Xanax Generic Name & Formulations
Alprazolam 0.25mg, 0.5mg, 1mg, 2mg+; scored tabs (+multi-scored).
XR—60; Tabs 0.25mg, 0.5mg, 1mg—100, 500, 1000; 2mg—100, 500
Anxiety. Panic disorder.
Xanax Dosage and Administration
Adjust at intervals of at least 3–4 days. ≥18yrs: Anxiety: initially 0.25–0.5mg 3 times daily; max 4mg daily in divided doses. Elderly or hepatic impairment: initially 0.25mg 2–3 times daily. Panic disorder: initially 0.5mg 3 times daily; usual range: 5–6mg daily in divided doses; max 10mg/day.
<18yrs: not established.
Concomitant strong CYP3A inhibitors (eg, itraconazole, ketoconazole), except ritonavir.
Xanax Boxed Warnings
Risks from concomitant use with opioids. Abuse, misuse, and addiction. Dependence and withdrawal reactions.
Increased risk of drug-related mortality from concomitant use with opioids. Suicidal ideation (monitor). Depression. Psychosis. Mania. Renal, cardiovascular, hepatic, or respiratory impairment; monitor. Discontinue if respiratory depression, hypoventilation, or apnea occurs. Monitor periodic CBCs, urinalysis, blood chemistry. Reevaluate periodically. Assess patient's risk for abuse, misuse, addiction prior to and during therapy. Write ℞ for smallest practical amount. Avoid abrupt cessation. Change dose gradually. Drug or alcohol abusers. Elderly. Neonatal sedation and withdrawal syndrome; monitor neonates exposed during pregnancy or labor. Pregnancy (esp. late stage). Nursing mothers: not recommended.
Alprazolam is 80% bound to human serum protein, and albumin accounts for the majority of the binding.
Renal. Half-life: ~11.2 hours
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 moderate or weak CYP3A inhibitors (eg, nefazodone, fluvoxamine, cimetidine, erythromycin); avoid or reduce alprazolam dose. Antagonized by CYP3A inducers (eg, carbamazepine, phenytoin); caution. Concomitant ritonavir; adjust alprazolam dose (see full labeling). Potentiates digoxin; monitor serum levels. May increase levels of imipramine, desipramine.
Xanax Adverse Reactions
CNS depression (eg, drowsiness, sedation, memory impairment, dysarthria, coordination abnormal, ataxia), hypotension, fatigue, lethargy, dyspnea, dry mouth, constipation, tremors, changes in libido, sexual dysfunction, paradoxical excitement, withdrawal reactions.
Xanax Clinical Trials
Xanax Patient Counseling