Alprazolam 1 mg instructions for use. Alprazolam - instructions for use. Synonyms of nosological groups

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Alprazolam is a drug from the group of benzodiazepines. This is an effective tranquilizer designed to suppress pathological anxiety against the background of a number of psycho-emotional disorders. According to the instructions for use of Alprazolam, it can be used to combat panic attacks, manifestations of depression or neuroses. Due to the characteristics of the drug, they try to prescribe it in cases where it is possible to get by with a short treatment course. At long-term therapy doctors are trying to replace the drug with safer, better tolerated analogues.

Compound

The active ingredient, alprazolam, gave a generic international name the drug itself. It is a white crystalline powder that dissolves in ethanol, methanol and certain conditions in water. The auxiliary ingredients are corn starch, lactose, povidone, microcrystalline cellulose, sodium benzoate, sodium docusate, magnesium stearate and silicon dioxide.

Release form

The drug "Alprazolam" is presented in tablets that contain 0.25 or 1 mg of the active substance. Today this is the only form of product release. The product is intended for oral administration. It is packaged in blisters or jars - 10 or 50 pieces per package.

pharmachologic effect

The active substance of the drug has a number of medicinal properties and useful chemical characteristics. The product can be used as part of a separate or complex therapy with many pathological conditions and physiological disruptions.

Pharmacological effects of the drug:

anxiolytic – reduces the severity of inexplicable fear, causeless anxiety, eliminates obsessive thoughts;
sedative – relieves emotional and mental stress, slows down reflexes, stops increased excitability of the brain;
sleeping pills – increases the duration of sleep, shortens the period of falling asleep, reduces the number of night awakenings. Reduces the severity of the influence external factors for the process of relaxation before bedtime;
anticonvulsant - achieved through general relaxation of the patient, elimination of muscle tension and spasms.

Such properties make it possible to successfully use the drug for muscle strain, epilepsy, and anxiety. The increased chemical activity of the product stimulates the work of other medications. In particular, it is used to enhance the effect of antidepressants during course therapy against the background of depression.

Pharmacodynamics and pharmacokinetics

At the organic level, the drug acts by binding to specific receptors in specific areas of the brain. The reaction and response of the central nervous system largely depend on the correctness of the selected dose, therefore such therapy is carried out only with the permission of a doctor and under his supervision.

After oral administration, the drug is quickly absorbed by the mucous membrane of the digestive organs. Its peak plasma concentration is observed after 1-2 hours. About 80% of the active substance is bound to the patient’s serum protein. Its metabolism occurs in the liver, after which the breakdown products are excreted by the kidneys. The medicine does not accumulate in the tissues of the body, so even with long-term use the likelihood of an overdose is minimal.

Indications for use of Alprazolam

The main purpose of taking the medication is to combat the manifestations of panic disorders, including the symptoms of agoraphobia.

The condition is characterized by the systematic development of panic attacks, which occur suddenly, increase over 5-10 minutes, and are accompanied by at least four of the classic manifestations. Panic attacks are characterized by tachycardia, tremors, increased sweating, choking or difficulty breathing, chest discomfort, nausea, chills or hot flashes, problems with coordination, changes in skin sensitivity.

Additional indications to the use of the medicine:

anxiety and irritability against a background of neuroses. Taking the drug gives good effect with emotional stress caused by insomnia, impotence, anorexia, bulimia, chronic pain;
an integrated approach to the treatment of depression, in which the patient’s sleep deteriorates and functionality decreases internal organs, interest in life disappears, suicidal thoughts appear, the thought process is disrupted;
pathological changes in the psycho-emotional background provoked somatic diseases. The medicine is shown in the composition complex treatment alcoholism, drug addiction, cardiovascular failure, malignant neoplasms;
tremor of the limbs of a neurological or mental nature;
sleep disorders.

Regardless of the type of symptoms and severity clinical picture the drug is prescribed by a doctor after diagnosis. If long-term therapy is planned - longer than 2 months - a systematic assessment of the usefulness of the product and a review of the availability of indications for its use are indicated.

Contraindications

Due to the increased chemical and therapeutic activity of the drug, its use is completely prohibited for a number of conditions. Ignoring restrictions threatens the development of more serious consequences than the symptoms that require its use.

TO absolute contraindications include:

collapse, coma or shock;
muscle weakness;
angle-closure glaucoma;
open-angle glaucoma during exacerbation;
acute poisoning with neuroleptics, hypnotics, opioids, alcohol;
signs of respiratory failure against the background of chronic obstructive lesions of the respiratory system;
severe depression;
pregnancy and lactation;
children under 18 years of age;
allergy to benzodiazepines, intolerance to the main or additional components of a particular drug.

Doctors identify a group increased risk on taking Alprazolam. This includes older people, people with chronic kidney disease and/or liver failure, ataxia, hyperkinesis. All of the above medications can be taken under the supervision of a doctor, according to an individually selected regimen. Also, increased caution should be observed in patients with apnea, drug dependence, organic lesions history of brain.

Side effects

The longer the drug is taken, the higher the risk that the patient will develop side effects. The decision on the possibility of further therapy is made by the doctor, taking into account the positive dynamics, the severity of the clinical picture, and the degree of discomfort.

Possible side effects:

neurological manifestations - most of these problems occur when starting to take the drug. They are often mild and go away quickly on their own. Patients may experience drowsiness, fatigue, decreased attention, fatigue, and slower reactions. Low mood and depression or euphoria rarely occur. With long-term use of the drug, headaches, confusion, disorientation, and dizziness occur more often. IN severe cases tremor, gait instability, muscle weakness appear;

mental problems - increased anxiety, suicidal thoughts, aggression, agitation, unreasonable fear;
dyspeptic disorders – copious discharge saliva or dry mucous membranes, nausea with vomiting, heartburn. Some patients lose their appetite completely, leading to anorexia. A common side effect is intestinal dysfunction, which manifests itself in the form of flatulence, diarrhea, and constipation. Jaundice rarely develops, liver performance decreases;
on the part of the hematopoietic system - a violation of the composition of the blood in various forms;
in the genitourinary area - involuntary loss of urine, problems with the kidneys, lack of urine. In adults and even older people, sexual desire can sharply increase or decrease. Women note violation menstrual cycle or increased PMS symptoms;
cardiovascular disorders - increased heart rate, decreased blood pressure, shortness of breath, hot flashes;
immune failures – allergic reactions as skin itching, rash, dermatitis, rhinitis;
other side effects are soreness in muscles and/or joints, unreasonable weight gain, double vision, ringing in the ears.

If you violate the rules or schedule for taking the drug, too long-term treatment drug dependence may develop. Sudden withdrawal from medication or a sharp decline dosage threatens the appearance of symptoms characteristic of withdrawal syndrome.

"Alprazolam": instructions for use - method and dosage

For the main indications for taking the drug, doctors rarely use its basic dosage, preferring an individual selection of the treatment regimen. Depending on the diagnosis, age, and severity of the problem, the indicator can vary widely. To obtain lasting therapeutic effect start with the minimum permissible volume of the active substance. It is gradually increased, bringing it to the level at which the desired response of the body is achieved - the alarming symptoms disappear.

Universal rules for taking the drug:

the product is taken orally, swallowed whole, without chewing, with 100 ml of water, regardless of food;
when taking a psychotropic drug for the first time and in old age, the starting and therapeutic doses are 50-70% of the base ones;
if during therapy the patient experiences decreased coordination or severe drowsiness, volume active substance reduce;
The daily volume of medication is divided into 2-3 doses. The largest dose is taken in the evening to reduce the risk of developing daytime sleepiness and ensure the patient gets a good night's sleep;
initial daily dosages of the drug are 0.25-0.5 mg. They are increased gradually, usually by 0.25 mg every 3 days, over several weeks. First, the increase affects the evening dose, then moves to the daytime dose;
maximum daily volume active component should not exceed 10 mg.

How long to take Alprazolam depends on the patient’s condition, indications, goals of therapy, and the severity of positive dynamics. Usually doctors try to make do with short courses of a few days. Such approaches allow you to get rid of acute fear, for example, against the background nervous shock. In such cases, therapy begins with basic volumes of the drug, which are not increased.

Long courses are necessary to combat chronic conditions that are accompanied by fear and anxiety. They last on average from 8 weeks to six months or longer.

Rules for drug withdrawal

From a lingering drug therapy the patient is removed gradually. If you do this abruptly, withdrawal syndrome will develop. It will manifest itself in the form of a rapid return of symptoms for which the medicine was used, an intensification of the clinical picture. On average, it takes 2-6 weeks to quit the drug, this period depends on the volume of the therapeutic dose.

To prevent complications, the therapeutic dosage begins to be reduced by 0.25-0.5 mg every 3 days. First, the morning and day doses are sequentially adjusted, then the evening doses. If during the withdrawal process the patient returns to relieved symptoms, the dosage is again slightly increased and maintained for 1-2 weeks. Then they return to the release schedule again, but if possible make it even smoother.

Overdose

Even if a single or daily dose of medication is significantly exceeded, it is difficult to provoke a negative response from the body. The risk that a patient will overdose increases significantly if Alprazolam is combined with alcohol or other benzodiazepine drugs. In this case, the patient may experience drowsiness, confusion, tremors of the limbs, weakened reflexes, shortness of breath, slow pulse, and a drop in blood pressure. IN difficult situations the victim develops a coma, which can lead to death. Death is usually recorded in people who have exceeded the permissible volumes of the drug due to alcohol intoxication.

First aid in severe cases of overdose consists of immediate gastric lavage and administration of energy sorbents to the victim in accordance with body weight. If necessary, it is possible to administer to the patient a specific benzodiazepine antidote - Flumazenil. Additionally carried out symptomatic therapy, aimed at stabilizing pulse, blood pressure, maintaining breathing.

Interaction with other drugs

The introduction of the product into complex therapy requires special caution. The increased chemical activity of its active substance in combination with other drugs often causes negative consequences. Failure to comply with the principles of product interaction can result in serious side effects, drug overdose, a decrease in the body's therapeutic response.

Consequences of combining the drug with other medications:

parallel use of Alprazolam with anticonvulsants or certain groups of narcotic analgesics leads to inhibition of central nervous system functions;
simultaneous use of the composition with tranquilizers and psychotropics can provoke the appearance of neurological symptoms;
reception oral contraceptives provides the drug with a prolonged effect, thanks to which the dosage schedule can be adjusted - instead of 3 doses per day, take 2;
combination with Digoxin increases the activity of cardiac glycoside, which threatens overdose;
under the influence of alprazolam, the effectiveness of some antihypertensive drugs increases;
"Ketoconazole" and some others antifungal agents enhance the effect of the drug;
the toxicity of Zidovudine increases under the influence of the drug;
Fluvoxamine increases concentration medicinal product in tissues, which often leads to the development of side effects;
in combination with Clozapine, the product can provoke respiratory depression;
combination with Fluoxetine often causes psychomotor disorders;
If you take Levodopa for Parkinson's disease, the effectiveness of the drug may decrease under the influence of the medication, so therapy requires dose adjustment.

Alprazolam and alcohol are incompatible. During therapy it is necessary to completely stop
from drinking any alcoholic beverages. Violation of the rule leads to mutual enhancement of the effects of the components. The result is a sharp decrease in blood pressure, a change in blood composition, a violation cerebral circulation. Even in mild cases, patients may complain of nausea and vomiting, and chills. In some cases, victims begin to bleed, develop a stroke or heart attack, followed by coma and death.

special instructions

Before starting therapy, you must familiarize yourself with a number of restrictions and recommendations for the use of the drug. Ignoring special instructions threatens to reduce the effectiveness of treatment, increases the risk of overdose or side effects.

When taking Alprazolam, you must remember that:

when combining the product and any antidepressant, the patient’s condition should be monitored for signs of manic or hypomanic disorder;
Taking the drug is strictly prohibited at all stages of pregnancy. When using the drug in the first trimester, there is a high probability of developing malformations in the fetus. Carrying out a course of therapy starting from the second trimester may provoke the development of withdrawal syndrome or underdevelopment of the central nervous system in the child;
the inclusion of medication in therapy during lactation will affect the general condition of the baby. Suppression of the newborn's sucking reflex will create difficulties with feeding;
patients with reduced liver and/or kidney function should be checked every two weeks for their blood composition and level of renal enzyme activity;
If possible, it is recommended to take the medicine in short courses. Long-term use of the drug often results in benzodiazepine addiction, a condition that is difficult to treat;
the use of the product for the treatment of children under 18 years of age significantly inhibits the activity of the nervous system. Patients become lethargic, apathetic, and lacking initiative.

If aggressiveness, fear, obsessive or suicidal thoughts appear while taking the drug, therapy should be stopped immediately and consult a doctor. Consultation with a specialist during such treatment is advisable for any signs of negative dynamics. Waiting for the body to get used to it and everything to return to normal is strictly prohibited.

Terms of sale

It is impossible to purchase Alprazolam in Russian pharmacies without a prescription. The appointment must be made on special form with a number and seal, indicating the need for special treatment.

Storage conditions and shelf life

The drug must be kept out of the reach of children, in a dark and dry place at a temperature not exceeding 30℃. It must be used within 5 years from the date of manufacture, after which there is a high probability of increased toxicity of the tablets.

Analogues of "Alprazolam"

Pharmacological companies around the world offer numerous synonyms for the drug. They all contain the same active substance, which determines their similar properties, descriptions, characteristics. This list includes Alzolam, Zolomax, Neurol, Helex, Alprox and a number of other drugs.

Analogues of the product contain other active ingredients, but give similar results when used. This is a broad group of medications, among which doctors distinguish Nozepam, Relanium, Sibazon, and Phenazepam. Only the attending physician can select a replacement for a prescription medication.

Organika OJSC

Country of origin

Russia

Anxiolytic (tranquilizer)

Release forms

50 - dark glass jars (1) - cardboard packs. 10 - contour cell packaging (5) - cardboard packs.

Description of the dosage form

pills

pharmachologic effect

Anxiolytic drug (tranquilizer), a derivative of triazolo-benzodiazepine. It has an anxiolytic, sedative, hypnotic, anticonvulsant, and central muscle relaxant effect. The mechanism of action is to enhance the inhibitory effect of endogenous GABA in the central nervous system by increasing the sensitivity of GABA receptors to the mediator as a result of stimulation of benzodiazepine receptors located in the allosteric center of postsynaptic GABA receptors of the ascending activating reticular formation of the brain stem and interneurons of the lateral horns spinal cord; reduces the excitability of subcortical structures of the brain ( limbic system, thalamus, hypothalamus), inhibits polysynaptic spinal reflexes. Pronounced anxiolytic activity (reduction of emotional stress, easing of anxiety, fear, restlessness) is combined with a moderately pronounced hypnotic effect; shortens the period of falling asleep, increases the duration of sleep, reduces the number of night awakenings. The mechanism of the hypnotic effect is the inhibition of the cells of the reticular formation of the brain stem. Reduces the impact of emotional, vegetative and motor stimuli that disrupt the mechanism of falling asleep.

Pharmacokinetics

After oral administration, alprazolam is quickly and completely absorbed from the gastrointestinal tract. Cmax in blood plasma is achieved within 1-2 hours. Plasma protein binding is 80%. Metabolized in the liver. T1/2 averages 12-15 hours. Alprazolam and its metabolites are excreted mainly by the kidneys.

Special conditions

At endogenous depressions alprazolam can be used in combination with antidepressants. When using alprazolam in patients with depression, cases of hypomanic and manic states have been observed. Alprazolam should be used with caution in patients with impaired liver and/or kidney function. In patients who have not previously taken medicines affecting the central nervous system, alprazolam is effective in lower doses compared to patients who received antidepressants, anxiolytics, or those suffering chronic alcoholism. With long-term use in high doses, addiction and drug dependence may develop, especially in patients prone to drug abuse. At rapid decline doses or abrupt withdrawal of alprazolam, a withdrawal syndrome is observed, the symptoms of which can range from mild dysphoria and insomnia to a severe syndrome with abdominal and skeletal muscle cramps, vomiting, increased sweating, tremors and convulsions. Withdrawal syndrome is more common in individuals who have been receiving alprazolam for a long time (more than 8-12 weeks). Other tranquilizers should not be used simultaneously with alprazolam. The safety of alprazolam in children and adolescents under 18 years of age has not been established. Children, especially in younger age, are very sensitive to the inhibitory effect of benzodiazepines on the central nervous system. During the treatment period, avoid drinking alcohol. Impact on the ability to drive vehicles and operate machinery During the treatment period, you should refrain from potentially engaging in activities dangerous species activities requiring increased attention and speed of psychomotor reactions (driving vehicles or working with machinery).

Alprazolam indications for use

Anxiety states, neuroses, accompanied by feelings of anxiety, danger, restlessness, tension, deterioration of sleep, irritability, as well as somatic disorders; mixed anxiety and depression; neurotic reactive-depressive states, accompanied by decreased mood, loss of interest in the environment, anxiety, loss of sleep, decreased appetite, somatic disorders; anxiety states And neurotic depression, developed against the background somatic diseases; panic disorders in combination with and without symptoms of phobia.

Alprazolam contraindications

Coma, shock, myasthenia gravis, angle-closure glaucoma ( acute attack or predisposition) acute poisoning alcohol (with weakening vital important functions), opioid analgesics, hypnotics and psychotropic drugs, chronic obstructive diseases respiratory tract with initial manifestations of respiratory failure, acute respiratory failure, severe depression (suicidal tendencies may occur), pregnancy (especially the first trimester), lactation period, childhood and adolescence up to 18 years old, increased sensitivity to benzodiazepines.

Alprazolam dosage

1 mg 25 mg

Alprazolam side effects

From the side of the central nervous system: at the beginning of treatment (especially in elderly patients) drowsiness, fatigue, dizziness, decreased ability to concentrate, ataxia, disorientation, unsteady gait, slowed mental and motor reactions; rarely - headache, euphoria, depression, tremor, memory loss, impaired coordination of movements, depressed mood, confusion, dystonic extrapyramidal reactions (uncontrolled movements, including the eyes), weakness, myasthenia gravis, dysarthria; in some cases - paradoxical reactions (aggressive outbursts, confusion, psychomotor agitation, fear, suicidal tendencies, muscle spasm, hallucinations, agitation, irritability, anxiety, insomnia). From the outside digestive system: possible dry mouth or drooling, heartburn, nausea, vomiting, loss of appetite, constipation or diarrhea, impaired liver function, increased activity of liver transaminases and alkaline phosphatase, jaundice. From the hematopoietic system: possible leukopenia, neutropenia, agranulocytosis (chills, hyperthermia, sore throat, excessive fatigue or weakness), anemia, thrombocytopenia. From the urinary system: possible urinary incontinence, urinary retention, impaired renal function, decreased or increased libido, dysmenorrhea. From the outside endocrine system: possible changes in body weight, libido disorders, menstrual irregularities.

Drug interactions

With the simultaneous use of psychotropic, anticonvulsants, drugs and ethanol, an increase in the inhibitory effect of alprazolam on the central nervous system is observed. When used simultaneously, histamine H2 receptor blockers reduce the clearance of alprazolam and enhance the inhibitory effect of alprazolam on the central nervous system; antibiotics from the macrolide group reduce the clearance of alprazolam. When used simultaneously hormonal contraceptives for oral administration, the T1/2 of alprazolam is increased. With the simultaneous use of alprazolam with dextropropoxyphene, more pronounced depression of the central nervous system is observed than in combination with other benzodiazepines, because it is possible to increase the concentration of alprazolam in the blood plasma. Simultaneous use digoxin increases the risk of developing intoxication with cardiac glycosides. Alprazolam increases plasma concentrations of imipramine. When used simultaneously, itraconazole and ketoconazole enhance the effects of alprazolam

Storage conditions

keep away from children
store in a place protected from light

Information provided by the State Register of Medicines.

Synonyms

Alzolam, Alprox, Kassadan, Xanax, Neurol, Frontin, Helex.

Alprazolam

Composition and release form of the drug

50 pcs. - dark glass jars (1) - cardboard packs.
10 pieces. - contour cell packaging (5) - cardboard packs.

pharmachologic effect

Pronounced anxiolytic activity (reduction of emotional stress, easing of anxiety, fear, restlessness) is combined with a moderately pronounced hypnotic effect; shortens the period of falling asleep, increases the duration of sleep, reduces the number of night awakenings. The mechanism of the hypnotic effect is the inhibition of the cells of the reticular formation of the brain stem. Reduces the impact of emotional, vegetative and motor stimuli that disrupt the mechanism of falling asleep.

Pharmacokinetics

After oral administration, alprazolam is quickly and completely absorbed from the gastrointestinal tract. Cmax in the blood is achieved within 1-2 hours.

Plasma protein binding is 80%.

Metabolized in the liver.

T1/2 averages 12-15 hours. Alprazolam and its metabolites are excreted mainly by the kidneys.

Indications

Anxiety states, neuroses, accompanied by feelings of anxiety, danger, restlessness, tension, deterioration of sleep, irritability, as well as somatic disorders; mixed anxiety and depression; neurotic reactive-depressive states, accompanied by decreased mood, loss of interest in the environment, anxiety, loss of sleep, decreased appetite, somatic disorders; anxiety states and neurotic depression that developed against the background of somatic diseases; panic disorders in combination with and without symptoms of phobia.

Contraindications

Coma, shock, myasthenia gravis, angle-closure glaucoma (acute attack or predisposition), acute poisoning with alcohol (with weakening of vital functions), opioids, hypnotics and psychotropic drugs, chronic obstructive airway diseases with initial manifestations of respiratory failure, acute respiratory failure, severe depression (suicidal tendencies may occur), pregnancy (especially the first trimester), lactation, childhood and adolescence up to 18 years, increased sensitivity to benzodiazepines.

Dosage

Individual. It is recommended to use minimum effective doses. The dose is adjusted during treatment depending on the effect achieved and tolerability. If it is necessary to increase the dose, it should be increased gradually, first in the evening and then in the daytime.

The initial dose is 250-500 mcg 3 times / day, if necessary, a gradual increase to 4.5 mg / day is possible.

Discontinuation or dose reduction of alprazolam should be carried out gradually, reducing daily dose no more than 500 mcg every 3 days; sometimes even slower withdrawal may be necessary.

Side effects

From the side of the central nervous system: at the beginning of treatment (especially in elderly patients) drowsiness, fatigue, dizziness, decreased ability to concentrate, ataxia, disorientation, unsteady gait, slowed mental and motor reactions; rarely - headache, euphoria, depression, tremor, memory loss, impaired coordination of movements, depressed mood, confusion, dystonic extrapyramidal reactions (uncontrolled movements, including the eye), weakness, myasthenia gravis, dysarthria; in some cases - paradoxical reactions (aggressive outbursts, confusion, psychomotor agitation, fear, suicidal tendencies, muscle spasms, hallucinations, agitation, irritability, anxiety, insomnia).

From the digestive system: possible dry mouth or drooling, heartburn, nausea, vomiting, loss of appetite, constipation or diarrhea, impaired liver function, increased activity of liver transaminases and alkaline phosphatase, jaundice.

From the hematopoietic system: possible leukopenia, neutropenia, agranulocytosis (chills, hyperthermia, excessive fatigue or weakness), anemia, thrombocytopenia.

From the urinary system: possible urinary incontinence, urinary retention, impaired renal function, decreased or increased libido, dysmenorrhea.

From the endocrine system: changes in body weight, libido disturbances, and menstrual irregularities are possible.

From the outside of cardio-vascular system: Possible decrease in blood pressure, tachycardia.

Allergic reactions: possible skin rash, itching.

Drug interactions

With the simultaneous use of psychotropic, anticonvulsants, drugs and ethanol, an increase in the inhibitory effect of alprazolam on the central nervous system is observed.

When used simultaneously, histamine H2 receptor blockers reduce the clearance of alprazolam and enhance the inhibitory effect of alprazolam on the central nervous system; antibiotics from the macrolide group reduce the clearance of alprazolam.

When used simultaneously, hormonal contraceptives for oral administration increase the half-life of alprazolam.

With the simultaneous use of alprazolam with dextropropoxyphene, more pronounced depression of the central nervous system is observed than in combination with other benzodiazepines, because it is possible to increase the concentration of alprazolam in the blood plasma.

Concomitant use of digoxin increases the risk of developing intoxication with cardiac glycosides.

Alprazolam increases plasma concentrations of imipramine.

With simultaneous use of itraconazole, the effects of alprazolam are enhanced.

With simultaneous use of paroxetine, the effects of alprazolam may be enhanced due to inhibition of its metabolism.

Fluvoxamine increases the concentration of alprazolam in the blood plasma and the risk of developing its side effects.

With simultaneous use, it is possible to increase the concentration of alprazolam in the blood plasma due to a decrease in its metabolism and clearance under the influence of fluoxetine, which is accompanied by psychomotor impairment.

We cannot exclude the possibility that the effect of alprazolam may be enhanced when used simultaneously with.

special instructions

For endogenous depression, alprazolam can be used in combination with antidepressants. When using alprazolam in patients with depression, cases of hypomanic and manic states have been observed.

Alprazolam should be used with caution in patients with impaired liver and/or kidney function.

In patients who have not previously taken drugs that affect the central nervous system, alprazolam is effective in lower doses compared to patients who have received antidepressants, anxiolytics, or those suffering from chronic alcoholism.

With long-term use in high doses, addiction and drug dependence may develop, especially in patients prone to drug abuse.

With a rapid dose reduction or abrupt withdrawal of alprazolam, a withdrawal syndrome occurs, the symptoms of which can range from mild dysphoria and insomnia to a severe syndrome with abdominal and skeletal muscle cramps, vomiting, increased sweating, tremors and convulsions. Withdrawal syndrome is more common in individuals who have been receiving alprazolam for a long time (more than 8-12 weeks).

Other tranquilizers should not be used simultaneously with alprazolam.

The safety of alprazolam in children and adolescents under 18 years of age has not been established. Children, especially at a young age, are very sensitive to the inhibitory effect of benzodiazepines on the central nervous system.

During the treatment period, avoid drinking alcohol.

Impact on the ability to drive vehicles and operate machinery

During the treatment period, you should refrain from engaging in potentially hazardous activities that require increased attention and speed of psychomotor reactions (driving vehicles or working with machinery).

Pregnancy and lactation

Alprazolam has toxic effect on the fetus and increases the risk of developing birth defects when used in the first trimester of pregnancy. Chronic use during pregnancy can lead to physical dependence with the development of withdrawal syndrome in the newborn. Taken in therapeutic doses of more than late dates pregnancy can cause depression of the central nervous system of the newborn. Use immediately before or during childbirth may cause respiratory depression in the newborn, decreased muscle tone, hypotension, hypothermia, and weak sucking (sluggish sucking syndrome of the newborn).

Use in old age

For elderly or weakened patients, the initial dose is 250 mcg 2-3 times / day, maintenance doses are 500-750 mcg / day, if necessary, taking into account tolerability, the dose can be increased.

There are no good diseases. But it’s doubly unpleasant to get sick if something happens to the psyche. For some reason everyone forgets what it is common illness, like ischemia or gastritis, and the patient is not sympathized with, but shunned. This is fundamentally wrong.

First appointment with a doctor

A completely unhappy person comes to the doctor. He is suspicious, it seems to him that they look at him wrong, they talk to him wrong. The patient is worried out of nowhere. He is upset and tearful. I have lost my appetite and don’t feel like eating at all. And a sick person is not interested in anything at all: neither close people, nor old acquaintances, nor television programs. The Internet and classmates are forgotten.

And the patient also has difficulty falling asleep and does not sleep soundly. The doctor, after listening to his sad stories, prescribes Alprazolam.

After the pharmacy

A prescription buys a box of tablets with a dosage of 1 mg and a quantity of 50 pieces per package.

Having received the pills and instructions from the doctor on how to take them, the patient still carefully reads the instructions. From the words he understands, he concludes that the tranquilizer Alprazolam will have a calming and hypnotic effect. His general state horror. He will begin to fall asleep faster, without constantly tossing and turning from side to side. The sleep will be sound and long. And he won't wake up at night.

Pharmacological action of "Alprazolam"

Tranquilizer, triazolo-benzodiazepine derivative. Calms, relieves cramps and tension, especially emotional: anxiety, fear, restlessness. At the same time, the braking effect in the central nervous system. Excitability decreases in the subcortical structures of the brain. It works well as a sleeping pill, it takes less time to fall asleep, the duration of sleep increases, and the number of night awakenings decreases. All irritants acting on the mechanism of falling asleep are noticeably weakened when using Alprazolam.

Pharmakinetics

After oral administration, it is quickly and completely absorbed gastrointestinal tract. Absorbed by the liver. Excreted mainly through urine.

Dosage

Individual. Starts with the minimum effective amount. The dose is changed during treatment. It depends on the result obtained and tolerability. If the dosage should be increased, this is done gradually, first in the evening and at night, and then during the day. The decline is also gradual.

Taking the drug

As prescribed by a doctor for severe depressed state In the evening, one-fourth or half of the tablet may be prescribed, and at night, in addition, a whole tablet.

What will happen if you take Alprazolam? Reviews say that sleep will begin to normalize: the time it takes a person to fall asleep will decrease, the number of causeless awakenings at night will decrease, and sleep will be long and lasting. And in the morning the anxiety will go away somewhat and your emotional state will improve.

Self-medication and concerns

People additionally try to self-medicate. Without a system, they try one thing or another, and then the prescribed medications do not help. When patients take Alprazolam on their own, patient reviews indicate that there is no effect: sleep does not improve, fears do not go away. They start drinking it with small doses, and also gradually reduce them, finishing the course. If you stop taking Alprazolam incorrectly, reviews indicate that convulsions, spasms, and vomiting occur. This suggests that the patient discontinued the drug on his own. And the result is unfavorable.

Patients are interested in whether it is possible to take sedative herbs in addition to a tranquilizer. This concern is understandable - I really want to normalize everything quickly. But the disease comes unnoticed, slowly, and goes away even more slowly, if it goes away at all. You need to be patient and drink only Alprazolam recommended by your doctor. Patient reviews will only become positive over time. Many patients are afraid to use the prescribed medicine, since the instructions contain a large number of contraindications. But the doctor who prescribed Alprazolam, the instructions for use, and patient reviews are very well known. He hears them either during rounds in the hospital, or at daily appointments. All dosages are selected individually. Therefore, you should not experiment on yourself and take the drug at your own discretion.

Treatment under control

Those who are seriously and painfully ill take many different medications. Apparently, the doctor selects them, taking into account their compatibility and indications for use. It is not so easy to find the right medicine. And only when Alprazolam is prescribed, patient reviews become positive. Many rightly believe that this drug is stronger than Phenazepam. It must be handled with care. At the beginning of treatment, it “presses” the person very hard. Apathy and lethargy appear, which then disappear. Those who use it “love” Alprazolam. Reviews from patients say that this is one of the most successful tranquilizers. This medicine is addictive. They start drinking it with small doses, and also gradually reduce them, finishing the course.

So this one is very good, but strong drug, so it must be taken strictly under the supervision of a doctor. Since after the conversation the doctor understands the patient’s condition, he makes prescriptions individually for each person. In this case, the effect of the drug "Alprazolam", the instructions, and reviews will be the same. There will be no unforeseen situations. If the medicine is prescribed, then you should not hesitate to use it. At feeling unwell You need to take Alprazolam tablets quickly. Reviews say that it works within half an hour. Panic, anxiety, and fear of death go away. Everything is as in the instructions.

Conclusion of patients in general

The whole world uses Alprazolam. Thousands of people have different attitudes towards the drug. Some people praise it very much, while others “didn’t like it.” For some, physical endurance decreases, but mental endurance increases. Some people have to drink a lot of coffee to relieve lethargy. For many, it relieves anxiety and panic attacks. That is, treatment with Alprazolam is ambiguous, like everything in life. Reviews are varied. Anyone who has not experienced this will not understand the importance both for the patient and for his loved ones of changes for the better. Yes, this medicine is addictive. Doctors know this and prescribe it very carefully.

They also explain how to properly start taking it and finish the course. Then everything happens under control and without negative symptoms. Very good and effective medicine"Alprazolam." Feedback from patients generally speaks volumes about this.

Doctors' opinion

Alprazolam has been used continuously for thirty years. practical work. Long-term therapy system and its possible complications occupy minds the best specialists countries. There is a process of consistent replacement of old drugs with new ones. This is especially true for the entire class of tranquilizers. But this process is far from over. Five or six drugs firmly retain their positions. These are mainly Diazepam, Clonazepam, Phenazepam, Medazepam and Alprazolam. Reviews from doctors say that they will not leave pharmacy shelves in the foreseeable future. Alprazolam still retains its status as a reference drug. Both young progressive psychiatrists and representatives of the “old school” will not stop using it. It is quite well studied. It just requires careful adherence to the duration of the courses of therapy. Alprazolam is the most prescribed medicine. It is important that the patient does not independently adjust the doctor’s instructions and contacts him often enough.

Positive and negative sides

Tranquilizers belong to the group psychotropic drugs, that is, acting on the psyche. They have three operating principles:

sedative (calming);
hypnotic;
anti-anxiety

One of the most positive qualities"Alprazolam" - speed, almost instantaneous action. That's why it is prescribed a lot and often.

The negative point is that the drug does not cure. He's just filming negative symptoms. But this is already a lot. For example, healthy person It’s hard to imagine, but that’s exactly how it is, out of nowhere, out of nowhere, an anxiety syndrome arose, or it can be called differently - panic attack. This can happen anywhere: at home, at work, on the subway. The fear of death grows with terrifying force. It seems to a person that his heart has stopped, his hands are even cold, his hands are shaking, his legs are buckling. And it’s getting worse and worse: I’m dying! It is precisely this condition that Alprazolam will relieve quite quickly. This is an incredible relief for both the patient and those around him.

The patient can experience this condition many times. But every time he has the same feeling - “I’m dying.” And no explanation that this has happened more than once helps. Only Alprazolam relieves this condition. Only after taking the drug does the patient experience relief. The panic passes. Everything returns to its place.

With constant use, strong dependence and addiction occurs. That is, to enhance the effect, you need to increase the dosage. But this cannot be done. And there is nothing to replace this drug. A vicious one appears vicious circle which should be monitored by a doctor.

Relationships with loved ones

All these points must be clearly understood by both the patient himself and his relatives and friends.

All sick people tire and irritate loved ones in one way or another. But it is not the patient’s fault that he got sick like this. He needs to be supported and given hope that with the help of medications he will live and work fully.