- 1 Important to know about Xanax (Alprazolam) Tablets ?
- 2 Xanax (Alprazolam) Tablets indication and Uses
- 3 Xanax (Alprazolam) Tablets Dosage
- 4 Xanax (Alprazolam) Tablets Side Effects
- 5 Xanax (Alprazolam) Tablets Interactions
- 6 Xanax (Alprazolam) Tablets Warnings and Precautions
- 7 Xanax (Alprazolam) Tablets and Pregnancy/ Breastfeeding
- 8 What should I do if I miss a dose?
- 9 What happens if I overdose from Xanax (Alprazolam) Tablets ?
Important to know about Xanax (Alprazolam) Tablets ?
Alprazolam works soothing , reduces anxiety, relaxes muscles and makes you drowsy.
With anxiety and tension, including panic disorder or social phobia .
Within a few hours after intake , you will become calmer. This lasts from 8 to 12 hours. A delayed release tablet can continue for up to 24 hours.
Do not use for longer than a few weeks in case of anxiety. In social phobia or panic disorder, you often have to use it for six months or a year.
If you use alprazolam daily, you can become dependent on it. It is then difficult to stop using it. Are you using it for more than a few weeks in a row? Do not stop at once. Build slowly in consultation with your doctor or pharmacist.
You may become drowsy, drowsy or tired and your responsiveness decreases. Do you use alprazolam every day? You may not drive. Do you use it occasionally? Then you may not drive for 3 days (72 hours) after each intake .
Watch out with alcohol. This can still make you suffer.
Other side effects: weak muscles, reduced coordination and memory problems. You can fall sooner.
Xanax (Alprazolam) Tablets indication and Uses
- Symptomatic treatment of severe and / or disabling anxiety disorders.
- Prevention and treatment of delirium tremens and other manifestations of alcohol withdrawal.
Xanax (Alprazolam) Tablets Dosage
Reserved for adults.
The dosage of 0.25 mg is more particularly adapted to the elderly, to the renal or hepatic insufficiency.
In all cases, treatment will be initiated at the lowest effective dose and the maximum dose of 4 mg / day will not be exceeded.
In general, in adults, treatment will be started at the dosage of 0.75 mg to 1 mg per day, divided into 3 doses as follows:
- 0.25 mg in the morning and at noon and 0.25 mg to 0.50 mg in the evening.
- The dosage will then be individually adapted according to the therapeutic response.
- The average dosage is between 1 and 2 mg per day.
- In the elderly, the renal or hepatic insufficiency : it is recommended to reduce the dosage, half for example.
- The safety and efficacy of alprazolam have not been studied in children and adolescents under 18 years of age. Its use is not recommended in this population.
The treatment should be as short as possible. The indication will be reviewed regularly especially in the absence of symptoms. The overall duration of treatment should not exceed 8 to 12 weeksfor the majority of patients, including the dose reduction period (see Warnings and Precautions section ).
In some cases, it may be necessary to prolong the treatment beyond the recommended periods. This requires accurate and repeated assessments of the patient’s condition.
Prevention and treatment of delirium tremens, and other manifestations of alcohol withdrawal : short treatment of the order of 8 to 10 days.
Xanax (Alprazolam) Tablets Side Effects
In addition to the desired effect, this medicine can cause side effects.
The main side effects are the following.
Regularly (with more than 30 in 100 people) , especially the first weeks of use
Drowsiness, fatigue and, less often, drowsiness . As a result, your reaction and concentration capacity is reduced, giving you a great chance of accidents. Accidents can occur, for example, in traffic, when climbing a ladder, operating devices or during monitoring and control work. But you also have a better chance of falling if you have to get out of bed at night to go to the toilet.
Rarely (between 1 and 10 out of 100 people), especially the first weeks of use
Reduced coordination . This allows you to be awkward in your movements and have difficulty speaking (articulating).
Muscle weakness and numbness in muscles .
This side effect may cause the following other symptoms.
Blurred vision or double vision due to a temporary effect on the eye muscles.
Incontinence for urine or difficult to urinate. These side effects are caused by insufficient control of the bladder muscle.
Snoring by slacking the uvula. Did you ever suffer during your sleep that your breath will stop for a short time ( sleep apnea )?
You can get more problems with this medicine.
Contact your doctor if you notice.
Fallespecially because this medication also reduces coordination. Especially the elderly and people with muscle diseases have a chance.
People with myasthenia gravis (a serious muscle disease) may suffer more from this disease. Consult your doctor if the symptoms are worsening (such as general muscle weakness, double vision, close eyelids, trouble swallowing, chewing or breathing).
Slower thinking , memory problems, more difficult to concentrate, less alert and confusion. These complaints can increase if you take this medication for a longer period of time.
Decrease feelings. This means not only reduces emotions such as anxiety and tension, but also positive, such as happiness and satisfaction.
You can also reduce your involvement and empathy in others.
Rarely (from 1 to 10 in 100 people)
Gastrointestinal disorders , such as nausea, constipation and diarrhea, dry mouth or extra saliva formation, and problems with swallowing, and altered appetite, namely more or less appetite.
This also changes the body weight.
Headache and dizziness. These side effects usually disappear after some time if you have become accustomed to the medicine.
Sweating and palpitations .
Dry eyes. Especially people with contact lenses can suffer from dry eyes.
Skin rash and itching .
Usually this is innocent , but (very rarely) the symptoms can be serious. Consult your doctor if the rash looks unusual, if you suffer from it, or if you also get a fever or blister.
You may experience withdrawal symptoms if you stop using it.
With short-term use, the chance of this is very small.
People who use this medication for more than two months at a time have a big chance.
You should therefore always phase out gradually if you have used this medicine for more than two months.
Very rare (affects less than 1 in 100 people)
Lively dreams or nightmares, usually in the early morning.
Unrest and irritability . So opposite symptoms than you would expect from this medicine.
It is also possible to avoid delusions and hallucinations . Especially children and the elderly are sensitive to these side effects.
Consult the doctor for these symptoms. A lower dose or other agent may be required.
Memory loss of events that take place during use of this medication. For example, events in the night.
Depressed feelings can come to light.
Less sense of sex .
Consult your doctor if you suffer too much from any of the above mentioned side effects or if you experience other side effects that you are worried about.
Xanax (Alprazolam) Tablets Interactions
Associations advised against
- Alcohol enhancement of the sedative effect of benzodiazepines and the like. Altered alertness can make driving dangerous and the use of machinery dangerous.
- Avoid taking alcoholic drinks and drugs containing alcohol.
Associations to consider
Other central nervous system depressants:
- Morphine derivatives (analgesics, antitussives and substitution treatments other than buprenorphine); neuroleptics including clozapine; barbiturates; other anxiolytics; hypnotics; sedative antidepressants; sedative antihistamines H1; central antihypertensives; baclofen; thalidomide; pizotifene.
- Increase of the central depression. Altered alertness can make driving dangerous and the use of machinery dangerous.
- In addition, for morphine derivatives (analgesics, antitussives and substitution treatments), barbiturates: increased risk of respiratory depression, especially present in the elderly, which can be fatal in case of overdose.
- Increased risk of collapse with respiratory and / or cardiac arrest.
- With buprenorphine used in substitution therapy: increased risk of respiratory depression, which can be fatal.
- Carefully evaluate the benefit / risk ratio of this combination. Inform the patient of the need to respect the prescribed doses.
Xanax (Alprazolam) Tablets Warnings and Precautions
This medicine contains lactose. Its use is not recommended in patients with intolerance to galactose, a deficiency of lapp lactase or a syndrome of glucose or galactose malabsorption (rare hereditary diseases).
The anxiolytic effect of benzodiazepines and related substances may decrease gradually despite the use of the same dose when administered for several weeks.
Any treatment with benzodiazepines and related drugs, especially with prolonged use, may result in a state of physical and mental dependence.
Various factors seem to favor the occurrence of dependence:
- Duration of treatment,
- History of other drug addictions, including alcoholic.
Drug dependence may occur at therapeutic doses and / or in patients without individualized risk factors.
In case of physical dependence, a sudden cessation of treatment may lead to withdrawal symptoms. These symptoms may be: insomnia, headache, myalgia, significant anxiety, nervous tension, impatience, confusion, irritability.
In severe cases, the following symptoms may occur: derealization, depersonalization, hyperacusis, numbness and tingling of the extremities, hypersensitivity to light, noise and physical contact, hallucinations, epileptic seizures.
Withdrawal symptoms may occur within days of stopping treatment. For short-acting benzodiazepines, and especially if given at high doses, symptoms may even occur in the interval between two doses.
The combination of several benzodiazepines, regardless of the anxiolytic or hypnotic indication, may increase the risk of drug dependence.
The risk of withdrawal is greater when the drug is stopped abruptly, it is recommended to gradually reduce the daily dose (see section Warnings and precautions for use , precautions for use, Duration and methods of stopping progressive treatment).
Cases of abuse have been reported.
REBOUND OF ANXIETY:
This transient syndrome, whose symptoms initially motivated treatment with benzodiazepines, can be exacerbated when treatment is stopped.
This syndrome can be accompanied by other reactions including mood changes, anxiety and sleep disorders and impatience.
As the risk of a rebound phenomenon is greater when stopping the drug is abrupt, it is recommended to gradually reduce the daily dose (see Warnings and precautions for use , precautions for use, Duration and stopping conditions). progressive treatment).
AMNESIA AND ALTERATIONS OF PSYCHOMOTIC FUNCTIONS:
Anterograde amnesia and alterations of the psychomotor functions are likely to appear in the hours following the taking.
PSYCHIATRIC AND PARADOXAL REACTIONS:
In some subjects, benzodiazepines and related products may result in a syndrome associating to varying degrees an impairment of consciousness and behavioral and memory disorders:
Can be observed:
- Worsening of insomnia, nightmares, agitation, nervousness;
- Delusions, anger, hallucinations, confuso-oniric state, psychotic symptoms;
- Disinhibition with impulsivity;
- Euphoria, irritability, aggressiveness;
- Anterograde amnesia;
This syndrome may be accompanied by potentially dangerous disorders for the patient or for others, such as:
- Unusual behavior for the patient;
- Self- or hetero-aggressive behavior, especially if the family is trying to interfere with the patient’s activity;
- Automatic driving with post-event amnesia.
These events require the cessation of treatment.
These behavioral disorders may occur more in children and elderly patients.
RISK OF ACCUMULATION:
- Benzodiazepines and related drugs (like all drugs) persist in the body for a period of about 5 half-lives (see section Pharmacokinetic properties ).
- In the elderly or with renal or hepatic insufficiency, the half-life may be considerably longer. When taken repeatedly, the drug or its metabolites reach the equilibrium plateau much later and at a much higher level. It is only after obtaining a balance plateau that it is possible to evaluate both the efficacy and the safety of the drug.
- Dosage adjustment may be necessary (see section Dosage and method of administration ).
- Benzodiazepines and related products should be used with caution in the elderly, because of the risk of sedation and / or myorelaxant effect that may lead to falls, with often severe consequences in this population.
- It is recommended to use the lowest effective dose in the elderly and / or the weakened subject to avoid the occurrence of excessive ataxia or sedation (see section Dosage and method of administration ).
Precautions for use:
- Great caution is advised in case of a history of alcoholism or other addictions, drug or not (see section Interactions with other drugs and other forms of interaction ).
AT THE SUBJECT HAVING A MAJOR DEPRESSIVE EPISODE:
Benzodiazepines and related drugs should not be used alone to treat depression because they cause or increase the risk of suicide.
Thus, alprazolam should be used with caution and its prescription should be framed in patients with signs and symptoms of depressive disorder or suicidal tendencies.
DURATION AND PROCEDURES FOR PROGRESSIVE STOPPING OF TREATMENT (see section Dosage and method of administration ):
- The treatment should be as short as possible.
- At the beginning of treatment, it may be useful to inform the patient that the duration of treatment will be limited.
- The modalities of gradual cessation of treatment must be stated to the patient in a precise manner.
- In addition to the need for gradual decrease in doses, patients should be warned of the possibility of a rebound phenomenon, to minimize the anxiety that may arise from the symptoms related to this interruption, even progressive.
- The patient must be warned of the possibly uncomfortable nature of this phase.
- With prolonged use of long-acting benzodiazepines, it is important to warn against switching to a short-acting benzodiazepine, with withdrawal symptoms likely to occur.
SUBJECT AGE, INSUFFICIENT RENAL, INSUFFICIENT HEPATIC:
- Benzodiazepines and related products should be used with caution in patients with renal impairment or mild to moderate hepatic impairment.
- The risk of accumulation leads to a reduction in the dosage, for example by half (see section Dosage and method of administration ).
In patients with respiratory insufficiency, the depressant effect of benzodiazepines and related substances should be taken into account (especially since anxiety and agitation may be signs of a call for a decompensation of the respiratory function which justifies the transition to intensive care unit).
CHILDREN AND ADOLESCENTS:
The safety and efficacy of alprazolam have not been studied in children and adolescents under 18 years of age. Its use is not recommended in this population.
Xanax (Alprazolam) Tablets and Pregnancy/ Breastfeeding
Xanax (Alprazolam) Tablets and Pregnancy :
Many data from cohort studies have not revealed the occurrence of malformative effects during benzodiazepine exposure during the course of 1 first trimester of pregnancy.
However, in some case-control epidemiological studies, an increase in the occurrence of cleft lip and palate has been observed with benzodiazepines.
According to these data, the incidence of cleft lip and palate in newborns would be less than 2/1000 after exposure to benzodiazepines during pregnancy while the expected rate in the general population is 1/1000.
If benzodiazepines are taken in high doses at 2 nd and / or 3 rd trimesters of pregnancy, a decrease in fetal active movements and a variability in fetal heart rate have been described.
Treatment with benzodiazepines at the end of pregnancy, even at low doses, may be responsible in the newborn for signs of impregnation such as axial hypotonia, sucking disorders resulting in low weight gain. These signs are reversible, but can last 1-3 weeks depending on the half-life of the prescribed benzodiazepine.
At high doses, respiratory depression or apnea, and hypothermia may occur in the newborn.
In addition, a neonatal withdrawal syndrome is possible, even in the absence of signs of impregnation.
It is characterized in particular by hyperexcitability, agitation and tremulations of the newborn occurring at a distance from the delivery.
The time of onset depends on the elimination half-life of the drug and may be important when it is long.
Based on these data, as a precautionary measure, the use of alprazolam is not recommended during pregnancy, regardless of the term.
When prescribing alprazolam to a woman of childbearing age, she should be advised of the need to contact her doctor if pregnancy is planned or started to re-assess the benefit of the treatment.
At the end of pregnancy, if it is really necessary to start a treatment with alprazolam, avoid prescribing high doses and take into account, for surveillance of the newborn, effects previously described.
Xanax (Alprazolam) Tablets and Breastfeeding:
Alprazolam is excreted in breast milk at low concentrations. However, the use of this medicine during breastfeeding is not recommended.
What should I do if I miss a dose?
- It is not harmful if you miss a dose . But if you have been using the medicine for several weeks, you have become accustomed to it and you can experience withdrawal symptoms with the forgotten tablet.
- Are you used to swallowing a tablet 2 or 3 times a day , and have you forgotten one? Never take a double dose . You can, however, overtake the tablet if you take the next tablet at least 3 hours later.
- If you take this medicine once a day : does it take more than 8 hours before you take the next dose normally? Take the forgotten dose as yet. Does it take less than 8 hours? Skip the forgotten dose .
What happens if I overdose from Xanax (Alprazolam) Tablets ?
Life-threatening may be at risk, especially in cases of polyintoxication involving other central nervous system depressants (including alcohol).
It is important to keep in mind that polypharmacy may be responsible for overdose.
In cases of massive intakes, signs of overdose are mainly manifested by CNS depression ranging from somnolence to coma, depending on the amount ingested.
Mild cases manifest as drowsiness, signs of mental confusion, lethargy.
More serious cases include ataxia, hypotonia, hypotension, respiratory depression, rarely coma and very rarely death.
In case of oral overdose prior to 1 hour, induction of vomiting will be practiced if the patient is conscious or, failing that, a gastric lavage with protection of the airways. After this period, the administration of activated charcoal can reduce the absorption.
Special monitoring of cardio-respiratory functions in a specialized environment is recommended.
The administration of flumazenil may be useful for the diagnosis and / or treatment of intentional or accidental benzodiazepine overdose.
Flumazenil antagonism of the effect of benzodiazepines may promote the development of neurological disorders (convulsions), particularly in epileptic patients.
Edrug-online contains comprehensive and detailed information about drugs available in the medical field, and is divided into four sections:
- Includes a general description of the drug, its use, brand names, FAQs, and relevant news and articles
- General explanation about dealing with the medicine: how to take the medicine, the doses and times of it, the start and duration of its effectiveness, the recommended diet during the period of taking the medicine, the method of storage and storage, recommendations in cases for forgetting the dose and instructions to stop taking the drug and take additional doses.
- For pregnant and breastfeeding women, the elderly, boys and drivers, and use before surgery.
- It treats possible side effects and drug interactions that require attention and its effect on continuous use.
- The information contained in this medicine is based on medical literature, but it is not a substitute for consulting a doctor.
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