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Alprazolam

Also indexed as: Xanax®

Alprazolam is used to treat anxiety and panic disorder, and is in a family of drugs known as benzodiazepines.

Interactions with Dietary Supplements

Vinpocetine
In a preliminary trial, an extract of periwinkle called vinpocetine was shown to produce minor improvements in short-term memory among people taking flunitrazepam, a benzodiazepine.1 Further study is needed to determine if vinpocetine would be a helpful adjunct to use of benzodiazepines, or alprazolam specifically.

Interaction with Herbs

Kava (Piper methysticum)
Kava is an herb used to treat anxiety disorder. One individual who took alprazolam and kava together, along with two other medications (cimetidine and terazosin) was hospitalized in a lethargic and disoriented condition.2 Further research is needed to determine whether the combination of kava and alprazolam produces an adverse interaction. However, individuals should not take alprazolam and kava together unless supervised by a doctor.

Interaction with Foods and other Compounds

Alcohol
Drinking alcoholic beverages while taking alprazolam may increase side effects such as drowsiness, confusion, and dizziness.3 Consequently, people taking alprazolam should avoid drinking alcohol, especially when they must stay alert.

Summary of Interactions for Alprazolam

Depletion or interference None known
Adverse interaction Alcohol
Kava*
Side effect reduction/prevention None known
Supportive interaction None known
Reduced drug absorption/bioavailability None known

For the convenience of the reader, the information in the summary is categorized as follows: “Depletion or interference” indicates the drug may deplete or interfere with the absorption or function of the supplement or herb. “Adverse interaction” indicates that the supplement or herb used together with the drug may result in undesirable effects. “Side effect reduction/prevention” indicates the supplement or herb may reduce the likelihood and/or severity of a potential side effect caused by the drug. “Supportive interaction” indicates the supplement or herb may support or aid the function of the drug. “Reduced drug absorption/bioavailability” indicates that the supplement or herb may decrease the absorption and/or activity of the drug in the body. An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

References:

1. Bhatti JZ, Hindmarch I. Vinpocetine effects on cognitive impairments produced by flunitrazepam. Int Clin Psychopharmacol 1987;2:325–31.

2. Almeida JC. Coma from the health food store: Interaction between kava and alprazolam. Ann Intern Med 1996;125:940–1.

3. Sifton DW, ed. Physicians’ Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 2492–6.