Indications for XANAX XR:
Swallow whole. ≥18yrs: initially 0.5–1mg once daily, preferably in the AM; increase at intervals of at least 3–4 days by up to 1mg/day. Taper no faster than by 0.5mg every 3 days. Usual range: 3–6mg/day; max 10mg/day. Elderly or debilitated: initially 0.5mg/day. Switching from immediate-release alprazolam: give same total daily dose of immediate-release once daily, preferably in the AM.
<18yrs: not established.
Concomitant itraconazole, ketoconazole.
Risks from concomitant use with opioids.
Increased risk of drug-related mortality from concomitant use with opioids. Suicidal ideation. Depression. Psychosis. Mania. Renal, cardiovascular, hepatic, or pulmonary impairment; monitor. Obesity. Reevaluate periodically. Change dose gradually. Avoid abrupt cessation. Monitor periodic CBCs, urinalysis, blood chemistry. Drug or alcohol abuse. Elderly. Debilitated. Labor & delivery. Pregnancy (Cat.D), nursing mothers: not recommended.
See Contraindications; other azole antifungals: not recommended. Increased sedation, respiratory depression, coma, and death with concomitant opioids; reserve use in those for whom alternative treatment options are inadequate; if needed, limit dosages/durations to minimum and monitor. Additive CNS depressant effects with alcohol or other CNS depressants (eg, other benzodiazepines, psychotropics, anticonvulsants, antihistamines); consider dose reductions. Potentiated by CYP3A inhibitors (eg, cimetidine, nefazodone, fluvoxamine); reduce alprazolam dose; caution with weaker CYP3A inhibitors (eg, fluoxetine, propoxyphene, oral contraceptives). Caution with diltiazem, isoniazid, erythromycin, clarithromycin, grapefruit juice, sertraline, paroxetine, ergotamine, cyclosporine, amiodarone, nicardipine, nifedipine, others metabolized by CYP3A. Antagonized by CYP3A inducers (eg, carbamazepine). May increase levels of imipramine, desipramine.
CNS depression (eg, sedation, somnolence, memory impairment, dysarthria, coordination abnormal, ataxia), fatigue, lethargy, dyspnea, dry mouth, constipation, withdrawal seizures, tremors, decreased libido, sexual dysfunction, paradoxical excitement.
XR—60; Tabs 0.25mg, 0.5mg, 1mg—100, 500, 1000; 2mg—100, 500