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XANAX is a brand name for Alprazolam. The medicine, its uses, side effects and dosage are the same regardless of brand.
Used for: Xanax is indicated for short-term symptomatic treatment of anxiety in adults. Xanax is only indicated when the disorder is severe, disabling or subjecting the individual to extreme distress.
Verbatim from this product's MHRA label. Tap a section to expand.
4). Xanax should be used in the lowest possible effective dose, for the shortest possible time and for a maximum of 2-4 weeks. The need for continued treatment should be reassessed frequently. Long-term treatment is not recommended. 4).
5 mg) three times daily, increasing if required to a total of 3 mg daily. 25 mg) two to three times daily to be gradually increased if needed and tolerated. If side-effects occur, the dose should be lowered. It is advisable to review treatment regularly and to discontinue use as soon as possible.
Should longer term treatment be necessary, then intermittent treatment may be considered to minimize the risk of dependence. Paediatric population The safety and efficacy of alprazolam in children and adolescents below the age of 18 years have not been established.
No data are available. Method of administration For oral use. The optimum dosage of Xanax should be based upon the severity of the symptoms and individual patient response. The lowest dose which can control symptoms should be used. Dosage should be reassessed frequently.
The usual dosage is stated above; in the few patients who require higher doses, the dosage should be increased cautiously to avoid adverse effects. When higher dosage is required, the evening dose should be increased before the daytime doses.
In general, patients who have not previously received psychotropic medications will require lower doses than those so treated, or those with a history of chronic alcoholism. 4). 4). Elderly patients There is a reduced clearance of the drug and, as with other benzodiazepines, an increased sensitivity to the drug in elderly patients.
2.
Adverse events, if they occur, are generally observed at the beginning of therapy and usually disappear upon continued medication or decreased dosage. The following undesirable effects have been observed and reported during treatment with alprazolam with the following frequencies: Very common (≥1/10); common (≥1/100 to <1/10); uncommon (≥1/1,000 to <1/100); rare (≥1/10,000 to <1/1,000); very rare (<1/10,000), not known (cannot be estimated from the available data).
4). These symptoms may be difficult to distinguish from the original symptoms for which the drug was prescribed. Withdrawal symptoms have occurred following rapid decrease or abrupt discontinuance of benzodiazepines including alprazolam.
These can range from mild dysphoria and insomnia to a major syndrome, which may include abdominal and muscle cramps, vomiting, sweating, tremor and convulsions. In addition, withdrawal seizures have occurred upon rapid decrease or abrupt discontinuation of therapy with alprazolam.
In severe cases the following symptoms may occur: derealisation; depersonalisation; hyperacusis; tinnitus; numbness and tingling of the extremities; hypersensitivity to light, noise, and physical contact; involuntary movements; hyperreflexia, tremor, nausea, vomiting; diarrhoea, abdominal cramps, loss of appetite, agitation, palpitations, tachycardia, panic attacks, vertigo, short-term memory loss, hallucinations/delirium; catatonia; hyperthermia, convulsions.
Convulsions may be more common in patients with pre-existing seizure disorders or who are taking other drugs that lower the convulsive threshold such as antidepressants. Amnesia Anterograde amnesia may occur at therapeutic dosages, the risk increasing at higher dosages.
4). Depression Pre-existing depression may be unmasked during benzodiazepine use. Psychiatric and paradoxical reactions Reactions like restlessness, agitation, irritability, aggressiveness, delusion, rages, nightmares, hallucinations, psychoses, inappropriate behaviour and other adverse behavioural effects are known to occur when using benzodiazepines or benzodiazepine-like agents.
2). An extension of the treatment time beyond this must not be made without a reassessment of the situation. It may be appropriate to inform the patient on initiation of treatment that the treatment is time-limited and to explain exactly how the dosage will be gradually decreased.
There is evidence to suggest that withdrawal symptoms may occur within the dosage interval when using short-acting benzodiazepines, especially at high doses. When long-acting benzodiazepines are used it is important to inform the patient that he/she should not change to a short-acting benzodiazepine, as withdrawal symptoms may then develop.
Renal and hepatic impairment Caution is recommended when treating patients with impaired renal function or mild to moderate hepatic insufficiency. Depression/anxiety Benzodiazepines and benzodiazepine-like agents should not be prescribed alone to treat depression as they may precipitate or increase the risk of suicide.
Xanax should be used with caution and the prescription size should be limited in patients with signs and symptoms of a depressive disorder or suicidal tendencies. Paediatric population Safety and efficacy of alprazolam have not been established in children and adolescents below the age of 18 years; therefore use of alprazolam is not recommended.
Elderly patients Benzodiazepines and related products should be used with caution in elderly, due to the risk of sedation and / or musculoskeletal weakness that can promote falls, often with serious consequences in this population.
2). A lower dose is also recommended for patients with chronic respiratory insufficiency due to risk of respiratory depression. 5). Risk from concomitant use of opioids Concomitant use of Xanax and opioids may result in sedation, respiratory depression, coma and death.
Because of these risks, concomitant prescribing of sedative medicines such as benzodiazepines or related drugs such as Xanax with opioids should be reserved for patients for whom alternative treatment options are not possible. 2). The patients should be followed closely for signs and symptoms of respiratory depression and sedation.
1. Benzodiazepines are also contraindicated in patients with myasthenia gravis, severe respiratory insufficiency, sleep apnoea syndrome and severe hepatic insufficiency.
Not medical advice. Always read the patient information leaflet and follow your prescriber or pharmacist.
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They may be quite severe with this product. They are more likely to occur in children and the elderly. In many of the spontaneous case reports of adverse behavioural effects, patients were receiving other CNS drugs concomitantly and/or were described as having underlying psychiatric conditions.
Patients who have borderline personality disorder, a prior history of violent or aggressive behaviour, or alcohol or substance abuse may be at risk of such events. Instances of irritability, hostility and intrusive thoughts have been reported during discontinuance of alprazolam in patients with post-traumatic stress disorder.
4). Psychic dependence may occur. Abuse of benzodiazepines has been reported. Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product.
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5). Drug dependence, tolerance and potential for abuse Drug addiction comprises behavioural, cognitive and physiological phenomena that may include a strong desire to take the drug, difficulties in controlling drug use and possible tolerance or physical dependence.
Physical dependence is a state that develops as a result of physiological adaptation in response to repeated drug use, which manifests as withdrawal signs and symptoms after abrupt discontinuation or a significant dose reduction of a drug.
Addiction and dependence are related but distinct presentations and in discussing these themes, terminology that apportion blame to the individual should be avoided. For all patients, prolonged use of this product may lead to drug dependence and addiction but can occur with short-term use at recommended therapeutic doses.
, major depression). Pharmacodependency may occur at therapeutic doses and/or in patients with no individualised risk factor. There is an increased risk of pharmacodependency with the combined use of several benzodiazepines regardless of the anxiolytic or hypnotic indication.
Cases of abuse have also been reported. Alprazolam may be subject to diversion. There have been reports of overdose-related deaths when alprazolam is abused with other central nervous system (CNS) depressants including opioids, other benzodiazepines, and alcohol.
These risks should be considered when prescribing or dispensing alprazolam. Additional support and monitoring may be necessary when prescribing for patients at risk of drug misuse. 9). A comprehensive patient history should be taken to document concomitant medications, including over-the-counter medicines and medicines obtained on-line, and past and present medical and psychiatric conditions.
Patients may find that treatment is less effective with chronic use and express a need to increase the dose to obtain the same level of symptom control as initially experienced. Patients may also supplement their treatment with additional medications to achieve the same effect.
These could be signs that the patient is developing tolerance. The risks of developing tolerance should be explained to the patient. Overuse or misuse may result in overdose and/or death. It is important that patients only use medicines that are prescribed for them at the dose they have been prescribed and do not give this medicine to anyone else.
Patients should be closely monitored for signs of misuse, abuse, or addiction. The clinical need for treatment with Xanax should be reviewed regularly, with frequent assessments of patients being undertaken during the course of their treatment.
Drug withdrawal syndrome Prior to starting treatment with Xanax, a discussion should be held with […]