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Xanax XR
alprazolam
Black Box Warnings .
Risks from Concomitant Opioid Use
concomitant benzodiazepine use w/ opioids may result in profound sedation, resp. depression, coma, and death; reserve concomitant use for pts w/ inadequate alternative tx options; limit to minimum required dosage and duration; monitor pts for s/sx of resp. depression and sedation
Addiction, Abuse, and Misuse
benzodiazepines expose users to risk of abuse, misuse, and addiction, can lead to overdose or death; commonly involves concomitant use w/ other meds, alcohol, and/or illicit substances, which is assoc. w/ incr. frequency of serious adverse outcomes; assess risk for abuse, misuse, and addiction before prescribing and throughout tx
Dependence and Withdrawal Reactions
cont. benzodiazepine use may lead to clinically significant physical dependence; risk of dependence and withdrawal incr. w/ longer tx duration and higher daily dose; use gradual taper to D/C after cont. use as abrupt D/C or rapid dose reduction may cause acute withdrawal reactions, potentially life-threatening
Adult Dosing .
Dosage forms: ER TAB: 0.5 mg, 1 mg, 2 mg, 3 mg
panic disorder
- [3-6 mg PO qd]
- Start: 0.5-1 mg PO qd, may incr. by up to 1 mg/day q3-4 days; Max: 10 mg/day; Info: start 0.5 mg PO qd in elderly or debilitated pts; doses >6 mg/day rarely more effective; do not cut/crush/chew tab; taper dose by no more than 0.5 mg/day q3 days to D/C; search 'benzodiazepine' for epocrates Benzodiazepine Deprescribing Advice decision tool
renal dosing
- [see below]
- renal impairment: no adjustment
- HD: no adjustment; no supplement; PD: not defined
hepatic dosing
- [see below]
- hepatic impairment: start 0.5 mg qd; Info: titrate gradually
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.