedation. Use Caution/Monitor.

  • chlorpromazine

    Monitor Closely (1)alprazolam and chlorpromazine both increase sedation. Use Caution/Monitor.

  • chlorzoxazone

    Monitor Closely (1)alprazolam and chlorzoxazone both increase sedation. Use Caution/Monitor.

  • cimetidine

    Serious – Use Alternative (1)cimetidine will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

  • cinnarizine

    Monitor Closely (1)cinnarizine and alprazolam both increase sedation. Use Caution/Monitor.

  • ciprofloxacin

    Minor (1)ciprofloxacin increases levels of alprazolam by decreasing metabolism. Minor/Significance Unknown.

  • clarithromycin

    Serious – Use Alternative (1)clarithromycin will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

  • clemastine

    Monitor Closely (1)clemastine and alprazolam both increase sedation. Use Caution/Monitor.

  • clobazam

    Monitor Closely (1)alprazolam, clobazam. Other (see comment). Use Caution/Monitor.
    Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression).

  • clomipramine

    Monitor Closely (1)alprazolam and clomipramine both increase sedation. Use Caution/Monitor.

  • clonazepam

    Monitor Closely (1)alprazolam and clonazepam both increase sedation. Use Caution/Monitor.

  • clonidine

    Monitor Closely (1)clonidine, alprazolam.
    Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration enhances CNS depressant effects.

  • clorazepate

    Monitor Closely (1)alprazolam and clorazepate both increase sedation. Use Caution/Monitor.

  • clozapine

    Monitor Closely (1)alprazolam and clozapine both increase sedation. Use Caution/Monitor.

  • cobicistat

    Serious – Use Alternative (1)cobicistat will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

  • codeine

    Monitor Closely (1)alprazolam and codeine both increase sedation. Use Caution/Monitor.

  • conivaptan

    Monitor Closely (1)conivaptan will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • cortisone

    Monitor Closely (1)cortisone will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • crizotinib

    Monitor Closely (1)crizotinib increases levels of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.

  • crofelemer

    Monitor Closely (1)crofelemer increases levels of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Crofelemer has the potential to inhibit CYP3A4 at concentrations expected in the gut; unlikely to inhibit systemically because minimally absorbed.

  • cyclizine

    Monitor Closely (1)cyclizine and alprazolam both increase sedation. Use Caution/Monitor.

  • cyclobenzaprine

    Monitor Closely (1)alprazolam and cyclobenzaprine both increase sedation. Use Caution/Monitor.

  • cyclosporine

    Monitor Closely (1)cyclosporine will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • cyproheptadine

    Monitor Closely (1)cyproheptadine and alprazolam both increase sedation. Use Caution/Monitor.

  • dabrafenib

    Monitor Closely (1)dabrafenib will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

  • dantrolene

    Monitor Closely (1)alprazolam and dantrolene both increase sedation. Use Caution/Monitor.

  • darifenacin

    Monitor Closely (1)darifenacin will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • darunavir

    Monitor Closely (1)darunavir will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • dasatinib

    Monitor Closely (1)dasatinib will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • deferasirox

    Monitor Closely (1)deferasirox will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • desflurane

    Monitor Closely (1)desflurane and alprazolam both increase sedation. Use Caution/Monitor.

  • desipramine

    Monitor Closely (1)alprazolam and desipramine both increase sedation. Use Caution/Monitor.

  • deutetrabenazine

    Monitor Closely (1)alprazolam and deutetrabenazine both increase sedation. Use Caution/Monitor.

  • dexamethasone

    Monitor Closely (1)dexamethasone will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • dexchlorpheniramine

    Monitor Closely (1)dexchlorpheniramine and alprazolam both increase sedation. Use Caution/Monitor.

  • dexfenfluramine

    Monitor Closely (1)alprazolam increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • dexmedetomidine

    Monitor Closely (1)alprazolam and dexmedetomidine both increase sedation. Use Caution/Monitor.

  • dexmethylphenidate

    Monitor Closely (1)alprazolam increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • dextroamphetamine

    Monitor Closely (1)alprazolam increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • dextromoramide

    Monitor Closely (1)alprazolam and dextromoramide both increase sedation. Use Caution/Monitor.

  • DHEA, herbal

    Monitor Closely (1)DHEA, herbal will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • diamorphine

    Monitor Closely (1)alprazolam and diamorphine both increase sedation. Use Caution/Monitor.

  • diazepam

    Monitor Closely (1)alprazolam and diazepam both increase sedation. Use Caution/Monitor.

  • diazepam intranasal

    Monitor Closely (1)diazepam intranasal, alprazolam.
    Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may potentiate the CNS-depressant effects of each drug.

  • diethylpropion

    Monitor Closely (1)alprazolam increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • difenoxin hcl

    Monitor Closely (1)alprazolam and difenoxin hcl both increase sedation. Use Caution/Monitor.

  • digoxin

    Monitor Closely (1)alprazolam increases levels of digoxin by unknown mechanism. Use Caution/Monitor.

  • diltiazem

    Monitor Closely (1)diltiazem will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor for increased alprazolam side effects including drowsiness or fatigue, nausea, vomiting, diarrhea or constipation.

  • dimenhydrinate

    Monitor Closely (1)dimenhydrinate and alprazolam both increase sedation. Use Caution/Monitor.

  • diphenhydramine

    Monitor Closely (1)diphenhydramine and alprazolam both increase sedation. Use Caution/Monitor.

  • diphenoxylate hcl

    Monitor Closely (1)alprazolam and diphenoxylate hcl both increase sedation. Use Caution/Monitor.

  • dipipanone

    Monitor Closely (1)alprazolam and dipipanone both increase sedation. Use Caution/Monitor.

  • disulfiram

    Monitor Closely (1)disulfiram increases levels of alprazolam by decreasing metabolism. Use Caution/Monitor.

  • dobutamine

    Monitor Closely (1)alprazolam increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • dopamine

    Monitor Closely (1)alprazolam increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • dopexamine

    Monitor Closely (1)alprazolam increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • dosulepin

    Monitor Closely (1)alprazolam and dosulepin both increase sedation. Use Caution/Monitor.

  • doxepin

    Monitor Closely (1)alprazolam and doxepin both increase sedation. Use Caution/Monitor.

  • doxylamine

    Monitor Closely (1)alprazolam and doxylamine both increase sedation. Use Caution/Monitor.

  • dronedarone

    Monitor Closely (1)dronedarone will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • droperidol

    Monitor Closely (1)alprazolam and droperidol both increase sedation. Use Caution/Monitor.

  • duvelisib

    Monitor Closely (1)duvelisib will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. will increase the level or effect of

  • efavirenz

    Monitor Closely (1)efavirenz will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • elagolix

    Monitor Closely (1)elagolix will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Elagolix is a weak-to-moderate CYP3A4 inducer. Monitor CYP3A substrates if coadministered. Consider increasing CYP3A substrate dose if needed.

  • elvitegravir/cobicistat/emtricitabine/tenofovir DF

    Monitor Closely (1)elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Cobicistat is a CYP3A4 inhibitor; consider benzodiazepine dose reduction.

  • encorafenib

    Monitor Closely (1)encorafenib, alprazolam. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. Coadministration of encorafenib with sensitive CYP3A4 substrates may result in increased toxicity or decreased efficacy of these agents.

  • ephedrine

    Monitor Closely (1)alprazolam increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • epinephrine

    Monitor Closely (1)alprazolam increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • epinephrine racemic

    Monitor Closely (1)alprazolam increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • erythromycin base

    Serious – Use Alternative (1)erythromycin base will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

  • erythromycin ethylsuccinate

    Serious – Use Alternative (1)erythromycin ethylsuccinate will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

  • erythromycin lactobionate

    Serious – Use Alternative (1)erythromycin lactobionate will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

  • erythromycin stearate

    Serious – Use Alternative (1)erythromycin stearate will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

  • esketamine intranasal

    Monitor Closely (1)esketamine intranasal, alprazolam.
    Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.

  • eslicarbazepine acetate

    Monitor Closely (1)eslicarbazepine acetate will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • esomeprazole

    Minor (1)esomeprazole increases levels of alprazolam by decreasing metabolism. Minor/Significance Unknown.

  • estazolam

    Monitor Closely (1)alprazolam and estazolam both increase sedation. Use Caution/Monitor.

  • ethanol

    Monitor Closely (1)alprazolam and ethanol both increase sedation. Use Caution/Monitor.

  • ethinylestradiol

    Monitor Closely (1)ethinylestradiol will increase the level or effect of alprazolam by Mechanism: decreasing metabolism. Use Caution/Monitor. Ethinyl estradiol may inhibit the clearance of benzodiazepines that undergo oxidation, thereby increasing serum concentrations of concomitantly administered benzodiazepines.

  • etomidate

    Monitor Closely (1)etomidate and alprazolam both increase sedation. Use Caution/Monitor.

  • etravirine

    Monitor Closely (1)etravirine will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • eucalyptus

    Minor (1)alprazolam and eucalyptus both increase sedation. Minor/Significance Unknown.

  • fedratinib

    Monitor Closely (1)fedratinib will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP3A4 substrates as necessary.

  • fenfluramine

    Monitor Closely (1)alprazolam increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • fexinidazole

    Serious – Use Alternative (1)fexinidazole will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Fexinidazole inhibits CYP3A4. Coadministration may increase risk for adverse effects of CYP3A4 substrates.

  • finerenone

    Monitor Closely (1)alprazolam will increase the level or effect of finerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor serum potassium during initiation and dosage adjustment of either finererone or moderate CYP3A4 inhibitors. Adjust finererone dosage as needed.

  • fleroxacin

    Minor (1)fleroxacin increases levels of alprazolam by decreasing metabolism. Minor/Significance Unknown.

  • flibanserin

    Monitor Closely (1)alprazolam and flibanserin both increase sedation. Modify Therapy/Monitor Closely. Risk for sedation increased if flibanserin is coadministration with other CNS depressants.

  • fluconazole

    Monitor Closely (1)fluconazole will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • fludrocortisone

    Monitor Closely (1)fludrocortisone will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • fluphenazine

    Monitor Closely (1)alprazolam and fluphenazine both increase sedation. Use Caution/Monitor.

  • flurazepam

    Monitor Closely (1)alprazolam and flurazepam both increase sedation. Use Caution/Monitor.

  • fluvoxamine

    Monitor Closely (1)fluvoxamine will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • formoterol

    Monitor Closely (1)alprazolam increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • fosamprenavir

    Monitor Closely (1)fosamprenavir will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • fosphenytoin

    Monitor Closely (1)fosphenytoin will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • gabapentin

    Monitor Closely (1)gabapentin, alprazolam.
    Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

  • gabapentin enacarbil

    Monitor Closely (1)gabapentin enacarbil, alprazolam.
    Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

  • gemifloxacin

    Minor (1)gemifloxacin increases levels of alprazolam by decreasing metabolism. Minor/Significance Unknown.

  • grapefruit

    Monitor Closely (1)grapefruit will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • green tea

    Minor (1)green tea decreases effects of alprazolam by pharmacodynamic antagonism. Minor/Significance Unknown. Caffeine component of green tea may decrease sedative effects of benzodiazepines.

  • griseofulvin

    Monitor Closely (1)griseofulvin will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • haloperidol

    Monitor Closely (1)alprazolam and haloperidol both increase sedation. Use Caution/Monitor.

  • hyaluronidase

    Monitor Closely (1)hyaluronidase, alprazolam. Other (see comment). Use Caution/Monitor.
    Comment: Drug combination has been found to be incompatible.

  • hydrocodone

    Serious – Use Alternative (1)hydrocodone, alprazolam.
    Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

  • hydrocortisone

    Monitor Closely (1)hydrocortisone will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • hydromorphone

    Monitor Closely (1)alprazolam and hydromorphone both increase sedation. Use Caution/Monitor.

  • hydroxyzine

    Monitor Closely (1)hydroxyzine and alprazolam both increase sedation. Use Caution/Monitor.

  • idelalisib

    Serious – Use Alternative (1)idelalisib will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Idelalisib is a strong CYP3A inhibitor; avoid coadministration with sensitive CYP3A substrates

  • iloperidone

    Monitor Closely (2)alprazolam and iloperidone both increase sedation. Use Caution/Monitor.

    iloperidone increases levels of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Iloperidone is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4.

  • imipramine

    Monitor Closely (1)alprazolam and imipramine both increase sedation. Use Caution/Monitor.

  • indinavir

    Monitor Closely (1)indinavir will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • isoniazid

    Monitor Closely (1)isoniazid will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • isoproterenol

    Monitor Closely (1)alprazolam increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • istradefylline

    Monitor Closely (1)istradefylline will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. This effect was not observed with istradefylline 20 mg/day. Consider dose reduction of sensitive CYP3A4 substrates.

  • itraconazole

    Serious – Use Alternative (1)itraconazole increases levels of alprazolam by decreasing metabolism. Avoid or Use Alternate Drug.

  • ivosidenib

    Serious – Use Alternative (1)ivosidenib will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternate therapies. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs.

  • ketamine

    Monitor Closely (1)ketamine and alprazolam both increase sedation. Use Caution/Monitor.

  • ketoconazole

    Contraindicated (1)ketoconazole increases levels of alprazolam by decreasing metabolism. Contraindicated.Serious – Use Alternative (1)ketoconazole will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

  • ketotifen, ophthalmic

    Monitor Closely (1)alprazolam and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.

  • lapatinib

    Monitor Closely (1)lapatinib will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • lasmiditan

    Monitor Closely (1)lasmiditan, alprazolam.
    Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.

  • lemborexant

    Monitor Closely (2)alprazolam will increase the level or effect of lemborexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Lower nightly dose of lemborexant recommended if coadministered with weak CYP3A4 inhibitors. See drug monograph for specific dosage modification.

    lemborexant, alprazolam.
    Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.

  • letermovir

    Monitor Closely (1)letermovir increases levels of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • levalbuterol

    Monitor Closely (1)alprazolam increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • levofloxacin

    Minor (1)levofloxacin increases levels of alprazolam by decreasing metabolism. Minor/Significance Unknown.

  • levonorgestrel oral/ethinylestradiol/ferrous bisglycinate

    Monitor Closely (1)levonorgestrel oral/ethinylestradiol/ferrous bisglycinate will increase the level or effect of alprazolam by decreasing metabolism. Use Caution/Monitor. Ethinyl estradiol may inhibit the clearance of benzodiazepines that undergo oxidation, thereby increasing serum concentrations of concomitantly administered benzodiazepines.

  • levorphanol

    Monitor Closely (1)alprazolam and levorphanol both increase sedation. Use Caution/Monitor.

  • lisdexamfetamine

    Monitor Closely (1)alprazolam increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • lithium

    Minor (1)alprazolam increases levels of lithium by decreasing renal clearance. Minor/Significance Unknown.

  • lofepramine

    Monitor Closely (2)alprazolam increases levels of lofepramine by decreasing metabolism. Use Caution/Monitor.

    alprazolam and lofepramine both increase sedation. Use Caution/Monitor.

  • lofexidine

    Monitor Closely (1)alprazolam and lofexidine both increase sedation. Use Caution/Monitor.

  • lomitapide

    Monitor Closely (1)alprazolam increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lomitapide dose should not exceed 30 mg/day.

  • lonafarnib

    Serious – Use Alternative (2)alprazolam will increase the level or effect of lonafarnib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of lonafarnib (a sensitive CYP3A substrate) with weak CYP3A inhibitors is unavoidable, reduce to, or continue lonafarnib at starting dose. Closely monitor for arrhythmias and events (eg, syncope, heart palpitations) since lonafarnib effect on QT interval is unknown.

    lonafarnib will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration with sensitive CYP3A substrates. If coadministration unavoidable, monitor for adverse reactions and reduce CYP3A substrate dose in accordance with product labeling.

  • lopinavir

    Serious – Use Alternative (1)lopinavir will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

  • loprazolam

    Monitor Closely (1)alprazolam and loprazolam both increase sedation. Use Caution/Monitor.

  • lorazepam

    Monitor Closely (1)alprazolam and lorazepam both increase sedation. Use Caution/Monitor.

  • lorlatinib

    Monitor Closely (1)lorlatinib will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • lormetazepam

    Monitor Closely (1)alprazolam and lormetazepam both increase sedation. Use Caution/Monitor.

  • loxapine

    Monitor Closely (1)alprazolam and loxapine both increase sedation. Use Caution/Monitor.

  • loxapine inhaled

    Monitor Closely (1)alprazolam and loxapine inhaled both increase sedation. Use Caution/Monitor.

  • lumefantrine

    Monitor Closely (1)lumefantrine will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • lurasidone

    Monitor Closely (1)lurasidone, alprazolam.
    Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
    Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.

  • maprotiline

    Monitor Closely (1)alprazolam and maprotiline both increase sedation. Use Caution/Monitor.

  • marijuana

    Monitor Closely (2)marijuana will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

    alprazolam and marijuana both increase sedation. Use Caution/Monitor.

  • melatonin

    Monitor Closely (1)alprazolam and melatonin both increase sedation. Use Caution/Monitor.

  • meperidine

    Monitor Closely (1)alprazolam and meperidine both increase sedation. Use Caution/Monitor.

  • meprobamate

    Monitor Closely (1)alprazolam and meprobamate both increase sedation. Use Caution/Monitor.

  • metaproterenol

    Monitor Closely (1)alprazolam increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • metaxalone

    Monitor Closely (1)alprazolam and metaxalone both increase sedation. Use Caution/Monitor.

  • methadone

    Monitor Closely (1)alprazolam and methadone both increase sedation. Use Caution/Monitor.

  • methamphetamine

    Monitor Closely (1)alprazolam increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • methocarbamol

    Monitor Closely (1)alprazolam and methocarbamol both increase sedation. Use Caution/Monitor.

  • methylenedioxymethamphetamine

    Monitor Closely (1)alprazolam increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • methylprednisolone

    Monitor Closely (1)methylprednisolone will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • metoclopramide intranasal

    Serious – Use Alternative (1)alprazolam, metoclopramide intranasal.
    Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug.
    Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.

  • metronidazole

    Monitor Closely (1)metronidazole will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • miconazole vaginal

    Monitor Closely (1)miconazole vaginal will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • midazolam

    Monitor Closely (1)alprazolam and midazolam both increase sedation. Use Caution/Monitor.

  • midazolam intranasal

    Monitor Closely (2)alprazolam will increase the level or effect of midazolam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of mild CYP3A4 inhibitors with midazolam intranasal may cause higher midazolam systemic exposure, which may prolong sedation.

    midazolam intranasal will increase the level or effect of alprazolam by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.

  • midodrine

    Monitor Closely (1)alprazolam increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • mifepristone

    Monitor Closely (1)mifepristone will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • mirtazapine

    Monitor Closely (1)alprazolam and mirtazapine both increase sedation. Use Caution/Monitor.

  • mitotane

    Monitor Closely (1)mitotane decreases levels of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments.

  • modafinil

    Monitor Closely (2)modafinil will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

    alprazolam increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • morphine

    Monitor Closely (1)alprazolam and morphine both increase sedation. Use Caution/Monitor.

  • motherwort

    Monitor Closely (1)alprazolam and motherwort both increase sedation. Use Caution/Monitor.

  • moxifloxacin

    Minor (1)moxifloxacin increases levels of alprazolam by decreasing metabolism. Minor/Significance Unknown.

  • moxonidine

    Monitor Closely (1)alprazolam and moxonidine both increase sedation. Use Caution/Monitor.

  • nabilone

    Monitor Closely (1)alprazolam and nabilone both increase sedation. Use Caution/Monitor.

  • nalbuphine

    Monitor Closely (1)alprazolam and nalbuphine both increase sedation. Use Caution/Monitor.

  • nefazodone

    Serious – Use Alternative (1)nefazodone will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

  • nelfinavir

    Monitor Closely (1)nelfinavir will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • nevirapine

    Monitor Closely (1)nevirapine will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • nifedipine

    Monitor Closely (1)nifedipine will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • nilotinib

    Monitor Closely (1)nilotinib will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • norepinephrine

    Monitor Closely (1)alprazolam increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • nortriptyline

    Monitor Closely (1)alprazolam and nortriptyline both increase sedation. Use Caution/Monitor.

  • ofloxacin

    Minor (1)ofloxacin increases levels of alprazolam by decreasing metabolism. Minor/Significance Unknown.

  • olanzapine

    Monitor Closely (1)alprazolam and olanzapine both increase sedation. Use Caution/Monitor.

  • oliceridine

    Monitor Closely (1)oliceridine, alprazolam.
    Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

  • ombitasvir/paritaprevir/ritonavir & dasabuvir

    Monitor Closely (1)ombitasvir/paritaprevir/ritonavir & dasabuvir will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Consider decreasing alprazolam dose based on clinical response

  • omeprazole

    Minor (1)omeprazole increases levels of alprazolam by decreasing metabolism. Minor/Significance Unknown.

  • opium tincture

    Monitor Closely (1)alprazolam and opium tincture both increase sedation. Use Caution/Monitor.

  • orphenadrine

    Monitor Closely (1)alprazolam and orphenadrine both increase sedation. Use Caution/Monitor.

  • oxazepam

    Monitor Closely (1)alprazolam and oxazepam both increase sedation. Use Caution/Monitor.

  • oxcarbazepine

    Monitor Closely (1)oxcarbazepine will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • oxycodone

    Monitor Closely (1)alprazolam and oxycodone both increase sedation. Use Caution/Monitor.

  • oxymorphone

    Monitor Closely (1)alprazolam and oxymorphone both increase sedation. Use Caution/Monitor.

  • paliperidone

    Monitor Closely (1)alprazolam and paliperidone both increase sedation. Use Caution/Monitor.

  • papaveretum

    Monitor Closely (1)alprazolam and papaveretum both increase sedation. Use Caution/Monitor.

  • papaverine

    Monitor Closely (1)alprazolam and papaverine both increase sedation. Use Caution/Monitor.

  • pentazocine

    Monitor Closely (1)alprazolam and pentazocine both increase sedation. Use Caution/Monitor.

  • pentobarbital

    Monitor Closely (2)pentobarbital will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

    pentobarbital and alprazolam both increase sedation. Use Caution/Monitor.

  • perampanel

    Monitor Closely (1)perampanel and alprazolam both increase sedation. Use Caution/Monitor.

  • perphenazine

    Monitor Closely (1)alprazolam and perphenazine both increase sedation. Use Caution/Monitor.

  • phendimetrazine

    Monitor Closely (1)alprazolam increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • phenobarbital

    Monitor Closely (2)phenobarbital will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

    phenobarbital and alprazolam both increase sedation. Use Caution/Monitor.

  • phentermine

    Monitor Closely (1)alprazolam increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • phenylephrine

    Monitor Closely (1)alprazolam increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • phenylephrine PO

    Monitor Closely (1)alprazolam increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

  • phenytoin

    Monitor Closely (1)phenytoin will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • pholcodine

    Monitor Closely (1)alprazolam and pholcodine both increase sedation. Use Caution/Monitor.

  • pimozide

    Monitor Closely (1)alprazolam and pimozide both increase sedation. Use Caution/Monitor.

  • pirbuterol

    Monitor Closely (1)alprazolam increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • posaconazole

    Monitor Closely (1)posaconazole will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • prednisone

    Monitor Closely (1)prednisone will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • pregabalin

    Monitor Closely (1)pregabalin, alprazolam.
    Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

  • primidone

    Monitor Closely (2)primidone will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

    primidone and alprazolam both increase sedation. Use Caution/Monitor.

  • prochlorperazine

    Monitor Closely (1)alprazolam and prochlorperazine both increase sedation. Use Caution/Monitor.

  • promethazine

    Monitor Closely (1)promethazine and alprazolam both increase sedation. Use Caution/Monitor.

  • propofol

    Monitor Closely (1)propofol and alprazolam both increase sedation. Use Caution/Monitor.

  • propylhexedrine

    Monitor Closely (1)alprazolam increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • protriptyline

    Monitor Closely (1)alprazolam and protriptyline both increase sedation. Use Caution/Monitor.

  • quazepam

    Monitor Closely (1)alprazolam and quazepam both increase sedation. Use Caution/Monitor.

  • quetiapine

    Monitor Closely (1)alprazolam and quetiapine both increase sedation. Use Caution/Monitor.

  • quinupristin/dalfopristin

    Monitor Closely (1)quinupristin/dalfopristin will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • ramelteon

    Monitor Closely (1)alprazolam and ramelteon both increase sedation. Use Caution/Monitor.

  • remimazolam

    Monitor Closely (1)remimazolam, alprazolam.
    Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.

  • ribociclib

    Monitor Closely (1)ribociclib will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • rifabutin

    Serious – Use Alternative (1)rifabutin will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.Minor (1)rifabutin decreases levels of alprazolam by increasing metabolism. Minor/Significance Unknown.

  • rifampin

    Serious – Use Alternative (1)rifampin will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

  • rifapentine

    Monitor Closely (1)rifapentine will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • risperidone

    Monitor Closely (1)alprazolam and risperidone both increase sedation. Use Caution/Monitor.

  • ritonavir

    Monitor Closely (1)ritonavir will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • rucaparib

    Monitor Closely (1)rucaparib will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP3A4 substrates, if clinically indicated.

  • rufinamide

    Monitor Closely (1)rufinamide will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • sage

    Minor (1)alprazolam and sage both increase sedation. Minor/Significance Unknown.

  • salmeterol

    Monitor Closely (1)alprazolam increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • saquinavir

    Serious – Use Alternative (1)saquinavir increases levels of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Potential for increased toxicity. Avoid coadministration. If need to use, decrease alprazolam dose.

  • scullcap

    Monitor Closely (1)alprazolam and scullcap both increase sedation. Use Caution/Monitor.

  • secobarbital

    Monitor Closely (2)secobarbital will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

    secobarbital and alprazolam both increase sedation. Use Caution/Monitor.

  • selinexor

    Serious – Use Alternative (1)selinexor, alprazolam. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.

  • sevoflurane

    Monitor Closely (1)sevoflurane and alprazolam both increase sedation. Use Caution/Monitor.

  • shepherd’s purse

    Monitor Closely (1)alprazolam and shepherd’s purse both increase sedation. Use Caution/Monitor.

  • sodium oxybate

    Serious – Use Alternative (1)alprazolam, sodium oxybate.
    Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

  • sofosbuvir/velpatasvir

    Monitor Closely (1)sofosbuvir/velpatasvir increases levels of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Velpatasvir inhibits CYP3A4. Caution if coadministered with drugs with narrow therapeutics indexes.

  • St John’s Wort

    Serious – Use Alternative (1)St John’s Wort will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

  • stiripentol

    Monitor Closely (2)stiripentol, alprazolam.
    Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.

    stiripentol, alprazolam. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP3A4 inhibitor and inducer. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. CYP3A4 substrates may require dosage adjustment.

  • sufentanil

    Monitor Closely (1)alprazolam and sufentanil both increase sedation. Use Caution/Monitor.

  • sufentanil SL

    Serious – Use Alternative (1)sufentanil SL, alprazolam.
    Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration may result in hypotension, profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

  • suvorexant

    Monitor Closely (1)suvorexant and alprazolam both increase sedation. Modify Therapy/Monitor Closely. Dosage adjustments of suvorexant and concomitant CNS depressants may be necessary

  • tapentadol

    Monitor Closely (1)alprazolam and tapentadol both increase sedation. Use Caution/Monitor.

  • tazemetostat

    Monitor Closely (2)tazemetostat will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

    alprazolam will increase the level or effect of tazemetostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • tecovirimat

    Monitor Closely (1)tecovirimat will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Tecovirimat is a weak CYP3A4 inducer. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered.

  • teduglutide

    Monitor Closely (1)teduglutide increases levels of alprazolam by Other (see comment). Use Caution/Monitor.
    Comment: Teduglutide may increase absorption of concomitant PO medications; caution with with drugs requiring titration or those with a narrow therapeutic index; dose adjustment may be necessary.

  • temazepam

    Monitor Closely (1)alprazolam and temazepam both increase sedation. Use Caution/Monitor.

  • terbutaline

    Monitor Closely (1)alprazolam increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • thioridazine

    Monitor Closely (1)alprazolam and thioridazine both increase sedation. Use Caution/Monitor.

  • thiothixene

    Monitor Closely (1)alprazolam and thiothixene both increase sedation. Use Caution/Monitor.

  • tipranavir

    Contraindicated (1)tipranavir increases levels of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Potential for increased toxicity. Tipranavir is used with ritonavir (boosted therapy) which is a potent CYP3A4 inhibitor.

  • topiramate

    Monitor Closely (2)topiramate will decrease the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

    alprazolam and topiramate both increase sedation. Modify Therapy/Monitor Closely.

  • tramadol

    Monitor Closely (1)alprazolam and tramadol both increase sedation. Use Caution/Monitor.

  • trazodone

    Monitor Closely (1)alprazolam and trazodone both increase sedation. Use Caution/Monitor.

  • triazolam

    Monitor Closely (1)alprazolam and triazolam both increase sedation. Use Caution/Monitor.

  • triclofos

    Monitor Closely (1)alprazolam and triclofos both increase sedation. Use Caution/Monitor.

  • trifluoperazine

    Monitor Closely (1)alprazolam and trifluoperazine both increase sedation. Use Caution/Monitor.

  • trimipramine

    Monitor Closely (1)alprazolam and trimipramine both increase sedation. Use Caution/Monitor.

  • triprolidine

    Monitor Closely (1)triprolidine and alprazolam both increase sedation. Use Caution/Monitor.

  • valerian

    Serious – Use Alternative (1)valerian and alprazolam both increase sedation. Avoid or Use Alternate Drug.

  • verapamil

    Monitor Closely (1)verapamil will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • vinpocetine

    Minor (1)alprazolam increases effects of vinpocetine by unspecified interaction mechanism. Minor/Significance Unknown. Desirable interaction enhanced memory improvement (based on preliminary trial).

  • voriconazole

    Monitor Closely (1)voriconazole will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • voxelotor

    Serious – Use Alternative (1)voxelotor will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid.

  • xylometazoline

    Monitor Closely (1)alprazolam increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • yohimbine

    Monitor Closely (1)alprazolam increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • zafirlukast

    Monitor Closely (1)zafirlukast will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

  • ziconotide

    Monitor Closely (1)alprazolam and ziconotide both increase sedation. Use Caution/Monitor.

  • ziprasidone

    Monitor Closely (1)alprazolam and ziprasidone both increase sedation. Use Caution/Monitor.

  • zolpidem

    Minor (1)zolpidem, alprazolam.
    Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

  • zotepine

    Monitor Closely (1)alprazolam and zotepine both increase sedation. Use Caution/Monitor.

  • Alprazolam (Xanax) | NAMI: National Alliance on Mental Illness

    Brand names:

    • Xanax®
      • Tablets: 0.25 mg, 0.5 mg, 1 mg, 2 mg
    • Xanax XR®
      • Extended release tablets: 0.5 mg, 1 mg, 2 mg, 3 mg
    • Niravam®
      • Orally disintegrating tablets: 0.25 mg, 0.5 mg, 1 mg, 2 mg
    • Alprazolam Intensol®
      • Liquid (concentrate): 1 mg/ml

    Generic name: alprazolam (al PRAY zoe lam)

    All FDA black box barnings are at the end of this fact sheet. Please review before taking this medication.

    What Is Alprazolam and What Does It Treat?

    Alprazolam is a benzodiazepine. It is approved for the treatment of generalized anxiety disorder (GAD) and panic disorder with or without agoraphobia. However, benzodiazepines are also commonly used to treat difficulty sleeping and alcohol withdrawal.

    Generalized Anxiety Disorder (GAD) occurs when a person experiences excessive anxiety or worry for at least six months. Other symptoms include:

    • Restlessness
    • Fatigue (low energy, feeling tired all the time)
    • Difficulty concentrating
    • Irritability
    • Muscle tension
    • Sleep disturbance (difficulty falling asleep or waking up in the middle of the night)

    Panic Disorder occurs when a person experiences unexpected and repeated episodes of intense fear. These episodes have physical symptoms including chest pain, shortness of breath, heart palpitations, sweating, dizziness, and nausea. Fear of future episodes is also part of panic disorder.

    What Is The Most Important Information I Should Know About Alprazolam?

    Do not drive a car or operate machinery until you know how this medication affects you because you may notice that you feel tired or dizzy.

    When starting alprazolam, anxiety or insomnia may improve rapidly or over a period of days.

    Benzodiazepines, such as alprazolam, are often used for short periods of time only. They may produce emotional and/or physical dependence (addiction) even when used as recommended. With input from you, your health care provider will assess how long you will need to take the medicine.

    Do not stop taking alprazolam without talking to your healthcare provider first. Stopping alprazolam abruptly may result in one or more of the following withdrawal symptoms: irritability, nausea, tremor, dizziness, blood pressure changes, rapid heart rate, and seizures.

    The use of alprazolam with drugs like opioid medications has led to serious side effects including slowed and difficulty breathing and death. Opioid drugs are medications used to treat pain and include medications such as: codeine, oxycodone, morphine, and illegal drugs like heroin. Some opioid medications are also in cough syrup.

    If you are taking alprazolam with an opioid medication, get medical assistance immediately if you feel dizziness or sleepiness, if you have slow or troubled breathing, or if you pass out. Caregivers must get medical help right away if a patient does not respond and does not wake up.

    Avoid alcohol while taking this medication.

    Are There Specific Concerns About Alprazolam and Pregnancy?

    If you are planning on becoming pregnant, notify your healthcare provider to best manage your medications. People living with anxiety disorders who wish to become pregnant face important decisions. It is important to discuss this with your doctor and caregivers.

    Regarding breastfeeding, caution is advised since alprazolam does pass into breast milk.

    What Should I Discuss With My Healthcare Provider Before Taking Alprazolam?

    • Symptoms of your condition that bother you the most
    • If you have thoughts of suicide or harming yourself
    • Medications you have taken in the past for your condition, whether they were effective or caused any adverse effects
    • If you experience side effects from your medications, discuss them with your healthcare provider. Some side effects may pass with time, but others may require changes in the medication.
    • Any other psychiatric or medical problems you have including obstructive sleep apnea
    • All other medications you are currently taking (including over the counter products and herbal and nutritional supplements) and any medication allergies you have
    • Other non-medication treatment you are receiving such as talk therapy or substance abuse treatment. Your provider can explain how these different treatments work with the medication
    • If you are elderly or are prone to falls
    • If you are pregnant, plan to become pregnant, or are breast-feeding
    • If you drink alcohol or use drugs

    How Should I Take Alprazolam?

    Alprazolam may be taken with or without food. Take with food if you experience an upset stomach.

    Alprazolam may be taken every day at regular times or on an as needed (“PRN”) basis. Typically, your healthcare provider will limit the number of doses you should take in one day.

    Your healthcare provider will determine the dose and method of taking the medication that is right for you based upon your response.

    Alprazolam orally disintegrating tablets must remain in their original packaging. Open the package with clean dry hands before each dose. Do not try to put tablets in a pillbox if you take the orally disintegrating tablets. Take the tablets right away, do not store for later use.

    Alprazolam orally disintegrating tablets will dissolve in your mouth within seconds and can be swallowed with or without liquid.

    Extended release tablets: Swallow whole. Do not chew, crush or split tablet.

    Alprazolam liquid: Measure with a dosing spoon or oral syringe, which you can get from your pharmacy.

    If you take the medication every day (instead of ‘as needed’), use a calendar, pillbox, alarm clock, or cell phone alert to help you remember to take it. You may also ask a family member or a friend to remind you or check in with you to be sure you are taking your medication.

    What Happens If I Miss a Dose of Alprazolam?

    If you miss a dose of alprazolam, take it as soon as you remember, unless it is closer to the time of your next dose. Discuss this with your healthcare provider. Do not double your next dose or take more than what is prescribed.

    What Should I Avoid While Taking Alprazolam?

    Avoid drinking alcohol and using illegal drugs while you are taking alprazolam. They may decrease the benefits (e.g., worsen your condition) and increase the adverse effects (e.g., sedation) of the medication. Alcohol increases the risk of accidental overdose with medications like alprazolam.

    What Happens If I Overdose With Alprazolam?

    If an overdose occurs call your doctor or 911. You may need urgent medical care. You may also contact the poison control center at 1-800-222-1222.

    Symptoms of overdose include confusion, impaired coordination, slow reflexes, coma, and death.

    A specific treatment to reverse the effects of alprazolam does exist. This medicine, called flumazenil, can reverse the effects of alprazolam but must be given through an IV at a hospital. Only a doctor can decide if you need this medication.

    What Are Possible Side Effects Of Alprazolam?

    Common side effects

    • Feeling dizzy, drowsy, fatigued, or lightheaded
    • Impaired coordination, decreased ability to concentrate

    If you experience these side effects after starting clonazepam they will often improve over the first week or two as you continue to take the medication

    Rare/serious side effects

    • Shortness of breath, trouble speaking, feeling very tired, dizziness, or passing out.
    • Increased heart rate, headache, memory impairment, irritability, and restlessness may occur.
    • Some people taking benzodiazepines develop a severe allergic reaction and swelling of the face. This can occur as early as with the first dose.
    • Some people taking benzodiazepines for sleep have experienced various behaviors while they were asleep/not fully awake, such as sleep driving, making phone calls, and preparing or eating food. The individuals have no memory of the events when they awaken.
    • Signs of feeling depressed or low mood, thoughts of harming or killing yourself, or lack of interest in life.

    Are There Any Risks For Taking Alprazolam For Long Periods Of Time?

    Alprazolam is a safe and effective medication when used as directed. Benzodiazepines may produce emotional and/or physical dependence (addiction) even when used as recommended. Physical dependence may develop after 2 or more weeks of daily use.

    What Other Medications May Interact With Alprazolam?

    The following medications may increase the levels and effects of alprazolam:

    • Ketoconazole (Nizoral®), itraconazole (Sporanox®), nefazodone (Serzone®), fluvoxamine (Luvox®), and cimetidine (Tagamet®)

    The following medications may decrease the levels and effects of alprazolam:

    • Carbamazepine (Tegretol®), phenytoin (Dilantin®), and phenobarbital (Luminal®)

    Alprazolam should not be taken with other benzodiazepine medications.

    Alprazolam may cause drowsiness, so caution should be used when combining it with other medications that cause drowsiness. These could include:

    • Antihistamines such as diphenhydramine (Benadryl®)
    • Narcotic pain medication such as morphine, oxycodone (OxyContin®), and hydrocodone (Vicodin® and Lortab®)
    • Opioid cough medications such as codeine cough syrup
    • Sleeping medications such as zolpidem (Ambien®)
    • Other anti-anxiety medications, antipsychotic medications, certain anticonvulsant medications, and tricyclic antidepressant medications (such as amitriptyline)

    How Long Does It Take For Alprazolam To Work?

    When starting alprazolam, anxiety or insomnia may improve rapidly or over a period of days or within hours of the first dose of medication.

    Summary of FDA Black Box Warnings

    The FDA has found that benzodiazepine drugs, such as alprazolam, when used in combination with opioid medications or other sedating medications can result in serious adverse reactions including slowed or difficult breathing and death. Patients taking opioids with benzodiazepines, other sedating medications, or alcohol, and caregivers of these patients, should seek immediate medical attention if that start to experience unusual dizziness or lightheadedness, extreme sleepiness, slow or difficulty breathing, or unresponsiveness.

     

    Provided by

    (January 2019)

    ©2019 The College of Psychiatric and Neurologic Pharmacists (CPNP) and the National Alliance on Mental Illness (NAMI). CPNP and NAMI make this document available under the Creative Commons Attribution-No Derivatives 4.0 International License. Last Updated: January 2016.

    This information is being provided as a community outreach effort of the College of Psychiatric and Neurologic Pharmacists. This information is for educational and informational purposes only and is not medical advice. This information contains a summary of important points and is not an exhaustive review of information about the medication. Always seek the advice of a physician or other qualified medical professional with any questions you may have regarding medications or medical conditions. Never delay seeking professional medical advice or disregard medical professional advice as a result of any information provided herein. The College of Psychiatric and Neurologic Pharmacists disclaims any and all liability alleged as a result of the information provided herein.

    Effects of Alprazolam on Driving Ability, Memory Functioning and Psychomotor Performance: A Randomized, Placebo-controlled Study

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  • Effect of alprazolam (0.5 mg) on driving performance of anxiety patients and healthy controls

    Alprazolam is a widely prescribed anxiolytic for the treatment of anxiety, panic disorder, and depression. Current literature suggests that alprazolam impairs driving performance. In the present study the major objective was to investigate the effect of alprazolam in treated and untreated anxiety patients compared to a healthy control group after oral alprazolam administration (0.5 mg) (acute phase) in a simulated environment. Primary variables were the vehicle variables (driving performance measures). The secondary objective was to compare multiple cognitive and subjective measures collected for each participant in order to establish the whole range of driving impairment. In this study, the alprazolam effect (0.5 mg) on driving performance was investigated in three experimental groups: a) treated anxiety patients, b) untreated anxiety patients, and c) control group. 51 participants completed two driving tasks; a lane tracking and a car following scenario with a semi-dynamic passenger car simulator. Impaired weaving control was observed in all groups after alprazolam administration. Increase in brake reaction time (sec) was found in treated and untreated anxiety patients when driving in the car following scenario. Healthy participants showed riskier close following behaviour after alprazolam administration compared to treated and untreated anxiety patients. A significant decrease in alertness -measured in computerised attention tests -was found only in healthy participants. Untreated patients and healthy participants reported decreased vigilance. This study clearly showed an alprazolam effect (0.5mg) in driving performance in treated, untreated anxiety patients and healthy participants.


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    • Authors:

      • Touliou, K
      • Bekiaris, E
      • Panou, M

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    • Publication Date: 2013-8

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    • Accession Number: 01495646

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    • Source Agency: ARRB

    • Files: ITRD, ATRI


    • Created Date:
      Oct 17 2013 10:10AM

    Alprazolam instructions for use: indications, contraindications, side effects – description of Alprazolam tab. 1 mg: 50 pcs. (13182)

    💊 Composition of the drug Alprazolam

    ✅ Application of the drug Alprazolam

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    Description of the active components of the drug

    Alprazolam
    (Alprazolam)

    The scientific information provided is generalized and cannot be used to make
    decisions about the possibility of using a particular drug.

    Update date: 2020.11.07

    Marketing Authorization Holder:

    Dosage form

    Alprazolam

    Tab.1 mg: 50 pcs.

    reg. No: LS-002581
    from 07/29/11
    – Indefinitely

    Release form, packaging and composition
    drug Alprazolam

    Tablets 1 tab.
    alprazolam 1 mg

    50 pcs.- cans of dark glass (1) – packs of cardboard.
    10 pcs. – contour cell packaging (5) – cardboard packs.

    Pharmacological action

    Anxiolytic agent (tranquilizer), a triazolo-benzodiazepine derivative. It has anxiolytic, sedative, hypnotic, anticonvulsant, central muscle relaxant effect. The mechanism of action is to enhance the inhibitory effect of endogenous GABA in the central nervous system by increasing the sensitivity of GABA receptors to the mediator as a result of stimulation of benzodiazepine receptors located in the allosteric center of postsynaptic GABA receptors of the ascending activating reticular formation of the brainstem and interneurons of the lateral horns of the spinal cord; reduces the excitability of the subcortical structures of the brain (limbic system, thalamus, hypothalamus), inhibits polysynaptic spinal reflexes.

    Pronounced anxiolytic activity (decrease in emotional stress, weakening of anxiety, fear, anxiety) is combined with a moderately pronounced hypnotic effect; shortens the period of falling asleep, increases the duration of sleep, reduces the number of night awakenings. The mechanism of hypnotic action is to inhibit the cells of the reticular formation of the brain stem. Reduces the impact of emotional, autonomic and motor stimuli that disrupt the mechanism of falling asleep.

    Pharmacokinetics

    After oral administration, alprazolam is rapidly and completely absorbed from the gastrointestinal tract. C max in blood plasma is achieved within 1-2 hours.

    Plasma protein binding is 80%.

    Metabolized in the liver.

    T 1/2 averages 12-15 hours. Alprazolam and its metabolites are excreted mainly by the kidneys.

    Indications of the active substances of the drug

    Alprazolam

    Anxiety, neuroses, accompanied by a feeling of anxiety, danger, anxiety, tension, sleep impairment, irritability, as well as somatic disorders; mixed anxiety-depressive states; neurotic reactive-depressive states, accompanied by a decrease in mood, loss of interest in the environment, anxiety, loss of sleep, loss of appetite, somatic disorders; anxiety and neurotic depression, developed against the background of somatic diseases; panic disorder with and without phobic symptoms.

    Dosing regimen

    The method of application and dosage regimen of a particular drug depends on its form of release and other factors. The optimal dosage regimen is determined by the doctor. It is necessary to strictly observe the compliance of the used dosage form of a particular drug with the indications for use and the dosage regimen.

    Individual.The minimum effective dose is recommended. The dose is adjusted in the course of treatment, depending on the achieved effect and tolerance. If it is necessary to increase the dose, it should be increased gradually, first in the evening, and then in the afternoon.

    The initial dose is 250-500 mcg 3 times / day, if necessary, a gradual increase to 4.5 mg / day is possible.

    For elderly or debilitated patients, the initial dose is 250 mcg 2-3 times / day, maintenance doses are 500-750 mcg / day, if necessary, taking into account the tolerance, the dose can be increased.

    Cancellation or reduction of the dose of alprazolam should be carried out gradually, reducing the daily dose by no more than 500 mcg every 3 days; sometimes an even slower cancellation may be required.

    Side effects

    From the side of the central nervous system: at the beginning of treatment (especially in elderly patients) drowsiness, fatigue, dizziness, decreased ability to concentrate, ataxia, disorientation, unsteadiness of gait, slowing of mental and motor reactions; rarely – headache, euphoria, depression, tremor, memory loss, impaired coordination of movements, depression of mood, confusion, dystonic extrapyramidal reactions (uncontrolled movements, incl.h. eyes), weakness, myasthenia gravis, dysarthria; in some cases – paradoxical reactions (aggressive outbursts, confusion, psychomotor agitation, fear, suicidal tendencies, muscle spasm, hallucinations, agitation, irritability, anxiety, insomnia).

    From the digestive system: possible dry mouth or salivation, heartburn, nausea, vomiting, loss of appetite, constipation or diarrhea, liver dysfunction, increased activity of hepatic transaminases and alkaline phosphatase, jaundice.

    From the hematopoietic system: possible leukopenia, neutropenia, agranulocytosis (chills, hyperthermia, sore throat, excessive fatigue or weakness), anemia, thrombocytopenia.

    From the urinary system: possible urinary incontinence, urinary retention, impaired renal function, decreased or increased libido, dysmenorrhea.

    From the endocrine system: possible changes in body weight, libido disturbances, menstrual irregularities.

    From the side of the cardiovascular system: may decrease blood pressure, tachycardia.

    Allergic reactions: possible skin rash, itching.

    Contraindications to use

    Coma, shock, myasthenia gravis, angle-closure glaucoma (acute attack or predisposition), acute alcohol poisoning (with weakening of vital functions), opioid analgesics, hypnotics and psychotropic drugs, chronic obstructive respiratory diseases with initial manifestations of respiratory failure, acute respiratory failure, severe depression (suicidal tendencies may occur), pregnancy (especially the first trimester), lactation, children and adolescence up to 18 years, hypersensitivity to benzodiazepines.

    Use during pregnancy and lactation

    Alprazolam has a toxic effect on the fetus and increases the risk of congenital defects when used in the first trimester of pregnancy. Continuous use during pregnancy can lead to physical dependence with the development of withdrawal syndrome in the newborn. Reception in therapeutic doses in later stages of pregnancy can cause depression of the central nervous system of the newborn.Application immediately before childbirth or during childbirth can cause respiratory depression, decreased muscle tone, hypotension, hypothermia and weak sucking in the newborn (sluggish sucking syndrome of the newborn).

    It is possible that benzodiazepines are excreted in breast milk, which can make the newborn sleepy and make feeding difficult.

    In experimental studies showed that alprazolam and its metabolites are excreted in breast milk.

    Application for violations of liver function

    Alprazolam should be used with caution in patients with impaired liver function.

    Application for impaired renal function

    Alprazolam should be used with caution in patients with impaired renal function.

    Use in children

    Contraindication: children and adolescents up to 18 years of age.

    Use in elderly patients

    For elderly or debilitated patients, the initial dose is 250 mcg 2-3 times / day, maintenance doses are 500-750 mcg / day, if necessary, taking into account the tolerance, the dose can be increased.

    Special instructions

    For endogenous depression, alprazolam can be used in combination with antidepressants. With the use of alprazolam in patients with depression, cases of the development of hypomanic and manic states have been noted.

    Alprazolam should be used with caution in patients with impaired liver and / or kidney function.

    In patients who have not previously taken drugs that affect the central nervous system, alprazolam is effective in lower doses, compared with patients who received antidepressants, anxiolytics or suffering from chronic alcoholism.

    With prolonged use in high doses, addiction and drug dependence may develop, especially in patients prone to drug abuse.

    With a rapid dose reduction or abrupt withdrawal of alprazolam, a withdrawal syndrome is observed, the symptoms of which can range from mild dysphoria and insomnia to a severe syndrome with abdominal and skeletal muscle cramps, vomiting, increased sweating, tremors and seizures. Withdrawal syndrome is more common in individuals for a long time (more than 8-12 weeks.) who received alprazolam.

    Do not use other tranquilizers simultaneously with alprazolam.

    The safety of using alprazolam in children and adolescents under the age of 18 has not been established. Children, especially at a younger age, are very sensitive to the inhibitory effect of benzodiazepines on the central nervous system.

    Avoid drinking alcohol during treatment.

    Influence on the ability to drive vehicles and mechanisms

    During the period of treatment, one should refrain from engaging in potentially hazardous activities that require increased attention and speed of psychomotor reactions (driving vehicles or working with mechanisms).

    Drug interactions

    With the simultaneous use of psychotropic, anticonvulsant, drugs and ethanol, an increase in the inhibitory effect of alprazolam on the central nervous system is observed.

    With the simultaneous use of blockers of histamine H 2 -receptors reduce the clearance of alprazolam and increase the inhibitory effect of alprazolam on the central nervous system; antibiotics from the macrolide group – reduce the clearance of alprazolam.

    With the simultaneous use of hormonal contraceptives for oral administration increase T 1/2 alprazolam.

    With the simultaneous use of alprazolam with dextropropoxyphene, a more pronounced depression of the central nervous system is observed than in combination with other benzodiazepines, because an increase in the concentration of alprazolam in blood plasma is possible.

    Simultaneous intake of digoxin increases the risk of cardiac glycoside intoxication.

    Alprazolam increases the concentration of imipramine in the blood plasma.

    With the simultaneous use of itraconazole, ketoconazole enhance the effects of alprazolam.

    With the simultaneous use of paroxetine, it is possible to enhance the effects of alprazolam, due to the inhibition of its metabolism.

    Fluvoxamine increases the plasma concentration of alprazolam and the risk of developing its side effects.

    With the simultaneous use of fluoxetine, it is possible to increase the concentration of alprazolam in the blood plasma due to a decrease in its metabolism and clearance under the influence of fluoxetine, which is accompanied by psychomotor disorders.

    The possibility of enhancing the action of alprazolam while being used with erythromycin cannot be ruled out.

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    instructions for use, analogs, articles »Drug Handbook

    From the nervous system: at the beginning of treatment (especially in elderly patients) – drowsiness, fatigue, dizziness, decreased ability to concentrate, ataxia, disorientation, mental and motor slowdown reactions; rarely – headache, euphoria, depression, tremor, memory loss, impaired coordination of movements, depression of mood, confusion, dystonic extrapyramidal reactions (uncontrolled movements, incl.h. eyes), weakness, myasthenia gravis, dysarthria; extremely rarely – paradoxical reactions (aggressive outbursts, confusion, psychomotor agitation, fear, suicidal tendencies, muscle spasm, hallucinations, agitation, irritability, anxiety, insomnia). From the side of hematopoietic organs: leukopenia, neutropenia, agranulocytosis (chills, hyperthermia, sore throat, excessive fatigue or weakness), anemia, thrombocytopenia.
    From the digestive system: dry mouth or salivation, heartburn, nausea, vomiting, loss of appetite, constipation or diarrhea; dysfunction of the liver, increased activity of “hepatic” transaminases and alkaline phosphatase, jaundice.
    From the genitourinary system: urinary incontinence, urinary retention, impaired renal function, decreased or increased libido, dysmenorrhea. Allergic reactions: skin rash, itching.
    Influence on the fetus: teratogenicity (especially the first trimester), depression of the central nervous system, respiratory failure and suppression of the sucking reflex in newborns whose mothers used the drug.
    Others: addiction, drug dependence; decrease in blood pressure; rarely – visual impairment (diplopia), weight loss, tachycardia. With a sharp decrease in dose or discontinuation of admission – withdrawal syndrome (irritability, nervousness, sleep disturbances, dysphoria, spasm of smooth muscles of internal organs and skeletal muscles, depersonalization, increased sweating, depression, nausea, vomiting, tremors, perception disorders, incl.h. hyperacusis, paresthesia, photophobia; tachycardia, convulsions, rarely acute psychosis).
    Overdose. Symptoms (intake of 500-600 mg): drowsiness, confusion, decreased reflexes, nystagmus, tremor, bradycardia, shortness of breath or shortness of breath, decreased blood pressure, coma.
    Treatment: gastric lavage, intake of activated carbon. Symptomatic therapy (maintaining breathing and blood pressure), the introduction of flumazenil (in a hospital setting). Hemodialysis is ineffective.

    Memorial Sloan Kettering Cancer Center

    This document, provided by Lexicomp ® , contains all the information you need to know about the drug, including the indications, route of administration, side effects and when you should contact your healthcare provider.

    Trade names: USA

    ALPRAZolam Intensol; ALPRAZolam XR; Xanax; Xanax XR

    Trade names: Canada

    ALPRAZolam TS; ALPRAZolam-1; APO-Alpraz; APO-Alpraz TS; JAMP-Alprazolam [DSC]; MYLAN-ALPRAZolam [DSC]; NAT-ALPRAZolam [DSC]; RIVA-ALPRAZolam [DSC]; TEVA-Alprazolam; Xanax; Xanax TS

    Warning

    • This drug is a benzodiazepine. Concomitant use of benzodiazepines with opioids has resulted in very severe side effects.Side effects observed included slowing or difficult breathing and death. Opioids include drugs such as codeine, oxycodone, and morphine. Opioids are used to treat pain and some are used to treat coughs. Consult your doctor.
    • If you are taking this medication with an opioid, get medical help right away if you feel very sleepy or dizzy, if you have slow, shallow or difficult breathing, or if you pass out.Caregivers or others should seek immediate medical attention if the patient does not respond, does not respond or does not respond normally, or if he is asleep and does not wake up.
    • There may be a risk of dependence, abuse or misuse when using benzodiazepines. Misuse or abuse of this drug can lead to overdose or death, especially when used in conjunction with certain other drugs, alcohol, or drugs.Addiction can occur even if you use this drug as directed by your doctor. Get immediate medical attention if you have changes in mood or behavior, suicidal thoughts or actions, seizures, or trouble breathing.
    • You will be closely monitored to avoid misuse, abuse or dependence on this drug.
    • Benzodiazepines may be addictive.Reducing the dose or stopping suddenly from this drug may cause withdrawal. This can be life threatening. The risk of addiction and withdrawal increases with long-term or high-dose use of this drug. Talk to your doctor before lowering the dose or stopping this drug. Follow your doctor’s instructions. Seek immediate medical attention if you experience problems controlling body movements, seizures, behavior or mood changes, such as depression or suicidal thoughts, thoughts of harming someone, hallucinations (vision or auditory perception), appear or become more severe non-existent things), loss of contact with reality, stupid movements or conversations, or any other side effects.
    • Sometimes withdrawal symptoms can last from several weeks to more than 12 months. Tell your doctor if you have anxiety; problems with memory, learning, or concentration; sleep problems; burning, numbness, or tingling; weakness; tremor; muscle twitching; ringing in the ears or any other side effects.

    What is this drug used for?

    • Used to treat anxiety.
    • Used to treat panic attacks.

    What do I need to tell my doctor BEFORE taking this drug?

    • If you are allergic to this drug, any of its ingredients, other drugs, foods or substances. Tell your doctor about your allergy and how it manifested itself.
    • If you have glaucoma.
    • If you are taking any of the following drugs: clarithromycin, itraconazole, or ketoconazole. There may be other drugs that should not be taken with this drug.Your doctor or pharmacist can tell you if you are taking a drug that should not be taken at the same time as this drug.
    • If you are breastfeeding. Do not breast-feed while taking this drug.

    This list of drugs and diseases that may be adversely associated with this drug is not exhaustive.

    Tell your doctor and pharmacist about all the medicines you take (both prescription and over-the-counter, natural products and vitamins) and your health problems.You need to make sure that this drug is safe for your medical conditions and in combination with other drugs you are already taking. Do not start or stop taking any drug or change the dosage without your doctor’s approval.

    What do I need to know or do while taking this drug?

    • Tell all healthcare providers that you are taking this drug.These are doctors, nurses, pharmacists and dentists.
    • If this drug is taken for a long time or in high doses, its effectiveness may be reduced and a higher dose may be needed to obtain the same effect. The so-called drug tolerance develops. Talk to your doctor if this drug stops working. Do not take the drug in higher doses than your doctor prescribed.
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    WARNING. In rare cases, some people with this drug can have serious and sometimes deadly side effects. Call your doctor right away or get medical help if you have any of the following signs or symptoms, which may be associated with serious side effects:

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    This list of potential side effects is not exhaustive. If you have any questions about side effects, please contact your doctor.Talk to your doctor about side effects.

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    What is the best way to take this drug?

    Use this drug as directed by your healthcare practitioner. Read all the information provided to you.Follow all instructions strictly.

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    How do I store and / or discard this drug?

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    Liquid (solution):

    • Protect from light.
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    General information about medicines

    • If your health does not improve or even worsens, see your doctor.
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    Use of information by consumer and limitation of liability

    This information should not be used to make decisions about taking this or any other drug. Only the attending physician has the necessary knowledge and experience to make decisions about which drugs are suitable for a particular patient. This information does not guarantee that the drug is safe, effective, or approved for the treatment of any disease or specific patient.Here are only brief general information about this drug. It does NOT contain all available information on the possible use of the drug with instructions for use, warnings, precautions, information about interactions, side effects and risks that may be associated with this drug. This information should not be construed as a treatment guide and does not replace information provided to you by your healthcare professional. Check with your doctor for complete information on the possible risks and benefits of taking this drug.Use of this information is governed by the Lexicomp End User License Agreement available at https://www.wolterskluwer.com/en/solutions/lexicomp/about/eula.

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    Treatment of anxiety in general medical practice

    Article No. 64. Anxiety disorders are often found in general medical practice in patients with somatic diseases: more than 20% of patients who come to medical consultations have clinically significant symptoms of anxiety.However, the word “anxiety” itself is rarely found in the complaints presented. More often you can hear complaints of anxiety about little things, insecurity, constant concern for your future, excessive fears, a feeling of constant expectation, easily arising anxiety, difficulty falling asleep or interrupted sleep, unpleasant dreams, irritability, inability to concentrate. These complaints are mental in nature and directly indicate the presence of anxiety. More difficult in the differential diagnosis are somatic complaints, such as fussiness, tension headaches, tremors, inability to relax, tachycardia, sweating, dry mucous membranes, difficulty breathing, nausea, dyspepsia, diarrhea, chills, persistent weakness, heart failure, feeling compression or compression in the chest, increased blood pressure (BP), abdominal cramping, back and lower back pain, myalgia, pallor or redness, “goose bumps”, itching, urticaria, sexual dysfunction, etc.[one]. Most of the somatic complaints are due to muscle tension and autonomic dysfunction, which is characteristic of anxiety.

    The ability to recognize possible somatic symptoms of anxiety is important for physicians in somatic specialties in order to differentiate between anxiety disorders and somatic diseases, taking into account their frequent combination with each other.

    The ICD-10 diagnostic criteria for generalized anxiety disorder (F41.1) are as follows.

    1. Generalized persistent anxiety, not limited to any specific circumstances (or arising mainly under these circumstances).

    2. Related:

    – fears (fears) for health and your life, life and health of loved ones, other bad feelings;

    – motor (muscle) tension – fussiness, tremor, inability to relax;

    – vegetative and vegetative pain symptoms.

    3. The presence of symptoms most days of the week for several weeks or months [2].

    In clinical practice, it often happens that in the presence of psychological and somatic symptoms of increased anxiety, their number or duration is insufficient for a definite diagnosis; then they speak of subsyndromal anxiety. It is often caused by high levels of personal anxiety. According to neurophysiological studies in such persons, there is a tendency to a background increase in pulse rate, blood pressure, heart disorders, as well as large shifts in these indicators in mental activity and stress [3].The question of the need to prescribe pharmacotherapy for subsyndromic anxiety is decided individually, in contrast to clinically expressed anxiety disorders. Numerous studies have shown that anxiety disorders have a long-term undulating course, exacerbating after stress. After 5 years, spontaneous complete remission is observed in only 1/3 of patients. In this regard, the mandatory appointment of anti-anxiety pharmacotherapy becomes clear.

    The search for the most effective drugs for the treatment of anxiety disorders is ongoing.It is known that neurochemical and neuroendocrine levels are involved in the development of anxiety: GABAergic, noradrenergic, serotonergic, histaminergic systems, as well as hormones or peptides like corticotropic releasing hormone associated with corticosteroid, neurosteroid hormones, hypothalamus hypothalamus axis and hypothalamus axis and hypothalamus axis. This explains such a wide range of pharmacological drugs used to relieve anxiety disorders.

    At the beginning of the XX century.bromides have been used to treat anxiety and insomnia; in the 40s – ethyl alcohol and its structural analogs, for example, Paraldehyde and Chloral hydrate; in the 50s. – barbiturates and propanediol derivatives, including meprobamate. In the 1960s. appeared benzodiazepines, which are still the most frequently prescribed drugs [4]. In modern medicine, in addition to the latter, “small” antipsychotics, antidepressants and non-benzodiazepine anxiolytics are also used. Let’s dwell on each of these groups in more detail.

    The effect of taking benzodiazepine drugs in case of anxiety is due to inhibition of the central nervous system through GABA receptors. In relatively low doses, they exhibit anxiolytic properties, and in higher doses, sedative-hypnotics. Based on the varying degrees of evidence of the studies carried out, as well as on their pharmacokinetic properties for each of the drugs, a predominant indication was derived. For example, Phenazepam, Flurazepam, Temazepam and Triazolam are used more often for the treatment of insomnia due to the pronounced hypnotic effect.

    Diazepam (Sibazon, Relanium, Seduxen) is effective in the drug treatment of situational anxiety at a dosage of 5 mg 3 times a day. If necessary, the dose can be increased to 30 mg / day. In the case of generalized anxiety disorder, the daily dose may be increased from 15-30 mg to 40-50 mg. In some patients, stable improvement occurs after 2–6 weeks of therapy, but in most cases, discontinuation of therapy leads to a relapse of anxiety. In this regard, it is recommended to combine psychopharmacotherapy with cognitive-behavioral psychotherapy [4].

    Alprazolam and Clonazepam have an obvious advantage of efficacy and pharmacokinetic parameters in the treatment of panic attacks. Alprazolam is usually prescribed at 2-6 mg / day, divided into 3-4 doses. Let’s consider the main problems associated with taking Alprazolam. He has a higher risk of developing addiction, which leads to more severe relapses and more severe withdrawal symptoms. Due to the short half-life in some patients, relapses of anxiety develop in the intervals between doses.Despite the frequent use of Alprazolam, patients may experience significant discomfort when the effect of the last dose wears off. They constantly monitor the time of taking the drug and often independently increase the dosage.

    When using Clonazepam, due to the longer half-life, the above problems can be avoided. Its daily dose is 1-4 mg and is divided into 2 doses, although the therapeutic range varies from 0.5 to 6.0 mg / day. The disadvantage of Clonazepam therapy compared with Alprazolam is a higher risk of depression [4].

    The widespread use of benzodiazepines in general medical practice in patients with complaints of anxiety and insomnia is due to a combination of efficacy and relative safety. However, over the past 20 years, addiction and abuse have increased. Indeed, with long-term use of even therapeutic doses of benzodiazepines (6 months or more), the risk of developing dependence or withdrawal syndrome is high. Most often, addiction is caused by drugs with a pronounced, but short-term effect, such as Alprazolam and Lorazepam.The use of benzodiazepines is also limited by their various side effects, such as muscle relaxation, daytime sleepiness, ataxia, memory impairment, decreased concentration, recoil syndrome and the already mentioned addiction, drug dependence and withdrawal syndrome [4].

    Until now, there are no detailed generally accepted recommendations on the tactics of withdrawing long-term benzodiazepines by outpatients. For these purposes, the most commonly used SSRI (trittico) [5].At the State Scientific Center for St. Petersburg and JV them. V.P. Serbian, a study was conducted using the atypical antipsychotic Eglek (Sulpiride) as a “cover-up therapy” for the period of withdrawal and subsequent replacement therapy. Providing a pronounced anti-anxiety effect already at a dose of 200 mg / day, Eglek effectively influenced the prevailing anxiety disorders of both paroxysmal and generalized nature. No less important is the somatotropic and vegetative stabilizing effects of Eglek [6].

    Due to its pronounced anxiolytic and sedative effect, another “small” neuroleptic, Thioridazine (Sonapax), is often prescribed in general medical practice.The experience of its application in clinical practice, especially in outpatient practice, has confirmed its firm position as a means necessary in the treatment of a wide range of anxiety-neurotic disorders. Undoubted indications for the appointment of Thioridazine are actually anxiety disorders, anxiety-phobic disorders with a different content of phobias, somatoform neurotic disorders, the so-called latent depression with senesto-hypochondriac and vegetative-vascular manifestations, acting under the guise of vegetative-vascular dystonia or various algic syndromes.The daily dose of the drug can vary from 10 to 300 mg. In general, Thioridazine is well tolerated, however, with the appointment of high doses and long-term administration, manifestations of arterial hypotension, especially orthostatic, are possible, although extremely rare, which are functional and reversible [7]. Neuroendocrine disorders can manifest as weight gain.

    From the middle of the XX century. antidepressants are increasingly being used in the treatment of anxiety disorders. As shown by numerous studies, the use of classical (tricyclic) antidepressants (Amitriptyline, Imipramine, Clomipramine) gives a more pronounced and lasting clinical effect.Moreover, antidepressant therapy excludes the possibility of the development of frequent complications arising from the use of anxiolytics – changes in tolerance, the formation of drug dependence and withdrawal syndrome. However, there are many complications in it – side effects. If it is necessary to use high doses of tricyclic antidepressants for long courses (from six months or more), such undesirable phenomena as excessive sedative effect, weakening of concentration, a decrease in the speed of reaction complicate social and professional, especially intellectual activity, study, create restrictions in work that requires speed and accuracy of actions (including driving).It should also be noted that the use of tricyclic antidepressants is impossible with some concomitant somatic diseases (severe cardiovascular pathology, prostate diseases, open-angle glaucoma) [8, 9].

    Antidepressants of the next generations, due to their selective effect, are safer when prescribed to patients with concomitant somatic diseases. Currently, selective serotonin reuptake inhibitors are most commonly used: Fluvoxamine, Fluoxetine, Trazodone, Citalopram, Escitalopram, Paroxetine, Sertraline, etc.Due to the fact that the therapeutic effect of antidepressants develops only on the 2-4th week of their use, in practice, if a somatic patient has a depressive disorder and severe anxiety symptoms, in about 80% of cases, doctors prescribe both an antidepressant and an anxiolytic at the same time. In about 75% of cases, it is benzodiazepine, which causes problems associated with its side effects and their pharmacokinetic interaction with each other. The result of a study carried out in France was the conclusion that the joint appointment of SSRIs and benzodiazepines is inappropriate, due to the fact that the latter reduce the antidepressant effect.Researchers suggest that, if necessary, the simultaneous administration of SSRIs and an anti-anxiety drug, prescribe a non-benzodiazepine anxiolytic. Representatives of this group are Atarax, Buspirone and Azophene.

    Atarax (Hydroxyzine) is an antagonist of histamine H1 receptors. It is used in a dose of 25-100 mg / day, divided into 3 doses. Atarax advantages is the lack of dependence and withdrawal syndrome. Due to the pronounced M-anticholinergic action, it is recommended not to prescribe or prescribe with caution Atarax to patients with glaucoma, prostatic hypertrophy, difficulty urinating, and constipation.Also, the drug during 1 week lowers attention and responsiveness, which limits its use in outpatient practice.

    Buspirone is a partial agonist of 5-HT1A receptors, whereby it reduces the serotonin turnover. In terms of the effectiveness of monotherapy for generalized anxiety disorders, it is comparable to benzodiazepines, but only with regular use. Significant advantages of Buspirone are the absence of sedation, dependence and withdrawal symptoms, as well as the presence of an antidepressant effect, which manifests itself when taking large doses of the drug.An obstacle to use is the lack of registration of the drug in Russia [4].

    As a result of a long search for the most optimal drug in the Scientific Research Institute of Pharmacology of the Russian Academy of Medical Sciences, a new selective anxiolytic, Afobazol, was created. It prevents the development of membrane-dependent changes in the GABA receptor. Afobazol has both anxiolytic and mild stimulating (activating) effect, which compares favorably with its predecessors. Reduction or elimination of anxiety (anxiety, bad feelings, fears, irritability), tension (fearfulness, tearfulness, feelings of anxiety, inability to relax, insomnia, fear), and, consequently, somatic (muscle, sensory, cardiovascular, respiratory, gastrointestinal) intestinal symptoms), vegetative (dry mouth, sweating, dizziness), cognitive (difficulty concentrating, impaired memory) disorders are observed on the 5-7th day of treatment.The drug is taken at 30 mg / day, divided into 3 doses. The duration of the course is 2-4 weeks. If necessary, the daily dose can be increased to 60 mg. Afobazol has passed clinical trials in many leading clinics in Moscow and St. Petersburg. A small number of contraindications contributes to the wider prescription of Afobazol by doctors of general medical practice. The advantages of the drug are also the absence of muscle relaxant properties, negative effects on cognitive processes, drug dependence and withdrawal syndrome.Due to the fact that anxious affect is often accompanied by severe vegetative disorders, attention should be paid to the vegetative effect of Afobazol [10].

    Thus, Afobazol is an effective drug both for monotherapy and for combined treatment with antidepressants in patients with generalized anxiety disorders and adjustment disorders, which are so common in general medical practice.

    References

    one.Starostina E.G. Generalized anxiety disorder and symptoms of anxiety in general medical practice // BC. 2004. T. 12. No. 22. P. 2–7.

    2. Classification of diseases in psychiatry and narcology: A guide for doctors / Ed. M. M. Milevsky. M., 2003.

    3. Vegetative disorders: clinical picture, diagnosis, treatment / Ed. A. M. Wein. M., 2003.

    4. Arana J., Rosenbaum J. Pharmacotherapy of mental disorders / Per. from English M., 2004.

    five.Register of medicines of Russia. Radar – Encyclopedia of Medicines. 14th issue / Ed. G. L. Vyshkovsky. M .: RLS-2006, 2005.

    6. Yastrebov D. V., Cheberda O. A., Kostycheva E. A. The effectiveness of the drug “Eglek” as a means of substitution therapy in patients taking benzodiazepine tranquilizers for a long time // Psychiatry and psychopharmacotherapy. 2005. T. 7. No. 4. P. 200–205.

    7. Raisky VA Psychotropic drugs in the clinic of internal diseases. M., 1988.

    8. Kolyutskaya EV Anxiety disorders (diagnosis and therapy) // BC. 2004.Vol. 132.No. 15, pp. 1019–1021.

    9. Mosolov SN Anxiety and depression: problems of diagnosis and therapy // Psychopharmacotherapy of depression. 2005. No. 4. P.1-15.

    10. Avedisova AS et al. A new anxiolytic afobazole in the treatment of generalized anxiety disorder (results of a comparative study with diazepam). [In the press].

    V.I.Kurpatov, Doctor of Medical Sciences,

    WITH.A. Osipova

    Medical Academy of Postgraduate Education, St. Petersburg, Russia

    90,000

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    Vinkatera, concentrate for solution for infusion, 10 mg / ml 1 ml No. 1

    Vinorelbin

    Vinkatera, concentrate for solution for infusion, 50 mg / 5 ml No. 1

    Vinorelbin

    Maverex, concentrate for solution for infusion, 10 mg / ml 1 ml No. 1

    Vinpocetine

    Vinpocetine Forte, tablets, 10 mg No. 30

    Vinpocetine

    Vinpocetine, tablets, 5 mg No. 30

    Bismuth tripotassium dicitrate

    De-Nol, film-coated tablets, 120 mg No. 112

    Galantamine

    Reminil, film-coated tablets, 12 mg No. 56

    Galantamine

    Reminil, film-coated tablets, 4 mg No. 14

    Galantamine

    Reminil, film-coated tablets, 8 mg No. 56

    Haloperidol

    Haloperidol decanoate, solution for intramuscular administration [oily], 50 mg / ml 1 ml, ampoule No. 5

    Haloperidol

    Haloperidol, tablets, 5 mg No. 50

    Gentamicin + Betamethasone + Clotrimazole

    Triderm, ointment for external use, 15 g.

    heparin sodium

    Heparin-Akrigel 1000, gel for external use 1 thousand IU / g 30 g No. 1

    Heparin sodium

    Trombless, gel for external use, 1 thousand IU / g 30 g No. 1

    Gefitinib

    Iressa, film-coated tablets, 250 mg No. 30

    Hydrazine sulfate

    Sehydrin, enteric coated tablets, 0.06 g No. 50

    Hydrocortisone

    Hydrocortisone, ointment for external use, 1% 10 g No. 1

    hydroxycarbamide

    Hydroxycarbamide Medac, capsules, 500 mg №100

    Hydrochlorothiazide

    Hypothiazide, tablets, 100 mg No. 20

    Hydrochlorothiazide

    Hypothiazide, tablets, 25 mg No. 20

    Hydrochlorothiazide + Triamterene

    Triampur compositum, tablets, No. 50

    Glibenclamide

    Maninil 1.75 tablets 1.75 mg No. 120

    Glibenclamide

    Maninil 3.5 tablets 3.5 mg No. 120

    Glibenclamide

    Maninil 5 tablets 5 mg No. 120

    Glibenclamide + Metformin

    Glibomet, film-coated tablets, 400 mg + 2.5 mg No. 40

    Glickvidone

    Glyurenorm tablets 30 mg No. 60

    Gliclazide

    Glidiab MV, modified release tablets, 30 mg No. 60

    Gliclazide

    Diabeton MV, modified release tablets, 30 mg No. 60

    Glimepiride

    Amaryl tablets 1 mg No. 30

    Glimepiride

    Amaryl tablets 2 mg No. 30

    Glimepiride

    Amaryl tablets 3 mg No. 30

    Glimepiride

    Glemaz tablets 4 mg No. 30

    Goserelin

    Zoladex, long-acting subcutaneous capsule, 3.6 mg No. 1

    Dakarbazine

    Dacarbazine Lahema, lyophilisate for preparation of solution for intravenous administration, 200 mg No. 10

    Dalteparin sodium

    Fragmin, solution for intravenous and subcutaneous administration, 10,000 IU (anti-Xa) / 1 ml, No. 10

    Dalteparin sodium

    Fragmin, solution for intravenous and subcutaneous administration, 2.5 thous.anti-Ha ME / 0.2 ml No. 10

    Dalteparin sodium

    Fragmin, solution for intravenous and subcutaneous administration, 5000 IU (anti-Xa) /0.2 ml, No. 10

    Dexamethasone

    Dexamethasone tablets, 0.5mg No. 10

    Dexamethasone

    Oftan-Dexamethasone, eye drops, 0.1% 5ml

    Desmopressin

    Minirin tablets 0.1 mg No. 30

    Desmopressin

    Minirin tablets 0.2 mg No. 30

    Josamycin

    Vilprafen, film-coated tablets, 500 mg No. 10

    Diazepam

    Sibazon tablets, 5 mg No. 20

    Digoxin

    Digoxin tablets, 0.25 mg No. 50

    Diclofenac

    Diklak, gel for external use, 5% 50 g, No. 1

    Diclofenac

    Diclogen, gel for external use, 1% 30 g, No. 1

    Diclofenac

    Diclofenac eye drops, 0.1% 5 ml, No. 1

    Diclofenac

    Diclofenac enteric-coated tablets, 50 mg No. 20

    Diclofenac

    Diclofenac-Acri retard, coated tablets of prolonged action, 100 mg No. 20

    Diclofenac

    Diclofenac-Acri, ointment for external use, 1% 30 g, No. 1

    Diclofenac

    Diclofenac-Altpharm, rectal suppositories, 50 mg No. 10

    Diclofenac

    Ortofen, ointment for external use, 2% 30 g No. 1

    Diclofenac

    Ortofen enteric-coated tablets, 25 mg No. 30

    Diltiazem

    Diltiazem Lannacher, extended-release film-coated tablets, 180 mg No. 30

    Diltiazem

    Diltiazem Lannacher, extended-release film-coated tablets, 90 mg No. 20

    Diosmin

    Phlebodia 600 coated tablets 600mg No. 15

    Diosmin + Hesperidin

    Venarus, film-coated tablets, 500 mg No. 30

    Diosmin + Hesperidin

    Detralex, film-coated tablets, 500 mg No. 30

    Dipyridamole

    Curantil 25, pills, 25 mg No. 100

    Dipyridamole

    Curantil N 75, coated tablets, 75 mg No. 40

    Doxazosin

    Artesin, tablets, 1 mg No. 30

    Doxazosin

    Artesin, tablets, 2 mg No. 30

    Doxazosin

    Artesin, tablets, 4 mg No. 30

    Doxycycline

    Doxycycline, capsules, 100mg No. 10

    Drotaverin

    Drotaverin forte, tablets, 80 mg No. 20

    Drotaverin

    Drotaverin tablets, 40mg No. 20

    Iron [III] hydroxide polymaltose

    Maltofer, syrup, 10 mg / ml 150 ml, vials No. 1

    Iron [III] hydroxide polymaltose

    Maltofer, chewable tablets, 100 mg No. 30

    Iron [III] hydroxide polymaltose

    Ferrum Lek, syrup, 10 mg / ml 100 ml No. 1

    Iron [III] hydroxide sucrose complex

    Venofer, solution for intravenous administration, 20 mg / ml 5 ml No. 5

    Iron sulfate + Ascorbic acid

    Sorbifer Durules, coated tablets, No. 50

    Zoledronic acid

    Zometa, concentrate for solution for infusion, 4 mg 5 ml, vials No. 1

    Zoledronic acid

    Rezoklastin FS, concentrate for solution for infusion, 4mg / 5ml, vials No. 1

    Zuclopenthixol

    Clopixol, film-coated tablets, 10 mg No. 100

    Zuclopenthixol

    Clopixol, film-coated tablets, 2 mg No. 100

    Zuclopenthixol

    Clopixol-akufaz, solution for intramuscular injection (oily), 50 mg / ml, ampoules 1 ml No. 5

    Ibuprofen

    Dolgit cream, cream for external use, 5% 50 g No. 1

    Ibuprofen

    Ibuprofen-Verte, gel for external use, 5% 50 g No. 1

    Disposable needles for insulin injector

    Needles one time.to the high pressure injector Micro-Fine Plus 30G (0.30x8mm) No. 100

    Disposable needles for insulin injector

    Disposable needles for insul.inject.VD MicroFine Plus 31G (0.25x5mm) No. 100

    Isosorbide mononitrate

    Monocinque retard, long-acting capsules, 50 mg No. 30

    Isosorbide mononitrate

    Pectrol, extended-release tablets, 40 mg No. 30

    Isosorbide mononitrate

    Pectrol, extended-release tablets, 60 mg No. 30

    Isosorbide dinitrate

    Isoket, spray dosed 1.25 mg / dose 300 doses No. 1

    Isosorbide dinitrate

    Cardiket, extended-release tablets, 20 mg No. 50

    Isosorbide dinitrate

    Cardiket, extended-release tablets, 40 mg No. 50

    Isosorbide dinitrate

    Cardiket, extended-release tablets, 60 mg No. 50

    Isosorbide mononitrate

    Monosan, tablets, 40 mg No. 30

    Isosorbide mononitrate

    Efoks 20, tablets, 20 mg No. 50

    Isosorbide mononitrate

    Efox long, retard tablets, 50mg No. 30

    Imatinib

    Gleevec, capsules, 100 mg No. 120

    Imipramine

    Melipramine, pills, 25 mg No. 50

    Normal human immunoglobulin [IgG + IgA + IgM]

    Pentaglobin, solution for infusion, 50 mg / ml 100 ml, vials No. 1

    Indapamide

    Indapamide-Verte capsules, 2.5mg No. 30

    Indapamide

    Ionic retard tab. with controlled release 1.5 mg No. 30

    Indomethacin

    Indomethacin Sopharma, ointment for external use, 10% 40 g No. 1

    Indomethacin

    Indomethacin Sopharma, rectal suppositories, 50 mg No. 6

    Indomethacin

    Indomethacin-Altpharm, rectal suppositories, 100 mg No. 10

    Insulin aspart

    NovoRapid Penfill, solution for intravenous and subcutaneous administration, 100 U / ml 3 ml, cartridges No. 5

    Insulin aspart

    NovoRapid FlexPen, solution for intravenous and subcutaneous administration, 100 IU / ml 3 ml, syringe pen No. 5

    Insulin aspart biphasic

    NovoMix 30 Penfill, suspension for subcutaneous administration, 100 IU / ml / 3 ml, cartridges No. 5

    Insulin aspart biphasic

    NovoMix 30 FlexPen, suspension for subcutaneous administration, 100 IU / ml 3 ml, cartridges with a syringe pen No. 5

    Insulin glargine

    Lantus SoloStar, solution for subcutaneous administration, 100 U / ml cartridges 3 ml No. 5 syringe pens

    Biphasic insulin [human genetic engineering]

    Gensulin M30, suspension for subcutaneous administration 100 IU / ml 10 ml, vials No. 1

    Biphasic insulin [human genetic engineering]

    Gensulin M30, suspension for subcutaneous administration, 100 IU / ml 3 ml, cartridges No. 5

    Biphasic insulin [human genetic engineering]

    Humulin M3, suspension for subcutaneous administration, 100 IU / ml 10 ml, vials No. 1

    Biphasic insulin [human genetic engineering]

    Humulin M3, suspension for subcutaneous administration, 100 IU / ml 3 ml, cartridges No. 5

    Insulin detemir

    Levemir FlexPen, solution for subcutaneous administration, 100 U / ml 3 ml, syringe pen No. 5

    Insulin lispro

    Humalog, solution for injection, 100 IU / ml 3 ml, cartridges No. 5

    Insulin soluble, [human genetically engineered]

    Actrapid NM Penfill, solution for injection, 100 IU / ml 3 ml, cartridges No. 5

    Insulin soluble, [human genetically engineered]

    Actrapid NM, solution for injection, 100 IU / ml 10 ml, vials No. 1

    Insulin soluble, [human genetically engineered]

    Gensulin R, solution for injection 100 IU / ml 10 ml, vials No. 1

    Insulin soluble, [human genetically engineered]

    Gensulin R, solution for injection, 100 IU / ml 3 ml, cartridges No. 5

    Insulin soluble, [human genetically engineered]

    Insuman Rapid GT, solution for injection, 100 IU / ml 3 ml, cartridges No. 5

    Insulin soluble, [human genetically engineered]

    Insuman Rapid GT, solution for injection, 100 IU / ml 5ml, vials No. 5

    Insulin soluble, [human genetically engineered]

    Humulin Regular, solution for injection, 100 IU / ml 10 ml, vials No. 1

    Insulin soluble, [human genetically engineered]

    Humulin Regular, solution for injection, 100 IU / ml 3 ml, cartridges, No. 5

    Insulin isophane [human genetic engineering]

    Gensulin N, suspension for subcutaneous administration 100 IU / ml 10 ml, vials No. 1

    Insulin isophane [human genetic engineering]

    Gensulin N, suspension for subcutaneous administration 100 IU / ml 3 ml, cartridges No. 5

    Insulin isophane [human genetic engineering]

    Insuman Basal GT, suspension for subcutaneous administration, 100 IU / ml 3 ml, cartridges No. 5

    Insulin isophane [human genetic engineering]

    Insuman Basal GT, suspension for subcutaneous administration, 100 IU / ml 5 ml, vials No. 5

    Insulin isophane [human genetic engineering]

    Protafan NM, suspension for subcutaneous administration, 100 IU / ml 10 ml, vials No. 1

    Insulin isophane [human genetic engineering]

    Protafan NM Penfill, suspension for subcutaneous administration, 100 IU / ml 3 ml, cartridges No. 5

    Insulin isophane [human genetic engineering]

    Humulin NPH, suspension for subcutaneous administration, 100 IU / ml 10 ml, vials No. 1

    Insulin isophane [human genetic engineering]

    Humulin NPH, suspension for subcutaneous administration, 100 IU / ml 3 ml, cartridges No. 5

    Interferon alpha-2a

    Roferon-A, solution for subcutaneous administration, 3 mln.IU / 0.5 ml, syringe tubes No. 1

    Interferon alpha-2b

    Alfarona, lyophilisate for preparation of solution for injection and topical use, 3 million IU, vials No. 5

    Interferon alpha-2b

    Intron A, solution for subcutaneous administration, 18 million IU 3 ml No. 1

    Interferon alpha-2b

    Realdiron, lyophilisate for the preparation of a solution for intramuscular and subcutaneous administration, 3 mln.ME No. 5

    Interferon alpha-2b

    Reaferon-EC, lyophilisate for the preparation of a solution for intramuscular and local use, 5 million IU, ampoule No. 5

    Interferon alpha-2b

    Reaferon-EC, lyophilisate for preparation of solution for injection and topical application, 3 million IU No. 5

    Interferon alpha-2b

    Reaferon-EC, lyophilisate for preparation of solution for injection and topical use, 500 thous.ME, ampoules No. 5

    Infliximab

    Remicade, lyophilisate for preparation of solution for infusion, 100 mg, vials No. 1

    Ipratropium bromide

    Atrovent N, metered dose aerosol for inhalation, 20 mcg / dose 200 doses No. 1

    Ipratropium bromide

    Atrovent, solution for inhalation, 0.25 mg / ml / 20 ml No. 1

    Ipratropium bromide + Fenoterol

    Berodual N, metered dose aerosol for inhalation, 20 mcg + 50 mcg / dose 200 doses No. 1

    Ipratropium bromide + Fenoterol

    Berodual, solution for inhalation, 0.25 mg + 0.5 mg / ml / 20 ml No. 1

    Irbesartan

    Aprovel, tablets, 150mg No. 28

    Irbesartan

    Aprovel, tablets, 150mg No. 14

    Itraconazole

    Itrazol, capsules, 100 mg No. 6

    Itraconazole

    Rumicosis, capsules, 100 mg No. 6

    Cabergoline

    Agalates tablets, 0.5 mg No. 2

    Cabergoline

    Agalates tablets, 0.5 mg No. 8

    Potassium and magnesium asparaginate

    Asparkam tablets, No. 50

    Calcitonin

    Alostin, dosed nasal spray, 200 IU / dose 14 doses 2 ml, No. 2

    Calcitonin

    Miacalcic, nasal spray, 200 IU / dose 14 doses, No. 1

    Candesartan

    Atacand tablets, 16 mg No. 28

    Candesartan

    Atacand, tablets, 8 mg No. 28

    Capecitabine

    Xeloda, film-coated tablets, 500 mg No. 120

    Captopril

    Captopril tablets 25 mg # 20

    Captopril + Hydrochlorothiazide

    Caposid, tablets, 50 mg + 25 mg No. 28

    Carbamazepine

    Carbalepsin retard, extended-release tablets, 400 mg No. 50

    Carbamazepine

    Carbamazepine-Acri, tablets, 200 mg No. 50

    Carbamazepine

    Tegretol CR film-coated tablets of prolonged action 200 mg # 50

    Carbamazepine

    Finlepsin retard, tab.prolonged action, 200 mg No. 50

    Carbamazepine

    Finlepsin, tablets, 200 mg No. 50

    Carvedilol

    Acridilol tablets, 6.25 mg No. 30

    Carvedilol

    Acridilol tablets, 12.5 mg No. 30

    Carvedilol

    Acridilol tablets, 25 mg # 30

    Quetiapine

    Seroquel, film-coated tablets, 100 mg No. 60

    Quetiapine

    Seroquel, film-coated tablets, 200 mg No. 60

    Ketoprofen

    Artrosilene capsules, 320 mg No. 10

    Ketoprofen

    Ketonal, cream for external use, 5% 30 g, No. 1

    Ketoprofen

    Ketonal, rectal suppositories, 100 mg No. 12

    Ketoprofen

    Flamax forte, film-coated tablets 100 mg, No. 20

    Ketoprofen

    Flamax, capsules, 50 mg No. 25

    Ketorolac

    Ketalgin, film-coated tablets, 10 mg No. 10

    Ketosteril

    Ketosteril, film-coated tablets, No. 100

    Ketotifen

    Ketotifen, tablets, 1 mg No. 30

    Clarithromycin

    Fromilid, film-coated tablets, 250 mg No. 14

    Clarithromycin

    Fromilid, film-coated tablets, 500 mg No. 14

    Clemastine

    Tavegil, tablets, 1 mg No. 20

    Clozapine

    Azaleptin tablets, 100 mg No. 50

    Clozapine

    Azaleptin, tablets, 25 mg No. 50

    Clomipramine

    Anafranil, film-coated tablets, 25 mg No. 30

    Clonazepam

    Clonazepam tablets, 0.5 mg No. 30

    Clonazepam

    Clonazepam, tablets, 2 mg No. 30

    Clonidine

    Clonidine, tablets, 0.15 mg No. 50

    Clonidine

    Clonidine tablets 75mkg # 50

    Clopidogrel

    Zylt, film-coated tablets, 75 mg No. 28

    Clopidogrel

    Plavix, coated tablets.shell. 75mg No. 28

    Clotrimazole

    Clotrimazole, cream for external use, 1% 20g

    Colecalciferol + Calcium carbonate

    Calcium-D3 Nycomed forte, chewable tablets, 400 IU + 1.25 g [lemon], No. 120

    Combined preparation containing metamizole sodium

    Pentalgin-N, tablets, No. 10

    Lactulose

    Duphalac, syrup, 667 mg / ml 200 ml

    Lactulose

    Duphalac, syrup, 667 mg / ml 500 ml

    Lamotrigine

    Lamictal, tablets, 25 mg No. 30

    Lamotrigine

    Lamictal tablets, 50 mg # 30

    Lamotrigine

    Lamitor, tablets, 100 mg No. 50

    Lamotrigine

    Lamitor, tablets, 25 mg No. 50

    Lamotrigine

    Lamelep, tablets, 50 mg No. 30

    Lappaconitine hydrobromide

    Allapinin, tablets, 25 mg No. 30

    Latanoprost

    Xalatan eye drops.0.005% 2.5ml No. 1

    Levodopa + Benserazide

    Madopar “125”, capsules, 100 mg + 25 mg No. 100

    Levodopa + Benserazide

    Madopar “250” tablets, 200 mg + 50 mg No. 100

    Levodopa + Benserazide

    Madopar fast-acting tablets (dispersible) “125”, dispersible tablets, 100 mg + 25 mg No. 100

    Levodopa + Carbidopa

    Nakom, tablets, 250 mg + 25 mg No. 100

    Levodopa + Carbidopa

    Tidomet forte, tablets, 250 mg + 25 mg No. 100

    Levodopa + Carbidopa

    Tremonorm tablets, 250 mg + 25 mg No. 100

    Levothyroxine sodium

    L-Thyroxin-Acri, tablets, 100 mcg No. 50

    Levothyroxine sodium

    Eutirox tablets, 150 mcg No. 100

    Levofloxacin

    Tavanik, film-coated tablets, 250 mg No. 5

    Levocetirizine

    Ksizal, coated tablets, 5mg No. 10

    Letrozole

    Letrotera, film-coated tablets, 2.5 mg No. 30

    Letrozole

    Femara, film-coated tablets, 2.5 mg No. 30

    Letrozole

    Extraza, film-coated tablets, 2.5 mg No. 30

    Bacterial lysates

    Imudon, lozenges, No. 40

    Bacteria lysates mixture

    Broncho-munal, capsules 7mg No. 10

    Bacteria lysates mixture

    IRS-19, nasal spray, 20ml

    Lisinopril

    Diroton tablets, 2.5 mg No. 28

    Lisinopril

    Lisinopril, tablets, 10 mg No. 30

    Lisinopril

    Lisinopril, tablets, 20 mg No. 20

    Lisinopril

    Lisinopril, tablets, 5 mg No. 30

    Lithium carbonate

    Sedalite, film-coated tablets, 300 mg No. 50

    Lovastatin

    Cardiostatin tablets 40mg # 30

    Losartan

    Lorista, film-coated tablets, 100 mg No. 30

    Losartan

    Lorista, film-coated tablets, 12.5 mg No. 30

    Losartan

    Lorista, film-coated tablets, 25 mg No. 30

    Losartan

    Lorista, film-coated tablets, 50 mg No. 30

    Losartan + Hydrochlorothiazide

    Lorista N, film-coated tablets, 50 mg + 12.5 mg No. 30

    Losartan + Hydrochlorothiazide

    Lorista ND, film-coated tablets, 100 mg + 25 mg No. 30

    Loperamide

    Loperamide, capsules, 2mg No. 20

    Loratadin

    Klallergin tablets 10 mg No. 10

    Maprotiline

    Lyudiomil, film-coated tablets, 10 mg No. 50

    Maprotiline

    Lyudiomil, film-coated tablets, 25 mg No. 30

    Mebhydrolin

    Diazolin, pills, 100 mg No. 10

    Mebeverin

    Duspatalin, long-acting capsules, 200 mg No. 30

    Medazepam

    Mezapam, tablets, 10 mg No. 50

    Meloxicam

    Meloxicam tablets, 15 mg No. 20

    Meloxicam

    Meloxicam tablets, 7.5 mg No. 20

    Meloxicam

    Movalis, tablets, 15 mg No. 20

    Melphalan

    Alkeran, film-coated tablets, 2 mg No. 25

    Mercaptopurine

    Puri-Netol tablets, 50 mg No. 25

    Mesalazine

    Salofalk, rectal suppositories, 250 mg No. 10

    Mesalazine

    Salofalk, rectal suppositories, 250 mg No. 30

    Mesalazine

    Salofalk, rectal suppositories, 500 mg No. 10

    Mesalazine

    Salofalk, enteric film coated tablets, 250 mg No. 50

    Mesalazine

    Salofalk, enteric film coated tablets, 500 mg No. 50

    Methylprednisolone

    Metipred tablets 4mg No. 30

    Methylprednisolone aceponate

    Advantan, ointment for external use, 0.1% 50 g

    Methylphenylthiomethyl-dimethylaminomethyl-hydroxybromindole carboxylic acid ethyl ester

    Arbidol capsules 100 mg No. 10

    Metoprolol

    Metoprolol-Acri, tablets, 50mg No. 30

    Metoprolol

    Metoprolol-ratiopharm tablets, 100 mg # 30

    Methotrexate

    Methotrexate-Ebeve tablets, 2.5 mg No. 50

    Methotrexate

    Methotrexate-Ebeve, tablets, 5 mg No. 50

    Metformin

    Glyformin, film-coated tablets, 1 g No. 60

    Metformin

    Glyformin, film-coated tablets, 850 mg No. 60

    Metformin

    Glyformin tablets, 500 mg No. 60

    Metformin

    NovoFormin tab.coated film about 500mg.№60

    Metformin

    Formin Pliva, coated tablets, 850 mg No. 60

    Midecamycin

    Macropen, film-coated tablets, 400 mg No. 16

    Moxifloxacin

    Avelox, film-coated tablets, 400 mg No. 5

    Moxonidine

    Physiotens, film-coated tablets, 0.2 mg No. 14

    Moxonidine

    Physiotens, film-coated tablets, 0.4 mg No. 14

    Molsidomin

    Sydnopharm, tablets, 2 mg No. 30

    Morphine

    Morphine, solution for injection, 10 mg / ml / amp./ 1 ml No. 10

    Morphine

    MCT continus, coated tablets, 100mg, No. 20

    Morphine

    MCT Kontinus, tablets of prolonged action, film-coated, 30 mg No. 20

    Morphine

    MCT continus, extended-release film-coated tablets, 60 mg No. 20

    Nadroparin calcium

    Fraxiparine, solution for subcutaneous administration, 9.5 thousand IU (anti-Xa) / ml 0.3 ml, No. 10

    Nadroparin calcium

    Fraxiparine, solution for subcutaneous administration, 9.5 thousand IU (anti-Xa) / ml 0.6 ml, No. 10

    Nebivolol

    Binelol 5 mg tablet number 14

    A nicotinic acid

    Nicotinic acid tablets, 50mg # 50

    Nystatin

    Nystatin, film-coated tablets, 500 thous.UNIT No. 20

    Nitrazepam

    Nitrazepam tablets, 5 mg # 20

    Nitroglycerine

    Nitrospray, sublingual metered spray, 0.4 mg / dose 200 doses 10 ml

    Nitroxoline

    Nitroxoline, coated tablets, 50mg No. 50

    Nitrofurantoin

    Furadonin tablets 100mg No. 20

    Nifedipine

    Calcigard retard, coated tablets, 20 mg No. 100

    Nifedipine

    Cordipin retard, film-coated tablets of prolonged action, 20 mg No. 30

    Nifedipine

    Nifecard CL, film-coated tablets with controlled release, 30 mg No. 30

    Nifedipine

    Nifecard CL, film-coated tablets with controlled release, 60 mg No. 30

    Norfloxacin

    Nolitsin 400 mg film-coated tablets No. 10

    Norethisterone

    Norkolut, tablets, 5mg No. 20

    Octreotide

    Octreotide-long FS, microspheres for preparation of a suspension for intramuscular administration of prolonged action, 10mg No. 1

    Octreotide

    Octreotide-long FS, microspheres for the preparation of a suspension for intramuscular administration of prolonged action.20mg No. 1

    Octreotide

    Sandostatin LAR, microspheres for the preparation of a suspension for intramuscular administration, 10 mg No. 1

    Octreotide

    Sandostatin LAR, microspheres for the preparation of a suspension for intramuscular administration, 20 mg No. 1

    Omega-3 triglycerides [EPA / DHA = 1.2 / 1 – 90%]

    Omakor, capsules, No. 28

    Omeprazole

    Omeprazole-FPO, capsules, 20 mg No. 30

    Omeprazole

    Ultop, capsules, 10 mg No. 14

    Omeprazole

    Ultop, capsules, 40 mg No. 28

    Ofloxacin

    Ofloxacin, coated tablets, 200mg No. 10

    Paclitaxel

    Abitaxel, concentrate for solution for infusion, 6 mg / ml 16.7 ml, vials No. 1

    Paclitaxel

    Abitaxel, concentrate for preparation of solution for infusion, 6 mg / ml 5 ml, vials No. 1

    Paclitaxel

    Paclitaxel-LENS, concentrate for preparation of solution for infusion, 6 mg / ml 17 ml, vials No. 1

    Paclitaxel

    Paclitaxel-LENS, concentrate for solution for infusion, 6 mg / ml 5 ml, bottle No. 1

    Pancreatin

    Creon 10 000, capsules, 150 mg No. 20

    Pancreatin

    Creon 25 000, capsules, 300 mg No. 20

    Pancreatin

    Mezim forte 10 000 enteric-coated tablets, No. 20

    Pancreatin

    Mezim forte enteric-coated tablets, No. 20

    Pancreatin

    Panzinorm forte 20 000 enteric-coated tablets, No. 30

    Pancreatin

    Pancreatin, enteric-coated tablets, 25 PIECES No. 60

    Pancreatin

    Enzistal-P enteric-coated tablets, No. 20

    Paroxetine

    Plizil, film-coated tablets, 20 mg No. 30

    Penicillamine

    Cuprenil, film-coated tablets, 250 mg No. 100

    Pentoxifylline

    Pentoxifylline, film-coated tablets, 100 mg No. 60

    Perindopril

    Perineva, tablets 4 mg No. 30

    Perindopril

    Perineva, tablets 8 mg No. 30

    Perindopril

    Prestarium A, film-coated tablets, 10 mg No. 30

    Perindopril

    Prestarium A, film-coated tablets, 5 mg No. 30

    Perindopril + Indapamide

    Noliprel A, coated tablets, 2.5 mg + 0.625 mg No. 30

    Perindopril + Indapamide

    Noliprel A forte, coated tablets, 5 mg + 1.25 mg No. 30

    Perphenazine

    Eperazine, film-coated tablets, 10 mg No. 50

    Perphenazine

    Eperazine, film-coated tablets, 4 mg No. 50

    Pilocarpine

    Pilocarpine eye drops, 1% 1.5ml, dropper tube # 5

    Pilocarpine + Timolol

    Fotil, eye drops, 20 mg + 5 mg / ml 5ml, dropper bottle No. 1

    Pilocarpine + Timolol

    Fotil forte eye drops, 40mg + 5mg / ml 5ml, dropper bottle # 1

    Pipemidic acid

    Pimidel, capsules, 200mg No. 20

    Pipofezin

    Azafen, tablets, 25 mg No. 50

    Piracetam

    Memotropil, film-coated tablets, 1200 mg No. 20

    Piracetam

    Piracetam capsules, 400 mg No. 60

    Piracetam

    Piracetam, film-coated tablets, 200 mg No. 60

    Piracetam

    Piracetam-Richter, film-coated tablets, 800 mg No. 20

    Piribedil

    Pronoran, controlled release film-coated tablets, 50 mg No. 30

    Pyridostigmine bromide

    Kalimin 60 N, tablets, 60 mg No. 100

    Pirlindol

    Pyrazidol, tablets, 25 mg No. 50

    Pirlindol

    Pyrazidol tablets, 50 mg No. 50

    Prednisone

    Prednisolone, tablets, 5 mg No. 100

    Prednisolone

    Prednisolone ointment 0.5% 10g

    Propranolol

    Anaprilin tablets, 10mg No. 100

    Propranolol

    Anaprilin tablets 40mg No. 100

    Peginterferon alfa-2a

    Pegasis, solution for subcutaneous administration, 0.18 mg / 0.5 ml, No. 1

    Rabeprazole

    Pariet enteric-coated tablets, 10mg No. 14

    Rabeprazole

    Pariet enteric-coated tablets, 20mg No. 14

    Ramipril

    Amprilan, tablets, 10 mg No. 30

    Ramipril

    Amprilan tablets, 2.5 mg No. 30

    Ramipril

    Amprilan, tablets, 5 mg No. 30

    Ranitidine

    Ranitidine-Acri, film-coated tablets, 150 mg No. 20

    Repaglinide

    NovoNorm, tablets, 0.5 mg No. 30

    Repaglinide

    NovoNorm, tablets, 1 mg No. 30

    Repaglinide

    NovoNorm, tablets, 2 mg No. 30

    Ribavirin

    Ribavirin tablets, 200 mg # 30

    Rilmenidine

    Albarel, tablets, 1 mg No. 30

    Risperidone

    Rispaxol, film-coated tablets 2 mg, No. 20

    Risperidone

    Rispaxol, film-coated tablets 4 mg, No. 20

    Risperidone

    Rispolept Konsta, powder for suspension for intramuscular administration of prolonged action, 25 mg No. 1

    Risperidone

    Rispolept Konsta, powder for suspension for intramuscular administration of prolonged action, 37.5 mg No. 1

    Risperidone

    Rispolept Konsta, powder for suspension for intramuscular administration of prolonged action, 50 mg No. 1

    Risperidone

    Rispolept, film-coated tablets, 4 mg No. 20

    Risperidone

    Risset, film-coated tablets 4 mg No. 20

    Risperidone

    Risset, film-coated tablets, 2 mg No. 20

    Risperidone

    Torendo Ku-tab, lozenges, 2 mg No. 30

    Rituximab

    MabThera, concentrate for solution for infusion, 100 mg / 10 ml, vials No. 2

    Rituximab

    MabThera, concentrate for solution for infusion, 500 mg / 50 ml, vials No. 1

    Rosuvastatin

    Krestor, film-coated tablets, 10 mg No. 28

    Rosuvastatin

    Krestor, film-coated tablets, 10 mg No. 7

    Rosuvastatin

    Krestor, film-coated tablets, 20 mg No. 28

    Rosiglitazone

    Avandia, film-coated tablets, 4 mg No. 28

    Rosiglitazone

    Avandia, film-coated tablets, 8 mg No. 28

    Salmeterol + Fluticasone

    Seretide Multidisk, powder for inhalation, dosed, 50 mcg + 0.1 mg / dose / 60 doses No. 1

    Salmeterol + Fluticasone

    Seretide Multidisk, powder for inhalation, dosed, 50 mcg + 0.25 mg / dose 60 doses No. 1

    Salmeterol + Fluticasone

    Seretide Multidisk, powder for inhalation, dosed, 50 mcg + 0.5 mg / dose 60 doses No. 1

    Salmeterol + Fluticasone

    Seretide, metered dose inhalation aerosol, 25 mcg + 0.25 mg / dose / 120 doses No. 1

    Salmeterol + Fluticasone

    Seretide, metered dose inhalation aerosol, 25 mcg + 0.125 mg / dose / 120 doses No. 1

    Salmeterol + Fluticasone

    Seretide, metered dose inhalation aerosol, 25 mcg + 50 mcg / dose / 120 doses No. 1

    Salbutamol

    Ventolin Nebula, solution for inhalation, 1 mg / ml 2.5 ml No. 20

    Salbutamol

    Salamol Eco Light Breath, metered dose inhalation aerosol activated by inhalation, 100 mcg / dose 200 doses No. 1

    Salbutamol

    Salamol Eco, metered dose aerosol for inhalation, 100 mcg / dose 200 doses No. 1

    Salbutamol

    Salgim, solution for inhalation, 1 mg / ml / 10 ml No. 10

    Salbutamol

    Salgim, solution for inhalation, 1 mg / ml / 2.5 ml No. 10

    Salbutamol

    Salgim, solution for inhalation, 1 mg / ml / 5 ml No. 10

    Salbutamol

    Saltos, extended-release film-coated tablets, 7.23 mg No. 30

    Sertraline

    Asentra, film-coated tablets, 50 mg No. 28

    Sertraline

    Serenata, film-coated tablets, 100 mg No. 30

    Simvastatin

    Vasilip, film-coated tablets, 10 mg No. 28

    Simvastatin

    Vasilip, film-coated tablets, 20 mg No. 28

    Simvastatin

    Vasilip, film-coated tablets, 40 mg No. 28

    Simvastatin

    Simvagexal film-coated tablets 30 mg No. 30

    Simvastatin

    Simgal film-coated tablets 40mg No. 28

    Simvastatin

    Simgal, film-coated tablets, 20mg No. 28

    Simvastatin

    Simgal, film-coated tablets, 10mg No. 28

    Somatropin

    Norditropin NordiLet, solution for subcutaneous administration, 10 mg 1.5 ml, syringe pens No. 1

    Somatropin

    Humatrop, lyophilisate for solution for injection, 6 mg (18 IU), 3 ml cartridges No. 1

    Sotalol

    Sotalex, tablets, 160 mg No. 30

    Spirapril

    Quadropril, tablets, 6 mg No. 30

    Spironolactone

    Veroshpilactone, tablets, 25 mg No. 20

    Spironolactone

    Veroshpiron tablets, 25 mg No. 20

    Sulpirides

    Sulpiride, tablets, 200 mg No. 30

    Sulpirides

    Sulpiride tablets, 50 mg No. 30

    Sulpirides

    Eglonil capsules, 50 mg No. 30

    Sulfasalazine

    Sulfasalazine, film-coated tablets, 500 mg No. 50

    Tamoxifen

    Vero-tamoxifen, tablets, 20 mg No. 30

    Tamsulosin

    Omnik Okas, film-coated tablets with controlled release, 0.4 mg No. 10

    Tamsulosin

    Omnik Okas, film-coated tablets with controlled release, 0.4 mg No. 30

    Tamsulosin

    Omnic, Modified Release Capsules, 0.4 mg No. 10

    Tamsulosin

    Omnic, Modified Release Capsules, 0.4 mg No. 30

    Tamsulosin

    Taniz-K, prolonged-release capsules, 0.4mg No. 30

    Taurine

    Taurine, eye drops, 4% 5 ml, dropper bottle No. 1

    Taurine

    Taufon, eye drops 4% 5 ml, dropper bottle No. 1

    Temozolomide

    Temodal, capsules, 100 mg No. 5

    Temozolomide

    Temodal, capsules, 20 mg No. 5

    Temozolomide

    Temodal, capsules, 250 mg No. 5

    Theophylline

    Teopek, extended release tablets, 300 mg No. 40

    Theophylline

    Teotard, capsules of prolonged action, 200 mg No. 40

    Theophylline

    Teotard, capsules of prolonged action, 350 mg No. 40

    Terazosin

    Cornam, tablets, 2 mg No. 30

    Terazosin

    Cornam, tablets, 5 mg No. 30

    Terazosin

    Setegis, tablets, 10 mg No. 30

    Terazosin

    Setegis, tablets, 2 mg No. 30

    Terazosin

    Setegis, tablets, 5 mg No. 30

    Terbinafine

    Thermicon, cream for external use, 1% 15 g

    Test strips

    Test strips for the Accu-Chek Active glucometer, No. 50

    Test strips

    Test strips for the “Accuchek Performa” glucometer, No. 50

    Test strips

    Test strips for the “UAN-TACH” Ultra glucometer, No. 50

    Test strips

    Test strips for the device for determining the level of glucose in blood “Kontur TS”, No. 50

    Thiamazole

    Mercazolil tablets, 5mg No. 50

    Tizanidine

    Tizanil, tablets, 2 mg No. 30

    Tizanidine

    Tizanil, tablets, 4 mg No. 30

    Timolol

    Timolol eye drops, 0.25% 5 ml

    Timolol

    Timolol eye drops, 0.5% 5 ml

    Thioctic acid

    Tiogamma, film-coated tablets, 600mg No. 60

    Thioridazine

    Sonapax, dragee, 10 mg No. 60

    Thioridazine

    Sonapax, dragee, 25 mg No. 60

    Thioridazine

    Thioril, film-coated tablets, 25 mg No. 100

    Tiotropium bromide

    Spiriva, powder capsules for inhalation, 18 mcg No. 30

    Tolperisone

    Mydocalm, film-coated tablets, 150 mg No. 30

    Tolperisone

    Mydocalm, film-coated tablets, 50 mg No. 30

    Topiramate

    Topamax, capsules, 25 mg No. 60

    Topiramate

    Topamax, capsules, 50 mg No. 60

    Topiramate

    Topsaver, film-coated tablets, 100 mg No. 28

    Topiramate

    Topsaver, film-coated tablets, 25 mg No. 28

    Topiramate

    Toreal, film-coated tablets, 100 mg No. 28

    Topiramate

    Toreal, film-coated tablets, 25 mg No. 28

    Tramadol

    Tramal (supp.rekt. 100 mg No. 5)

    Tramadol

    Tramal / caps / 50 mg No. 20

    Tramadol

    Tramal retard, coated tablets retard, 100mg No. 10

    Tramadol

    Tramal retard, coated tablets retard, 200mg No. 10

    Tramadol

    Tramal, solution for injection, 50 mg / ml 1ml / amp./ No. 5

    Tramadol

    Tramal, solution for injection, 50mg / ml 2ml / amp./ No. 5

    Trastuzumab

    Herceptin, lyophilisate for the preparation of a concentrate for the preparation of a solution for infusion, 440 mg, vials No. 1

    Triamcinolone

    Kenalog tablet 4mg No. 50

    Triamcinolone

    Polcortolone tablets, 4mg No. 50

    Trihexyphenidil

    Cyclodol tablets, 2mg No. 50

    Trimeperidine

    Promedol, solution for injection, 10 mg / ml 1 ml / amp./ # 10

    Trimeperidine

    Promedol, solution for injection, 2% (20 mg / ml) 1 ml / amp./ No. 10

    Trimeperidine

    Promedol, tablets, 25 mg No. 10

    Trimetazidine

    Deprenorm MV, modified release film-coated tablets, 35mg No. 60

    Trimetazidine

    Preductal MB, modified release film-coated tablets 35mg No. 60

    Trimetazidine

    Trimectal, capsules, 20 mg No. 60

    Trimetazidine

    Trimetazidine, coated tablets, 20 mg No. 60

    Triptorelin

    Diphereline, lyophilisate for the preparation of a suspension for intramuscular administration of prolonged action, 3.75 mg, vials No. 1

    Troxerutin

    Troxevasin, capsules, 300 mg No. 50

    Tropisetron

    Navoban, capsules, 5 mg No. 5

    Ursodeoxycholic acid

    Ursosan, capsules, 250 mg No. 50

    Famotidine

    Famotidine-Acri, film-coated tablets, 20 mg No. 20

    Felodipine

    Felodip, prolonged-release film-coated tablets, 10 mg No. 30

    Felodipine

    Felodip, extended-release film-coated tablets, 2.5 mg No. 30

    Felodipine

    Felodip, long-acting film-coated tablets, 5 mg No. 30

    Phenylpiracetam

    Phenotropil, tablets, 100 mg No. 30

    Phenobarbital

    Phenobarbital, tablets, 100 mg No. 10

    Fenoterol

    Berotek N, metered dose inhalation aerosol, 0.1 mg / dose 200 doses No. 1

    Fenoterol

    Berotek, solution for inhalation, 1 mg / ml / 20 ml No. 1

    Fentanyl

    Durogesic Matrix TDTS 50 mcg / h / pack./ No. 5

    Fentanyl

    Durogesic Matrix TDTS 25 mcg / h / pack./ No. 5

    Fentanyl

    Durogesic Matrix TDTS 75 mcg / h / pack./ # 5

    Finasteride

    Alfinal, film-coated tablets, 5 mg No. 30

    Fluvoxamine

    Fevarin, film-coated tablets, 100 mg No. 15

    Fluvoxamine

    Fevarin, film-coated tablets, 50 mg No. 15

    Fludrocortisone

    Kortineff, tablets, 0.1 mg No. 20

    Fluoxetine

    Profluzac, capsules, 20 mg No. 20

    Fluoxetine

    Fluoxetine, capsules, 10 mg No. 20

    Fluoxetine

    Fluoxetine, capsules, 20mg No. 20

    Fluocinolone acetonide

    Sinaflan, topical ointment, 0.025% 10 g

    Flupentixol

    Fluanksol, film-coated tablets, 1 mg No. 50

    Flutamide

    Flutamide Pliva, tablets, 250 mg No. 100

    Fluphenazine

    Moditen depot, solution for intramuscular administration [oily], 25 mg / ml No. 5

    Flupentixol

    Fluanksol, sugar-coated tablets, 5 mg No. 100

    Fosinopril

    Monopril, tablets, 20 mg No. 28

    Fosinopril

    Fozicard, tablets, 10 mg No. 28

    Fosinopril

    Fozicard, tablets, 20 mg No. 28

    Folic acid

    Folic acid, tablets, 1 mg No. 50

    Formoterol

    Oxis Turbuhaler, metered powder for inhalation, 4.5 mcg / dose 60 doses # 1

    Formoterol

    Oxis Turbuhaler, powder for inhalation, dosed, 9 μg / dose 60 doses No. 1

    Formoterol

    Foradil, powder capsules for inhalation, 12 mcg No. 30

    Formoterol + Budesonide

    Symbicort Turbuhaler, metered powder for inhalation, 4.5 mcg + 160 mcg / dose 120 doses No. 1

    Formoterol + Budesonide

    Symbicort Turbuhaler, powder for inhalation, dosed, 4.5 mcg + 160 mcg / dose 60 doses No. 1

    Formoterol + Budesonide

    Symbicort Turbuhaler, powder for inhalation, dosed, 4.5 mcg + 80 mcg / dose 120 doses No. 1

    Formoterol + Budesonide

    Symbicort Turbuhaler, metered powder for inhalation, 4.5 mcg + 80 mcg / dose 60 doses # 1

    Formoterol + Budesonide

    Symbicort Turbuhaler, powder for inhalation, dosed, 9 mcg + 320 mcg / dose 60 doses No. 1

    Formoterol + Budesonide

    Foradil Combi, powder capsules for inhalation, 12/200 mcg 60 + 60

    Formoterol + Budesonide

    Foradil Combi, powder capsules for inhalation, 12/400 mcg 60 + 60

    Phosphogliv

    Phosphogliv, capsules, No. 50

    Fosfomycin

    Monural, granules for the preparation of oral suspension, 3 g No. 1

    Furazidine

    Furagin tablets, 50mg No. 30

    Furosemide

    Furosemide tablets, 40 mg No. 50

    Hinapril

    Akcupro, film-coated tablets, 10 mg No. 30

    Hinapril

    Akcupro, film-coated tablets, 20 mg No. 30

    Chloropyramine

    Suprastin, tablets, 25 mg No. 20

    Chloroquine

    Delagil tablets, 250mg # 30

    Chlorpromazine

    Aminazine, dragee, 100 mg No. 10

    Chlorpromazine

    Aminazine, dragee, 25 mg No. 10

    Chlorpromazine

    Aminazine, dragee, 50 mg No. 10

    Chlorprothixene

    Truxal, film-coated tablets, 25 mg No. 100

    Chlorprothixene

    Truxal, film-coated tablets, 50 mg No. 50

    Chlorprothixene

    Chlorprothixene, film-coated tablets, 15 mg No. 30

    Chlorprothixene

    Chlorprothixene, film-coated tablets, 50 mg No. 30

    Cerebrolysin

    Cerebrolysin, solution for injection, 1 ml No. 10

    Cerebrolysin

    Cerebrolysin, solution for injection, 5 ml No. 5

    Cetirizine

    Parlazin drops, 10mg / ml 20ml

    Cyclosporine

    Sandimmun Neoral, soft capsules, 50 mg No. 50

    Cyclosporine

    Sandimmun Neoral, soft capsules, 100 mg No. 50

    Cyclosporine

    Sandimmun Neoral, soft capsules, 25 mg No. 50

    Cyclophosphamide

    Endoxan, sugar-coated tablets 50 mg No. 50

    Cinnarizine

    Cinnarizine, tablets, 25 mg No. 50

    Cyproterone

    Androkur, tablets, 100 mg No. 60

    Cyproterone

    Androkur, tablets, 50 mg No. 50

    Ciprofloxacin

    Vero-Ciprofloxacin, film-coated tablets, 500mg No. 10

    Ciprofloxacin

    Ciprofloxacin, coated tablets, 250 mg No. 10

    Ciprofloxacin

    Ciprofloxacin-AKOS eye drops, 0.3% 5ml

    Ciprofloxacin

    Ciprofloxacin-FPO, film-coated tablets, 500 mg No. 10

    Exemestan

    Aromasin, film-coated tablets, 25 mg No. 30

    Enalapril

    Enalapril, tablets, 10 mg No. 20

    Enalapril

    Enalapril tablets, 20 mg No. 20

    Enalapril

    Enalapril, tablets, 5 mg No. 20

    Enalapril

    Enam pills, 2.5 mg No. 20

    Enalapril + Hydrochlorothiazide

    Enap N, tablets, 10 mg + 25 mg No. 20

    Enalapril + Hydrochlorothiazide

    Enap-NL 20, tablets, 20 mg + 12.5 mg No. 20

    Enalapril + Hydrochlorothiazide

    Enap-NL, tablets, 10 mg + 12.5 mg No. 20

    Enalapril + Indapamide

    Enzix duo, tablets, 10 + 2.5 mg No. 30 + 15

    Enoxaparin sodium

    Clexane, solution for injection, 2 thousand anti-Ha IU / 0.2 ml No. 2

    Enoxaparin sodium

    Clexane, solution for injection, 4 thousand anti-Ha IU / 0.4 ml No. 10

    Enoxaparin sodium

    Clexane, solution for injection, 6 thous.anti-Ha ME / 0.6 ml, syringes No. 2

    Enoxaparin sodium

    Clexane, solution for injection, 8 thousand anti-Ha IU / 0.8 ml No. 10

    Epoetin alfa

    Eprex, solution for intravenous and subcutaneous administration, 40 thousand IU 1 ml, syringes No. 6 complete with a needle protection device

    Epoetin alfa

    Eralfon, solution for intravenous and subcutaneous administration, 2 thous.IU / 0.5 ml syringes # 6

    Epoetin beta

    Vero-Epoetin, lyophilisate for preparation of solution for intravenous and subcutaneous administration of 2 thousand IU No. 1

    Epoetin beta

    Vero-Epoetin, lyophilisate for solution preparation for intravenous and subcutaneous administration, 10 thousand IU No. 1

    Epoetin beta

    Recormon, solution for intravenous and subcutaneous administration, 10 thous.IU / 0.6 ml, syringe tubes No. 6

    Epoetin beta

    Recormon, solution for intravenous and subcutaneous administration, 2 thousand IU / 0.3 ml, syringe tubes No. 6, complete with injection needles

    Epoetin beta

    Epostim, solution for intravenous and subcutaneous administration, 10 thousand IU / 1 ml No. 5

    Epoetin beta

    Epostim, solution for intravenous and subcutaneous administration, 2 thous.IU / 1 ml No. 5

    Eprosartan

    Teveten, film-coated tablets, 600 mg No. 14

    Eprosartan + Hydrochlorothiazide

    Teveten plus, film-coated tablets, 600 mg + 12.5 mg No. 14

    Estriol

    Ovestin, vaginal cream, 1 mg / g 15 g

    Estriol

    Ovestin, vaginal suppositories, 0.5 mg No. 15

    Escitalopram

    Cipralex, film-coated tablets, 10 mg No. 28

    Ethylmethylhydroxypyridine succinate

    Mexicor, capsules, 100mg No. 20

    Ethylmethylhydroxypyridine succinate

    Mexiprim, coated tablets, 125mg No. 30

    Etoposide

    Laste, capsules, 100 mg No. 10

    Etoposide

    Laste, capsules, 50 mg No. 20

    *** Prescriptions are issued if there are drug residues in pharmacies

    instructions for use, analogs, composition, indications

    Side effects, as a rule, occur at the beginning of treatment and gradually disappear with further use of the drug or dose reduction.
    From the side of the central nervous system: at the beginning of treatment (especially in elderly patients) – drowsiness, fatigue, dizziness, impaired concentration, ataxia, disorientation, retardation of mental and motor reactions; rarely – headache, euphoria, decreased mood, tremor, memory loss, impaired coordination of movements, confusion, dystonic extrapyramidal reactions (uncontrolled movements, including the eyes), muscle weakness, blurred speech, extremely rarely – paradoxical reactions (aggressive outbreaks, confusion, psychomotor agitation, fear, suicidal tendencies, muscle spasm, hallucinations, anxiety, insomnia).
    From the side of hematopoiesis: leukopenia, neutropenia, agranulocytosis (chills, hyperthermia, sore throat, unusual fatigue or weakness), anemia, thrombocytopenia.
    From the digestive system: dry mouth or salivation, heartburn, nausea, vomiting, anorexia, constipation, diarrhea; dysfunction of the liver, increased activity of “hepatic” transaminases and alkaline phosphatase (ALP), jaundice.
    From the genitourinary system: urinary incontinence, urinary retention, impaired renal function, decreased or increased libido, dysmenorrhea.
    Allergic reactions: skin rash, itching.
    Influence on the fetus: teratogenicity (especially the first trimester), depression of the central nervous system, respiratory failure and suppression of the sucking reflex in newborns whose mothers used the drug.
    Other: addiction, drug dependence; lowering blood pressure (BP), rarely – visual impairment (diplopia), weight loss, tachycardia. With a sharp decrease in the dose or discontinuation of the intake – withdrawal syndrome (increased irritability, sleep disturbance, dysphoria, spasm of smooth muscles of internal organs and skeletal muscles, depersonalization, increased sweating, decreased mood, nausea, vomiting, tremors, perception disorders, incl.h. hyperacusia, paresthesia, photophobia; tachycardia, convulsions, rarely acute psychosis).

    Alprazolam tab 1mg No. 50 (Alprazolam)

    Indications: Anxiety and neuroses with anxiety, tension, anxiety, irritability, poor sleep, somatic disorders. Anxiety associated with depression (as part of complex therapy). Panic disorder (treatment). Tremor (senile, essential). Insomnia
    Contraindications: Coma, shock, myasthenia gravis, angle-closure glaucoma (acute attack or predisposition), acute alcohol poisoning (with weakening of vital functions), opioid analgesics, hypnotics and psychotropic drugs, chronic obstructive respiratory diseases with initial manifestations of respiratory failure, acute respiratory failure , severe depression (suicidal tendencies may occur), pregnancy (especially the first trimester), lactation, children and adolescence up to 18 years, hypersensitivity to benzodiazepines.

    Active substance: Alprazolam.
    Release form: 1. Tablets 0.25 mg No. 50; 2. Tablets 1 mg No. 50.

    Inside, 2-3 times a day, regardless of food intake. Doses are selected depending on the severity of the syndrome, the individual sensitivity of the patient and his reaction to the drug. They start with the minimum doses (0.25-0.5 mg / day), followed by an increase first in the evening, and then in the daytime. Elderly and debilitated patients – 0.25 mg 2-3 times a day. Further dose increase (up to 0.5-0.75 mg / day) is carried out with caution if the drug is well tolerated. In case of anxiety, anxiety, the initial daily dose is 0.75-1.5 mg and can be increased to 3-4.5 mg / day. With panic disorder – 0.5 mg 3 times a day, the daily dose can reach 3-6 mg, the highest daily dose is 10 mg. The duration of the appointment of alprazolam is from several days (in an acute state of fear) to 3 months. Due to the possibility of drug dependence, longer continuous administration of the drug is not recommended.If it is necessary to discontinue therapy, the dose is gradually reduced by 0.5 mg every 3 days (abrupt cessation of therapy may exacerbate anxiety and fear).

    Interactions: There is a mutual enhancement of the effect with the simultaneous administration of antipsychotic (neuroleptic), antiepileptic or hypnotic drugs, as well as central muscle relaxants, narcotic analgesics, ethanol and drugs for general anesthesia. Inhibitors of microsomal oxidation of liver enzymes increase, and inducers reduce the concentration of alprozalam in plasma (a change in the effectiveness of alprazolam is possible).Alprazolam may increase the severity of blood pressure lowering in the presence of antihypertensive drugs. When administered simultaneously with clozapine, increased respiratory depression may be increased. Reduces the effectiveness of levodopa in patients with parkinsonism. May increase the toxicity of zidovudine.

    Side effects: From the nervous system: at the beginning of treatment (especially in elderly patients) – drowsiness, fatigue, dizziness, decreased ability to concentrate, ataxia, disorientation, retardation of mental and motor reactions; rarely – headache, euphoria, depression, tremor, memory loss, impaired coordination of movements, depression of mood, confusion, dystonic extrapyramidal reactions (uncontrolled movements, incl.h. eyes), weakness, myasthenia gravis, dysarthria; extremely rarely – paradoxical reactions (aggressive outbursts, confusion, psychomotor agitation, fear, suicidal tendencies, muscle spasm, hallucinations, agitation, irritability, anxiety, insomnia). From the side of hematopoietic organs: leukopenia, neutropenia, agranulocytosis (chills, hyperthermia, sore throat, excessive fatigue or weakness), anemia, thrombocytopenia. From the digestive system: dry mouth or drooling, heartburn, nausea, vomiting, loss of appetite, constipation or diarrhea; liver dysfunction, jaundice.From the genitourinary system: urinary incontinence, urinary retention, impaired renal function, decreased or increased libido, dysmenorrhea. Allergic reactions: skin rash, itching. Influence on the fetus: teratogenicity (especially the first trimester), depression of the central nervous system, respiratory failure and suppression of the sucking reflex in newborns whose mothers used the drug. Others: addiction, drug dependence; decrease in blood pressure; rarely – visual impairment (diplopia), weight loss, tachycardia. With a sharp decrease in dose or discontinuation of admission – withdrawal syndrome (irritability, nervousness, sleep disturbances, dysphoria, spasm of smooth muscles of internal organs and skeletal muscles, depersonalization, increased sweating, depression, nausea, vomiting, tremors, perception disorders, incl.h. hyperacusis, paresthesia, photophobia; tachycardia, convulsions, rarely acute psychosis).
    Special instructions: For endogenous depression, alprazolam can be used in combination with antidepressants. With the use of alprazolam in patients with depression, cases of the development of hypomanic and manic states have been noted.
    Alprazolam should be used with caution in patients with impaired liver and / or kidney function.
    In patients who have not previously taken drugs that affect the central nervous system, alprazolam is effective in lower doses, compared with patients who received antidepressants, anxiolytics, or suffering from chronic alcoholism.With prolonged use in high doses, addiction and drug dependence may develop, especially in patients prone to drug abuse.
    With a rapid dose reduction or abrupt withdrawal of alprazolam, a withdrawal syndrome is observed, the symptoms of which can range from mild dysphoria and insomnia to a severe syndrome with abdominal and skeletal muscle cramps, vomiting, increased sweating, tremors and seizures. Withdrawal syndrome is more common in individuals for a long time (more than 8-12 weeks.) who received alprazolam.
    Do not use other tranquilizers simultaneously with alprazolam.
    The safety of using alprazolam in children and adolescents under the age of 18 has not been established. Children, especially at a younger age, are very sensitive to the inhibitory effect of benzodiazepines on the central nervous system.
    Avoid drinking alcohol during treatment.
    During the period of treatment, one should refrain from engaging in potentially hazardous activities that require increased attention and speed of psychomotor reactions (driving vehicles or working with mechanisms).

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