Alprazolam drug interactions

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

List of drug interactions

Benzodiazepines

CYP 3A inhibitors

In vitro interactions

Other clinically suggested interactions



Benzodiazepines

The benzodiazepines, including Alprazolam, produce additive CNS depressant effects when coadministered with other psychotropic medications, anticonvulsants, antihistaminics, ethanol and other drugs which themselves produce CNS depression. Return to top

CYP 3A inhibitors

The initial step in Alprazolam metabolism is hydroxylation catalyzed by cytochrome P450 3A (CYP 3A). Drugs which inhibit this metabolic pathway may have a profound effect on the clearance of Alprazolam.

  • Fluoxetine--Coadministration of fluoxetine with Alprazolam increased the maximum plasma concentration of Alprazolam by 46%, decreased clearance by 21%, increased half-life by 17%, and decreased measured psychomotor performance.
  • Propoxyphene--Coadministration of propoxyphene decreased the maximum plasma concentration of Alprazolam by 6%, decreased clearance by 38%; and increased half-life by 58%.
  • Oral contraceptives--Coadministration of oral contraceptives increased the maximum plasma concentration of Alprazolam by 18%, decreased clearance by 22%, and increased half-life by 29%.

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In vitro interactions

Data from in vitro studies of Alprazolam suggest a possible drug interaction with Alprazolam for the following: sertraline and paroxetine. Return to top

Other clinically suggested interactions

Available data from clinical studies of benzodiazepines other than Alprazolam suggest a possible drug interaction with Alprazolam for the following: diltiazem, isoniazid, macrolide antibiotics such as erythromycin and clarithromycin, and grapefruit juice.
Data from in vitro studies of benzodiazepines other than Alprazolam suggest a possible drug interaction for the following: ergotamine, cyclosporine, amiodarone, nicardipine, and nifedipine. Caution is recommended during the coadministration of any of these with Alprazolam. Return to top

Complete List of Drug Interactions of Alprazolam

Major Interactions

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Moderate Interactions

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Minor Interactions

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Adapted from the FDA Package Insert.