Indications for: XANAX XR
Swallow whole. ≥18yrs: initially 0.5–1mg once daily, preferably in the AM; increase at intervals of at least 3–4 days by up to 1mg/day. Taper no faster than by 0.5mg every 3 days. Usual range: 3–6mg/day; max 10mg/day. Elderly or hepatic impairment: initially 0.5mg/day. Switching from immediate-release alprazolam: give same total daily dose of immediate-release once daily, preferably in the AM.
<18yrs: not established.
XANAX XR Contraindications:
Concomitant strong CYP3A inhibitors (eg, itraconazole, ketoconazole), except ritonavir.
Risks from concomitant use with opioids. Abuse, misuse, and addiction. Dependence and withdrawal reactions.
XANAX XR Warnings/Precautions:
Increased risk of drug-related mortality from concomitant use with opioids. Suicidal ideation (monitor). Depression. Psychosis. Mania. Renal, cardiovascular, hepatic, or respiratory impairment; monitor. Discontinue if respiratory depression, hypoventilation, or apnea occurs. Monitor periodic CBCs, urinalysis, blood chemistry. Reevaluate periodically. Assess patient's risk for abuse, misuse, addiction prior to and during therapy. Write ℞ for smallest practical amount. Avoid abrupt cessation. Change dose gradually. Drug or alcohol abusers. Elderly. Neonatal sedation and withdrawal syndrome; monitor neonates exposed during pregnancy or labor. Pregnancy (esp. late stage). Nursing mothers: not recommended.
XANAX XR Classification:
XANAX XR Interactions:
See Contraindications; other azole antifungals: not recommended. Increased sedation, respiratory depression, coma, and death with concomitant opioids; reserve use in those for whom alternative treatment options are inadequate; if needed, limit dosages/durations to minimum and monitor. Additive CNS depressant effects with alcohol or other CNS depressants (eg, other benzodiazepines, psychotropics, anticonvulsants, antihistamines); consider dose reductions. Potentiated by moderate or weak CYP3A inhibitors (eg, nefazodone, fluvoxamine, cimetidine, erythromycin); avoid or reduce alprazolam dose. Antagonized by CYP3A inducers (eg, carbamazepine, phenytoin); caution. Concomitant ritonavir; adjust alprazolam dose (see full labeling). Potentiates digoxin; monitor serum levels. May increase levels of imipramine, desipramine.
CNS depression (eg, drowsiness, sedation, memory impairment, dysarthria, coordination abnormal, ataxia), hypotension, fatigue, lethargy, dyspnea, dry mouth, constipation, tremors, changes in libido, sexual dysfunction, paradoxical excitement, withdrawal reactions.
Renal. Half-life: 10.7–15.8 hours
Generic Drug Availability:
XR—60; Tabs 0.25mg, 0.5mg, 1mg—100, 500, 1000; 2mg—100, 500