Indications
Alprax Tablet is used for:
Anxiety disorders, Panic disorders, Nausea due to chemotherapy
Adult Dose
Oral
Short-term management of anxiety
Adult: 0.25-0.5 mg tid, increased to 3-4 mg daily if necessary.
Elderly: Initially, 0.25 mg bid/tid.
Panic attacks
Adult
Immediate-release
0.5 mg PO q8hr; may increase q3-4Days by ?1 mg/day
Average dose: 5-6 mg/day PO
May require up to 10 mg/day PO divided q8hr
Extended-release
0.5-1 mg PO qDay; may increase q3-4Days by <1 mg/day
Average dose: 3-6 mg PO qDay
Anxiety Associated With Depression
1-4 mg/day PO divided q8hr
Hepatic impairment: Avoid in severe impairment.
Child Dose
<18 years old: Not recommended
Renal Dose
Renal impairment: Use caution; not studied
Administration
Administration May be taken with or without food. Side effects eg sleepiness/drowsiness may be reduced if taken immediately after meals.
Contra Indications
Acute narrow-angle glaucoma, preexisting CNS depression or coma, resp depression, acute pulmonary insufficiency or sleep apnoea; severe hepatic impairment; pregnancy, lactation.
Precautions
Dosage reduction or gradual withdrawal. Dependence. Geriatric or debilitated patients. Muscle weakness, impaired hepatic or renal function; arteriosclerosis; obesity; depression particularly suicidal tendency; chronic pulmonary insufficiency. May impair ability to drive or operate machinery. Children <18 yr.
Lactation: Enters breast milk/not recommended
Pregnancy-Lactation
Pregnancy category: D
Lactation: Enters breast milk/not recommended
Minor tranquilizers should be avoided in first trimester of pregnancy due to increased risk of congenital malformations
Maternal use shortly before delivery is associated with floppy infant syndrome (good and consistent evidence)
Prenatal benzodiazepine exposure slightly increases oral cleft risk (limited or inconsistent evidence)
Interactions
Potentiates action of alcohol and CNS depressants. Reduced conc with cigarette smoking by 50%.
Potentially Fatal: Cimetidine and fluoxetine reduce the clearance of alprazolam. Alprazolam enhances activity of imipramine and desipramine.
Side Effects
Side effects of Alprazolam :
>10% (4 mg dose)
Drowsiness (41%), Depression (10-15%), Headache (10-15%), Constipation (10-15%), Diarrhea (10-15%), Dry mouth (10-15%)
>10% (10 mg dose)
Drowsiness (77%), Impaired coordination (40-50%), Increased appetite (30-35%), Fatigue (30-35%), Memory impairment (30-35%), Irritability (30-35%), Decreased salivation (30-35%), Cognitive disorders (20-30%), Insomnia (20-30%), Dcreased appetite (20-30%), Headache (20-30%), Lightheadedness (20-30%), Dysarthria (20-30%), Diarrhea, constipation, and nausea/vomiting (20-30%), Weight change (20-30%), Nasal congestion (15-20%), Decreased or increased libido (10-15%), Menstrual disorder (10-15%), Difficult micturition (10-15%)
1-10% (4 mg dose)
Tachycardia (5-10%), Confusion (5-10%), Insomnia (5-10%), Nausea/vomiting (5-10%), Blurred vision (5-10%), Nasal congestion (5-10%), Hypotension (1-5%), Syncope (1-5%), Akathisia (1-5%), Dizziness (1-5%), Increased salivation (1-5%), Nervousness (1-5%), Tremor (1-5%), Weight change (1-5%)
1-10% (10 mg dose)
Increased salivation (5-10%), Talkativeness (1-5%), Incontinence (1-5%)
Potentially Fatal: Blood dyscrasias.
Mode of Action
Alprazolam binds to stereospecific benzodiazepine receptors on the postsynaptic GABA neuron at several sites w/in the CNS, including the limbic system, reticular formation. Enhancement of the inhibitory effect of GABA on neuronal excitability results by increased neuronal membrane permeability to Cl ions, which results in hyperpolarisation (a less excitable state) and stabilisation. Benzodiazepine receptors and effects appear to be linked to the GABA-A receptors.
Note
Alprax 0.25mg Tablet generic name is Alprazolam. Alprax 0.25mg Tablet is manufactured by Opsonin Pharma LimitedAlprax is availble in all over Bangladesh.
Mes BD drug index information on Alprax Tablet is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.