ALPRAZOLAM (Generic for XANAX)

Alprazolam 0.5mg, Oral tablet

Caffeine-containing Foods/Beverages

· Severity: Mild

· Notes for Consumers: If you are taking medicine to help you sleep, avoid taking Caffeine and Caffeine-containing foods or beverages like colas, coffee, teas, or chocolates within several hours prior to bedtime.

· Notes for Professionals: Patients taking benzodiazepines for insomnia should not use caffeine-containing products prior to going to bed as these products may antagonize the sedative effects of the benzodiazepine.

Alprazolam 0.5mg, Oral tablet

Marijuana

· Severity: Major

· Notes for Consumers: Avoid combining Benzodiazepines and marijuana. This combination may lead to serious side effects. Do not drive or operate machinery until you know how this combination will affect you. Contact your health care provider right away if you notice slurred speech, confusion, severe drowsiness, increased heart rate, or any other new or unusual side effects.

· Notes for Professionals: Coadministration of marijuana with benzodiazepines may result in an exaggerated sedative effect. Instruct patients receiving these medications concurrently not to drive or operate machinery.

Alprazolam 0.5mg, Oral tablet

Grapefruit juice

· Severity: Major

· Notes for Consumers: Grapefruit juice and grapefruit-containing foods may increase the actions or side effects (such as drowsiness or slowed breathing) of Alprazolam. Avoid taking Alprazolam with grapefruit juice (or grapefruit) whenever possible, and do not increase your intake of grapefruit while taking Alprazolam. You may take Alprazolam with orange juice if desired. If you notice slurred speech, confusion, severe weakness, or difficulty breathing after taking Alprazolam, contact your health care provider immediately.

· Notes for Professionals: Grapefruit juice has been shown to significantly increase peak serum concentrations and AUC of triazolam and oral midazolam. According to the manufacturer, a similar interaction may theoretically occur with alprazolam; however, one in-vivo pharmacokinetic study demonstrated that the bioavailability of alprazolam is unlikely to be effected by coadministration with grapefruit juice. Use with caution.

Alprazolam 0.5mg, Oral tablet

Alcohol

· Severity: Major

· Notes for Consumers: Avoid alcohol-containing drinks while taking this medicine. Using this drug along with alcohol can lead to serious side effects. You may feel drowsy or more tired when taking these drugs together. Do not drive or operate machinery until you know how this drug affects you, and especially if you are drinking alcohol-containing beverages. If you notice slurred speech, confusion, severe weakness, or difficulty breathing, contact your health care provider immediately.

· Notes for Professionals: Alcohol is associated with CNS depression. The combined use of alcohol and CNS depressants can lead to additive CNS depression, which could be dangerous in tasks requiring mental alertness and fatal in overdose. Alcohol taken with other CNS depressants can lead to additive respiratory depression, hypotension, profound sedation, or coma. Consider the patient's use of alcohol or illicit drugs when prescribing CNS depressant medications. In many cases, the patient should receive a lower dose of the CNS depressant initially if the patient is not likely to be compliant with avoiding alcohol.

Alprazolam 0.5mg, Oral tablet

Tobacco

· Severity: Moderate

· Notes for Consumers: Tobacco smoke may decrease the effectiveness of alprazolam in treating your condition. If you smoke tobacco, notify your prescriber if you notice that alprazolam is not working well for you. If you suddenly stop smoking tobacco, this may increase the actions of alprazolam; you should notify your prescriber if you notice increased drowsiness, dizziness, difficulty staying alert, breathing problems, or other unusual side effects.

· Notes for Professionals: The clinical significance of the pharmacokinetic effect of tobacco smoking on alprazolam clearance is unclear. According to the manufacturer, alprazolam concentrations may be reduced by up to 50% in tobacco smokers vs. non-smokers. In one small study (n = 10), the mean half-life of alprazolam was significantly shorter in smokers ( more than 10 cigarettes/day) than in nonsmokers. No significant differences between groups were found in the Cmax or AUC. A bioavailability study (n = 17) evaluating the immediate-release and controlled-release formulations of alprazolam found that cigarette smokers had a 100% increase in clearance of alprazolam compared with nonsmokers. Polycyclic aromatic hydrocarbons (PAHs) found in tobacco smoke are potent inducers of CYP1A1, CYP1A2, and possibly CYP2E1. Because alprazolam is a primary substrate of CYP3A4, further evaluation of this potential interaction is needed in order to determine its clinical impact to patients.

<b>DISCLAIMER:</b><em> This drug information content is provided for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Patients should always consult their physician with any questions regarding a medical condition and to obtain medical advice and treatment. Drug information is sourced from GSDD (Gold Standard Drug Database ) provided by Elsevier.</em>