ALPRAZOLAM ER (Generic for XANAX XR)

Alprazolam 0.5mg, Oral tablet, extended release

Grapefruit juice

· Severity: Severe

· Notes for Consumers: Do not use grapefruit juice or grapefruit with Alprazolam. Side effects from Alprazolam may get worse. Do not drive, use machinery, or do anything that needs mental alertness until you know how Alprazolam affects you. If you notice slurred speech, confusion, severe weakness, or breathing problems, contact your health care provider immediately.

· Notes for Professionals: Advise patients to avoid grapefruit juice and grapefruit during alprazolam treatment. Use of grapefruit juice and alprazolam is contraindicated due to the potential for elevated alprazolam concentrations, which may cause prolonged sedation and respiratory depression. Alprazolam is a CYP3A4 substrate and grapefruit juice is a strong CYP3A4 inhibitor.

Alprazolam 0.5mg, Oral tablet, extended release

Tobacco

· Severity: Major

· Notes for Consumers: Do not smoke or use tobacco products while taking this medication. When used together, your medication may not work as well for you.

· Notes for Professionals: Advise patients to avoid smoking tobacco while taking alprazolam. According to the manufacturer, alprazolam concentrations may be reduced by up to 50% in tobacco smokers vs. non-smokers. A bioavailability study (n = 17) evaluating the immediate-release and controlled-release formulations of alprazolam found that cigarette smokers had a 100% increase in clearance of alprazolam compared with nonsmokers.

Alprazolam 0.5mg, Oral tablet, extended release

Caffeine-containing Foods/Beverages

· Severity: Mild

· Notes for Consumers: If you are taking medicine to help you sleep, avoid taking Caffeine and Caffeine-containing foods or beverages like colas, coffee, teas, or chocolates within several hours prior to bedtime.

· Notes for Professionals: Patients taking benzodiazepines for insomnia should not use caffeine-containing products prior to going to bed as these products may antagonize the sedative effects of the benzodiazepine.

Alprazolam 0.5mg, Oral tablet, extended release

Cannabis

· Severity: Major

· Notes for Consumers: Discuss cannabis use with your care team. The effects of your medication may be altered if used with cannabis. Call emergency services right away if you experience slow or shallow breathing, shortness of breath, feeling faint, dizziness, confusion, or trouble staying awake.

· Notes for Professionals: Advise patients to avoid cannabis use while taking CNS depressants due to the risk for additive CNS depression and potential for other cognitive adverse reactions.

Alprazolam 0.5mg, Oral tablet, extended release

Alcohol

· Severity: Major

· Notes for Consumers: Do not drink alcohol while taking this medication. Drinking alcohol while taking this medication can cause serious side effects, such as central nervous system (CNS) depression, and can increase the risk of falling. Call emergency services right away if you experience symptoms of CNS depression: slow or shallow breathing, shortness of breath, feeling faint, dizziness, confusion, trouble staying awake.

· Notes for Professionals: Advise patients to avoid alcohol consumption while taking CNS depressants. Alcohol consumption may result in additive CNS depression.

<b>DISCLAIMER:</b><em> This drug information content is provided for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Patients should always consult their physician with any questions regarding a medical condition and to obtain medical advice and treatment. Drug information is sourced from GSDD (Gold Standard Drug Database ) provided by Elsevier.</em>