Indications for Alprazolam Orally Disintegrating Tablets:
Anxiety disorder. Short-term treatment of anxiety symptoms. Panic disorder (with or without agoraphobia).
≥18yrs: Anxiety: Initially 0.25–0.5mg three times daily. May increase at 3–4 day intervals to 4mg/day in divided doses. Panic: Initially 0.5mg three times daily; may increase at intervals of 3–4 days in increments of up to 1mg/day; usual max 10mg/day. Advanced liver disease, elderly, or debilitated: initially 0.25mg 2–3 times daily. For all: individualize; reevaluate periodically; withdraw gradually.
<18yrs: not recommended.
Acute narrow-angle glaucoma. Concomitant itraconazole, ketoconazole.
Risks from concomitant use with opioids.
Risks from concomitant use with opioids; see Interactions. Not for use in untreated open-angle glaucoma. Discard unused portions of scored tabs (drug stability not ensured). Suicidal ideation. Depression. Psychosis. Mania. Renal, cardiovascular, hepatic, or pulmonary impairment; monitor. Obesity. Reevaluate periodically. Change dose gradually. Withdrawal symptoms on abrupt cessation or dose reduction. Monitor periodic CBCs, urinalysis, blood chemistry. Drug or alcohol abuse. Elderly. Debilitated. Labor & delivery. Pregnancy (Cat.D), nursing mothers: not recommended.
See Contraindications; other azole antifungals: not recommended. Increased sedation, respiratory depression, coma, and death with concomitant opioids; reserve use in those for whom alternative treatment options are inadequate; if needed, limit dosages/durations to minimum and monitor. Additive CNS depressant effects with alcohol or other CNS depressants (eg, other benzodiazepines, psychotropics, anticonvulsants, antihistamines); consider dose reductions. Potentiated by CYP3A inhibitors (eg, cimetidine, nefazodone, fluvoxamine); reduce alprazolam dose; caution with weaker CYP3A inhibitors (eg, fluoxetine, propoxyphene, oral contraceptives). Caution with diltiazem, isoniazid, erythromycin, clarithromycin, grapefruit juice, sertraline, paroxetine, ergotamine, cyclosporine, amiodarone, nicardipine, nifedipine, others metabolized by CYP3A. Antagonized by CYP3A inducers (eg, carbamazepine). May increase levels of imipramine, desipramine. Absorption may be affected by drugs or conditions that affect salivation or gastric pH.
CNS depression (eg, sedation, somnolence, memory impairment, dysarthria, coordination abnormal, ataxia), fatigue, lethargy, dyspnea, dry mouth, constipation, withdrawal seizures, tremors, decreased libido, sexual dysfunction, paradoxical excitement.