Xanax - instructions, analogues, reviews
In this article, you can read the instructions for using the drug Xanax. Comments of visitors of the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Xanax in their practice are presented. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Xanax in the presence of existing structural analogs. Use to treat anxiety, depression, increased irritability in adults, children, as well as during pregnancy and lactation. Composition and interaction of the drug with alcohol.
Xanax - has an anxiolytic, sedative, miorelaksiruyuschee effect.
Linking with benzodiazepine and GABAergic receptors, causes inhibition of the limbic system, the thalamus, the hypothalamus, polysynaptic spinal reflexes.
Composition
Alprazolam + auxiliary substances.
Pharmacokinetics
After oral administration, it is rapidly absorbed from the digestive tract. The binding with plasma proteins is 80%. Passes through the blood-brain barrier (BBB) and placental barrier, penetrates into breast milk. Metabolised in the liver. It is excreted mainly by the kidneys. Re-appointment at intervals of less than 8-12 hours may result in cumulation.
Indications
- anxious states and neuroses with a sense of anxiety, tension, anxiety, irritability, deterioration of sleep, somatic disorders;
- mixed anxious-depressive and neurotic reactive-depressive conditions, accompanied by a decrease in mood, loss of interest in the environment, psychomotor agitation, sleep disturbances, decreased appetite, changes in body weight, somatic complaints, impaired cognitive activity, suicidal thoughts (guilt, low value) energy;
- with somatic disorders, alcohol withdrawal syndrome, functional and organic diseases (cardiovascular, dermatological, gastrointestinal);
- panic conditions (in combination or without phobic symptoms);
- Attacks of panic and phobia in case of agoraphobia.
Forms of release
Tablets 0.25 mg and 0.5 mg.
Tablets of prolonged action of 0.5 mg and 1 mg (Xanax Retard).
Instructions for use and dosing regimen
Inside, the optimal dose is set individually, depending on the severity of the symptoms and the severity of the clinical effect. Increase the dose is better done by taking more medication in the evening (before bedtime). In general, patients who have never previously been treated with psychotropic drugs require lower doses. Older and weakened patients are advised to take smaller doses of alprazolam, since an overdose can cause the development of excessive sedation or ataxia. It is recommended to periodically reevaluate the patient's condition and then adjust the dose of alprazolam.
Typically, the usual dose is sufficient for most patients.If a higher dose is required, the dose should be increased with caution to avoid side effects.
Duration of therapy: up to 6 months - with anxiety and depressive disorders; up to 8 months - in the treatment of panic disorders.
A decrease in the dose of the drug should be carried out gradually (possibly the development of withdrawal or withdrawal symptoms). It is recommended to reduce the daily dose by no more than 0.5 mg every 3 days. In some cases, a slower dose reduction is required.
Side effect
- headache;
- dizziness;
- drowsiness;
- sleep disorders;
- fatigue;
- memory impairment;
- depression;
- muscle weakness;
- tremor;
- coordination disorders;
- ataxia;
- changes in body weight;
- dyspepsia, anorexia;
- dystonia;
- jaundice;
- decreased libido;
- dysmenorrhea;
- urinary incontinence or retention;
- visual impairment;
- irritability;
- hallucinations;
- hostility and aggressiveness of behavior (more often with alcohol, drug abuse, when taking other psychotropic drugs);
- addiction (especially with alcoholism, toxic or addiction);
- drug dependence;
- abstinence phenomena (with a sharp drug withdrawal).
Contraindications
- hypersensitivity;
- psychotic depression (not effective);
- pregnancy (especially the first trimester);
- children's adolescence and adolescence (up to 18 years);
- thyroid gland diseases (tablets 0.5 mg).
Application in pregnancy and lactation
Xanax is contraindicated in pregnancy (especially in the first trimester).
For the period of intake lactating women must refuse breastfeeding.
Use in children
Contraindicated in children and adolescents under the age of 18 years (studies on the efficacy and safety of Xanax in people under the age of 18 years have not been conducted).
special instructions
With extreme caution apply when there is a violation of liver and kidney function, severe depression, suicidal mood, panic disorder.
In order to avoid the withdrawal syndrome (withdrawal symptoms), treatment is stopped gradually, reducing the dose by no more than 0.5 mg every 3 days.
Impact on the ability to drive vehicles and manage mechanisms
During treatment, it is not recommended to drive or other potentially dangerous mechanisms.
Drug Interactions
Against the background of amprenavir, biotransformation is blocked, the concentration of Alprazolam in the plasma increases, the activity and the risk of toxicity increase.
The potential effect of increasing plasma concentrations of alprazolam (metabolized via CYP3A4) should be taken into account when concomitantly administering alprazolam with aprepitant.
Clinical monitoring of respiratory depression and / or prolonged sedation should be carried out carefully while simultaneous application of boceprevir with intravenous administration of alprazolam. Xanax dosage adjustment is necessary.
Against the background of valproic acid, CNS depression is increasing.
Strengthens (mutually) with Haloperidol oppression of the central nervous system; Care should be taken when concomitant use is indicated.
Strengthens (mutually) with Diazepam oppression of the central nervous system, increases the risk of apnea (with intravenous administration).
Against the background of alprazolam plasma concentration increases, clearance decreases and / or Vss digoxin, the risk of toxicity increases.
It is possible to intensify the effect with Diltiazem; Care should be taken when concomitant use is indicated.
Itraconazole as an inhibitor of CYP3A4 slows down biotransformation, significantly reduces clearance, increases the concentration of alprazolam in plasma, enhances effects, incl. collateral; joint use is contraindicated.
Strengthens (mutually) the depression of the central nervous system with carbamazepine.
Ketoconazole as an inhibitor of CYP3A can significantly reduce the clearance of alprazolam; joint use is contraindicated.
There have been reports of the development of hallucinations when taking Ketorolac in the form of tablets in patients taking Xanax.
Simultaneous use of Clarithromycin (as part of a set of tablets and capsules of clarithromycin + lansoprazole + amoxicillin) with alprazolam (metabolized by the isoenzyme CYP3A) is contraindicated.
Strengthens (mutually) oppression of the central nervous system with Codeine.
Strengthens (mutually) the sedative effect of metoclopramide.
With the combined application of milk thistle, the extract, which inhibits the cytochrome P450 system, can enhance the Xanax effect.
Strengthens (mutually) the effect of Tramadol; when combined appointment increases the risk of convulsions.
Strengthens (mutually) the depression of the central nervous system by Phenobarbital.
Fluconazole as an inhibitor of CYP3A slows biotransformation and reduces clearance; joint appointment is not recommended.
Joint use of alprazolam and Fluoxetine led to an increase in the level of alprazolam in plasma and a decrease in psychomotor activity.
Strengthens (mutually) the depression of the central nervous system with Chlorpromazine and Chloroproticsen; Care should be taken when concomitant use is indicated.
Slows down the elimination of Erythromycin; Care should be taken when concomitant use is indicated.
Against the background of alprazolam, the effect on ethanol (alcohol) on the central nervous system increases.
Analogues of the drug Xanax
Structural analogs for the active substance:
- Alzolam;
- Alprazolam;
- Alprox;
- Zolomax;
- Kassadan;
- Xanax retard;
- Neurol;
- Front;
- Helex.
Analogues on the pharmacological group (anxiolytics):
- Adaptol;
- Anvifen;
- Atarax;
- Afobazol;
- Bromazepam;
- Valium Rosh;
- Hydroxysine;
- Grandaxin;
- Diazepam;
- Diazepec;
- Diapam;
- Ipronal;
- Lexotan;
- Librax;
- Lorazepam;
- Loram;
- Laurafen;
- Mebicar;
- Mezapam;
- Mexiprim;
- Mexicin;
- Merlit;
- Miolastane;
- Napoton;
- Neurophasole;
- Nobrethum;
- Nozepam;
- Noophen;
- Oxazepam;
- Relanium;
- Relium;
- Seduxen;
- Sibazon;
- Tazepam;
- Tenoten;
- Tenoten for children;
- Tofizopam;
- Phenazepam;
- Fenibut;
- Elenium;
- Elzepam.