What other medicines can interact with alprazolam?
If alprazolam is to be combined with other psychotropic agents or anticonvulsant drugs, careful consideration should be given to the pharmacology of the agents to be employed, particularly with compounds which might potentiate the action of benzodiazepines. The benzodiazepines, including alprazolam, produce additive CNS depressant effects when co-administered with other psychotropic medicines, anticonvulsants, antihistaminics, sedatives/hypnotics, narcotic analgesics and other drugs or herbs which themselves produce CNS depression. Most of the interactions that have been documented with alprazolam are with medicines that are inducers, inhibitors or substrates of cytochrome P450 3A4 (CYP3A4). Inducers of CYP3A4 can markedly decrease the plasma concentrations of alprazolam leading to decreased clinical efficacy, and inhibitors can markedly increase plasma concentrations leading to toxicities. The triazolobenzodiazepines are all exclusively substrates of CYP3A4 (differing from other benzo
