Xiotic

Indications

Alprazolam is used for the short-term relief of severe anxiety and for panic disorder (sudden attacks of intense fear), with or without fear of open or crowded places. It is a prescription medicine and is usually given for a limited time.

How It Works

Alprazolam is a benzodiazepine. It boosts the effect of GABA, a natural calming chemical in the brain, which reduces anxiety and panic and causes relaxation and sleepiness.

Dosage and Administration

• Anxiety, adults: commonly 0.25 to 0.5 mg three times a day. The doctor may adjust the dose; the total for anxiety is usually not more than 4 mg a day.
• Older or frail people: start lower, often 0.25 mg two or three times a day.
• Panic disorder and extended-release (XR) tablets: as prescribed. Swallow XR tablets whole.
• Use the lowest effective dose for the shortest time. Do not stop suddenly after regular use; the doctor will reduce the dose slowly.
• Not for children.

Interactions

• Alcohol, opioid painkillers and cough medicines (such as Tramadol or Codeine), sleeping tablets, other sedatives and sedating antihistamines: risk of deep sleepiness and dangerously slow breathing.
• Ketoconazole and Itraconazole greatly raise alprazolam levels and must not be combined.
• Clarithromycin, Erythromycin, Fluvoxamine, Fluoxetine, some HIV medicines and grapefruit juice can also raise levels.
• Carbamazepine and Rifampicin can lower its effect.

Contraindications

• Allergy to alprazolam or other benzodiazepines.
• Myasthenia gravis (a muscle weakness disease).
• Severe breathing problems or sleep apnoea.
• Severe liver failure.
• Acute narrow-angle glaucoma.
• Use with Ketoconazole or Itraconazole.

Side Effects

Common: drowsiness, dizziness, tiredness, unsteadiness, poor concentration, memory problems and slurred speech.

Get urgent medical help for: slow or shallow breathing, extreme sleepiness or difficulty waking, severe confusion, unusual agitation or aggressive behaviour, thoughts of self-harm, fits (seizures) after stopping, or signs of an allergic reaction such as swelling of the face or difficulty breathing.

Pregnancy and Lactation

Avoid in pregnancy, especially in the first three months and near delivery, as it can cause floppiness, breathing problems and withdrawal in the newborn. Not recommended during breastfeeding, as it passes into milk and can make the baby sleepy. Talk to the doctor before stopping or starting.

Precautions and Warnings

• It can cause dependence and withdrawal, even at normal doses. Take only as prescribed and do not share it.
• Do not drive or use machines if you feel drowsy.
• Older people have a higher risk of falls and confusion.
• Use with care in depression, breathing disease, liver or kidney disease, and in people with a history of alcohol or drug misuse.

Overdose

Overdose causes deep drowsiness, confusion, poor coordination, slow breathing and coma, and is more dangerous with alcohol or opioids. This is an emergency: get medical help immediately. Hospitals may use an antidote (Flumazenil) in selected cases.

Therapeutic Class

Benzodiazepine; anxiolytic (anti-anxiety medicine).

Storage

Store below 30°C in a dry place, away from light. Keep safely out of the reach of children and others.