What is xanax. Xanax: instructions for use. Topical medicines in the modern world

pharmachologic effect

Anxiolytic agent (tranquilizer), a derivative of triazolo-benzodiazepine. It has an anxiolytic, sedative, hypnotic, anticonvulsant, central muscle relaxant effect. The mechanism of action is to increase the inhibitory effect of endogenous GABA in the CNS by increasing the sensitivity of GABA receptors to the mediator as a result of stimulation of benzodiazepine receptors located in the allosteric center of postsynaptic GABA receptors of the ascending activating reticular formation of the brainstem and intercalary neurons of the lateral horns of the spinal cord; reduces the excitability of the subcortical structures of the brain (limbic system, thalamus, hypothalamus), inhibits polysynaptic spinal reflexes.

Pronounced anxiolytic activity (decrease in emotional stress, weakening of anxiety, fear, anxiety) is combined with a moderately pronounced hypnotic effect; shortens the period of falling asleep, increases the duration of sleep, reduces the number of night awakenings. The mechanism of hypnotic action is to inhibit the cells of the reticular formation of the brain stem. Reduces the impact of emotional, vegetative and motor stimuli that disrupt the mechanism of falling asleep.

Pharmacokinetics

After oral administration, alprazolam is rapidly and completely absorbed from the gastrointestinal tract. Cmax in the blood is achieved within 1-2 hours.

Plasma protein binding is 80%.

Metabolized in the liver.

T 1/2 averages 12-15 hours. Alprazolam and its metabolites are excreted mainly by the kidneys.

Indications

Anxiety, neurosis, accompanied by a sense of anxiety, danger, restlessness, tension, worsening sleep, irritability, as well as somatic disorders; mixed anxiety-depressive states; neurotic reactive-depressive states, accompanied by a decrease in mood, loss of interest in the environment, anxiety, loss of sleep, loss of appetite, somatic disorders; anxiety states and neurotic depressions that have developed against the background of somatic diseases; panic disorder with and without phobia symptoms.

Contraindications

Coma, shock, myasthenia gravis, angle-closure glaucoma (acute attack or predisposition), acute alcohol poisoning (with weakened vital functions), opioids, hypnotics and psychotropic drugs, chronic obstructive airway disease with initial manifestations of respiratory failure, acute respiratory failure, severe depression (suicidal tendencies may occur), pregnancy (especially the first trimester), lactation, children and adolescents under 18 years of age, hypersensitivity to benzodiazepines.

Dosage

Individual. It is recommended to use the minimum effective dose. The dose is adjusted during treatment, depending on the effect achieved and tolerability. If it is necessary to increase the dose, it should be increased gradually, first in the evening, and then in the daytime.

The initial dose is 250-500 mcg 3 times / day, if necessary, a gradual increase to 4.5 mg / day is possible.

Cancellation or dose reduction of alprazolam should be carried out gradually, reducing the daily dose by no more than 500 mcg every 3 days; sometimes even slower cancellation may be needed.

Side effects

From the side of the central nervous system: at the beginning of treatment (especially in elderly patients) drowsiness, fatigue, dizziness, decreased ability to concentrate, ataxia, disorientation, gait instability, mental and motor reactions slowdown; rarely - headache, euphoria, depression, tremor, memory loss, impaired coordination of movements, depressed mood, confusion, dystonic extrapyramidal reactions (uncontrolled movements, including the eyes), weakness, myasthenia gravis, dysarthria; in some cases - paradoxical reactions (aggressive outbursts, confusion, psychomotor agitation, fear, suicidal tendencies, muscle spasm, hallucinations, agitation, irritability, anxiety, insomnia).

From the digestive system: possible dry mouth or salivation, heartburn, nausea, vomiting, loss of appetite, constipation or diarrhea, impaired liver function, increased activity of hepatic transaminases and alkaline phosphatase, jaundice.

From the hematopoietic system: possible leukopenia, neutropenia, agranulocytosis (chills, hyperthermia, excessive fatigue or weakness), anemia, thrombocytopenia.

From the urinary system: possible urinary incontinence, urinary retention, impaired renal function, decreased or increased libido, dysmenorrhea.

From the endocrine system: possible changes in body weight, libido disorders, menstrual disorders.

From the side of the cardiovascular system: possible decrease in blood pressure, tachycardia.

Allergic reactions: possible skin rash, itching.

drug interaction

With the simultaneous use of psychotropic, anticonvulsant drugs and ethanol, an increase in the inhibitory effect of alprazolam on the central nervous system is observed.

With simultaneous use of blockers of histamine H 2 receptors, they reduce the clearance of alprazolam and increase the inhibitory effect of alprazolam on the central nervous system; macrolide antibiotics - reduce the clearance of alprazolam.

With simultaneous use of hormonal contraceptives for oral administration, increase T 1/2 of alprazolam.

With the simultaneous use of alprazolam with dextropropoxyphene, a more pronounced CNS depression is observed than in combination with other benzodiazepines, tk. it is possible to increase the concentration of alprazolam in the blood plasma.

The simultaneous use of digoxin increases the risk of developing intoxication with cardiac glycosides.

Alprazolam increases the concentration of imipramine in plasma.

With simultaneous use of itraconazole, enhance the effects of alprazolam.

With the simultaneous use of paroxetine, it is possible to enhance the effects of alprazolam, due to the inhibition of its metabolism.

Fluvoxamine increases the plasma concentration of alprazolam and the risk of its side effects.

With simultaneous use, it is possible to increase the concentration of alprazolam in the blood plasma due to a decrease in its metabolism and clearance under the influence of fluoxetine, which is accompanied by psychomotor disorders.

It is impossible to exclude the possibility of enhancing the action of alprazolam with simultaneous use with.

special instructions

In endogenous depression, alprazolam can be used in combination with antidepressants. When using alprazolam in patients with depression, there have been cases of the development of hypomanic and manic states.

Alprazolam should be used with caution in patients with impaired liver and/or kidney function.

In patients who have not previously taken drugs that affect the central nervous system, alprazolam is effective at lower doses compared with patients who received antidepressants, anxiolytics or who suffer from chronic alcoholism.

With prolonged use in high doses, addiction and drug dependence may develop, especially in patients prone to drug abuse.

With a rapid dose reduction or abrupt withdrawal of alprazolam, a withdrawal syndrome is observed, the symptoms of which can range from mild dysphoria and insomnia to a severe syndrome with abdominal and skeletal muscle cramps, vomiting, increased sweating, tremors and convulsions. The withdrawal syndrome is more common in individuals who have received alprazolam for a long time (more than 8-12 weeks).

Other tranquilizers should not be co-administered with alprazolam.

The safety of alprazolam in children and adolescents under 18 years of age has not been established. Children, especially at a younger age, are very sensitive to the inhibitory effect of benzodiazepines on the central nervous system.

Avoid drinking alcohol during treatment.

Influence on the ability to drive vehicles and control mechanisms

During the period of treatment, one should refrain from engaging in potentially hazardous activities that require increased attention and speed of psychomotor reactions (driving vehicles or working with mechanisms).

Pregnancy and lactation

Alprazolam has a toxic effect on the fetus and increases the risk of congenital malformations when used in the first trimester of pregnancy. Chronic use during pregnancy can lead to physical dependence with the development of withdrawal syndrome in the newborn. Reception in therapeutic doses in later stages of pregnancy can cause depression of the central nervous system of the newborn. Use immediately before or during labor may cause respiratory depression, decreased muscle tone, hypotension, hypothermia, and poor suckling (poor neonatal sucking syndrome) in the neonate.

Use in the elderly

For elderly or debilitated patients, the initial dose is 250 mcg 2-3 times / day, maintenance doses - 500-750 mcg / day, if necessary, taking into account tolerance, the dose can be increased.

In this article, you can read the instructions for using the drug Xanax. Reviews of site visitors - consumers of this medicine, as well as opinions of doctors of specialists on the use of Xanax in their practice are presented. A big request to actively add your reviews about the drug: did the medicine help or not help get rid of the disease, what complications and side effects were observed, perhaps not declared by the manufacturer in the annotation. Analogues of Xanax in the presence of existing structural analogues. Use to treat anxiety, depression, irritability in adults, children, and pregnancy and lactation. The composition and interaction of the drug with alcohol.

Xanax- has an anxiolytic, sedative, muscle relaxant effect.

By binding to benzodiazepine and GABAergic receptors, it causes inhibition of the limbic system, thalamus, hypothalamus, and polysynaptic spinal reflexes.

Compound

Alprazolam + excipients.

Pharmacokinetics

After oral administration, it is rapidly absorbed from the gastrointestinal tract. Plasma protein binding is 80%. Passes through the blood-brain barrier (BBB) and the placental barrier, penetrates into breast milk. Metabolized in the liver. It is excreted mainly by the kidneys. Re-appointment with an interval of less than 8-12 hours may lead to cumulation.

Indications

anxiety and neurosis with a sense of anxiety, tension, restlessness, irritability, worsening sleep, somatic disorders;
mixed anxiety-depressive and neurotic reactive-depressive states, accompanied by a decrease in mood, loss of interest in the environment, psychomotor agitation, sleep disturbance, loss of appetite, changes in body weight, somatic complaints, cognitive impairment, suicidal thoughts (feelings of guilt, low value), decreased energy;
with somatic disorders, alcohol withdrawal syndrome, functional and organic diseases (cardiovascular, dermatological, gastrointestinal tract);
panic states (with or without phobic symptoms);
panic attacks and phobias in agoraphobia.

Release form

Tablets 0.25 mg and 0.5 mg.

Long-acting tablets 0.5 mg and 1 mg (Xanax Retard).

Instructions for use and dosing regimen

Inside, the optimal dose is set individually, depending on the severity of the symptoms and the severity of the clinical effect. Increasing the dose is best done by taking more of the drug in the evening (before bedtime). In general, patients who have never previously been treated with psychotropic drugs require lower doses. Elderly and debilitated patients are advised to take lower doses of alprazolam, since an overdose may cause the development of excessive sedation or ataxia. It is recommended to periodically re-evaluate the patient's condition with subsequent clarification of the dose of alprazolam.

As a rule, the usual dose is sufficient for most patients. If the patient requires a higher dose, the dose increase should be carried out with caution to avoid the development of side effects.

Duration of therapy: up to 6 months - with anxiety and depressive disorders; up to 8 months - in the treatment of panic disorders.

Reducing the dose of the drug should be carried out gradually (possibly the development of a withdrawal syndrome or abstinence). It is recommended to reduce the daily dose by no more than 0.5 mg every 3 days. In some cases, a slower dose reduction is required.

Side effect

headache;
dizziness;
drowsiness;
sleep disorders;
fatigue;
memory impairment;
depression;
muscle weakness;
tremor;
coordination disorders;
ataxia;
changes in body weight;
dyspepsia, anorexia;
dystonia;
jaundice;
decreased libido;
dysmenorrhea;
incontinence or urinary retention;
visual disturbances;
irritability;
hallucinations;
hostility and aggressiveness of behavior (more often with the abuse of alcohol, drugs, while taking other psychotropic drugs);
addiction (especially with alcoholism, toxic or drug addiction);
drug addiction;
withdrawal symptoms (with abrupt withdrawal of the drug).

Contraindications

hypersensitivity;
psychotic depression (not effective);
pregnancy (especially 1st trimester);
children's adolescence and youth (up to 18 years);
thyroid diseases (tablets 0.5 mg).

Use during pregnancy and lactation

Xanax is contraindicated during pregnancy (especially in the 1st trimester).

During the period of admission, lactating women should stop breastfeeding.

Use in children

Contraindicated in children and adolescents under the age of 18 years (studies on the efficacy and safety of Xanax in persons under 18 years of age have not been conducted).

special instructions

It is used with extreme caution in case of impaired liver and kidney function, severe depression, suicidal mood, panic disorders.

In order to avoid withdrawal syndrome (withdrawal phenomena), treatment is stopped gradually, reducing the dose by no more than 0.5 mg every 3 days.

Influence on the ability to drive vehicles and control mechanisms

drug interaction

Against the background of amprenavir, biotransformation is blocked, the concentration of alprazolam in plasma increases, activity and the risk of toxicity increase.

The potential effect of increasing the plasma concentration of alprazolam (which is metabolized via CYP3A4) should be taken into account when alprazolam is coadministered with aprepitant.

Careful clinical monitoring of cases of respiratory depression and / or prolonged sedation should be carried out during the simultaneous use of boceprevir with intravenous administration of alprazolam. Dose adjustment of Xanax is required.

Against the background of valproic acid, CNS depression is enhanced.

Enhances (mutually) with Haloperidol CNS depression; with a combined appointment, caution is necessary.

Enhances (mutually) with Diazepam CNS depression, increases the risk of apnea (when administered intravenously).

Against the background of alprazolam, plasma concentration increases, clearance and / or Vss of digoxin decreases, and the risk of toxicity increases.

It is possible to enhance the effect with Diltiazem; with a combined appointment, caution is necessary.

Itraconazole, as an inhibitor of CYP3A4, slows down biotransformation, significantly reduces clearance, increases the plasma concentration of alprazolam, enhances effects, incl. side; joint use is contraindicated.

Enhances (mutually) CNS depression with Carbamazepine.

Ketoconazole as a CYP3A inhibitor can significantly reduce the clearance of alprazolam; joint use is contraindicated.

It was reported about the development of hallucinations when taking ketorolac in the form of tablets in patients taking Xanax.

The simultaneous use of clarithromycin (as part of a set of tablets and capsules clarithromycin + lansoprazole + amoxicillin) with alprazolam (metabolized by the CYP3A isoenzyme) is contraindicated.

Enhances (mutually) CNS depression with Codeine.

Enhances (mutually) the sedative effect of metoclopramide.

With the combined use of milk thistle fruits, an extract that inhibits the cytochrome P450 system can enhance the effect of Xanax.

Enhances (mutually) the effect of Tramadol; with a combined appointment, the risk of developing convulsive seizures increases.

Strengthens (mutually) oppression of TsNS by Phenobarbital.

Fluconazole as an inhibitor of CYP3A slows down biotransformation and reduces clearance; co-administration is not recommended.

The combined use of alprazolam and fluoxetine led to an increase in plasma levels of alprazolam and a decrease in psychomotor activity.

Enhances (mutually) CNS depression Chlorpromazine and Chlorprothixene; with a combined appointment, caution is necessary.

Slows down the elimination of Erythromycin; with a combined appointment, caution is necessary.

Against the background of alprazolam, the effect of ethanol (alcohol) on the central nervous system is enhanced.

Analogues of the drug Xanax

Structural analogues for the active substance:

Alzolam;
Alprazolam;
Alprox;
Zolomax;
Cassadan;
Xanax retard;
Neurol;
Frontin;
Helex.

Analogues by pharmacological group (anxiolytics):

Adaptol;
Anvifen;
Atarax;
Afobazole;
Bromazepam;
Valium Roche;
Hydroxyzine;
Grandaxin;
diazepam;
Diazepex;
diapam;
Ipronal;
Lexotan;
Librax;
Lorazepam;
Loram;
Lorafen;
Mebicar;
Mezapam;
Mexiprim;
Mexifin;
Merlit;
Myolastan;
Napoton;
Neurofasol;
Nobritem;
Nozepam;
Noofen;
Oxazepam;
Relanium;
Relium;
Seduxen;
Sibazon;
Tazepam;
Tenoten;
Tenoten for children;
Tofisopam;
Phenazepam;
Phenibut;
Elenium;
Elzepam.

In the absence of analogues of the drug for the active substance, you can follow the links below to the diseases that the corresponding drug helps with and see the available analogues for the therapeutic effect.

Pronunciation

Generic Name: alprazolam (al PRAY zoe lam)
Names stamps:Niravam, Xanax, Xanax XR

What is Xanax?

Xanax (alprazolam) is a benzodiazepine (benzoide-dye-aze-e-stump). Alprazolam affects chemicals in the brain that can be out of balance in people with anxiety.

Xanax is used to treat anxiety disorders, panic disorders, and depression-related anxiety.

Xanax may also be used for purposes not listed in this medication guide.

Important information

You should not use Xanax if you have narrow-angle glaucoma, if you are also taking itraconazole or ketoconazole, or if you are allergic to Xanax or similar medicines (Valium, Ativan, Tranxene, and others).

Xanax Slideshow: 12 Things You Should Know

Do not use Xanax if you are pregnant. This medicine may cause birth defects or life-threatening withdrawal symptoms in newborns.

Alprazolam may be habit-forming. Misuse of addictive medicine can cause addiction, overdose, or death.

Do not drink alcohol while taking Xanax. This medicine may increase the effect of alcohol. Alprazolam may be habit-forming and should only be used by the person for whom it was prescribed. Keep the medicine in a safe place where others cannot get to it.

Before taking this medicine

It is dangerous to purchase Xanax online or from vendors outside of the United States. Medicines distributed from online sales may contain hazardous ingredients or may not be dispensed by a licensed pharmacy. The sale and distribution of Xanax outside the United States does not comply with Food and Drug Administration (FDA) regulations for the safe use of this medication.

You should not take Xanax if you have:

Narrow angle glaucoma;

if you are also taking itraconazole or ketoconazole; or

If you are allergic to alprazolam or other benzodiazepines such as chlordiazepoxide (Librium), clorazepate (Tranxen), diazepam (Valium), lorazepam (Ativan), or oxazepam (Serax).

To make sure Xanax is safe for you, tell your doctor if you have:

Seizures or epilepsy;

kidney or liver disease (especially alcoholic liver disease);

asthma or other breathing disorder;

Open glaucoma;

a history of depression or suicidal thoughts or behavior;

a history of drug or alcohol addiction; or

If you are also using a narcotic (opioid) medicine.

Do not use Xanax if you are pregnant. This medicine can cause birth defects. Your child may also become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after the baby is born. Babies born into habituation addiction may need treatment for several weeks. Tell your doctor if you are pregnant or plan to become pregnant. Use effective birth control to prevent pregnancy while you are taking Xanax.

Alprazolam can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using Xanax.

The sedative effects of Xanax may last longer in older people. Accidental falls are common in elderly patients who take benzodiazepines. Use caution to avoid falling or accidental injury while taking Xanax.

Xanax is not approved for use by anyone under the age of 18.

How to take Xanax?

Take Xanax exactly as prescribed by your doctor. Follow all directions on the prescription label. Never use alprazolam in large amounts or for longer than prescribed. Tell your doctor if the medicine seems to stop working in treating your symptoms as well.

Alprazolam may be habit-forming. Never share Xanax with another person, especially someone who is addicted or drug addicted. Keep the medicine in a place where others cannot get to it.

Misuse of addictive medicine can cause addiction, overdose, or death. Selling or giving away this medicine is against the law.

Do not crush, chew, or break a Xanax extended release tablet. Swallow the tablet whole.

Call your doctor if this medication seems to stop working in treating panic or anxiety symptoms as well.

Do not stop using Xanax suddenly, or you may experience unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.

If you are using this medicine for the long term, you may need frequent medical tests.

Store Xanax at room temperature away from moisture and heat.

Keep track of the amount of medicine used in each new bottle. Xanax is a drug of abuse and you should be aware if someone is using your medicine incorrectly or without a prescription.

See also: Dosing information (in more detail)

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up for a missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help Line at 1-800-222-1222. An overdose of alprazolam can be fatal. Overdose symptoms may include extreme drowsiness, confusion, muscle weakness, loss of balance or coordination, feeling light-headed, and fainting.

What should I avoid while taking Xanax?

Xanax may impair your thinking or reactions. Be careful if you drive or do anything that requires your attention.

Avoid alcohol. Dangerous side effects may occur.

Grapefruit and grapefruit juice may interact with alprazolam and lead to unwanted side effects. Discuss the use of grapefruit products with your doctor.

Side effects of Xanax

Get emergency medical help if you have signs of an allergic reaction to Xanax: hives; Labored breathing; Swelling of the face, lips, tongue, or throat.

Call your doctor right away if you have:

depressed mood, suicidal thoughts or self-harm;

racing thoughts, increased energy, unusual risk-taking behavior;

confusion, agitation, hostility, hallucinations;

uncontrolled muscle movements, tremors, seizures (convulsions); or

Pounding heartbeat or flutter in the chest.

Common Xanax side effects may include:

Drowsiness, feeling tired;

slurred speech, lack of balance or coordination;

memory problems; or

Feeling restless early in the morning.

This is not a complete list of side effects and others may occur. Ask your doctor about side effects. You can report side effects to the FDA at 1-800-FDA-1088.

Xanax dosing information

Usual Adult Dose of Xanax for Anxiety:

Initial dose: 0.25-0.5 mg orally 3 times a day

Maintenance dose: may increase up to a maximum daily dose of 4 mg in divided doses

Usual Adult Dose for Panic Disorder:

This dose may be gradually increased every 3-4 days if needed and allowed.
Maintenance dose: 1 to 10 mg per day in divided doses
Average dose used: 5-6 mg per day in divided doses

Initial dose: 0.5 to 1 mg once a day
The daily dose may be gradually increased by no more than 1 mg every 3-4 days if necessary and allowed.
Maintenance dose: 1 - 10 mg once a day
Average dose used: 3 to 6 mg once a day

Usual Adult Dose of Xanax for Depression:

Immediate release tablets, oral disintegration tablets, oral concentrate:
Initial dose: 0.5 mg orally 3 times a day
The daily dose can be gradually increased by no more than 1 mg every 3-4 days.
Average dose: Studies on the use of alprazolam for the treatment of depression reported a median effective dose of 3 mg orally daily in divided doses
Maximum Dose: Studies on the use of alprazolam for the treatment of depression have reportedly used 4.5 mg orally daily in divided doses as the maximum.

Usual Geriatric Dose for Anxiety:

Immediate release tablets, oral disintegration tablets, oral concentrate:

Usual Geriatric Dose for Depression:

Immediate release tablets, oral disintegration tablets, oral concentrate:
Initial dose: 0.25 mg orally 2 to 3 times daily in elderly or debilitated patients
If necessary, this dose can be gradually increased.

Due to increased sensitivity to benzodiazepines in elderly patients, alprazolam in daily doses greater than 2 mg meets the criteria for beer as a drug that is potentially unsuitable for the elderly. Smaller doses may be effective as well as safer. The total daily dose should rarely exceed the recommended maximums.

Usual Geriatric Dose for Panic Disorder:

Immediate release tablets, orally disintegrating tablets:
Initial dose: 0.25 mg orally 2 to 3 times daily in elderly or debilitated patients
If necessary, this dose can be gradually increased.

Extended release tablets:
Initial dose: 0.5 mg once a day, preferably in the morning
If necessary, this dose can be gradually increased.

What other drugs will affect Xanax?

Taking this medicine with other drugs that make you sleepy or slow your breathing can cause dangerous side effects or death. Ask your doctor before taking a sleeping pill, narcotic pain medicine, prescription cough medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Tell your doctor about all your current medications and any you start or stop using, especially:

cimetidine;

digoxin;

fluvoxamine;

nefazodon;

ritonavir or other medicines to treat HIV or AIDS; or

Antifungal medicine - fluconazole, voriconazole.

This list is not complete. Other drugs may interact with alprazolam, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

Your pharmacist can provide more information about Xanax.

Video about Xanax

Prohibited during pregnancy

Prohibited while breastfeeding

Forbidden to children

Has restrictions for the elderly

Has limitations for liver problems

Has limitations for kidney problems

Xanax is a drug that causes a depressant effect on the central nervous system, in other words, reduces its activity. It is taken by people suffering from anxiety disorders, as it has a calming effect. Xanax belongs to the group of anxiolytic drugs, which are most often used off-label - to obtain the effect of euphoria.

General information about the drug

Xanax is a psychoactive drug. This drug is poorly combined with other antidepressants of the central nervous system, such combinations can lead to negative consequences, up to the death of the patient.

Drug group, INN, scope

INN Xanax - Alprazolam. Xanax is a drug that belongs to triazolo-benzodiazepine derivatives and has an effect on the central nervous system, namely, a dose-dependent inhibitory effect, carried out by binding to stereospecific receptors.

The scope of this medication includes the treatment of alcohol withdrawal syndrome, panic disorders, neuroses and other conditions.

Dosage forms and prices in pharmacies in Russia

The drug is available in several dosages and only in the form of tablets. The table shows the average prices for the drug, depending on the content of the active ingredient.

Compound

The composition of one tablet of Xanax includes alprazolam pilyule_nervi-245 (0.25-1 mg). Alprazolam is an anti-anxiety drug (anxiolytic) and is a benzodiazepine derivative. Also, the composition of this drug includes the following excipients:

microcrystalline cellulose;
lactose;
starch;
sodium docusate + sodium benzoate;
colloidal silicon dioxide;
magnesium stearate.

Pharmacodynamics and pharmacokinetics

Xanax has anticonvulsant, muscle relaxant (capable of reducing muscle tone and reducing physical activity) and anxiolytic (reducing or completely suppressing the phenomena of fear, emotional stress and anxiety) actions. Its effect on the central nervous system is due to the excitation of benzodiazepine receptors, with the assistance of GABA liberation and its participation in synaptic transmission.

The drug is characterized by rapid absorption. The maximum concentration of alprazolam in the blood is reached 1-2 hours after administration. Its ability to pass through the placenta, the blood-brain barrier, and be excreted into breast milk has been revealed.

Alprazolam is metabolized in the liver to inactive or inactive metabolites. Its half-life is 11.2 hours on average. With metabolites, it is excreted mainly in the urine. That is, excretion is mainly carried out by the kidneys in the form of compounds with glucuronic acid.

However, the absorption, metabolism and excretion of benzodiazepines may vary in relation to the influence of various factors, such as age, alcoholism, obesity, pathological changes in the liver and kidneys. For example, in the elderly, an increase in the half-life of alprazolam was observed. The same phenomenon was observed in obese people.

In patients with liver pathology of alcoholic origin, the half-life ranged from 9.9 to 40.4 hours, while in healthy patients this figure varies from 6.3 to 26.9 hours. There was also a decrease in the concentration of alprozolam by 50% in smokers (relative to non-smokers).

Studies conducted in vivo have shown that some compounds, namely substances that are inhibitors of the CYP3A isoenzyme (erythromycin, itraconazole, ketoconazole, fluvoxamine, nefazodone), increase the concentration of alprazolam in blood plasma.

Analogues of Xanax

If it is necessary to choose a replacement for Xanax, you can turn to therapy with the drugs named in the table.

Indications and contraindications

Indications for the use of Xanax are:

anxiety disorders;
neurosis, accompanied by a sense of anxiety, somatic disorders, sleep disorders;
panic states with or without phobic symptoms;
mixed anxiety-depressive and neurotic reactive-depressive states;
insomnia;
presence of senile or essential tremor.

Xanax is contraindicated in persons with hypersensitivity to benzodiazepines, patients with narrow-angle glaucoma (however, it can be used in patients with open-angle glaucoma), thyroid diseases.

Reception of the drug during pregnancy is limited, especially during the first trimester, since this drug has a teratogenic effect, that is, it can lead to a violation of embryonic development. Also during the reception it is necessary to stop breastfeeding.

This drug is not prescribed to persons under 18 years of age, since its safety and effectiveness in pediatric patients have not been proven. It should be added that Xanax is not used by people with psychotic depression, as in this case the drug will not be effective. It is contraindicated to use Xanax with Ketoconazole and Itraconazole.

Instructions for use

It should be noted that the appointment of doses must be carried out, focusing on the instructions for use and taking into account individual characteristics, making an adjustment for the condition of patients, their age, bad habits, and so on. For example, in patients with panic disorder, Xanax doses of 4 mg per day may not be enough. In this case, an individual dose adjustment of the drug is carried out.

Patients who have not previously taken psychotropic drugs need smaller doses to achieve the desired therapeutic effect. Also, the dose of Xanax is reduced for debilitated individuals and elderly patients. It is strongly recommended to regularly monitor the intake of the drug by specialists in order to assess the condition of patients and, if necessary, adjust the dose of the drug.

The rules for calculating the dosage are presented in the table.

For elderly patients, debilitated patients or persons with liver pathology, it is necessary to adhere to the following initial dose - 0.25 mg 2-3 times a day. If necessary and a satisfactory response of the patient to the drug, a gradual increase in dose is possible.

When the drug is stopped, it is necessary, given the possible risk of developing withdrawal symptoms, to gradually reduce the dose of Xanax, and not abruptly stop taking the drug. Dose reduction occurs according to the scheme - no more than 0.5 mg every 3 days.

If we talk about anxiety, depressive disorders, the duration of treatment can be up to 6 months. And during the treatment of panic disorders, the course, if necessary, increases to 8 months.

Before the individual reaction of the patient to the drug is revealed, it is necessary to exclude such activities as: driving a car, working with various equipment, etc. That is, exclude those areas in which it is necessary to maintain a high level of concentration and psychomotor reaction, since such activities may pose a danger to the patient taking Xanax, or others.

Side effects and overdose when taking Xanax

The following possible side effects of Xanax have been noted:

episodes of irritability and hostility;
slurred speech;
cephalgia;
dizziness;
intrusive thoughts;
sleep disturbance;
depression;
dysmenorrhea;
change in body weight;
visual impairment.

Perhaps the development of addiction in the case of prolonged use of the drug, but most often addiction develops against the background of alcoholism, drug addiction or substance abuse. With a sharp withdrawal of the drug, withdrawal symptoms may occur.

With an overdose of Xanax, the following symptoms are possible:

drowsiness;
lack of coordination;
decreased reflexes;
impaired consciousness up to coma.

If a large dose of alprazolam enters the body, a fatal outcome is likely. Also, a fatal outcome is possible in persons with an overdose of alprazolam who take alcohol during therapy with this drug.