Introduction

Name

• Alprazolam/Xanax.

Class of drug

• Benzodiazepine.

Description

Chemical name

• 8-chloro-1-methyl-6-phenyl-4H-[1,2,4]triazolo[4,3-a][1,4]benzodiazepine

Molecular formula

• C₁₇H₃ClN₄

Molecular weight

• 308.769

Physical properties

• Solid.

Storage requirements

• Alprazolam is stable under standard storage conditions when recommended maintaining the medication in tightly closed container kept in a dry and well ventilated space. 

Uses

Indications

• Alprazolam is used across species. In humans, alprazolam is commonly used to treat panic disorder, a range of anxiety disorders, including generalized anxiety disorder and agoraphobia. Treatment can be alone or in combination with other medications (most common). In dogs and cats, alprazolam is used alone or in combination with other medications to treat noise/storm phobia, situational phobia (eg going to the veterinary office Reducing stress (visits to practice), going to the groomer) and various anxieties, including generalized anxiety disorder.

Administration

Pharmacokinetics

Precautions

Interactions

With other drugs

• Medications that use the same CYP 450 system enzymes (CYP34A) in metabolism will change pharmacokinetics of alprazolam.

With diagnostic tests

• May decrease thyroid uptake of I-131.

Adverse Reactions

Further Reading

Publications

Refereed Papers

• Recent references from VetMedResource and PubMed.
• Bushnell G A et al (2017) Simultaneous antidepressant and bendzodiazepine new use and subsequent long-term benzodiazepine use in adults with depression, United States, 2001-2014). JAMA Psychiatry 74 (7), 747-735 PubMed.
• Baldwin D S et al (2013) Benzodiazepines: Risks and benefits. A reconsideration. J Psychopharm 27 (11), 867-971 PubMed.
• Soler L I, Boix A, Lauroba J, Colom H & Domenech J (2012) Transdermal delivery of alprazolam from a monolithic patch: formulation based on in vitro characterization. Drug Dev Ind Pharm 38 (10), 1171-1178 PubMed.
• Singh A P, Saraf S K & Saraf S A (2012) SLN approach for nose-to-brain delivery of alprazolam. Drug Deliv Transl Res 2 (6), 498-507 PubMed.
• Ibáñez M, Anzola B (2009) Use of fluoxetine, diazepam, and behaviour modification as therapy for treatment of anxiety-related disorders in dogs. J Vet Behav Clin Appl Res 4, 223-229.
• Sherman B L, Mills D S (2008) Canine anxieties and phobias: An update on separation anxiety and noise aversions.  Vet Clin North Am Sm Anim Pract 38, 1081-1106 PubMed.
• Crowell-Davis S L et al (2003) Use of clomipramine, alprazolam, and behaviour modification for treatment of storm phobia in dogs. JAVMA 222 (6),744-748 PubMed.
• Verster J C, Volkerts E R (2004) Clinical pharmacology, clinical efficacy, and behavioral toxicity of alprazolam: a review of the literature. CNS Drug Reviews 10, 45-76 PubMed.

Other sources of information

• Ramsey I (2017) Alpraxolam. In: BSAVA Small Animal Formulary. 9th edn. pp 12.
• Overall K L (2013) Manual of Clinical Behavioral Medicine for Dogs and Cats. Elsevier.