{"id":627110,"date":"2024-03-08T15:41:26","date_gmt":"2024-03-08T20:41:26","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=627110"},"modified":"2024-10-25T10:04:18","modified_gmt":"2024-10-25T14:04:18","slug":"alprazolam-interactions","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/alprazolam-interactions\/","title":{"rendered":"Alprazolam interactions to avoid"},"content":{"rendered":"

Alprazolam<\/span><\/a> is a <\/span>benzodiazepine<\/span><\/a> that is approved by the U.S. Food and Drug Administration (FDA) to manage <\/span>generalized anxiety disorder<\/span><\/a>. It is also used <\/span>off-label<\/span><\/a> for other forms of anxiety, like agoraphobia, panic disorders, and acute <\/span>vertigo<\/span><\/a> episodes. Other benzodiazepines include clonazepam, diazepam, and lorazepam. <\/span>Xanax<\/span><\/a> is the brand name of the medication, but it is readily available as a generic formulation in an oral concentrate solution, tablets, orally disintegrating tablets, and extended-release tablets. Alprazolam is an important member of the armamentarium of medications for mental health disorders. Still, it is a <\/span>controlled substance<\/span><\/a> and comes with the risk of drug abuse and physical dependence. Abruptly stopping alprazolam in those with physical dependence can result in withdrawal symptoms, like restlessness, insomnia and other sleep disturbances, irritability, and poor concentration. Alprazolam also causes central nervous system (CNS) adverse effects like sedation, drowsiness, fatigue, and confusion, so many drug interactions will arise when used with other medications with similar effects, including opioids. In addition to CNS depressants, other medications that interact with alprazolam include CYP3A4 inhibitors and inducers and Selective Serotonin Reuptake Inhibitors (SSRIs). <\/span><\/p>\n

RELATED: <\/b>Xanax side effects and how to avoid them<\/b><\/a><\/p>\n

Alprazolam drug interactions<\/span><\/h2>\n

Alprazolam’s most serious drug interactions arise with opioids, certain antidepressants, muscle relaxants, and other CNS depressants due to the additive risk of side effects like slowed breathing. Other medications interact with alprazolam metabolism, such as azole antifungals, macrolide antibiotics, anticonvulsants, and miscellaneous medications from various drug classes.<\/span><\/p>\n

Opioids<\/span><\/h3>\n

Opioids<\/span><\/a> are prescribed for persistent chronic pain and are usually not as first-line therapy. They are CNS depressants and alone may result in serious side effects, including respiratory depression (slowed breathing) and death. An <\/span>FDA drug safety communication<\/span><\/a> described that combining opioids with benzodiazepines like alprazolam has resulted in serious adverse events related to the additive CNS depression contributed by both types of medication. This warning came from studies like those that demonstrated a <\/span>10-fold higher risk of opioid-related death<\/span><\/a> in individuals who also received benzodiazepines. Combinations of opioids with benzodiazepines should be done judiciously and potentially only under conditions with close monitoring of the individual by a medical professional, given the life-threatening implications. <\/span><\/p>\n

Selective Serotonin Reuptake Inhibitors (SSRIs)<\/span><\/h3>\n

CNS depressants like alprazolam may enhance the adverse and sometimes toxic effects of <\/span>SSRIs<\/span><\/a>. The combination is not an absolute contraindication and generally only requires increased monitoring and cognizance of specifically enhanced psychomotor impairment. Individuals receiving alprazolam with an SSRI require thorough education from a healthcare provider to exercise caution when operating automobiles and other hazardous machinery until it is known how the combination affects them. This warning will be included in the <\/span>prescribing information<\/span><\/a> of these SSRIs. <\/span><\/p>\n

SSRIs that may interact with alprazolam in this way include:<\/span><\/p>\n