Potentiation of the effect of gamma-amino butyrate (GABA). Example: diazepam,

Potentiation of the effect of gamma-amino butyrate (GABA). Example: diazepam,

Specific Dosage

Use

Treatment of anxiety disorder (GAD); panic disorder, with or without agoraphobia; anxiety associated with depression

Dosing: Adult

Note: Treatment >4 months should be re-evaluated to determine the patient's continued need for the drug

Anxiety: Oral: Immediate release: Effective doses are 0.5-4 mg/day in divided doses; the manufacturer recommends starting at 0.25-0.5 mg 3 times/day; titrate dose upward; usual maximum: 4 mg/day. Patients requiring doses >4 mg/day should be increased cautiously. Periodic reassessment and consideration of dosage reduction is recommended.

Anxiety associated with depression: Oral: Immediate release: Average dose required: 2.5-3 mg/day in divided doses

Ethanol withdrawal (unlabeled use): Oral: Immediate release: Usual dose: 2-2.5 mg/day in divided doses

Panic disorder: Oral:

Immediate release: Initial: 0.5 mg 3 times/day; dose may be increased every 3-4 days in increments ≤1 mg/day. Mean effective dosage: 5-6 mg/day; many patients obtain relief at 2 mg/day, as much as 10 mg/day may be required

Extended release: 0.5-1 mg once daily; may increase dose every 3-4 days in increments ≤1 mg/day (range: 3-6 mg/day)

Switching from immediate release to extended release: Patients may be switched to extended release tablets by taking the total daily dose of the immediate release tablets and giving it once daily using the extended release preparation.

Preoperative sedation: Oral: 0.5 mg in evening at bedtime and 0.5 mg 1 hour before procedure

Dose reduction: Abrupt discontinuation should be avoided. Daily dose may be decreased by 0.5 mg every 3 days, however, some patients may require a slower reduction. If withdrawal symptoms occur, resume previous dose and discontinue on a less rapid schedule.

Dosing: Pediatric

(For additional information see "Alprazolam: Pediatric drug information")

Anxiety (unlabeled use): Oral: Immediate release: Initial: 0.005 mg/kg/dose or 0.125 mg/dose 3 times/day; increase in increments of 0.125-0.25 mg, up to a maximum of 0.02 mg/kg/dose or 0.06 mg/kg/day (0.375-3 mg/day). See "Dose Reduction" comment in adult dosing.

Note: Treatment >4 months should be re-evaluated to determine the patient's continued need for the drug.

Dosing: Geriatric

Initial: 0.125-0.25 mg twice daily; increase by 0.125 mg/day as needed. The smallest effective dose should be used.

Immediate release: Initial 0.25 mg 2-3 times/day

Extended release: Initial: 0.5 mg once daily

Dosing: Renal Impairment

No guidelines for adjustment; use caution.

Dosing: Hepatic Impairment

Oral: Reduce dose by 50% to 60% or avoid in cirrhosis