Alprazolam (Antianxiety Agent)

Question 1

What are the brand names of alprazolam?

Answer 1

Xanax (XR)

Question 2

What strength immediate release Xanax tablets are available?

Answer 2

0.25 mg, 0.5 mg, 1 mg, 2 mg

Question 3

What strength extended release tablets are available of alprazolam?

Answer 3

0.5 mg, 1 mg, 2 mg, 3 mg

Question 4

What strength alprazolam ODT tablets are available?

Answer 4

0.25 mg, 0.5 mg, 1 mg, 2 mg

Question 5

What strength Xanax oral solution concentrate is available?

Answer 5

1mg/mL

Question 6

What are the approved indications of Xanax?

Answer 6

Management of anxiety disorders, treatment of panic disorder

Question 7

What dose of Xanax is given for the management of anxiety disorders or for the short term relief of the symptoms of anxiety-associated depressive states (immediate release tablets)?

Answer 7

0.25 mg to 0.5 mg initially, given three times a day. Titrate dose to individual needs. May take up to 4 mg a day in divided doses.

Question 8

What dose of immediate release Xanax is used for the treatment of panic disorders?

Answer 8

Initial dose is 0.5 mg three times a day. Depending on the response, the dose may be increased at intervals of 3 to 4 days in increments of no more than 1 mg/day.

Question 9

What dose of Xanax is used for the treatment of time of disorder, with or without agoraphobia?

Answer 9

(Extended-Release tablets)*: One tablet daily, preferably in the morning. Initiate dose with 0.5 mg to 1 mg. Doses may be increased in 1 mg increments every 3 to 4 days. The recommended total daily dose ranges between 3 to 6 mg/day. Elderly patients should be initiated at 0.5 mg per day.

Question 10

What is the mechanism of action of Xanax?

Answer 10

Benzodiazepines facilitate the inhibitory neuro- transmitter action of gamma-aminobutyric acid (GABA), which mediates both pre- and post- synaptic inhibition in all regions of the CNS.

Question 11

What are the drug interactions of Xanax?

Answer 11

CNS depression is increased when used with other CNS depressants. Oral contraceptives can increase the effects of alprazolam

Question 12

What are the contraindications of Xanax?

Answer 12

• Contraindicated in patients hypersensitive to benzodiazepines or in patients with narrow-angle glaucoma.
• CONCOMITANT USE WITH OPIOIDS INCREASES THE RISK OF RESPIRATORY DEPRESSION, COMA, AND DEATH.
• Use with caution in patients with primary depression, psychosis, and impaired renal or hepatic function.
• Withdrawal symptoms can be serious, especially in patients on high doses or extended therapy (>8-12 weeks).
• Use only during pregnancy or lactation when benefits clearly outweigh risks.
• Pregnancy Category D.

Question 13

What are the adverse effects of alprazolam?

Answer 13

Drowiness & hypotension

Question 14

What should the pharmacist tell the patient when they are counseling them for the use of Xanax?

Answer 14

• May cause drowsiness. Use caution while operating machinery or when mental alertness is required.
• Avoid alcohol while taking this medication.
• WARNING: This medication may be habit- forming.
  If a dose is missed, skip it and return to normal dosing schedule.
• XR tablets should not be discontinued abruptly.
• XR tablets should be swallowed whole – do not crush, chew, or break.
• Therapy should not be discontinued abruptly. Reduce dosage by 0.5 mg every 3 to 4 days.