Patient/caregiver was educated on contraindications for using Alprazolam as follows:
- When taken together, Alprazolam can interact with a number of other medications and can precipitate serious reactions. Some medications, such as, oral contraceptives, some antibiotics, anti-GERD agents like omeprazole, inhibit the enzymes needed for the metabolism of Alprazolam. Concurrent administration of these medications with Alprazolam can inhibit the metabolism of alprazolam. Thus, alprazolam stays in the body for prolonged duration of time in comparison to normal and stand the risk of causing toxicity.
- Avoid taking Alprazolam with grapefruit juice, as it can also inhibit the enzymes needed for the metabolism of Alprazolam. Concurrent administration of grapefruit juice with alprazolam can inhibit the metabolism of alprazolam. Thus, alprazolam stays in the body for prolonged duration of time in comparison to normal and stand the risk of causing toxicity.
- Alprazolam is extensively metabolized in the liver and the metabolites are excreted in the urine. If liver function is deficient, the metabolism of Alprazolam can be compromised. In individuals with history of compromised renal function, the excretion of alprazolam can be compromised. In either case, alprazolam and metabolites stay in the body for prolonged duration of time in comparison to normal leading to increased blood levels of the medication and metabolites for longer periods of time. This can lead to increased risk for side-effects and consequent toxicity. So, Alprazolam could be cautiously administered or avoided for an alternative medication, in individuals with hepatic and/or renal dysfunction. Periodical labs for liver and/or renal function could be ordered and individuals monitored for development of any toxic symptoms. Discuss with your physician regarding history of compromised liver or kidney function, if any.
