Drug
Alprazolam
Pronounced
"al-PRA-zoe-lam"
Drug Interactions
See also Warning section.
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
Some products that may interact with this drug include: kava, sodium oxybate.
Other medications can affect the removal of alprazolam from your body, which may affect how alprazolam works. Examples include adagrasib, azole antifungals (such as itraconazole, ketoconazole), cimetidine, certain anti-depressants (such as fluoxetine, fluvoxamine, nefazodone), protease inhibitors (such as indinavir), macrolide antibiotics (such as erythromycin), rifamycins (such as rifabutin), St. John's wort, drugs used to treat seizures (such as phenytoin), among others.
The risk of serious side effects (such as slow/shallow breathing, severe drowsiness/dizziness) may be increased if this medication is taken with other products that may also cause drowsiness or breathing problems. Tell your doctor or pharmacist if you are taking other products such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), other drugs for sleep or anxiety (such as diazepam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).
Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.
Cigarette smoking decreases blood levels of this medication. Tell your doctor if you smoke or if you have recently stopped smoking.
Negative Interactions
2- Potential Negative Interaction
Alprazolam
Kava
Kava (Piper methysticum) is an herb used to treat anxiety disorder. One individual who took alprazolam and kava together, along with two other medications (cimetidine and terazosin) was hospitalized in a lethargic and disoriented condition. Further research is needed to determine whether the combination of kava and alprazolam produces an adverse interaction. However, individuals should not take alprazolam and kava together unless supervised by a doctor.
KavaAlprazolam- Almeida JC, Grimsley EW. Coma from the health food store: Interaction between kava and alprazolam. Arch Intern Med 1996;125:940-1.
- Potential Negative Interaction
Alprazolam
St. John’s Wort
St. John's wort increases the activity of an enzyme in the body that metabolizes alprazolam. Consequently, supplementation with St. John's wort may increase the metabolism of, and therefore reduce the activity of, alprazolam.St. John’s WortAlprazolam- Roby CA, Anderson GD, Kantor E, et al. St John's Wort: effect on CYP3A4 activity. Clin Pharmacol Ther 2000;67:451-7.
Supportive Interactions
1- Support Medicine
Alprazolam
Vinpocetine
In a preliminary trial, an extract of periwinkle called vinpocetine was shown to produce minor improvements in short-term memory among people taking flunitrazepam, a benzodiazepine. Further study is needed to determine if vinpocetine would be a helpful adjunct to use of benzodiazepines, or alprazolam specifically.
VinpocetineAlprazolam- Bhatti JZ, Hindmarch I. Vinpocetine effects on cognitive impairments produced by flunitrazepam. Int Clin Psychopharmacol 1987;2:325-31.