Alpranax Drug Interactions

The sedative effects may be enhanced when alprazolam is used in combination with alcohol. This affects the ability to drive or use machines. Therefore it is not recommended to take alprazolam and alcohol concomitantly.
Alprazolam produces additive CNS depressant effects when co-administered with antipsychotics (neuroleptics), hypnotics, anxiolytics/sedatives, antidepressant agents, narcotic analgesics, anti-epileptic drugs, anaesthetics and sedative antihistamines.
The CYP3A isoenzymes are involved in the metabolism of Alprazolam. Concurrent use with drugs that inhibit CYP3A isoenzymes, eg. nefazodone, fluvoxamine and cimetidine, should be undertaken with caution, and reduction in Alprazolam dosage should be considered. Caution should be exercised when Alprazolam is co-administered with fluoxetine, propoxyphene, oral contraceptives, sertraline, diltiazem, or macrolide antibiotics such as erythromycin and troleandomycin. The co-administration of alprazolam with ketoconazole, itraconazole, or other azole-type antifungals is not recommended. Interactions involving HIV protease inhibitors (eg. ritonavir) and alprazolam are complex and time dependent. Low doses of ritonavir caused a large impairment of alprazolam clearance, prolonged its elimination half-life and thereby enhanced the clinical effects. However, upon extended exposure to ritonavir, CYP3A induction offset this inhibition. A dose adjustment or discontinuation of alprazolam will be required.