Summary

XANAX Pfizer
Alprazolam

Use:
Anxiolytic de Benzodiazepine. Disorders of anxiety: Adults, initially, 0,25 magnesium 2 or 3 daily times. Increase the metering in 0.25 increase of magnesium, if he is required. Maximum: 3 mg/day in divided doses.

Old or debilitated to patients: Initially, 0,125 magnesium 2 or 3 daily times; increased gradually, if it is required, depending on tolerance and answer.

Deteriorated hepática or renal function: 0.125-0.25 magnesium 2 or 3times daily. Increase gradually if necessary and it is tolerated.

Disorders of the panic: Initially, 0,5 - 1 3 magnesium in bedtime or 0,5 magnesium times/day. Each 3-4 increases in increases nongreater than 1 magnesium days until the patient is free of attacks.

Some patients can require up to 10 mg/day. Slowly continue alprazolam diminishing the daily metering by not more than 0,5 magnesium every 3 days. A diminution of 0,5 each 2-3 weeks of magnesium is more appropriate when a dose of magnesium 6 newspaper or has not been administered more even by only some months. Once a dose of the newspaper of magnesium 2 is reached, the dose by 0,25 magnesium by 2 to 3 weeks diminishes.

Contraindications:
Gravis de Myasthenia, glaucoma narrow acute of the angle.

Precautions:
Not recommended in embarrassed women, mothers of care, patients < 18 years of age, psychotic or depressed patients, individuals prone to drug or alcohol abuse. Use with caution in elderly or debilitated patients and those with impaired renal or hepatic function. Avoid abrupt withdrawal of alprazolam. For repeated cycles of therapy, perform periodic blood counts and hepatic function tests.

Indirect effect:
Somnolencia, vertigos, difficulties of the coordination. The launching of the hostility and other paradoxical effects such as irritability and hallucinations can happen with benzodiazepines.

Interactions:
the Co-administration with the agents antifungi such as ketoconazole or itraconazole is not recommended. Nafazodone, fluvoxamine, cimetidine (it considers the reduction of the dose of Xanax). Fluoxetine, OCs, sertraline, diltiazem, antibiotics of macrolide (precaution of the exercise).

Extremities of the patient:
Warn against the concomitante use of the alcohol and other depressing ones of the CNS. Notice re the vertigos, somnolencia (NOTE that leads).

Provided:
0,25 magnesium, 0,5 magnesium of magnesium 1, 2 tablets of magnesium.

to the cover

Pharmacology

Anxiolytic - Antipanic

Alprazolam, an analog of benzodiazepine of triazolo 1,4, ties with high affinity to the complex of the receiver of benzodiazepine of GABA. The considerable evidence suggests them central actions of pharmacologic/therapeutic of alprazolam are half-full via the interaction with this complex of the receiver.

Oral administered him the 1 to 2 hours is absorbed easily in man with maximum concentrations of the plasma that happen that they follow the administration. The average range of the life is 6 to 20 hours that follow the single administration of the dose. With the multiple doses, given 3 daily times, the constant state is reached in the term of 7 days. Alprazolam and his metabolites are excreted mainly in tinkles it. The degradation happens mainly by the oxidation that renders metabolites primary and secondary that is active and appears to have periods similar to alprazolam but he is present in only the low levels in the plasma. Alprazolam is limit of the protein of 80%.

Magnetocardiograma of Alprazolam 500 (0,5 magnesium), administered 3 by a day by 14 days, did not affect times of the prothrombin or the levels of warfarin of the plasma in man voluntarily offer warfarin administered of oral sodium.

to the cover

Indications

For the management of the anxiety disorders or the short term symptomatic relevación of symptoms of the excessive anxiety. The anxiety or the tension associated to the tension of the daily life does not require generally the treatment with anxiolytic.

Alprazolam is indicated for the treatment of the generalized disorder of anxiety (GAD) and also is indicated for the management of the disorder of the panic with or without agoraphobia.

to the cover

Contraindications

Hipersensibilidad to alprazolam or others benzodiazepines. Alprazolam is also contraindicated in pregnancy, infants and patients with gravis of myasthenia and glaucoma narrow acute of the angle.

to the cover

Warnings

Alprazolam is not recommended for the use in the patients who primary diagnosis is psychosis or depression.

Occupational Dangers:
Like with other sedative drugs of the CNS, the patients must be noticed against the activities that require the mental monitoring, judgment and the physical coordination as machinery that lead or of operation, particularly in the early phases of the treatment and until the appropriate adjustment to the indirect effect has settled down. The alcohol and benzodiazepines must never be mixed when leading due to the unforseeable sedative effects of the CNS of this combination.

Pregnancy:
The security in pregnancy has not settled down, therefore its use is not recommended. The studies have suggested an increasing risk of the congenital malformations associated to the use of benzodiazepines, such as chlordiazepoxide, they diazepan, and also meprobamate, during the first trimester of the pregnancy. Since alprazolam is a derivative of benzodiazepine, its administration justifies itself rarely in women of the potential of the maternity. If the drug prescribes a woman of the potential of the bearing of the boy to it must to him notice that it consults to his doctor with respect to the discontinuación of the drug if it preputs itself to become or suspects that it is embarrassed.

Lactancia:
The studies in rats have indicated that alprazolam and his metabolites are secretados in milk. Therefore, the care does not have to be undertaken whereas a patient is receiving the drug.

The security and the effectiveness of alprazolam in patients under age of 18 years have not settled down.

to the cover

Precautions

Old and debilitated to patients, or has found those with organic syndrome of the brain, to be prone to the sedative activity of the CNS of benzodiazepines even after low doses. The manifestations include ataxia, oversedation and the hypotension. Therefore, the medication is due to administer with the precaution to these patients, particularly if a drop in the arterial pressure could lead to the complications cardiac. The initial doses must be low and the increases are due to do gradually, depending on the answer of the patient, to avoid oversedation, the neurological weakening and other possible adverse reactions.

Alprazolam is not due to administer to the individuals prone to the abuse of the drug. The precaution is due to observe in all the patients who consider themselves to have potential for the psicologica dependency. The symptoms of the retirement have been observed after the discontinuación hasty of benzodiazepines. These include the abdominal irritability, nervousness, insomnia, agitation, tremors, convulsions, diarrea, cramps, to vomit and the mental weakening. Since these symptoms can be similar to for which they are treating the patient, it can appear that it has undergone a relapse on the discontinuación. Alprazolam is suggested is retired gradually if they suspect to the individual to get to be employee, perhaps or the drug has been used in high prolonged doses.

The suicidal tendencies can be present in patients with emotional disorders, particularly when they are pressed and those protective measures and appropriate treatment can be necessary and they are due to institute without delays.

Alprazolam is not due to use in the suspected patients to have sicopáticas tendencies since the enthusiasm and other paradoxical reactions can be from the anxiolytic-sedative use in these patients. Like with others benzodiazepines, alprazolam is not due to use in individuals with the physiological anxiety or the normal tension of the newspaper that only lives but in the presence of manifestations that disqualify of an appropriate disorder of pathological anxiety.

These drugs are not effective in patients with disorders characterological and of the personality or those with obsessive obligatory disorders. Alprazolam is not recommended for the management of depressive or sicopáticos disorders.

If the treatment is necessary in patients with deteriorated the hepática or renal function, the therapy is due to initiate in increasing a very low dose and the metering until the point of is only compatible with the degree of the residual function of these organs.

If alprazolam is administered for the repeated cycles of the therapy, the periodic tests of the accounts of blood and the hepática function are recommendable.

Since benzodiazepines can once in a while exacerbar magnificent graspings of badly, the precaution is required when it is used in epilépticos patients and an adjustment can be necessary in its anticonvulsive medication. The retirement hasty of alprazolam must be avoided.

Benzodiazepines can reciprocally reinforce or build with effects of other temporarias drugs of the CNS such as alcohol, narcotic, barbiturates, hypnosis of nonbarbiturate, antihistamine, phenothiazines, butyrophenones, inhibitors of MAO, tricyclic and anticonvulsive antidepressants. Therefore, if alprazolam is going away to be combined with other drugs that act in the CNS, the careful consideration is due to give to the pharmacology of the agent implied due to the possible effects of the added one or reinforcement. Adviertese to the patients must also be advised against the simultaneous use of other sedative drugs of the CNS and must that does not take the alcohol during the administration from alprazolam.

to the cover

Injurious Effects

Disclosed more frequently possible they are the somnolencia, difficulties of the coordination with vertigos. The launching of the hostility and other paradoxical effects such as irritability, the excitabilidad and the hallucinations are known to happen with the use of benzodiazepines. Other indirect effect disclosed, enumerated less frequently by the systems of the body, include the following one:

Neurological:
The guarded vision, headache, graspings, slurred the speech, difficulty in the depth opinion.

Psychiatric:
Agitation, mental disorder, depression, irritability, nervousness, disturbances of the dream, euphoria, lethargy, stupor.

Gastrointestinal:
Dry mouth, gastrointestinales nausea, nonspecific disturbances, vomiting.

Musculoskeletal:
Espasmo of the muscle, weakness of the muscle.

Cardiovascular:
Hipotensión, palpitaciones, tachycardia.

Dermatological:
Prurito, eruption.

Genitourinario:
Incontinence, change in libido.

Hematologic:
Diminished of the hemoglobina and hematocrit, flood and diminished WBC.

Hepático:
Elevations of phosphatase alkaline, bilirubin, AST (SGOT), ALT (SGPT).

Misceláneo:
Blood increasing and diminished sugar levels.

to the cover

Overdose

Symptoms:
Showed like extension of the activity pharmacologic of alprazolam. The degrees that vary of sedative effects of the CNS such as somnolencia and hypnosis can happen. Other manifestations can include the weakness of the muscle, ataxia, disartria and particularly in the paradoxical enthusiasm of the children. In more severe cases it diminished the reflections, confusion and the coma can happen. An overdose must be remembered when treating that the multiple agents could be ingested. The fatalities with benzodiazepines happen rarely unless when other aggravating drugs, alcohol or factors are implied.

Treatment:
Vomiting can be induced if the patient is completely wide-awake. The vital samples must be supervised and the measures of general support are due to use according to the indicated thing. The gastric washing is due to institute as soon as possible. The I.V. liquids can be administered and an suitable aerial route must be maintained.

The animal experiments have indicated that the collapse to cardiopulmonar can happen with the massive doses of i.v. of alprazolam. This could be invested with positive the mechanical breathing and the infusion of i.v. of levarterenol.

The related experiences with animals with alprazolam and compounds have suggested it hemodialisis and the forced diuresis is probably of little value.

to the cover

Metering

It must be individualized and to be titled carefully to avoid the excessive sedación or the mental weakening and of the motor. Like with other anxiolytic-sedative, the short courses of the treatment must be the rule for the symptomatic relevación of the excessive anxiety and the course of the initial treatment does not have to last more of length of 1 week without the new valuation. In case of necessity, the metering of the drug can be fit after 1 week. The prescriptions are due to limit the short courses of the therapy.

Adults:
Initially:
0,25 magnesium (250 magnetocardiograma) daily dice of 2 or 3 times. If they are required, the increases can be done in 0.25 increase of magnesium (magnetocardiograma 250) according to the severity of symptoms and of the patient answer. It is recommended that the dose of afternoon is increased before the doses of the day. The very severe manifestations of the anxiety can daily require greater doses of the initial. The optimal metering is one that allows symptomatic control of the excessive anxiety without the weakening of the mental function and the motor. Exceptionally, it can be necessary to increase to the metering to a maximum of magnesium 3 newspaper, dice in divided doses.

Old and patient of Debilitated:
The initial metering is 0,125 magnesium (125 magnetocardiograma) 2 or 3 daily times. In case of necessity, this metering can be increased depending on patient tolerance and answer gradually.

to the cover

Provided

Xanax:
0,25 magnesium:
Each white tablet, ovoid-formed written down, "based Upjohn 29," contain: Alprazolam 0,25 magnesium (magnetocardiograma 250). Gluten-free. Bottles of 100 and 1000.

0,5 magnesium:
Each one written down, peach, ovoid-formed the tablet, "based Upjohn 55," contain: Alprazolam 0,5 magnesium (magnetocardiograma 500). Gluten-free. Bottles of 100 and 1000.

1 magnesium:
Each one written down, lavanda, ovoid-formed the tablet, "based Upjohn 90" contains: Alprazolam 1 magnesium (magnetocardiograma 1000). Gluten-free. Bottles of 100.

TS Of Xanax:
magnesium 2:
Each target, triscored the tablet (3 accounts), with number "2" in a side and Xanax in the other side contains: Magnesium of Alprazolam 2. The tablets can be broken in 4 equal portions of 0,5 magnesium. Bottles of 100.

to the cover

Investigation

The information of the investigation is available separately in mental health of the Internet.