Brand name: Xanax
Active ingredient (generic name): Alprazolam
Manufacturer: Pfizer
Importer: Behestan Darou
Pharmacotherapeutic group: anti-anxiety
Pharmaceutical form: 0.5mg tablets
Pharmacodynamic:
Alprazolam, like other benzodiazepines, has a high affinity for the benzodiazepine binding site in the brain. It facilitates the inhibitory neurotransmitter action of gamma-aminobutyric acid, which mediates both pre- and post synaptic inhibition in the central nervous system (CNS).
Pharmacokinetic:
Alprazolam is readily absorbed. Following oral administration peak concentration in the plasma occurs after 1 - 2 hours.
The mean half-life is 12 - 15 hours. Repeated dosage may lead to accumulation and this should be borne in mind in elderly patients and those with impaired renal or hepatic function. Alprazolam and its metabolites are excreted primarily in the urine.
Therapeutic indication:
Xanax is indicated for the short-term treatment of moderate or severe anxiety states and anxiety associated with depression. It is only indicated when the disorder is severe, disabling or subjecting the individual to extreme distress.
Xanax should not be used to treat short-term mild anxiety, such as anxiety or tension associated with the stress of everyday life. As the efficacy of Xanax in depression and in phobic or obsessional states has yet to be established, specific treatment may have to be considered.
Dosage and administration:
The optimum dosage of Xanax should be based upon the severity of the symptoms and individual patient response.
Anxiety: 250 micrograms (0.25 mg) to 500 micrograms (0.5 mg) three times daily increase if required to a total of 4 mg daily.
Panic Disorder: treatment for patients with agoraphobia associated with panic disorders should be initiated with a dose of 0.5-1mg given before bed time, for one or two days.
Adverse reaction:
Sedation/drowsiness, light-headedness, reduced alertness, confusion, fatigue, headache, dizziness, muscle weakness, ataxia, double or blurred vision, insomnia, tremor, change in weight.
These phenomena occur predominantly at the start of therapy and usually disappear with repeated administration. Other side effects like gastrointestinal disturbances, changes in libido or skin reactions have been reported occasionally.
Contraindication:
It is prohibited in patients with hypersensitivity to benzodiazepines or any of the other constituents of the tablet.
Pharmacokinetic interactions:
The co-administration of alprazolam with ketoconazole, itraconazole, or other azole-type antifungals is not recommended.
Caution and consideration of dose reduction is recommended when alprazolam is co-administered with nefazodone, fluvoxamine and cimetidine.
Caution is recommended when alprazolam is co-administered with fluoxetine and propoxyphene.
Special warnings:
Use of benzodiazepines may lead to the development of physical and psychic dependence upon these products. The risk of dependence increases with dose and duration of treatment; it is also greater in patients with a history of alcohol and drug abuse.
Treatment should always be tapered off gradually. During discontinuation of alprazolam treatment, the dosage should be reduced slowly in keeping with good medical practice. It is suggested that the daily dosage of alprazolam be decreased by no more than 0.5 mg every three days. Some patients may require an even slower dosage reduction
Patients should be cautioned about operating motor vehicles or engaging in other dangerous activities while taking Xanax.
Pregnancy and lactation:
Xanax should not be used during pregnancy unless your doctor deems treatment absolutely necessary after careful assessment of the benefits against possible risks and it is prohibited during breast-feeding.
Storage temperature:
Room temperature (15-25 C)
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