Alpranax Special Precautions

Alprazolam is not recommended in patients whose primary diagnosis is schizophrenia.
Due to the predisposition to habituation and dependence, individuals who are prone to abuse drugs eg. alcoholics and known drug addicts, should be under surveillance.
Abrupt discontinuation of Alprazolam must be avoided. Gradual tapering of the dosage must be performed to preclude sequelae of rapid withdrawal. These can range from mild dysphoria and insomnia to a major syndrome including abdominal and muscle cramps, vomiting, sweating, tremor and occasionally convulsions. These signs and symptoms are generally more common in patients on excessive doses over an extended period. However, withdrawal symptoms have also been reported following abrupt discontinuance of benzodiazepines taken at therapeutic levels. Consequently, abrupt discontinuation should be avoided and a gradual tapering in dosage followed.
The usual precautions for treating patients with renal or hepatic impairment should be exercised. Benzodiazepines are not indicated to treat patients with severe hepatic insufficiency as they may precipitate encephalopathy.
A lower dose is also recommended for patients with chronic respiratory insufficiency due to risk of respiratory depression.
Benzodiazepines should not be used alone to treat depression or anxiety associated with depression (suicide may be precipitated in such patients). Administration to severely depressed or suicidal patients should be done with appropriate precautions and appropriate size of the prescription.
Effects on the Ability to Drive or Operate Machinery: Patients should be advised not to operate motor vehicles or dangerous machinery until it is established that they do not become drowsy or dizzy while receiving Alprazolam.
Use in Children: The safety and efficacy of Alprazolam in children <18 years has not been established. Benzodiazepines should not be given to children without careful assessment of the need to do so; the duration of treatment must be kept to a minimum.
Use in the Elderly: It is recommended that the dosage be limited to the smallest effective dose to preclude the development of ataxia or oversedation which may be a particular problem in elderly or debilitated patients.