Drug interactions
Alprazolam + Erythromycin stearate
Severity: Moderate
Alprazolam and Erythromycin stearate: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Erythromycin inhibits CYP3A4 and increases alprazolam concentrations, which can cause excessive sedation, confusion and impaired coordination. The effect is usually manageable but more significant in older patients.
What this interaction means in plain words
Alprazolam and Erythromycin stearate can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Inhibition of CYP3A4-mediated metabolism of alprazolam by erythromycin.
What to do
Consider reducing the alprazolam dose and monitor for sedation during the antibiotic course. Alternatively use azithromycin or a benzodiazepine cleared by glucuronidation.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Alprazolam
- Alprazolam + Calcium / magnesium / potassium / sodium oxybates Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Alprazolam + Ketoconazole Contraindicated
- Alprazolam + Levoketoconazole Contraindicated
- Alprazolam + Sodium oxybate Contraindicated
- Alfentanil + Alprazolam Major
Frequently asked questions
Can I take Alprazolam with Erythromycin stearate?
MediHelp rates the interaction as moderate. Alprazolam and Erythromycin stearate can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Erythromycin inhibits CYP3A4 and increases alprazolam concentrations, which can cause excessive sedation, confusion and impaired coordination. The effect is usually manageable but more significant in older patients.
How serious is the interaction between Alprazolam and Erythromycin stearate?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Consider reducing the alprazolam dose and monitor for sedation during the antibiotic course. Alternatively use azithromycin or a benzodiazepine cleared by glucuronidation.
What other medicines interact with Alprazolam?
MediHelp also lists interactions of Alprazolam with, for example, Calcium / magnesium / potassium / sodium oxybates, Itraconazole, Ketoconazole. The full list is on the Alprazolam page.
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