What are the primary uses of Alprazolam. How should Alprazolam be dosed for anxiety and panic disorders. What are the potential side effects of Alprazolam. How does Alprazolam affect different patient populations. What precautions should be taken when using Alprazolam.

Understanding Alprazolam: A Powerful Anxiolytic Medication

Alprazolam, commonly known by its brand name Xanax, is a potent benzodiazepine medication widely prescribed for the treatment of anxiety disorders and panic attacks. This comprehensive guide delves into the various aspects of Alprazolam, including its uses, dosage recommendations, potential side effects, and important precautions.

What is Alprazolam?

Alprazolam belongs to the benzodiazepine class of drugs, which act on the central nervous system to produce a calming effect. It works by enhancing the activity of gamma-aminobutyric acid (GABA), a neurotransmitter that inhibits brain activity associated with anxiety and stress.

Primary Uses of Alprazolam: Anxiety and Panic Disorders

Alprazolam is primarily prescribed for two main conditions:

• Generalized Anxiety Disorder (GAD)
• Panic Disorder, with or without agoraphobia

Are there other uses for Alprazolam? While its primary indications are anxiety and panic disorders, some healthcare providers may prescribe Alprazolam off-label for other conditions such as insomnia or as a pre-medication for medical procedures. However, these uses are not FDA-approved and should be approached with caution.

Alprazolam Dosage Guidelines: Finding the Right Balance

The dosage of Alprazolam varies depending on the condition being treated, the patient’s age, and other individual factors. It’s crucial to follow the prescribed dosage carefully and never adjust it without consulting a healthcare provider.

Dosage for Anxiety Disorders

For adults with anxiety disorders, the typical dosage recommendations are as follows:

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

How should the dosage be adjusted? The dosage may be increased at intervals of 3 to 4 days, in increments of no more than 1 mg per day. The goal is to find the lowest effective dose that provides symptom relief.

Dosage for Panic Disorder

For adults with panic disorder, the dosage recommendations differ slightly:

• Immediate-release tablets or ODTs: 0.5 mg orally, administered 3 times a day
• Extended-release tablets: Initial dose of 0.5 to 1 mg orally once a day, with a maintenance dose of 3 to 6 mg orally per day
• Maximum daily dose: 10 mg

Is the dosage different for elderly patients? Yes, for elderly or debilitated patients, the recommended starting dose is lower. Typically, 0.25 mg orally administered 2 or 3 times a day for immediate-release formulations, or 0.5 mg once daily for extended-release tablets.

Alprazolam Side Effects: What to Watch For

Like all medications, Alprazolam can cause side effects. It’s important to be aware of these potential adverse reactions:

Common Side Effects

• Drowsiness and sedation
• Dizziness
• Impaired coordination
• Memory problems
• Slurred speech
• Difficulty concentrating

Serious Side Effects

While less common, some serious side effects may occur and require immediate medical attention:

• Severe drowsiness or confusion
• Mood changes or depressive symptoms
• Suicidal thoughts
• Hallucinations
• Seizures
• Yellowing of the skin or eyes (jaundice)

Can Alprazolam cause physical dependence? Yes, Alprazolam has a potential for abuse and can lead to physical dependence, especially when used at high doses or for prolonged periods. Abrupt discontinuation can result in withdrawal symptoms, which is why dosage should always be tapered gradually under medical supervision.

Special Considerations for Different Patient Populations

Alprazolam’s effects can vary among different patient groups, necessitating special considerations:

Elderly Patients

Older adults may be more sensitive to the effects of Alprazolam and are at higher risk of falls and cognitive impairment. Lower starting doses are typically recommended for this population.

Patients with Liver or Kidney Impairment

Alprazolam is metabolized in the liver and excreted through the kidneys. Patients with liver or kidney dysfunction may require dose adjustments:

• Mild to moderate liver dysfunction: Use with caution
• Severe liver dysfunction: Reduced dosage of 0.25 mg orally 2 or 3 times a day for immediate-release formulations, or 0.5 mg once daily for extended-release tablets
• Impaired renal function: Use with caution

Pregnant and Breastfeeding Women

Alprazolam is classified as a Pregnancy Category D drug, indicating potential risks to the fetus. It should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Alprazolam is also excreted in breast milk and may cause adverse effects in nursing infants.

Precautions and Warnings: Ensuring Safe Use of Alprazolam

Several important precautions should be observed when using Alprazolam:

Risk of Concomitant Use with Opioids

The US FDA has issued a boxed warning regarding the concomitant use of benzodiazepines like Alprazolam with opioids. This combination can result in profound sedation, respiratory depression, coma, and death. Healthcare providers should reserve such combined prescriptions for patients where alternative treatments are inadequate.

Potential for Abuse and Dependence

Alprazolam is a controlled substance due to its potential for abuse and dependence. Patients with a history of substance abuse may be at higher risk and should be closely monitored.

Gradual Dose Reduction

When discontinuing Alprazolam or reducing the dosage, it’s crucial to do so gradually. The daily dosage should be decreased by no more than 0.5 mg every 3 days, and some patients may require an even slower taper.

Interactions with Other Medications

Alprazolam can interact with various other medications, potentially altering its effectiveness or increasing the risk of side effects. Some key interactions include:

• CYP3A inhibitors (e.g., ketoconazole, itraconazole): May increase Alprazolam levels
• CYP3A inducers (e.g., rifampin, carbamazepine): May decrease Alprazolam levels
• Other CNS depressants: May enhance sedative effects

Long-term Use of Alprazolam: Balancing Benefits and Risks

While Alprazolam can be highly effective for short-term management of anxiety and panic disorders, its long-term use remains a topic of debate in the medical community.

Benefits of Long-term Use

For some patients with chronic anxiety or recurrent panic attacks, long-term use of Alprazolam may provide consistent symptom relief and improved quality of life. It can help maintain stability in severe cases where other treatments have failed.

Risks of Long-term Use

However, prolonged use of Alprazolam carries several potential risks:

• Tolerance: The body may adapt to the medication, requiring higher doses to achieve the same effect
• Dependence: Physical and psychological dependence can develop, making it difficult to discontinue the medication
• Cognitive impairment: Long-term use may affect memory and cognitive function, particularly in older adults
• Increased risk of falls and accidents: Especially in the elderly population

How can the risks of long-term Alprazolam use be mitigated? Healthcare providers often employ strategies such as intermittent dosing, using the lowest effective dose, and combining Alprazolam with other treatment modalities like cognitive-behavioral therapy to minimize long-term risks.

Alternatives to Alprazolam: Exploring Other Treatment Options

While Alprazolam is effective for many patients, it’s not the only option for managing anxiety and panic disorders. Several alternatives exist, each with its own benefits and considerations:

Other Benzodiazepines

Different benzodiazepines may be prescribed based on the specific symptoms and patient characteristics:

• Clonazepam: Longer-acting, often used for panic disorder
• Lorazepam: Shorter-acting, useful for acute anxiety
• Diazepam: Long-acting, sometimes used for generalized anxiety

Non-Benzodiazepine Medications

Several non-benzodiazepine medications can be effective for anxiety and panic disorders:

• SSRIs (e.g., sertraline, fluoxetine): First-line treatment for many anxiety disorders
• SNRIs (e.g., venlafaxine, duloxetine): Effective for generalized anxiety disorder
• Buspirone: An anxiolytic with a lower risk of dependence
• Beta-blockers: Can help with physical symptoms of anxiety

Non-Pharmacological Approaches

Many patients benefit from non-drug treatments, either alone or in combination with medication:

• Cognitive-Behavioral Therapy (CBT): Helps patients identify and change thought patterns contributing to anxiety
• Exposure Therapy: Particularly useful for specific phobias and panic disorder
• Mindfulness and Meditation: Can help reduce overall anxiety levels
• Lifestyle Changes: Regular exercise, improved sleep habits, and stress reduction techniques can all contribute to anxiety management

Which alternative is best for a given patient? The choice of alternative treatment depends on various factors, including the specific diagnosis, severity of symptoms, patient preferences, and potential side effects. A comprehensive treatment plan often involves a combination of approaches tailored to the individual’s needs.

Managing Alprazolam Withdrawal: A Gradual Approach

Discontinuing Alprazolam, especially after long-term use, requires careful management to minimize withdrawal symptoms and ensure patient safety.

Withdrawal Symptoms

Common withdrawal symptoms may include:

• Increased anxiety and panic attacks
• Insomnia
• Irritability and agitation
• Tremors
• Nausea and vomiting
• Seizures (in severe cases)

Tapering Schedule

A gradual tapering schedule is crucial for safe discontinuation of Alprazolam:

• Typical reduction: No more than 0.5 mg every 3 days
• Slower taper: Some patients may require even slower reduction, such as 0.25 mg every 2 weeks
• Duration: The entire tapering process may take several weeks to months, depending on the starting dose and individual response

How can withdrawal symptoms be managed during tapering? Supportive measures such as psychological support, sleep hygiene techniques, and in some cases, temporary use of longer-acting benzodiazepines can help manage withdrawal symptoms during the tapering process.

Future Directions in Anxiety Treatment: Beyond Alprazolam

As research in neuroscience and psychiatry progresses, new approaches to anxiety treatment are emerging that may provide alternatives or complements to traditional medications like Alprazolam:

Novel Pharmacological Approaches

• GABA Modulators: New drugs targeting specific GABA receptor subtypes may offer anxiolytic effects with reduced side effects
• Glutamate Modulators: Compounds affecting the glutamate system show promise in anxiety treatment
• Neuropeptide-based Therapies: Targeting neuropeptides involved in stress responses may lead to new anxiety treatments

Technological Interventions

Emerging technologies are offering new ways to approach anxiety treatment:

• Virtual Reality Therapy: Immersive environments for exposure therapy and relaxation training
• Neurofeedback: Training patients to control their brain activity patterns associated with anxiety
• Transcranial Magnetic Stimulation (TMS): Non-invasive brain stimulation technique showing promise in anxiety disorders

Personalized Medicine Approaches

Advancements in genetic research and biomarker identification may lead to more tailored treatment strategies:

• Pharmacogenomics: Using genetic information to predict medication response and side effects
• Biomarker-guided Treatment: Identifying biological markers that can guide treatment selection and monitoring
• AI-assisted Decision Making: Utilizing artificial intelligence to analyze complex patient data and suggest optimal treatment strategies

What role will Alprazolam play in future anxiety treatment? While Alprazolam will likely continue to be an important tool in the treatment of anxiety disorders, its use may become more targeted and refined as new alternatives emerge and our understanding of individual patient factors improves.

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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Niravam 0. 25 mg

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Xanax 0.25 mg

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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

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

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

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.
• Avoid driving or other activities that require increased attention until you see how this drug affects you.
• Avoid drinking alcohol while taking this drug.
• Consult your doctor before using marijuana, other forms of cannabis, prescription or over-the-counter drugs that may slow you down.
• With long-term use of the drug, a blood test should be performed. Talk to a medical professional.
• Consult a healthcare professional if you frequently drink grapefruit juice or eat grapefruit.
• If you have phenylketonuria, talk to your doctor.Some foods contain phenylalanine.
• If you start or stop smoking, consult a doctor. It may be necessary to change the dose of the drug you need.
• If you are 65 years of age or older, use this drug with caution. You may have more side effects.
• When used during pregnancy, especially during the first trimester, the drug may have a harmful effect on the fetus.
• If you are pregnant or become pregnant while taking this drug, call your doctor right away.

What side effects should I report to my doctor immediately?

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:

• Signs of an allergic reaction such as rash, hives, itching, reddened and swollen skin with blistering or scaling, possibly associated with fever, wheezing or wheezing, tightness in the chest or throat, difficulty breathing, swallowing or speaking, unusual hoarseness, swelling in the mouth, face, lips, tongue, or throat.
• Signs of depression, suicidal thoughts, ups and downs, thought disorders, anxiety or lack of interest in life.
• Balance change.
• Shortness of breath.
• Severe dizziness or fainting.
• Confusion of consciousness.
• Violation or loss of memory.
• Difficulty speaking.
• Obstruction of the urinary tract.
• For problems with body movement control.
• Muscle cramps.
• Rapid heartbeat.
• Blurred vision.
• Menstrual irregularities.

What are some other side effects of this drug?

Any medicine can have side effects. However, many people have little or no side effects. Call your doctor or get medical help if these or any other side effects bother you or do not go away:

• Feeling dizzy, sleepy, tired, or weak.
• Dry mouth.
• Unexplained change in appetite.
• Constipation, diarrhea, vomiting or nausea.
• Change in sex drive.
• Sexual dysfunction.
• Weight gain or loss.
• Sleep disorders.
• Headache.
• Excessive sweating.

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.

You can report side effects to the National Health Office.

You can report side effects to the FDA at 1-800-332-1088. You can also report side effects at https://www.fda.gov/medwatch.

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.

All forms of issue:

• Take with or without food. Take with food if the medicine causes nausea.

Liquid (solution):

• Use the pipette supplied to deliver the desired dose of the drug.
• Mix liquid with water, fruit juice, apple juice or pudding before use.
• Swallow the mixture immediately. Do not store for future use.

Lozenge:

• If tablets are supplied in a foil blister, do not squeeze the tablet out of the foil when opening. The tablet should be removed from the foil with dry hands.
• Place the tablet on your tongue and let it dissolve. There is no need to drink water. Do not swallow the tablet whole. Do not chew, crush, or crush the tablet.

Extended release tablets:

• Swallow whole.Do not chew, break, or crush.

What to do if a dose of a drug is missed?

• Take the missed dose as soon as you can.
• If it is time for your next dose, do not take the missed dose and then return to your normal dose.
• Do not take 2 doses at the same time or an additional dose.
• Some drugs should be taken as needed. If you are taking this drug as needed, do not do it more often than your doctor has recommended.

How do I store and / or discard this drug?

All forms of issue:

• Store at room temperature in a dry place. Do not store in the bathroom.
• Store this medication in a protected place, out of the reach of children, and out of the reach of other people. A box or room, which is locked with a key, can act as a protected storage location for the drug. Keep all medicines out of the reach of pets.
• Dispose of unused or expired drugs. Do not empty into toilet or drain unless directed to do so. If you have any questions about the disposal of your medicinal products, consult your pharmacist. Your area may have drug recycling programs.

Liquid (solution):

• Protect from light.
• Throw away all unused portions of this medicine 90 days after opening the package.

General information about medicines

• If your health does not improve or even worsens, see your doctor.
• Do not give your medicine to anyone or take other people’s medicines.
• Some medicines may come with other patient information sheets. If you have questions about this drug, talk with your doctor, nurse, pharmacist, or other healthcare professional.
• A separate patient instruction sheet is attached to the product. Please read this information carefully. Reread it every time you replenish your supply. If you have questions about this drug, talk with your doctor, pharmacist, or other healthcare professional.
• If you think an overdose has occurred, call a Poison Control Center immediately or seek medical attention. Be prepared to tell or show which drug you took, how much and when it happened.

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.

Copyright

© UpToDate, Inc. and its affiliates and / or licensors, 2021. All rights reserved.

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

Medicines for certain categories of citizens

INN

TN (Full name)

Ademetionine

Heptor enteric-coated tablets, 400mg No. 20

Azapentacen

Quinax eye drops 0.015% 15ml

Azathioprine

Azathioprine tablets, 0.05 g No. 50

Azithromycin

Zitrolide forte, capsules, 500 mg No. 3

Azithromycin

Sumamed, coated tablets, 125 mg No. 6

Acarbose

Glucobay tablets, 100 mg No. 30

Acarbose

Glucobay tablets, 50 mg No. 30

Algeldrate + Magnesium hydroxide

Maalox chewable tablets No. 20

Algeldrate + Magnesium hydroxide

Maalox, oral suspension, 15 ml No. 30

Allopurinol

Allopurinol, tablets, 100 mg No. 50

Allopurinol

Allopurinol-Egis, tablets, 300 mg No. 30

Alprazolam

Alprazolam tablets, 0.25 mg No. 50

Alprazolam

Alprazolam, tablets, 1 mg No. 50

Alfacalcidol

Alpha D-3-Teva, capsules, 0.25mcg No. 30

Alfacalcidol

Alpha D-3-Teva, capsules 0.25 mcg No. 60

Ambroxol

Ambroxol, tablets, 30 mg No. 20

Ambroxol

Lazolvan, syrup, 15 mg / 5 ml 100 ml, vials No. 1

Ambroxol

Lazolvan syrup, 30 mg / 5 ml 100 ml

Ambroxol

Halixol, syrup, 30 mg / 10 ml / 100 ml No. 1

Aminophenylbutyric acid

Phenibut tablets, 250 mg No. 20

Amiodarone

Cordaron, tablets, 200 mg No. 30

Amitriptyline

Amitriptyline, tablets, 25 mg No. 50

Amlodipine

Amlodipine, tablets, 10 mg No. 30

Amlodipine

Amlodipine, tablets, 5 mg No. 30

Amlodipine

Norvasc, tablets, 10 mg No. 30

Amoxicillin

Amoxicillin, tablets, 250 mg No. 10

Amoxicillin + Clavulanic Acid

Amoxiclav, film-coated tablets, 250 mg + 125 mg No. 15

Amoxicillin + Clavulanic Acid

Flemoklav Solutab, dispersible tablets, 250 mg + 62.5 mg No. 20

Amoxicillin + Clavulanic Acid

Flemoklav Solutab, dispersible tablets, 500 mg + 125 mg No. 20

Anastrozole

Anastera, film-coated tablets, 1 mg No. 28

Anastrozole

Arimidex, film-coated tablets, 1 mg No. 28

Anastrozole

Vero-Anastrozole, film-coated tablets, 1 mg No. 28

Atorvastatin

Atorvastatin-Teva, film-coated tablets, 10 mg No. 30

Atorvastatin

Atorvastatin-Teva, film-coated tablets, 20 mg No. 30

Atorvastatin

Atorvastatin-Teva, film-coated tablets, 40 mg No. 30

Atorvastatin

Atoris film-coated tablets 10 mg No. 30

Atorvastatin

Atoris film-coated tablets 20 mg No. 30

Atorvastatin

Atoris film-coated tablets 40 mg No. 30

Acetazolamide

Diacarb, tablets, 250 mg No. 24

Acetylsalicylic acid

Aspikor, enteric-coated tablets, 100 mg No. 30

Acetylsalicylic acid

CardiASK, enteric-coated tablets, 300 mg No. 30

Acetylsalicylic acid

CardiASK, enteric-coated tablets, 50 mg No. 30

Acetylcysteine

ACTS 100, effervescent tablets, No. 20

Acyclovir

Acyclovir tablets 200mg No. 20

Baclofen

Baklosan, tablets, 10 mg No. 50

Baclofen

Baklosan, tablets, 25 mg No. 50

Bevacizumab

Avastin, concentrate for solution for infusion, 25 mg / ml, 16 ml, vials No. 1

Bevacizumab

Avastin, concentrate for solution for infusion, 25 mg / ml 4 ml, vials No. 1

Beclomethasone

Beklazon Eco Light Breathing, metered dose inhalation aerosol activated by inhalation, 100 μg / dose 200 doses No. 1

Beclomethasone

Beklazon Eco Light Breathing, metered dose inhalation aerosol activated by inhalation, 250 mcg / dose 200 doses No. 1

Beclomethasone

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

Beclomethasone

Beklazon Eco, metered dose aerosol for inhalation, 250 mcg / dose 200 doses No. 1

Beclomethasone

Nasobek, dosed nasal spray, 50 mcg / dose 200 doses, vials No. 1

Benzobarbital

Benzonal tablets 100mg No. 50

Bencyclan

Galidor tablets 100mg No. 50

Betahistine

Betahistine tablets, 16 mg No. 30

Betahistine

Betahistin tablets, 24 mg No. 20

Betahistine

Betahistine tablets, 8 mg No. 30

Betahistine

Betaserc tablets, 16 mg # 30

Betahistine

Betaserc, tablets, 24 mg # 20

Betahistine

Betaserc, tablets, 24 mg No. 60

Betahistine

Betaserc, tablets, 8 mg No. 30

Betaxolol

Betoptic eye drops 0.5% 5ml

Betamethasone

Celestoderm-V, cream for external use, 0.1% 30g

Betamethasone

Celestoderm-B, ointment for external use, 0.1% 30g

Bicalutamide

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

Bicalutamide

Bilumid, film-coated tablets, 150 mg No. 28

Bicalutamide

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

Bicalutamide

Casodex, coated tablets, 150 mg No. 28

Bicalutamide

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

Bisacodyl

Bisacodyl, enteric-coated tablets, 5 mg No. 30

Bisacodyl

Bisacodyl-Altpharm, rectal suppositories, 10 mg No. 10

Bisoprolol

Aritel, film-coated tablets, 10 mg No. 30

Bisoprolol

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

Bisoprolol

Concor Cor, film-coated tablets, 2.5 mg No. 30

Bifidobacterium bifidum

Bifidumbacterin Forte, powder for oral and local use, 5 doses No. 30

Botulinum toxin type A-hemagglutinin complex

Botox, lyophilisate for the preparation of a solution for intramuscular injection, 100 UNITS No. 1

Botulinum toxin type A-hemagglutinin complex

Dysport, lyophilisate for the preparation of a solution for intramuscular and subcutaneous administration, 500 ED No. 1

Bromhexine

Bromhexin Obolenskoe, film-coated tablets, 8 mg No. 20

Bromodihydrochlorophenylbenzodiazepine

Phenazepam tablets, 0.5 mg No. 50

Bromodihydrochlorophenylbenzodiazepine

Phenazepam, tablets, 1 mg No. 50

Bromodihydrochlorophenylbenzodiazepine

Phenazepam tablets, 2.5 mg No. 50

Bromocriptine

Bromocriptine-Richter tablets, 2.5 mg No. 30

Budesonide

Benacort, metered dose powder for inhalation, 0.2 mg / dose 200 doses, No. 1

Budesonide

Pulmicort turbuhaler, powder for inhalation, dosed, 0.1 mg / dose 200 doses No. 1

Budesonide

Pulmicort turbuhaler, powder for inhalation, dosed, 0.2 mg / dose 100 doses No. 1

Budesonide

Pulmicort, dosed suspension for inhalation, 0.25 mg / ml 2 ml, No. 20

Budesonide

Pulmicort, dosed suspension for inhalation, 0.5 mg / ml 2 ml, No. 20

Buserelin

Buserelin-long FS, lyophilisate for preparation of a suspension for intramuscular administration of prolonged action, 3.75 mg vials No. 1 complete with a solvent ampoule 2 ml No. 1

Valganciclovir

Valcyte, film-coated tablets, 450 mg No. 60

Valsartan

Valsafors, film-coated tablets, 80 mg No. 28

Valsartan

Valsafors, coated tablets, 160 mg No. 28

Valproic acid

Valparin XP, prolonged-release film-coated tablets, 300 mg No. 100

Valproic acid

Valparin XP, film-coated tablets of prolonged action, 500 mg No. 100

Valproic acid

Depakine enteric 300 enteric coated tablets 300 mg No. 100

Valproic acid

Depakine chrono tablets of prolonged action, film-coated 500 mg No. 30

Valproic acid

Depakine chrono, tablets of prolonged action, coated 300 mg No. 100

Valproic acid

Depakine, syrup, 50 mg / ml 150 ml, No. 1

Valproic acid

Konvulex, drops for oral administration, 300 mg / ml 100 ml, No. 1

Valproic acid

Konvulex, tablets of prolonged action, coated, 300 mg No. 50

Valproic acid

Konvulex, tablets of prolonged action, film-coated, 500 mg No. 50

Warfarin

Warfarex, tablets, 3 mg No. 100

Warfarin

Warfarex, tablets, 5 mg No. 100

Warfarin

Warfarin Nycomed, tablets, 2.5 mg No. 100

Venlafaxine

Velafax, tablets, 75 mg No. 28

Verapamil

Verapamil, film-coated tablets, 80 mg No. 20

Verapamil

Verogalid EP 240, tablets of prolonged action, coated 240 mg, No. 30

Vinorelbin

Vinkarelbin, conc.for inviting. solution for infusion, 10 mg / ml / 1 ml No. 1

Vinorelbin

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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