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Soma Alprazolam Get Vicodin Vicodin Percocet Sleeping Pills RX Hydrocodone XANAX Use: Elderly or debilitated patients: Initially, 0.125 mg 2 or 3 times daily;
increased gradually, if required, depending on tolerance and response. Impaired hepatic or renal function: 0.125-0.25 mg 2 or 3times daily. Increase
gradually if needed and tolerated. Panic disorders: Initially, 0.5 - 1 mg at bedtime or 0.5 mg 3 times/day.
Increase by increments no greater than 1 mg every 3-4 days until patient is free
of attacks. Some patients may require up to 10 mg/day. Discontinue alprazolam slowly by
decreasing the daily dosage by no more than 0.5 mg every 3 days. A decrease of
0.5 mg every 2-3 weeks is more appropriate when a dose of 6 mg daily or more has
been administered even for only a few months. Once a dose of 2 mg daily is
achieved, decrease the dose by 0.25 mg per 2 to 3 weeks. Contraindications: Precautions: Side effects: Interactions: Patient tips: Supplied:
Pharmacology
Anxiolytic - Antipanic Alprazolam, a triazolo 1,4 benzodiazepine analog, binds with high affinity to
the GABA benzodiazepine receptor complex. Considerable evidence suggest that the
central pharmacologic/therapeutic actions of alprazolam are mediated via
interaction with this receptor complex. Orally administered it is readily absorbed in man with peak plasma
concentrations occurring 1 to 2 hours following administration. The half life
range is 6 to 20 hours following single dose administration. With multiple
doses, given 3 times daily, steady state is reached within 7 days. Alprazolam
and its metabolites are excreted primarily in the urine. Degradation occurs
mainly by oxidation yielding the primary and secondary metabolites which are
active and appear to have half-lives similar to alprazolam but are present at
only low levels in the plasma. Alprazolam is 80% protein bound. Alprazolam 500 mcg (0.5 mg), administered 3 times a day for 14 days, did not
affect prothrombin times or plasma warfarin levels in male volunteers
administered sodium warfarin orally.
Indications
For the management of anxiety disorders or the short-term symptomatic relief
of symptoms of excessive anxiety. Anxiety or tension associated with the stress
of everyday life usually does not require treatment with an anxiolytic. Alprazolam is indicated for the treatment of Generalized Anxiety Disorder
(GAD) and is also indicated for the management of panic disorder with or without
agoraphobia.
Contraindications
Hypersensitivity to alprazolam or other benzodiazepines. Alprazolam is also
contraindicated in pregnancy, in infants and in patients with myasthenia gravis
and acute narrow angle glaucoma.
Warnings
Alprazolam is not recommended for use in patients whose primary diagnosis is
psychosis or depression. Occupational Hazards: Pregnancy: Lactation: Safety and efficacy of alprazolam in patients under the age of 18 years has
not been established.
Precautions
Elderly and debilitated patients, or those with organic brain syndrome, have
been found to be prone to the CNS depressant activity of benzodiazepines even
after low doses. Manifestations include ataxia, oversedation and hypotension.
Therefore, medication should be administered with caution to these patients,
particularly if a drop in blood pressure might lead to cardiac complications.
Initial doses should be low and increments should be made gradually, depending
on the response of the patient, in order to avoid oversedation, neurological
impairment and other possible adverse reactions. Alprazolam should not be administered to individuals prone to drug abuse.
Caution should be observed in all patients who are considered to have potential
for psychological dependence. Withdrawal symptoms have been observed after
abrupt discontinuation of benzodiazepines. These include irritability,
nervousness, insomnia, agitation, tremors, convulsions, diarrhea, abdominal
cramps, vomiting and mental impairment. Since these symptoms may be similar to
those for which the patient is being treated, it may appear that he has suffered
a relapse upon discontinuation. It is suggested that alprazolam should be
withdrawn gradually if the individual is suspected of having become dependent,
or the drug perhaps has been used in prolonged high doses. Suicidal tendencies may be present in patients with emotional disorders,
particularly when depressed and that protective measures and appropriate
treatment may be necessary and should be instituted without delay. Alprazolam should not be used in patients suspected of having psychotic
tendencies since excitement and other paradoxical reactions can result from the
use of anxiolytic-sedatives in these patients. As with other benzodiazepines,
alprazolam should not be used in individuals with physiological anxiety or
normal stress of daily living but only in the presence of disabling
manifestations of an appropriate pathological anxiety disorder. These drugs are not effective in patients with characterological and
personality disorders or those with obsessive compulsive disorders. Alprazolam
is not recommended for the management of depressive or psychotic disorders. If treatment is necessary in patients with impaired hepatic or renal
function, therapy should be initiated at a very low dose and the dosage
increased only to the extent that it is compatible with the degree of residual
function of these organs. If alprazolam is administered for repeated cycles of therapy, periodic blood
counts and liver function tests are advisable. Since benzodiazepines may occasionally exacerbate grand mal seizures, caution
is required when used in epileptic patients and an adjustment may be necessary
in their anticonvulsive medication. Abrupt withdrawal of alprazolam should be
avoided. Benzodiazepines may potentiate or interact with effects of other CNS acting
drugs such as alcohol, narcotics, barbiturates, nonbarbiturate hypnotics,
antihistamines, phenothiazines, butyrophenones, MAO inhibitors, tricyclic
antidepressants and anticonvulsants. Therefore, if alprazolam is to be combined
with other drugs acting on the CNS, careful consideration should be given to the
pharmacology of the agent involved because of the possible additive or
potentiating effects. Patients should also be advised against the simultaneous
use of other CNS depressant drugs and should be cautioned not to take alcohol
during the administration of alprazolam.
Adverse Effects
The most frequently reported are drowsiness, coordination difficulties with
dizziness. Release of hostility and other paradoxical effects such as
irritability, excitability and hallucinations are known to occur with the use of
benzodiazepines. Other side effects less frequently reported, listed by body
systems, include the following: Neurologic: Psychiatric: Gastrointestinal: Musculoskeletal: Cardiovascular: Dermatologic: Genitourinary: Hematologic: Hepatic: Miscellaneous:
Overdose
Symptoms: Treatment: Experiments in animals have indicated that cardiopulmonary collapse can occur
with massive i.v. doses of alprazolam. This could be reversed with positive
mechanical respiration and the i.v. infusion of levarterenol. Animal experiments with alprazolam and related compounds have suggested that
hemodialysis and forced diuresis are probably of little value.
Dosage
Must be individualized and carefully titrated in order to avoid excessive
sedation or mental and motor impairment. As with other anxiolytic-sedatives,
short courses of treatment should be the rule for the symptomatic relief of
excessive anxiety and the initial course of treatment should not last longer
than 1 week without reassessment. If necessary, drug dosage can be adjusted
after 1 week. Prescriptions should be limited to short courses of therapy. Adults: Elderly and Debilitated Patients:
Supplied
Xanax: 0.5 mg: 1 mg: Xanax TS: |
