Therapeutic Indications

Alprazolam is indicated for:

Moderate or severe anxiety, anxiety associated with depression

Irrespective of gender only Elderly (65 years old or older)

Alprazolam is indicated for the short-term treatment of moderate or severe anxiety states and anxiety associated with depression. It is only indicated when the disorder is severe, disabling or subjecting the individual to extreme distress.

Alprazolam should not be used to treat short-term mild anxiety, such as anxiety or tension associated with the stress of everyday life. As the efficacy of alprazolam in depression and in phobic or obsessional states has yet to be established, specific treatment may have to be considered.

For this indication, the medical literature mentions below treatments (click for details):

Treatment 1: Oral - 0.25 mg two to three times daily

Moderate or severe anxiety, anxiety associated with depression

Irrespective of gender only Adults (18 - 65 years old)

Alprazolam is indicated for the short-term treatment of moderate or severe anxiety states and anxiety associated with depression. It is only indicated when the disorder is severe, disabling or subjecting the individual to extreme distress.

Alprazolam should not be used to treat short-term mild anxiety, such as anxiety or tension associated with the stress of everyday life. As the efficacy of alprazolam in depression and in phobic or obsessional states has yet to be established, specific treatment may have to be considered.

For this indication, the medical literature mentions below treatments (click for details):

Treatment 1: Oral - 0.25-0.5 mg three times daily

Panic disorder with or without agoraphobia

Irrespective of gender only Adults (18 years old or older)

Alprazolam is indicated for panic disorder with or without agoraphobia.

For this indication, the medical literature mentions below treatments (click for details):

Treatment 1: Oral - 0.5-1 mg

Contraindications

Active ingredient Alprazolam is contraindicated in the following cases:

Alcohol

No gender/age discrimination

Concomitant intake with alcohol is not recommended.

Severe hepatic insufficiency

No gender/age discrimination

Alprazolam is contraindicated in patients with severe hepatic insufficiency.

Ketoconazole, itraconazole, other azole-type antifungals

No gender/age discrimination

The co-administration of alprazolam with ketoconazole, itraconazole, or other azole-type antifungals is not recommended.

Breast-feeding

No gender/age discrimination

Alprazolam is excreted in breast milk at low level. However, alprazolam is not recommended during breast-feeding.

Pregnancy

No gender/age discrimination

The data concerning teratogenicity and effects on postnatal development and behavior following benzodiazepine treatment are inconsistent. A large amount of data based on cohort studies indicate that first trimester exposure to benzodiazepine is not associated with an increase in the risk of major malformation. However, some early case-control epidemiological studies have found a twofold increased risk of oral clefts.

Benzodiazepine treatment at high dose, during the second and/or the third trimester of pregnancy, has revealed a decrease of fetal active movements and a variability of fetal cardiac rhythm.

When treatment has to be administered for medical reasons during the last part of pregnancy, even at low doses, floppy infant syndrome such as axial hypotonia, sucking troubles leading to a poor weight gain may be observed. These signs are reversible but they may last from 1 up to 3 weeks, according to the half-life of the product. At high doses, respiratory depression or apnoea and hypothermia in newborn may appear. Moreover, neonatal withdrawal symptoms with hyper excitability, agitation and tremor may be observed a few days after birth, even if no floppy infant syndrome is observed. The apparition of withdrawal symptoms after birth depends on the half-life of the substance.

Alprazolam should not be used during pregnancy unless the clinical condition of the woman requires treatment with alprazolam. If alprazolam is used during pregnancy, or of the patient becomes pregnant while taking alprazolam, the patient should be apprised of the potential hazard to the fetus.

If alprazolam treatment is necessary during last part of pregnancy, high doses should be avoided and withdrawal symptoms and/or floppy infant syndrome should be monitored in newborn.

Severe respiratory insufficiency

No gender/age discrimination

Alprazolam is contraindicated in patients with severe respiratory insufficiency.

Sleep apnoea syndrome

No gender/age discrimination

Alprazolam is contraindicated in patients with sleep apnoea syndrome.

Myasthenia gravis

No gender/age discrimination

Alprazolam is contraindicated in patients with myasthenia gravis.