Because of these risks, reserve concomitant prescribing of these drugs in patients for whom alternative treatment options are inadequate. ĥ.1 Risks from Concomitant Use with OpioidsĬoncomitant use of benzodiazepines, including alprazolam tablets, and opioids may result in profound sedation, respiratory depression, coma, and death. After a period of extended freedom from panic attacks, a carefully supervised tapered discontinuation may be attempted, but there is evidence that this may often be difficult to accomplish without recurrence of symptoms and/or the manifestation of withdrawal phenomena. The necessary duration of treatment for PD in patients responding to alprazolam tablets is unknown. In a controlled postmarketing dose-response study, patients treated with doses of alprazolam tablets greater than 4 mg per day for 3 months were able to taper to 50% of their total maintenance dose without apparent loss of clinical benefit. Occasional patients required as much as 10 mg per day.įor patients receiving doses greater than 4 mg per day, periodic reassessment and consideration of dosage reduction is advised. The mean dosage was approximately 5 mg to 6 mg daily. Depending on the response, the dosage may be increased at intervals of every 3 to 4 days in increments of no more than 1 mg per day.Ĭontrolled trials of alprazolam tablets in the treatment of panic disorder included dosages in the range of 1 mg to 10 mg daily. The recommended starting oral dosage of alprazolam tablets for the treatment of PD is 0.5 mg three times daily. To reduce the risk of withdrawal reactions, use a gradual taper to discontinue alprazolam tablets or reduce the dosage. Abrupt discontinuation or rapid dosage reduction of alprazolam tablets after continued use may precipitate acute withdrawal reactions, which can be life-threatening. The risks of dependence and withdrawal increase with longer treatment duration and higher daily dose. The continued use of benzodiazepines, including alprazolam tablets, may lead to clinically significant physical dependence.Before prescribing alprazolam tablets and throughout treatment, assess each patient’s risk for abuse, misuse, and addiction. Abuse and misuse of benzodiazepines commonly involve concomitant use of other medications, alcohol, and/or illicit substances, which is associated with an increased frequency of serious adverse outcomes. The use of benzodiazepines, including alprazolam tablets, exposes users to risks of abuse, misuse, and addiction, which can lead to overdose or death.Follow patients for signs and symptoms of respiratory depression and sedation. Limit dosages and durations to the minimum required. Reserve concomitant prescribing of these drugs for patients for whom alternative treatment options are inadequate. Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death.WARNING: RISKS FROM CONCOMITANT USE WITH OPIOIDS ABUSE, MISUSE, AND ADDICTION and DEPENDENCE AND WITHDRAWAL REACTIONS Abrupt discontinuation or rapid dosage reduction of alprazolam tablets after continued use may precipitate acute withdrawal reactions, which can be life-threatening. Reserve concomitant prescribing for use in patients for whom alternative treatment options are inadequate. See full prescribing information for complete boxed warning. WARNING: RISKS FROM CONCOMITANT USE WITH OPIOIDS ABUSE, MISUSE, AND ADDICTION and DEPENDENCE AND WITHDRAWALRE ACTIONS
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